Week 6 Assignment: EBP Change Process Form

Week 6 Assignment: EBP Change Process Form

ACE Star Model of Knowledge Transformation

Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson. Please do not use any of the Nurse Daniel information for your topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process ACE Star Model of Knowledge Transformation.

Name: [Your Name]

Star Point 1: Discovery (Identify topic and practice issue)

Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)

The focus of discussion will be infections acquired in medical facilities, with a specific emphasis on catheter-associated urinary tract infections (CAUTIs).

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

I have chosen to address CAUTIs because they are a significant concern, as they contribute to patient morbidity and mortality, longer hospital admissions, and increased healthcare costs. Approximately 80 percent of urinary tract infections in healthcare settings are linked to indwelling catheters, leading to an estimated 13,000 deaths annually.

Star Point 2: Summary (Evidence to support the need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

The practice problem is the incidence of CAUTIs in hospitals, exacerbated by the fact that Medicare does not cover the treatment for CAUTIs since 2008. There is a lack of rigorous analysis regarding nurse-driven guidelines’ impact on clinical outcomes.

PICOT question

In acute care patients (P), does a nurse-driven protocol (I), compared to traditional management (C), decrease the incidence of catheter-associated urinary tract infections (O) within 6 months? (T)

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

Systematic Review: Durant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. American Journal of Infection Control, 45(12), 1331-1341. https://doi.org/10.1016/j.ajic.2017.07.020

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

During my research, I came across an article titled “Implementation of a nurse-driven CAUTI prevention algorithm,” which provides relevant information on CAUTI prevention methods and associated costs.

Additional Source: Russell, J. A., Leming-Lee, T., & Watters, R. (2019). Implementation of a nurse-driven CAUTI prevention algorithm. Nursing Clinics of North America, 54(1), 81-96. https://doi.org/10.1016/j.cnur.2018.11.001

I also found an article discussing the impact of nurse-driven procedures on CAUTI risk reduction.

Additional Source: Wood, K. L. (2018). Do nurse-driven protocols have an impact on the prevention of catheter-associated urinary tract infections? American Journal of Infection Control, 46(6), S83. https://doi.org/10.1016/j.ajic.2018.04.162

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

The systematic review suggests that nurse-driven protocols, aimed at proper catheter use and timely removal, have a positive impact on clinical indicators and CAUTI incidence. However, there is a need for improved study designs and methodological rigor in quality improvement initiatives.

The strength of the evidence lies in the systematic review’s thorough search strategy and transparency in detailing the synthesis process, reducing the likelihood of bias.

Outline one or two evidence-based solutions you will consider for the trial project.

One evidence-based solution is the establishment of a multidisciplinary taskforce to implement CAUTI prevention strategies, which has shown promise in reducing CAUTI rates.

Source: Taha, H., Raji, S. J., Khallaf, A., Abu Hija, S., Mathew, R., Rashed, H., Du Plessis, C., Allie, Z., & Ellahham, S. (2017). Improving catheter-associated urinary tract infection rates in the medical units. BMJ Quality Improvement Reports, 6(1), u209593.w7966. https://doi.org/10.1136/bmjquality.u209593.w7966

Star Point 3: Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).

Standard care protocols for urinary catheters should include patient and staff education on infection prevention, proper catheter care, and early detection of CAUTI signs. Aseptic techniques for catheter insertion and removal, hand hygiene, and equipment maintenance should also be part of the protocols.

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).

1. Nurse Leader: Oversees the trial, ensures proper implementation, and manages day-to-day operations.
2. Unit Nurses: Assist in catheter replacement and provide bedside care for patients with indw

elling catheters.
3. Patients: Provide informed consent for the trial and assist in identifying CAUTI symptoms.

What specifically is your nursing role in the change process? Other nursing roles?

As the nurse in charge of the trial, my role is to ensure all necessary resources, education, and documentation are in place for the successful implementation of the trial. Unit nurses are responsible for the day-to-day care of indwelling catheters and specimen collection. They also play a crucial role in diagnosing potential CAUTIs.

List your stakeholders by position titles (charge nurse, pharmacist, etc.). Why are the members chosen (stakeholders) important to your project?

1. Medical Doctor: Orders indwelling urinary catheters.
2. Nurse Manager: Ensures adherence to change process rules and provides support as needed.
3. Nurse Educator: Provides education and training to staff on CAUTI prevention.
4. Unit Nurse: Implements catheter care and provides bedside care.
5. Certified Nursing Assistant: Assists in patient care and catheter maintenance.

These stakeholders are chosen because they are directly involved in or affected by CAUTI prevention and management. Their collaboration and support are crucial for the success of the project.

What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?

A cost-effectiveness analysis (CEA) will be needed to assess the intervention’s cost in relation to its impact on patient health. The finance department should be involved to determine the budget allocation for necessary resources.

Week 2: Discussion 2 on Essential Terminology and Concepts

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?

Permission to plan and initiate the trial must be obtained from the health center administration. Without their approval, no trial can proceed. The finance team should also be consulted to allocate funds for the project.

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

Nurse educators will be instrumental in staff education. They will provide training on CAUTI prevention, catheter care, and early detection of infection. Continuous refresher training will be available during the trial, accommodating all shifts.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).

The change process will span six months:

– Month 1: Weekly meetings to kickstart the trial.
– Months 2-6: Bi-monthly meetings to monitor progress.
– Staff education and trial patient recruitment throughout.

List the measurable outcomes based on the PICOT. How will these be measured?

Measurable outcomes will include the number of CAUTI episodes over six months, tracked through CAUTI event reports, prescribed CAUTI-related medications, and the frequency of indwelling catheterizations on the unit.

What forms, if any, might be used for recording purposes during the pilot change process? Describe.

Forms may be used to record staff training and self-assessment of catheter care knowledge. These forms will help track staff preparedness and knowledge.

What resources are available to staff (include yourself) during the change pilot?

Resources include additional catheter care supplies, educational materials for staff and patients on CAUTI prevention, and guidelines for catheter care.

Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they meet?

Stakeholder meetings will occur at various points during the trial to discuss progress and potential adjustments. The first month will have weekly meetings, followed by bi-monthly meetings in subsequent months. All stakeholders are invited to participate in these meetings.

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

Trial outcomes will be presented in a data report displayed in common areas for staff. A concluding meeting will be held to assess the trial’s success or failure.

What would be the next steps for the use of the change process information?

The trial findings will inform ongoing adjustments to CAUTI prevention strategies. Staff will continue to work on reducing CAUTI rates based on the lessons learned during the trial and further evaluations.