ACE Star Model of Knowledge Transformation
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 own 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:_____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify thetopic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)
Infections acquired in medical facilities will be the topic of discussion. The frequent occurrence of UTIs caused by catheters (CAUTIs) is the chosen nursing practice issue.
Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.
CAUTIs is the chosen issue, and I believe it is extremely essential to examine them since their incidence may be reduced and, in certain cases, even avoided entirely. ACE Star Model of Knowledge Transformation Nurses who are aware of the potential causes and manifestations of Hospital acquired infections are better able to take preventative measures.
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Among the most prevalent types of infections that patients pick up in hospitals is an infection of the urinary tract. A urinary catheter that is left in place for an extended period of time is linked to at least 80 percent of all cases of urinary tract infections. An estimated 13,000 people each year pass away as a result of urinary tract infections related with catheter use. CAUTIs have been linked to longer hospital admissions, higher rates of morbidity and death, and higher overall healthcare expenses.
Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate your PICOT question.
The practice problem is that since 2008, Medicare does not pay for the treatment of catheter-associated urinary tract infections (CAUTIs), which are one of the most prevalent types of illnesses that patients get while in a hospital. Although it has been claimed that nurse-driven guidelines make it easier to make proper use of catheters and remove them in a timely manner, there has been very little effort made to rigorously analyze how these protocols affect clinical outcomes ACE Star Model of Knowledge Transformation.
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.
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 describeother sources used for data and information. List any otheroptional scholarly source used as a supplement to the systematic review in APA format.
During the course of my research for supporting evidence, I came across an article titled “Implementation of a nurse-driven CAUTI prevention algorithm.” The evidence obtained in this article is pertinent to my PICOT because I would want to explore a solution to reduce or prevent the number of CAUTI cases that occur in a hospital environment. The expenditures associated with CAUTI are discussed after a brief history of the disease’s incidence and prevalence are presented in the article. The article also discusses measures that may be taken to prevent CAUTI ACE Star Model of Knowledge Transformation. In addition, the article delves into a method for reducing the incidence of CAUTI called an algorithm. I also came across an article that discussed whether or not nurse-driven procedures have a role in the reduction of the risk of CAUTIs.
References
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
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
Brieflysummarize the main findings (in your own words) from the systematic review and the strength of the evidence.
The most significant findings from the systematic review are that nurse-driven practices to promote accurate catheter use and early removal seem to have a favorable influence on the clinical indicators as well as the incidence of CAUTI. Nevertheless, there is a requirement to enhance the study design of quality improvement initiatives carried out in the patient care environment due to the limited levels of evidence available and the absence of methodologic integrity in current research.
The strength of the evidence in this systematic review can be deduced from its effort to eliminate the likelihood of bias in the way of locating and choosing studies for data extraction, and utilizing a thorough search strategy. In addition, the study’s openness in detailing each step of the synthesis process is another one of the review’s strengths.
Outline one or two evidence-based solutions you will consider for the trial project.
An evidence-based solution would be the involvement of the multidisciplinary taskforce team in the CAUTI nursing practice issue. According to studies, the multidisciplinary taskforce team has the potential to undertake quality improvement initiatives and change management approaches, both of which may lead to a substantial and lasting decrease in the number of CAUTIs that occur in inpatient units (Taha et al., 2017).
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).
As part of the standard of care for urinary catheters, staff and patients alike should be educated about the significance of infection prevention, the signs of a urinary tract infection, and how to properly care for an indwelling urinary catheter. Other protocols include washing hands thoroughly before and after handling an indwelling catheter, using aseptic methods to implant and remove the catheter, fastening the tubing and drainage bag, ensuring sterility, and replacing supplies as needed.
List yourstakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).
Nurse Leader- the one who is in charge of the trial and is accountable for the everyday operations and complexities of the project.
Unit Nurses- These professionals will help facilitate the catheter replacement procedure and provide routine bedside care to patients who have permanent catheters.
Patient- provides informed consent for a clinical trial and assists in the identification of indications of CAUTI
What specifically is your nursing role in the change process? Other nursing roles?
In this process of change, the responsibility that I play as a nurse is to be at the vanguard of the process. As the nurse who is in charge of the trial, it would be my responsibility to make sure that all of the necessary materials, education, and paperwork are in place during the whole process. This would guarantee that the trial is conducted effectively. All aspects of an indwelling catheter’s care, including insertion, removal, and daily maintenance, fall within the purview of the unit’s nursing staff. Additionally, the collecting of specimens is the responsibility of nurses. Additionally, nurses are the primary individuals responsible for making a diagnosis of a patient who is thought to have CAUTI.
List your stakeholders by position titles (charge nurse, pharmacist, etc.).Why are the members chosen (stakeholders) important to your project?
Medical doctor
Nurse Manager
Nurse Educator
Unit Nurse
Certified Nursing Assistant
It is the duty of the attending doctor to place the order for the indwelling urinary catheter. Unit nurses and certified nursing assistants play a significant role in the care that must be provided for indwelling catheters on a daily basis. The nurse manager plays a crucial role in ensuring that the rules pertaining to the change process are adhered to and, if required, offers further help.
What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?
A cost effectiveness analysis would be the kind of cost analysis that would be required. An investigation of an intervention’s cost in relation to its impact on a patient’s health is known as a cost-effectiveness analysis (CEA). In this particular stage of the change process, participation from the department of finance is required. This is essential in order to determine how much money may be contributed to the project in order to acquire the necessary resources.
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 administration of the health center must provide their approval before a study can even begin to be planned out and carried out. Without the management’s approval, one cannot carry out a trial of any kind. The financial team must also be brought on board to determine how much money may be set aside for the endeavor.
Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.
To begin, it is essential to coordinate efforts with a nurse educator so that they can educate staff members on the procedure for making changes. The appropriate procedure of avoiding CAUTI may be taught by nurse educators to other staff members, and continuous refresher training can be provided during the trial period. It would be more convenient for the personnel if educators were accessible throughout the day for all of the shifts
Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).
The process of making the change would take place over the course of six months. As part of this process, employees would be instructed on how to take care of catheters and what information should be recorded. The trial involving patients who have given their informed consent to participate would also be incorporated into this timeframe.
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List the measurable outcomesbased on the PICOT. How will these be measured?
The number of CAUTI episodes that occur over a period of six months would serve as the measurable result based on the PICOT model. CAUTI event reports, drugs used to treat CAUTI, and the frequency of indwelling catheterizations performed on the unit are all good indicators of this.
What forms, if any, might be used for recording purposes during the pilot change process. Describe.
Forms might be used to keep track of things like staff training and education. Care for the growing number of patients requiring indwelling catheters would be optimized by having staff do a self-assessment of their own preparedness and knowledge of catheterization.
What resources are available to staff (include yourself) during the change pilot?
Extra catheter care supplies, including Foley catheter bags, perineal soap, stat locks, tubing and other items, would be among the resources that the personnel would have access to. Staff and patients’ educational resources include recognizing warning signs of a catheter-associated urinary tract infection (CAUTI), the best practices for avoiding CAUTI, and the fundamentals of caring for a catheter that is left in place.
Will there bemeetings of certain stakeholders throughout the trial? If so, who and when will they meet?
Stakeholders will be invited to attend meetings at various points throughout the trial to discuss the status of the trial and whether or not any essential adjustments are needed. The first month of the trial will consist of weekly meetings, with subsequent months consisting of bimonthly meetings. In order to keep everyone apprised of what is going on with the trial, meetings will be open to participation from all stakeholders.
Star Point 5: (Evaluation)
How will youreport the outcomes of the trial?
A data report summarizing the trial’s outcomes will be displayed in all unit staff common areas. At the conclusion of the trial, there will be a meeting to review its success or failure.
What would be the next steps for the use of the change process information?
The findings of the trial may be used to influence continuing adjustments that can be applied towards CAUTI. The staff will be able to make strides in reducing the number of CAUTIs that occur on the unit after they have evaluated what did and did not work, adapted what actually worked, and built on the knowledge they have gleaned from those evaluations ACE Star Model of Knowledge Transformation.
