Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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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.)

An increase in the incidences of CAUTIs (Catheter-Associated Urinary Tract Infections) concerning the use of the non-silver foley catheters increases the costs of care by increasing the reimbursement costs.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Health payers and insurers use the pay for performance reimbursement model to reimburse healthcare organizations and providers for the healthcare costs. Since reimbursements are linked with patient outcomes, the increasing incidence of CAUTIs among hospitalized patients that results in poor health outcomes and prolonged hospitalization is an issue of significance.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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.​       

Among hospitalized patients aged 60 years or older(P), does the use of an antiseptic novel silver Foley catheter(I) compared to a non-foley catheter(C) reduce the incidence of CAUTIs(O) within 12 weeks(T)?

List the systematic review chosen from the CCN Library databases. Type the complete ​APAreference​ for the systematic review selected.

Sun, Y., Ren, P., & Long, X. (2020). Role of noble metal-coated catheters for short-term urinary catheterization of adults: a meta-analysis. PloS one, 15(6), e0233215.

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

Ardehali, S. H., Sedaghatmanesh, M., & Fatemi, A. (2019). The Role of Foley Catheter Coated with Gold, Silver, and Palladium in Decreasing Urinary Tract Infections in the Intensive Care Unit; a Letter to Editor. Archives of academic emergency medicine, 7(1), 40.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

Chung, H. Y., Wong, C. W., Lai, C. K., Siu, H. K., Tsang, D. N., Yeung, K. Y., … & Tam, P. K. (2017). A prospective interventional study to examine the effect of a silver alloy and hydrogel–coated catheter on the incidence of catheter-associated urinary tract infection. Hong Kong Medical Journal.

Colletta, A., Wu, J., Wo, Y., Kappler, M., Chen, H., Xi, C., & Meyerhoff, M. E. (2015). S-Nitroso-N-acetylpenicillamine (SNAP) impregnated silicone foley catheters: a potential biomaterial/device to prevent catheter-associated urinary tract infections. ACS biomaterials science & engineering, 1(6), 416-424.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

Leuck, A. M., Johnson, J. R., Hunt, M. A., Dhody, K., Kazempour, K., Ferrieri, P., & Kline, S. (2015). Safety and efficacy of a novel silver-impregnated urinary catheter system for preventing catheter-associated bacteriuria: a pilot randomized clinical trial. American journal of infection control, 43(3), 260–265.

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

The systematic review included 13 studies whereby twelve were RCTs and one was a prospective trial study. There were two groups in the study whereby, one group was the noble metal alloy-coated (silver, gold, and palladium) while another group had the silver alloy coated. The findings revealed that both the noble-alloy and silver alloy-coated catheters decreased the likelihood of bacteriuria and subsequent CAUTIs.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Washing hands with soap and clean running water before changing a catheter.

Star Point 3:  Translation (Action Plan)

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

Appropriate use of catheters

Appropriate insertion and maintenance of a catheter

Timely removal of urinary catheters.

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

Infection prevention officer- train nurses on the procedures and guidelines of preventing and controlling HAIs particularly CAUTIs. ​

Nurse leader- serve as a champion for the change project.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

Charge nurse-Oversee the appropriate use, insertion, maintenance, and removal of urinary catheters.

Procurement officer– procuring silver-coated foley catheters from trusted vendors.

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

Coordinating members of the implementation team and oversee a highly effective, efficient, and successful change.

To clearly define, and assign each member of the implementation of team-specific roles and responsibilities from implementation to monitoring and evaluation.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Infection prevention and control specialist

Nurse leader

Procurement Officer

Charge nurse

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

Cost-benefit analysis incorporating the charge nurse, procurement officer, chief finance officer, and vendors.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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?

The process will start with peer review, obtaining approval from the board, conducting safety and biomedical checks, obtaining authorization then approval. The specific stakeholders who will be involved in this process are the project sponsors, the hospital’s ethical approval and review board, and regulatory agencies.

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

The author will provide a memo describing the purpose of the change project, process, and expected outcomes. The process section will include a description of where, when, and how training will be done. Education will take place the initial week before beginning the change project and the second week thereafter to assess the knowledge obtained.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Implementation will start the second week after obtaining ethical approval, training will occur in the second week (pre and post-assessment), and implementation will occur between week three and week ten. Assessment and evaluationwill occur in week eleven while in week twelve will be the formulation of guidelines and policies to guide clinical practice.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

CAUTIs incidences- the number of patients identifiedwith symptomatic bacteriuria as captured in the incidence register before and after implementation

CAUTIs-related healthcare costs-CAUTIs financial costs before and after implementing the change process.

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

Incidence registers will be used to record confirmed incidences of CAUTIs, inpatient admission registers will be used to record CAUTIs-hospitalizations, while monitoring and evaluation forms will be used to record evaluation outcomes (financial, and the number of silver-foley catheters used).Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Financial resources for the purchase of silver foley catheters are vital to ensure the availability of foley catheters to use. Similarly, it will be vital to incorporate all stakeholders involved in direct and indirect nursing patient care in the change pilot as this will help to pool together skills, and knowledge.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Yes. All nursing staff will meet after every three weeks for briefings on the progress of the proposed change. The initial meeting before implementation will focus on training and education about preventing CAUTIs. There will also be a post-implementation meeting to assess the knowledge obtained from training.  There will also be bi-weekly meetings of the members of the implementation team (nurse leader, RN, charge nurse, infection prevention and control officer, procurement officer) to discuss and assess implementation progress.

Week 6 Assignment: Evidence-Based Practice Change Process Essay.

Star Point 5: (Evaluation)

How will you report the outcomes​ of the trial? ​

PowerPoint presentation to all healthcare staff, publishing guidelines, and policies to guide practice.Week 6 Assignment: Evidence-Based Practice Change Process Essay.

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

Implementing the proposed intervention; using a silver foley catheter for all hospitalized patients to decrease the incidence of CAUTI within 12 weeks.Week 6 Assignment: Evidence-Based Practice Change Process Essay.