Week 6 Homework: Form ACE EBP Change Process Star Model of How Knowledge Changes
In the weekly Illustration part of the lesson, Nurse Daniel will be your guide through the process. Please don’t use any information about Nurse Daniel for your own topic, nursing action, or project to make a change. Nurse Daniel is only used as an example to show how change works.Name: _____________________
Point 1: We found it. (Identify topic and practice issue)
Find the theme and the nursing practice problem that goes with it. (This MUST involve a nursing practice issue.)
Urinary tract infections caused by catheters (CAUTI)
Nursing Practice Issue: Urinary catheters are mainly used to manage urinary problems such as urinary incontinence and urinary retention. These tubes are the gold standard for dealing with problems with emptying the bladder and for use during surgery. After the catheter is put in, nurses play a very important part in taking care of the patient, keeping the catheter in place, preventing infections, and keeping records. The nursing practice problem has to do with the routine care for catheters that have been put in. This includes washing your hands before handling the catheters, emptying the urine drainage, and checking to see if the catheters are still needed. By not following the above rules, the number of CAUTI cases in the hospital has gone up.
Give a short explanation of why you chose the topic you did. Describe how big the issue or trouble is.
The chosen topic on CAUTIs talks about how many healthcare-associated diseases there are in the world. This is a problem that all healthcare facilities face. Healthcare-associated infections are diseases that happen to a patient while they are getting care but were not there when they were admitted. About 34% of all hospital-acquired infections are in the urinary stream, and CAUTIs are the most common of these. According to a study from the CDC, about 15% of hospitalized people get catheters at some point, and 75% of these people get CAUTIs. CAUTIs are the most common infections caused by medical care. To reduce the problem, healthcare organizations should educate their staff and use methods that have been shown to work.
Point 2: Summarize (Evidence to support need for a change)
In your own words, explain the practice problem and make your PICOT question.
The group is having trouble keeping CAUTIs from happening because people aren’t following the rules. The healthcare teams, especially the nursing team, are hesitant to give routine care to and check up on patients with indwelling catheters, which leads to more CAUTIs. First, people don’t wash their hands well enough when they take care of their catheters, and many patients don’t know how to take care of their catheters. Second, most patients say that their catheters are taken out when they are full instead of when they are three-quarters full, which is what is suggested. Also, there isn’t enough contact between health care teams about assessing when catheters can be taken out, so patients have to keep them in for a long time. These signs show that a plan needs to be put into place to make it easier for healthcare teams to work together and manage catheters.
How does educating nurses on catheter care (I) versus not educating them (C) affect the number of CAUTIs (O) in adult patients in acute care facilities (P) over a six-month intervention time (T)?
List the systematic review that was picked from the databases in the CCN Library. Type the full APA citation for the systematic review that you chose.
Meddings, J., Saint, S., Krein, S. L., Gaies, E., Reichert, H., Hickner, A., McNamara, S., Mann, J. D., & Mody, L. (2017). Systematic Review of Interventions to Reduce Urinary Tract Infections in Nursing Home Residents.Journal of hospital medicine, 12(5), pages 356–368. https://doi.org/10.12788/jhm.2724
List and quickly describe other data and information sources. In APA format, list any other scholarly sources that could be added to the systematic study.
Davies, P. E., Daley, M. J., Hecht, J., Hobbs, A., Burger, C., Watkins, L.,…, and Coopwood, T. B. (2018). How well a bundled approach works to lower the number of urinary catheters and the number of infections in trauma patients.The American journal of virus control, 46(7), pages 758-763. https://doi.org/10.1016/j.ajic.2017.11.032
Catheterization is a popular procedure in hospitals for people who have been hurt, especially in trauma wards. Even though hospitals do this a lot, catheters can be dangerous because they can cause major infections in the urinary tract. In 2015, the Centers for Medicare and Medicaid Services started fining schools with higher-than-expected CAUTI rates. (Davies et al., 2018). This study looked at how important it is to use the bundled strategy to improve the urinary catheterization process and culture techniques to cut down on false positives. To limit the number of catheter days, a bundle method was used. This approach included strategies for avoiding catheters, keeping your hands clean, caring for your perineum, and reviewing the need for a catheter every day. After the changes were made, the rate of CAUTI dropped by more than a third in just two years. The study’s result is that implementing a CAUTI prevention bundle improves both patient safety and the performance of the hospital.
Summarize in your own words the main results of the systematic review and how strong the evidence is.
The goal of the systematic study was to look at ways to prevent urinary tract infections, especially CAUTIs, in older people in nursing homes. Different methods were used in the studies, such as reducing catheter use (13 studies), preventing infections in general (99 studies), and using standard management guidance for CAUTI prevention (other studies). (Meddings et al., 2017). The results of the research show that interventions to improve hand hygiene and the use of bundled approaches worked better in preventing CAUTIs. There was also proof that CAUTI infection rates went down when nurses helped patients clean up better and taught them how to do it. All of the studies agreed that a CAUTI rate could be lowered by putting in place a successful infection control program with multiple interventions.
Outline one or two solutions that are backed up by proof that you will think about for the trial project.
I will suggest that the facility use a “bundled approach” to stop CAUTIs. Evidence-based practice shows that hand hygiene, reviewing the need for catheters, taking care of the genital area, and using methods to avoid catheters can greatly cut down on CAUTIs in acute care facilities. (Meddings et al., 2017). This means that nurses need to learn about different ways to avoid CAUTIs, such as collaborative care.Three stars: Translation (Action Plan)
Find any care standards, practice guides, or protocols that may be in place to help you plan your intervention. (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).
The Centers for Disease Control and Prevention (CDC) has rules about how tubes should be put in, cared for, and taken out. Healthcare workers should show how to use urinary catheters correctly by only putting them in when they are needed. The CDC also says that patients and people who live in nursing homes shouldn’t use tubes to treat urinary incontinence. When it comes to the right way to place a catheter, it is very important to wash your hands and have a trained person do it. Other measures include taking care of the perineum on a regular basis, making sure the catheter is well-secured, and emptying the urinary drainage when it is 3/4 full.
List your stakeholders (by titles, not names; include yourself) and describe their roles and duties in the change process. (no more than 5).
Nurse Educator: Will make sure that nurses get the training they need while the CAUTI prevention bundle is being used.
Administration: Will make sure that there are enough resources, such as money, to make the new change happen. The government will also work to make sure that different healthcare teams work together to give care.
Registered nurses will take part in programs to learn more about how to avoid CAUTIs in the facility. The nurses will also be part of the team that looks at how well the new plans work.
Me: I’ll work with the management and unit managers to make sure that the new ways of preventing CAUTIs are being checked on regularly.
What is your job as a nurse in the process of change? What else do nurses do?
My main job is to be a nurse researcher who gathers data and puts evidence-based practices into place so that the organization’s processes can change. Among their other responsibilities, they will be in charge of coordinating how care is given and evaluating practices to help the company provide better care.
Make a list of your stakeholders with their job names. (charge nurse, pharmacist, etc.).-Why are the people you choose to be part of your project important?
Charge Nurses will be in charge of making sure the new change is put into place in their own units. Will also be part of the team that looks at how well the new plan works.
Administrator: Will organize the process of putting the new change into place and help make policy decisions about it.
The nurse educator will make sure that nurses know how to avoid CAUTIs and will also coordinate regular progress checks on the new strategy.
Before a trial, what kind of cost research will be needed? Who needs to take part in this?
Implementing the new change will cost very little. The administrator will be in charge of making sure there are enough catheters for insertion and allocating money for the teaching programs.
Four stars: (Implementation)
Explain how you can get permission to plan and start a study. Is a certain group, committee, or nurse boss in charge?
I will talk to the hospital administration through the hospital project manager to get permission for the study. With the proof given, the project manager can persuade the administration that the new change is needed. I will make sure that there is a written report about the new project, as well as the tools and help that are needed to finish it. I will also talk about how the project could help the group in other ways, such as financially and by improving patient care.
Explain how the staff will be informed about the change process study and how they will be affected or asked to take part.
The nurse trainer is seen as a key player in the project’s implementation. The plan is to bring in the nurse trainer, who will ask experts for advice on how to teach nurses how to avoid CAUTIs. At the first meeting, the nurses will learn about the new change, how it will affect the company, and how it will help the patient. I will show research that backs up the new change, and I think the hospital administration will be able to convince workers to take part in the trial.
Outline the process for putting the change into place, including when it will start and when it will end, and what steps will happen along the way.
It will take six months to make the change, which includes time for planning the project, teaching the nurses about it, and making the change itself. In the first month, we will ask for permission, raise awareness, and teach staff about how to avoid CAUTIs. From the second to the fifth month, the bundled method to preventing CAUTIs and evaluating progress will be used. In the sixth month, the plan will be evaluated and the results will be shared.
Based on the PICOT, write down the results that can be measured. How will we know how well they work?
We can tell that CAUTI cases have gone down by comparing what we know now with what we knew before.
Better HCAHPS results can be seen by comparing them to what was found before.
During the trial change process, what forms, if any, could be used to keep track of things? Describe.
No forms will be used to keep track of anything.
During the change pilot, what tools are there for staff, including you?
The first resource is help from the administration, which will make sure that workers are interested in making the new change happen. Second, the project will be more likely to succeed if nurse leaders and experts are involved. This is because they will guide the project’s implementation and use their experience to solve any problems that come up.
Will there be talks of those who have an interest in the trial? If so, who will they meet and when?
The execution team will get together once a week to look at how the project is going and talk about any problems that might come up. The team will also get together with the managers to talk about how things are going.
Five stars: (Evaluation)
How will you let people know how the trial went?
I’ll let the unit managers know how things turned out by sending them a private memo. Second, I’ll make sure that the results reports are posted on the hospital bulletin boards. The administration will be asked for permission to put the results on the website of the group.
How should the facts about the change process be used next?
The knowledge about the change process will be used to improve the organization’s performance in preventing CAUTIs. I think that the administration will think about making rules about how to use a bundled method to stop CAUTI in the facility. If the project doesn’t work, more study will be needed to make the steps of the change process more precise.
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