NUR 590 Topic 7 Assignment; Evidence-Based Practice Project Proposal Presentation
CAUTI Prevention Project Proposal CAUTI Prevention Project Proposal Student Name Grand Canyon University NUR-590 Evidence based practice project Professor’s Name Due Date Introduction Catheter-associated urinary tract infection (CAUTI) is a significant issue in healthcare systems It is a major recurrent device-related infection mostly acquired in hospitals CAUTI has increased mortality and morbidity rates due to bloodstream infections (Atkins et al., 2020; Whitaker et al., 2022) CAUTI affects other vital organs like kidneys, prostate, bladder, and urethra in severe incidences (Kolstad, 2020). Further, CAUTI leads to high healthcare costs, increased risk of hospitalization, significant patient discomfort, and increased hospital stays The study discusses on how CAUTI affects the healthcare system and possible interventions to implement PICOT question: In an acute care unit inpatient with indwelling urinary catheters (P), how does using multi-modal evidence-based practices (I) compared with the current indwelling catheter care (C) impact the prevention rate of CAUTIs (O) within six months? (T) Organizational Culture and Readiness Most health organizations have adopted EBPs to ensure improved patient care This is mostly patient-centered and focuses on quality (Randall et al., 2019) Organizational culture regulates healthcare processes and systems which influence workforce in attaining facility care goals and objectives. Culture and readiness influence performance due to empowerment (Runtu et al., 2019) The current organizational culture is value based, thus, supporting change Its operations are patient-focused, culturally centered, collaborative, teamwork, and stewardship core values The facility has embraced interprofessional collaboration and team engagement which is crucial in change implementation (Willgerodt et al., 2020). This is fostered by effective communication using IT systems (Melnyk & Fineout-Overholt (2022) Cont’d - Organizational Readiness Tool The project will utilize the Partnership Assessment Tool for Health (PATH) as the organizational readiness tool. PATH enhances organizational natural analysis and stakeholder partnerships in change implementation initiatives (Larson et al., 2022) Its 4 main components include: internal and external relationships, workflow and service delivery, data outcomes, and funding and finance A facility must be well-equipped to adapt EBPs in reducing CAUTIs A proactive and feasible culture is necessary to support EBP changes (Kaiser et al., 2022) Interprofessional collaboration is essential in attaining change goals: empowerment, efficient workflow, efficient communication, and shared healthcare goals. Cont’d – Healthcare processes & Systems and Strategies to facilitate readiness Recommended healthcare processes and systems enhance quality improvement, cost- effectiveness and safety during EBP implementation Such entails: interprofessional collaboration, communication, patient management systems and continuous improvements in CAUTI eradication Processes and systems improve trust and understanding among nurses, improve patient- centered care, and care tracking (Kaiser et al., 2022) Essential strategies to foster readiness include involving stakeholders and using systemic change approaches including PDCA cycle (Atkins et al., 2020; Liu et al., 2022). Cont’d - Stakeholders & team members and ICT Stakeholders and team members for this project will include patients, leadership team, acute care nurses, and IT personnel Stakeholder inclusion foster efficient project execution through resource allocation, change regulation, communication, and data collection ICT components essential for the change implementation include consumer health IT applications Their integration will include EMRs, clinical email communication, interactive communication tech, and health information literacy These will foster communication, speedy care through patient monitoring, and timely intervention. Problem Statement CAUTI is a growing healthcare problem in acute care units causing major health complications for patients and facilities Bacterium causes most CAUTIs (Whitaker et al., 2022) Common symptoms include fever, chills, burning sensation in genitalia, pain or pressure in the abdomen, bloody/cloudy urine etc. CAUTIs have led to high mortality and morbidity rates, extended hospital stays, high care costs, and high readmission rates (Whitaker et al., 2022). The study aims at implementing EBPs in reducing or preventing CAUTIs among acute care in-patients using the PICOT question. Literature Review There are various barriers and facilitators of CAUTI behaviors and prevalence. They are related to resources, social influences, environment, and nursing knowledge (Atkins et al., 2020) Common barriers to CAUTI prevention: lack of awareness and training among nurses, staff shortages and high workloads, and time constraints to focus on patients (Fasugba et al., 2021). Teamwork, nursing practice competencies, and positive workforce culture will enhance CAUTI prevention Further, hand hygiene, augmented use of aseptic techniques, and systemic bundled interventions reduce CAUTI incidences (Frödin et al., 2022). Cont’d Common factors influencing CAUTI incidences are relates to patient, hospital/CAUTI catheter, caregivers, environment, and economic (Kafayat et al., 2019) Patient related factors include compromised immune systems, diabetes mellitus, renal dysfunction, and female gender Examples of CAUTI catheter factors include insertion technique, catheter care, and catheterization duration Using BIP and NMA-coated Foley Catheters enhances CAUTI reduction (Kai-Larsen et al., 2021). These specific EBP recommendations for CAUTI prevention Other EBPs include ▪ ▪ ▪ Using daily checklists such as Bundle ABCDE in catheterization care (Kolstad, 2022) Utilizing professional working skills and knowledge among nurses (Teshager et al., 2022) Using aseptic techniques during indwelling catheter insertion and removal (Saint et al., 2019). Selected Model and its Relevance to the Project Models and frameworks for implementing EBPs function by being linked with the main research action Selected model for this project implementation is the John Hopkins Evidence- Based Practice Model (Loma Linda University, 2022). The model is useful in problem-solving and clinical decision-making It uses user-friendly tools for guidance at individual and organizational level. This practice model is designed to meet nursing practice and research needs It contains three essential steps in use: Practice question, evidence, and translation (PET) (Dang et al., 2022). PET ensures latest research findings and practices are incorporated in patient care Cont’d a) Stages of the Change Model/Framework Step 1: Practice question • • • Guidance for the study towards attaining its aims and objectives Helps in identifying the specific health issue existing, needed change, and project tools/resources to enhance its execution The PICOT question has been used to identify research elements like study problem Step II: Evidence ▪ It entails searching, appraising, and synthesizing quality evidence to support or clearly answer the practice question (White, 2016). Step III: Translation ▪ ▪ Entails taking action on evidence collected by ensuring its efficient use in practice This ensures action plans are developed to foster change execution (Dang et al., 2022) Cont’d Applicability of each Stage of the Model during the Implementation & Concept Map for the Conceptual Model The practice question include the already developed PICOT question. This defines the study’s population, interventions, comparison, outcomes, and timelines for project implementation The evidence phase includes project execution using attained study evidence to support the intervention chosen and fill care gaps identified. Translation step includes implementation plan development for the project’s systemic execution. Implementation Plan Study setting – Hospital’s acute care inpatient unit with post-surgical patients Potential subjects – Include children and adults admitted in the health facility Their medical records will be used for provision of information to support the study question on CAUTI prevention The information will provide a pattern and trend of CAUTI elimination, a review on the need to implement multimodal EBPs No consent to health information access but there is need to attain nurse leaders’ permission for the researcher to access EMRs. The project will be implemented within 6 months This is enough for implementation of project activities and making modifications Cont’d Furthermore, the implementation plan must include budget and resources Essential resources needed: human, financial, and material The human resources - skilled nursing workforce, IT experts, and catheterization specialists Material resources – equipment such as writing materials, projectors etc. Financial resources – useful for system upgrades, participant incentives, buying material resources, and miscellaneous Estimated budget for the project’s implementation is $35, 000 Data collection design utilized is qualitative research – affordable, timeliness It uses non-numerical approaches in understanding specific experiences (Busetto et al., 2020). Questionnaires, and random observations will enhance project implementation monitoring Cont’d Intervention delivery process includes various steps namely: Prioritizing the intervention implementation sequencing for specific process action Efficient identification of stakeholders involved in the intervention process To determine and develop a schedule to deliver the intervention Conducting a needs assessment to identify skills and knowledge gaps in intervention implementation Planning an intervention delivery process ensures efficient timelines are created This guides project milestones for easy progress tracking (Khalil & Kynoch, 2021) Training is essential among participants to enhance their competencies in influencing CAUTI prevention trends (Lehane et al., 2019) Stakeholders needed – nurse leaders, nurses, physicians, and IT personnel in acute care Potential barriers - Stakeholder resistance, inadequate support, and time constraint Evaluation Plan The expected outcome for the EBP project proposal includes Reduced healthcare costs for patients and care facility Reduced hospitalization and health complications incidences Improved readmission rates (Schweiger et al., 2020). Enhanced education among nurses and physicians in acute care Facilitated advocacy for alternative toileting options (Potugari et al., 2020) Promotion of proper use of aseptic techniques in catheter insertion and removal Data collection tool to be used – Electronic medical records (EMR) It is valid, reliable, and applicable on providing CAUTI prevention trends. Statistical tests for the project – Chi-square test to determine differences between the observed and anticipated data on CAUTI prevention (Collins, 2021) Cont’d The research will utilize document analysis and record review methods in data collection under qualitative research (Taherdoost, 2021) These will provide essential experiences and patterns on CAUTI prevention They are affordable, timely, and available tool to use causing limited disruptions to daily routines of the participants The project change implementation outcomes will be measured and evaluated using the urinary catheterization impacts among inpatients If the outcomes are negative, there will be need to re-evaluate or restart the whole project process Any action after project implementation will depend on the leadership support, communication, and modifications (Cullen et al., 2022) References Anicoche, M. L. (2021). The Johns Hopkins Evidence-Based Practice (EBP) Model: Weinberg Perianesthesia interventions for a healing environment. Journal of Perianesthesia Nursing, 36(4), e21. https://doi.org/10.1016/j.jopan.2021.06.064 Atkins, L., Sallis, A., Chadborn, T., Shaw, K., Schneider, A., Hopkins, S., ... & Lorencatto, F. (2020). Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioral analysis of interventions. Implementation Science, 15(1), 1-22. https://doi.org/10.1186/s13012-020-01001-2 Billups, F. D. (2019). Qualitative data collection tools: Design, development, and applications (Vol. 55). Sage Publications. Busetto, L., Wick, W., & Gumbinger, C. (2020). How to use and assess qualitative research methods. Neurological Research and practice, 2(1), 1-10. https://doi.org/10.1186/s42466-020-00059-z Collins, K. M. (2021). Chi-square automatic interaction detection analysis of qualitative data. In The Routledge Reviewer’s Guide to Mixed Methods Analysis (pp. 69-76). Routledge. Cullen, L., Hanrahan, K., & Farrington, M. (2022). Evidence-Based Practice in Action, Second Edition: Comprehensive Strategies, Tools, and Tips from University of Iowa Hospitals & Clinics (2nd ed. edition). SIGMA Theta Tau International. Cont’d Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: model and guidelines. 4th ed. Indianapolis, IN: Sigma Theta Tau International Fasugba, O., McInnes, E., Baye, J., Cheng, H., Gordon, R., & Middleton, S. (2021). Barriers and enablers to implementing hospital-acquired urinary tract infection prevention strategies: a qualitative study using the Theoretical Domains Framework. The Journal of hospital infection, 113, 172–179. https://doi.org/10.1016/j.jhin.2021.03.028 Frödin, M., Ahlstrom, L., Gillespie, B. M., Rogmark, C., Nellgård, B., Wikström, E., & Erichsen Andersson, A. (2022). Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients. Journal of Infection Prevention, 23(2), 41-48. https://doi.org/10.1177/17571774211060417 Gauron, G., & Bigand, T. (2021). Implementation of evidence-based strategies to reduce catheter- associated urinary tract infections among hospitalized, post-surgical adults. American Journal of infection control, 49(6), 843-845. https://doi.org/10.1016/j.ajic.2020.11.016 Kafayat, A., Adeolu Augustine, A., Adeleye Amos, O., & Balogun James, A. (2019). Perceived causes and prevention of catheter-associated urinary tract infections among spinal cord injured patients. Journal of Clinical Nephrology. 3: 175-180. https://doi.org/10.29328/journal.jcn.1001045 Kai-Larsen, Y., Grass, S., Mody, B., Upadhyay, S., Trivedi, H. L., Pal, D., ... & Singh, S. (2021). Foley catheter with noble metal alloy coating for preventing catheter-associated urinary tract infections: a large, multi-centre clinical trial. Antimicrobial Resistance & Infection Control, 10(1), 1-10. https://doi.org/10.1186/s13756-021-00907-w Cont’d Kaiser, L., Conrad, S., Neugebauer, E. A., Pietsch, B., & Pieper, D. (2022). Interprofessional collaboration and patient-reported outcomes in inpatient care: a systematic review. Systematic reviews, 11(1), 1-25. https://doi.org/10.1186/s13643-022-02027-x Khalil, H., & Kynoch, K. (2021). Implementation of sustainable complex interventions in health care services: the triple C model. BMC Health Services Research, 21(1), 1-10. https://doi.org/10.1186/s12913-021-06115-x Kolstad, H. (2022). Indwelling urinary catheter daily checklist to reduce device utilization and catheter-associated urinary tract infections. Nursing Research and EBP Day. 15. https://scholar.rochesterregional.org/nursingresearchday/15 Larson, C. P., Plamondon, K. M., Dubent, L., Bicaba, F., Bicaba, A., Minh, T. H., ... & Gyorkos, T. W. (2022). The equity tool for valuing global health partnerships. Global Health: Science and Practice, 10(2). https://doi.org/10.9745/GHSP-D-21-00316 Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., O’Connor, M., Corrigan, M., Burke, F., Hayes, M., Lynch, H., Sahm, L., Heffernan, E., O’Keeffe, E., Blake, C., Horgan, F., & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: an expert view. BMJ evidence-based medicine, 24(3), 103–108. https://doi.org/10.1136/bmjebm-2018-111019 Liu, C., Liu, Y., Tian, Y., Zhang, K., Hao, G., Shen, L., & Du, Q. (2022). Application of the PDCA cycle for standardized nursing management in sepsis bundles. BMC anesthesiology, 22(1), 1-8. https://doi.org/10.1186/s12871-022-01570-3 Cont’d Loma Linda University (2022). Nurses’ guide to evidence-based practice. https://libguides.llu.edu/evidence/modelsframeworks McDougle, J., Sabirovic, M., Pietropaoli, S., & Hamilton, K. (2020). The gulf between emergency plans and the resources needed: a global review. Revue Scientifique et Technique (International Office of Epizootics), 39(2), 373–384. https://doi.org/10.20506/rst.39.2.3088 Melnyk, B. M., & Fineout-Overhold, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins. Niederhauser, A., Züllig, S., Marschall, J., Schwappach, D. L., & progress! Safe Urinary Catheterization Collaboration Group (2020). Nurses' and Physicians' Perceptions of Indwelling Urinary Catheter Practices and Culture in Their Institutions. Journal of patient safety, 16(2), e82–e89. https://doi.org/10.1097/PTS.0000000000000502 Potugari, B. R., Umukoro, P. E., & Vedre, J. G. (2020). Multi-modal Intervention Approach Reduces Catheter-associated Urinary Tract Infections in a Rural Tertiary Care Center. Clinical medicine & research, 18(4), 140–144. https://doi.org/10.3121/cmr.2020.1533 Randall, T. C., Sauvaget, C., Muwonge, R., Trimble, E. L., & Jeronimo, J. (2019). Worthy of further consideration: An updated meta-analysis to address the feasibility, acceptability, safety, and efficacy of thermal ablation in the treatment of cervical cancer precursor lesions. Preventive medicine, 118, 81–91. https://doi.org/10.1016/j.ypmed.2018.10.006 Cont’d Runtu, T. M., Novieastari, E., & Handayani, H. (2019). How does organizational culture influence care coordination in hospitals? A systematic review. Enfermería Clínica, 29, 785-802. http://dx.doi.org/10.1016/j.enfcli.2019.04.119 Saint, S., Greene, M. T., Fowler, K. E., Ratz, D., Patel, P. K., Meddings, J., & Krein, S. L. (2019). What US hospitals are currently doing to prevent common device- associated infections: results from a national survey. BMJ quality & safety, 28(9), 741-74. http://dx.doi.org/10.1136/bmjqs-2018-009111 Schweiger, A., Kuster, S. P., Maag, J., Züllig, S., Bertschy, S., Bortolin, E., ... & Marschall, J. (2020). Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes. Journal of hospital infection, 106(2), 364-371. https://doi.org/10.1016/j.jhin.2020.07.002 Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers associated with evidence‐ based practice among nurses in low‐and middle‐income countries: A systematic review. Worldviews on Evidence‐Based Nursing, 16(1), 12-20. https://doi.org/10.1111/wvn.12337 Staniland, K., & Dingwall, R. (2020). Qualitative Research Methods for Nurses. Qualitative Research Methods for Nurses, 1-232. Cont’d Taherdoost, H. (2021). Data Collection Methods and Tools for Research; A Step-by-Step Guide to Choose Data Collection Technique for Academic and Business Research Projects. International Journal of Academic Research in Management (IJARM), 10(1), 10-38. https://hal.archives-ouvertes.fr/hal-03741847/ Teshager, T., Hussien, H., Kefyalew, M., Wondimneh, F., Ketema, I., & Habte, S. (2022). Knowledge, practice and associated factors of nurses towards preventing catheter- associated urinary tract infection in intensive care unit of public hospitals administered by Federal Government in Addis Ababa, Ethiopia: a cross-sectional institutional-based study. BMC nursing, 21(1), 1-10. https://doi.org/10.1186/s12912-022-00968-1 Willgerodt, M. A., Abu-Rish Blakeney, E., Summerside, N., Vogel, M. T., Liner, D. A., & Zierler, B. (2020). Impact of leadership development workshops in facilitating team-based practice transformation. Journal of interprofessional care, 34(1), 76–86. https://doi.org/10.1080/13561820.2019.1604496 White, K. M. (2016). Evidence-based practice. Translation of Evidence into Nursing and Health Care. 2nd ed. New York: Springer Publishing Company. https://doi.org/10.1891/9780826147370.0001 Whitaker, A., Colgrove, G., Scheutzow, M., Ramic, M., Monaco, K., & Hill, J. L., Jr (2022). Decreasing Catheter-Associated Urinary Tract Infection (CAUTI) at a community academic medical center using a multidisciplinary team employing a multi-pronged approach during the 19 COVID-pandemic. American Journal of infection control, S0196- 6553(22)00602-2. Advanced online publication. https://doi.org/10.1016/j.ajic.2022.08.006
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Contributor: Kyle Shanahan
$15
NUR 514 Topic 5 Assignment; The Evolution of Nursing Informatics Presentation
Contributor: Kyle Shanahan
$15
NUR 514 Topic 8 Assignment; Benchmark - Electronic Health Record Implementation Paper
Contributor: Kyle Shanahan
$15
NUR 590 Topic 3 Assignment; Benchmark - Evidence-Based Practice Proposal Project; Framework-Model for Change
Contributor: Sherri Hill
$15
NUR 590 Topic 5 Assignment; Evidence-Based Practice Proposal Project; Implementation Plan
Contributor: Sherri Hill
$15
NUR 590 Topic 1 Assignment; Summary of Current Course Content Knowledge..
Contributor: Sherri Hill
$15
NUR 590 Topic 1 Assignment; Summary of Current Course Content Knowledge.
Contributor: Sherri Hill
$15
NUR 590 Topic 8 Assignment; Benchmark - Evidence-Based Practice Project Proposal Final Paper
Contributor: Sherri Hill
$15
NUR 590 Topic 6 Assignment; Evidence-Based Practice Project Proposal; Evaluation Plan
Contributor: Sherri Hill
$15
NUR 513 Topic 1 Assignment; Navigating the Online Environment Scavenger Hunt
Contributor: Sherri Martel
$15
NUR 513 Topic 1 Assignment; Navigating the Online Environment Scavenger Hunt.
Contributor: Sherri Martel
$15
NUR 513 Topic 1 Assignment; Navigating the Online Environment Scavenger Hunt..
Contributor: Sherri Martel
$15
NUR 513 Topic 6 Quiz; APA, GCU Library Resources, and Scholarly Research
Contributor: Sherri Martel
$25
NUR 513 Topic 6 Quiz; APA, GCU Library Resources, and Scholarly Research.
Contributor: Sherri Martel
$25
NUR 513 Topic 6 Quiz; APA, GCU Library Resources, and Scholarly Research..
Contributor: Sherri Martel
$25
NUR 513 Topic 6 Quiz; APA, GCU Library Resources, and Scholarly Research...
Contributor: Sherri Martel
$25
NUR 513 Topic 8 Assignment; Benchmark; Future Scope, Role and Professional Obligations Paper
Contributor: Sherri Martel
$15
NUR 513 Topic 4 APA Assignment; Meaningful Application of Nursing Theory to Patient Care
Contributor: Sherri Martel
$15
NUR 513 Topic 5 Assignment; Worldview and Nursing Process Personal Statement.
Contributor: Sherri Martel
$15
NUR 513 Topic 5 Assignment; Worldview and Nursing Process Personal Statement
Contributor: Sherri Martel
$15
