Benchmark – Capstone Project Change Proposal

Benchmark – Capstone Project Change Proposal In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: 1.Background 2.Clinical problem statement. 3.Purpose of the change proposal in relation to providing patient care in the changing health care system. 4.PICOT question. 5.Literature search strategy employed. 6.Evaluation of the literature. 7.Applicable change or nursing theory utilized. 8.Proposed implementation plan with outcome measures. 9.Discussion of how evidence-based practice was used in creating the intervention plan. 10.Plan for evaluating the proposed nursing intervention. 11.Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. 12.Appendix section, if tables, graphs, surveys, educational materials, etc. are created. Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: RN to BSN 1.1: Exemplify professionalism in diverse health care settings. 2.2: Comprehend nursing concepts and health theories. 3.2: Implement patient care decisions based on evidence-based practice.

Central Line-associated Blood Stream Infection (CLABSI) with Hospital Acquired Infections (HAIs) presents a key concern in healthcare matters and mostly in the ICU. Both are associated with increased mortality and morbidity rates that tend to increase hospital bills and stays. In the recent past, there have been multiple strategies put in place in managing these infections. However, these strategies have been challenged due to presence of multidrug resistance organism that requires new intensive intervention. Chlorhexidine wipes antibacterial agents have widely been used due to their effectiveness in reducing microbe colonies on the skin, thus preventing patients from spreading microorganisms and infections (Boonyasiri, et al., 2016). The use of these wipes compared to traditional water basin baths and soap has notably reduced rates of CLABSIs among patients and adults in the ICU. Therefore, this paper issues a proposal for a practical solution aligned with the literature covered on the same issue.Benchmark – Capstone Project Change Proposal

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Problem statement

This paper address increased levels of CLABSIs in patients in the ICU. This issue forces patients to exceed their stay in the hospital without any health improvement. Notably, there are increased cases of HAIs, resulting in mortality and morbidity to inpatients are CLABSIs whose development starts with the use of short-term devices (Hersh, et al., 2019). In such a case, the devices allow microorganisms on the skin to connect with inner tissues, thus developing to poor health. There are various evidence-based strategies which objectively aim at preventing CLABSIs, including vascular access devices insertion bundles, use of protocols for hand hygiene, and antiseptic method that are implemented in the ICU. However, although these strategies are scientifically applicable, it is evident that they are expensive to maintain. These call for a proper intervention capable of reducing mortalities, morbidities, and CLABSIs incidences. According to experimental recovery, it is important to use chlorhexidine gluconate wipes to reduce skin colonization caused by bacteria.

Purpose of the change proposal

Patients with CLABSI tend to suffer from symptoms that are directly connected to various mortalities and comorbidities (Jayaweera & Sivakumar, 2020). A significant evidence-based plan to prevent CLABSIs is by use chlorhexidine gluconate wipes. These wipes are a topical antiseptics applied as a decolonization therapy to control cross-infections. However, it has a safety profiling that is excellent on positive and gram-negative bacteria, fungi, and viruses. According to research, it is suggested chlorhexidine is known to have a long-lasting antibacterial agent capable of decreasing the decolonization of the patient’s skin and preventing secondary contamination on the skin surface. Present studies show that subsequent use of chlorhexidine wipes decrease contamination of care giver’s hands and skin colonization by bacteria. In particular, routine cleaning of inpatient with chlorhexidine reduces the chances of colonization.

PICOT

Hospitalized patients with COPD exacerbations (P), can the application of GOLD guidelines plan care buddle (I) in comparison with no care buddle (C) minimize exacerbation that needs hospitalization (O) between two months after discharge?

Literature search strategy employed

The literature research sort structure of crucial terms applied in databases. The key phrases for search queries were put to generate exact results by coming up with terms, keywords, and phrases. In this scenario, the main research question was framed, defined, and written following multiple concepts related to the subject through brainstorming of main points. Additionally, the terms, words, and phrases were distinguished and termed as synonyms. These required creating a timeline of identifying the type of material to be included and the reason.Benchmark – Capstone Project Change Proposal

This search used in this strategy was Boolean Searching. These allow searches to apply such terms as OR, NOT, AND and to develop more significant results. The search method is crucial in providing info ration that is limited within the applied phrases and keywords. These allow the search to become more accessible, precise, and straightforward. However, in the search, it involved a wide range of databases such as PubMed, CINAHL, and PubMed that provide at least eight reviewed articles supporting the literature review (Frost, et al., 2016).

Evaluation of the literature

This proposal engages highly significant sources on the topic. The applied resources are central and limited to the main issue. The selection of resources devoted was based on the time when the information was collected with evidence applicable to society. Still, the resources contain the current theories supporting chlorhexidine gluconate to reduce colonization and CLABSIs. Most of the used sources are based on primary data that allowed the collection of firsthand information is significant in decision making. For instance, the applied articles contain information published between 2015 and 2020, making them useful by generalizing the modern clinical setup.

Applicable change or nursing theory utilized

Routine bathing of patients using chlorhexidine in managing CLABSIs in acute cases in ICU where there are rampant instances of HAIs is essential in eliminating HAIs (Kaieski, et al., 2020). These changes tend to seek the employment of the Rogers’ Change Theory. However, this theory creates awareness regarding the proposed change with the aim f preparing stakeholders within the required course of action. This theory is a Multi-Step Flow that explains why some individuals accept any change while others object. This theory aims to explain the importance of any difference and the need to change since they acknowledge the change’s purpose and the potential outcome.

Proposed implementation plan with outcome measures

Like any other adopted change in healthcare, the main aim of this proposal is to improve the results by reducing the cost and the number of patients through the management of CLABIs. The recommendation within this project involves diagnosis, planning, implantation, evaluation, and assessment. Assessing this proposal involves critical thinking for both objective and subjective data. The following stage makes diagnosis to determine whether the proposition is viable to changes that align with a potential healthcare plan. In the planning stage, the development of goals is done, followed by an implementation that involves the introduction of the use of chlorhexidine wipes to manage CLABSIs. Finally, an evaluation is done to reassess to note the changes attainable from the proposal.Benchmark – Capstone Project Change Proposal

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

The main obstacle in this proposal is the presence of an inadequate supply of resources that drains down the intended changes within healthcare’s economic guidelines. Like, the introduction of change will require the introduction of new training on methods of managing the chlorhexidine baths and making purchases of wipes, and with the required supplements, it might be expensive. Also, poor communication is a barrier in a health setting, creating friction in the implementation, thereby resulting in resistance from the patience and nurses creating less awareness in introducing the changes. Remarkably, the presence of confusing plans in a health organization undermines flexibility to adopt new changes due to fear in the reception by the management leaders. These barriers can be overridden by implementing Rogers’s theory, which makes sure the stakeholders are affected by a proposed change acknowledge and get enough involvement during decision making on how to cope with new changes. Promotion of flexibility, good leadership skills, communication skills, and collaboration are essential traits in adopting recent change. However, the organization can seek financial back up from donors and grants to effect the required change. Benchmark – Capstone Project Change Proposal

References

Boonyasiri, A., Thaisiam, P., Permpikul, C., Judaeng, T., Suiwongsa, B., Apiradeewajeset, N., & Thamlikitkul, V. (2016). Effectiveness of chlorhexidine wipes for the prevention of multidrug resistant bacterial colonization and hospital-acquired infections in intensive care unit patients: a randomized trial in Thailand. infection control & hospital epidemiology, 37(3), 245-253.

Frost, S. A., Alogso, M. C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R., & Hillman, K. M. (2016). Chlorhexidine bathing and healthcare-associated infections among adult intensive care patients: a systematic review and meta-analysis. Critical Care, 20(1), 379. https://dx.doi.org/10.1186%2Fs13054-016-1553-5

Hersh, E. H., Yaeger, K. A., Neifert, S. N., Kim, J., Dangayach, N. S., & Weiss, N. (2019). Patterns of Health Care Costs Due to External Ventricular Drain Infections. World neurosurgery, 128, e31-e37.

Jayaweera, J. A. A. S., & Sivakumar, D. (2020). Asymptomatic central line-associated bloodstream infections in children implanted with long term indwelling central venous catheters in a teaching hospital, Sri Lanka. BMC Infectious Diseases, 20(1), 1-10.

Kaieski, N., da Costa, C. A., da Rosa Righi, R., Lora, P. S., & Eskofier, B. (2020). Application of artificial intelligence methods in vital signs analysis of hospitalized patients: A systematic literature review. Applied Soft Computing, 106612. Benchmark – Capstone Project Change Proposal