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Create a detailed proposal using the ACE Star model for evidence-based practice change related to a nursing problem. Include the scope of the issue, stakeholders, evidence search, recommendations, implementation plan, evaluation, dissemination, and a conclusion summarizing the key aspects of the change process.

Paper For Above instruction

The following paper presents a comprehensive proposal designed to address a significant nursing practice problem using evidence-based strategies guided by the ACE Star Model of Knowledge Transformation. This approach aims to facilitate sustainable change within a healthcare setting by systematically integrating best practices and evidence into clinical protocols to enhance patient outcomes.

Change Model Overview

The ACE Star Model of Knowledge Transformation is a structured framework that guides nurses through five stages: Knowledge Discovery, Evidence Summary, Translation, Practice Integration, and Process, Outcomes, and Evaluation. Its purpose is to convert research evidence into clinical practice efficiently, thus fostering high-quality, evidence-based care. The model's emphasis on systematic progression supports nurses in developing, implementing, and sustaining change initiatives. Utilizing this model ensures that nursing interventions are grounded in the best available evidence, ultimately leading to improved patient safety, quality of care, and organizational effectiveness.

Applying the ACE Star Model to the selected practice issue provides a clear pathway for change, ensuring the process is organized and evidence-driven. Nurses should adopt this model as it promotes critical thinking, encourages stakeholder engagement, and promotes continuous quality improvement. Its structured steps help prevent ad hoc practices, ensuring that changes are based on validated evidence and aligned with organizational goals.

Scope of the EBP

The practice issue under review concerns the high incidence of healthcare-associated infections (HAIs), specifically catheter-associated urinary tract infections (CAUTIs) within a hospital unit. CAUTIs are a prevalent complication leading to increased morbidity, extended hospital stays, and higher healthcare costs. According to the Centers for Disease Control and Prevention (CDC), CAUTIs account for approximately 30% of all healthcare-associated infections in U.S. hospitals, with an estimated 93,000 cases annually (CDC, 2021). This issue not only affects patient health but also contributes significantly to hospital readmissions and financial penalties imposed by payers based on infection rates.

On a broader scale, reducing CAUTIs aligns with national patient safety initiatives and enhances compliance with quality standards set by accrediting agencies like The Joint Commission. Therefore, addressing this practice issue is vital for improving patient outcomes, reducing healthcare costs, and fulfilling institutional quality requirements.

Stakeholders and Responsibilities

The success of this quality improvement project hinges on the collaborative efforts of multidisciplinary stakeholders. The core team will include the charge nurse, infection control practitioner, hospital epidemiologist, quality improvement officer, and bedside nurses. Pharmacy representatives and physicians involved in catheter management may also be included based on organizational structure.

Each team member has specific responsibilities. The charge nurse oversees daily implementation and staff coordination. Infection control practitioners lead the evidence review and data collection. The epidemiologist analyzes infection trends and benchmarks. The quality improvement officer facilitates process mapping and outcomes evaluation. Bedside nurses are vital for practice adherence, providing frontline insights and implementing interventions.

This diverse team ensures comprehensive coverage of the clinical, operational, and educational aspects necessary for successful change, leveraging their unique expertise to address barriers and promote best practices.

Evidence Search and Summary

The evidence was obtained through rigorous internal audits of infection rates and external searches in reputable databases such as PubMed, CINAHL, and the Cochrane Library. The evidence sources include systematic reviews, clinical practice guidelines, and quality improvement reports.

Systematic reviews, such as one by Saint et al. (2016), advocate for evidence-based strategies like nurse-led catheter removal protocols, continuous staff education, and daily catheter necessity assessments. The CDC’s guidelines recommend stringent catheter insertion and maintenance protocols, proper hand hygiene, and regular audits of practices (CDC, 2021). Evidence suggests that these interventions collectively reduce CAUTI rates significantly. The strength of this evidence lies in its consistency across multiple high-quality studies and its alignment with established standards.

Supporting data from quality improvement initiatives demonstrates successful reduction in CAUTIs through multidisciplinary interventions, emphasizing the importance of compliance with evidence-based protocols. These findings reinforce the need for structured practice change and resource allocation to sustain improvements.

Summary of Evidence-Based Interventions

The systematic review and guidelines highlight interventions such as: (1) daily assessment of catheter need; (2) strict aseptic technique during insertion; (3) use of closed drainage systems; (4) staff education and competency validation; and (5) regular clinical audits with feedback. Implementing these strategies collectively has demonstrated a significant decrease in infection rates, supporting their inclusion in the revised practice protocol.

Recommendations for Change

Based on the accumulated evidence, the primary recommendation is to implement a standardized catheter management policy emphasizing timely removal, aseptic insertion techniques, and ongoing staff education. The policy should incorporate daily assessments to determine catheter necessity and empower bedside staff to remove unnecessary devices proactively. This evidence-supported approach aims to reduce CAUTI incidence, improve patient safety, and foster a culture of continuous quality improvement.

Translation Action Plan

The implementation plan begins with conducting staff training sessions on the new protocols, scheduled over a two-week period. A pilot phase will be initiated in one unit, with ongoing monitoring of infection rates and staff compliance over a three-month period. Data will be collected through chart audits, infection logs, and staff feedback. Outcomes such as reduction in CAUTI rates, adherence rates, and staff confidence levels will be measured monthly.

A reporting system will be established to regularly update stakeholders through meetings and written reports. These reports will include process measures (e.g., adherence to protocols), outcome measures (e.g., infection rates), and balancing measures (e.g., staff workload). Based on the pilot results, adjustments will be made, and the plan expanded across other units to ensure wider adoption.

Next steps involve institutionalizing the policy through staff orientation, incorporating it into standard protocols, and establishing ongoing audit and feedback mechanisms to sustain improvements. Continuous education and leadership support are essential to embed the changes in organizational culture.

Conclusion

This proposal leverages the ACE Star Model to facilitate a structured and evidence-based approach to significantly reducing CAUTI rates. The problem's scope—its impact on patient health and hospital costs—necessitates systematic change grounded in credible research and multidisciplinary collaboration. The five stages of the model—knowledge discovery, evidence summary, translation, practice integration, and evaluation—guide the development and implementation of a sustainable intervention. Maintaining the change involves continuous monitoring, staff engagement, and leadership support, ensuring that evidence-based practices become standard care protocols. Employing this model fosters a culture of continuous improvement and aligns clinical practices with the highest standards of patient safety and quality care.

References

• Centers for Disease Control and Prevention. (2021). Healthcare-associated infections—Hospital (HAI). Retrieved from https://www.cdc.gov/hai/data/portal.html
• American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.
• Saint, S., Baldwin, D., & Lipman, J. (2016). Reducing urinary catheter-related bloodstream infections: Implementation of evidence-based practices. Journal of Nursing Care Quality, 31(4), 292–297.
• Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia, PA: Wolters Kluwer.
• Guidelines for the prevention of catheter-associated urinary tract infections. (2021). Infect Control Hosp Epidemiol, 42(4), 409-417.
• Hooton, T. M., & Bradley, S. F. (2014). Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: A systematic review. Annals of Internal Medicine, 149(2), 139–146.
• Lehmann, U., & Sanders, D. (2007). Community health workers: What do we know about them? WHO/PEPnet. Retrieved from https://www.who.int/hrh/documents/community_health_workers.pdf
• Lo, E., Nicolle, L. E., & Campion, T. (2014). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infect Control Hosp Epidemiol, 35(8), 1003-1014.
• Schaffer, S., et al. (2013). Strategies for effective implementation of evidence-based practice: A systematic review. Worldviews on Evidence-Based Nursing, 10(4), 206–219.
• Sohrabi, C., et al. (2019). Evidence-based management of urinary catheters. International Journal of Urology, 26(4), 362–369.