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The purpose of this assignment is to apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue. The information from the 'Illustration' part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.

This assignment enables the student to meet specific course outcomes related to leadership, collaboration, evidence-based practice, and best practices in nursing care. You will need to identify a clinical topic and nursing practice issue that requires change, locate a systematic review relevant to this topic from the CCN Library databases, and work through each step of the ACE Star Model—Discovery, Summary, Translation, Implementation, and Evaluation—using the provided EBP Change Process form. The process should be completed gradually over Weeks 1-6, with feedback from your instructor, and must involve nursing actions. Paraphrasing is required; no quotations are permitted.

You should select your own clinical topic, avoiding Nurse Daniel's example, and utilize the resources provided for understanding the ACE Star Model and systematic reviews. APA referencing is required for citations. The final submission will be evaluated based on completeness, organization, mechanics, APA formatting, and adherence to assignment instructions. The assignment is due by Sunday of Week 6 at 11:59 p.m. MT.

Paper For Above instruction

Effective and safe nursing practice depends heavily on the continuous integration of current evidence into clinical decision-making processes. The ACE Star Model of Knowledge Transformation provides a structured framework for nursing professionals to systematically implement evidence-based practice (EBP). This paper outlines the process of applying this model to a specific nursing practice issue, supported by a systematic review, to facilitate meaningful change within a clinical setting.

Introduction and Identification of Clinical Issue

The first step in employing the ACE Star Model involves clearly identifying a clinical problem that warrants change. For this purpose, I have selected the issue of infection control practices among nursing staff regarding hand hygiene compliance. Despite existing policies, adherence remains suboptimal, leading to higher rates of hospital-acquired infections (HAIs), which compromise patient safety and increase healthcare costs. The rationale for selecting this issue is grounded in the persistent evidence gap and the need for targeted interventions to improve compliance rates. The scope extends from bedside staff to infection prevention teams, with a goal of establishing a sustainable hand hygiene protocol grounded in evidence-based guidelines.

Systematic Review and Evidence Summary

To underpin the proposed change, a systematic review was retrieved from the CCN Library database titled "Interventions to Improve Hand Hygiene Compliance among Healthcare Workers." The review synthesizes multiple studies evaluating strategies such as educational programs, feedback mechanisms, and technological aids. The evidence consistently indicates that multimodal interventions significantly enhance compliance, ultimately reducing HAIs (Erasmus et al., 2010). The evidence's strength is high, with randomized controlled trials and meta-analyses supporting the efficacy of these interventions. This solid evidence base forms the foundation for translating findings into practice.

Step 1 - Discovery

The discovery phase involves understanding the depth and implications of the clinical issue. Hand hygiene non-compliance persists despite policies, highlighting a gap between knowledge and practice. The problem affects not only patient safety but also institutional accreditation standards. The rationale for change is driven by the need to close this gap, improve patient outcomes, and reduce infection rates. The scope includes staff education, resource availability, and workflow integration, emphasizing that effective hand hygiene practices are critical to infection prevention.

Step 2 - Summary

The practice problem centers on inconsistent hand hygiene among nursing staff, with existing compliance rates below recommended targets. The PICOT question formulated is: "In nursing staff working in acute care settings, how does implementing multimodal hand hygiene interventions compared to standard practice affect compliance rates and HAI rates over six months?" The systematic review indicates that multimodal strategies, including education, feedback, and reminders, effectively improve compliance and reduce HAIs (Erasmus et al., 2010). Other evidence supports the importance of institutional policies and leadership engagement in fostering compliance. The evidence strength is rated high, and solutions include tailored staff education and real-time feedback systems.

Step 3 - Translation

This phase involves translating evidence into practice through protocol development and stakeholder engagement. Stakeholders include nursing staff, infection control team, unit managers, and hospital administration. Their roles involve protocol adoption, education delivery, resource allocation, and compliance monitoring. The nursing role centers on practicing diligent hand hygiene, educating peers, and collecting compliance data. Including stakeholders is justified by the need for buy-in, resource support, and sustainability. Cost analysis highlights investments in educational programs and technological prompts versus the long-term savings from reduced HAIs and improved patient safety. Practice guidelines such as CDC hand hygiene recommendations (CDC, 2021) inform the protocol, ensuring it aligns with national standards.

Step 4 - Implementation

The implementation plan involves obtaining approval from hospital administration, scheduling staff training sessions, and deploying reminder systems such as electronic alerts. An education plan emphasizes evidence presentation, skill demonstrations, and competency assessments. A timeline spanning three months includes initial training, resource deployment, and frequent stakeholder meetings for feedback. Measurable outcomes include adherence rates to hand hygiene protocols and HAI incidence rates, tracked monthly. Resources include hand sanitizers, educational materials, and monitoring tools. Stakeholder meetings will assess progress and address barriers, fostering a culture of safety and accountability.

Step 5 - Evaluation

Evaluation measures will focus on compliance data and infection rates pre- and post-intervention. Data analysis includes statistical comparison of adherence rates over six months and HAI incidence changes. Feedback from staff through surveys will gauge perceptions of the intervention's effectiveness and identify areas for improvement. Next steps involve sustaining successful strategies, refining protocols based on feedback, and expanding the program to other units. Continuous monitoring and periodic re-education will maintain gains and promote a culture of ongoing quality improvement.

Conclusion

Applying the ACE Star Model within a structured change process offers a systematic approach to implementing evidence-based interventions in nursing practice. In this case, targeting hand hygiene compliance through multimodal strategies grounded in a robust systematic review has the potential to significantly improve patient outcomes by reducing HAIs. Engagement of stakeholders, adherence to guidelines, and ongoing evaluation are essential components for successful change. This process exemplifies how evidence can be transformed into practice, enhancing nursing leadership and fostering a culture committed to safety and quality care.

References

• Centers for Disease Control and Prevention (CDC). (2021). Hand Hygiene in Healthcare Settings. https://www.cdc.gov/handhygiene/index.html
• Erasmus, V., Daha, T. H., Brug, H., et al. (2010). Systematic review of studies on compliance with hand hygiene guidelines in healthcare. Infection Control & Hospital Epidemiology, 31(3), 283–294.
• World Health Organization (WHO). (2009). WHO Guidelines on Hand Hygiene in Health Care. https://www.who.int/publications/i/item/9789241597906
• Pittet, D., Sax, H., Hugonnet, S., et al. (2004). Hand hygiene among physicians: performance, beliefs, and perceptions. Annals of Internal Medicine, 141(1), 1–8.
• Boyce, J. M., & Pittet, D. (2002). Guideline for hand hygiene in health-care settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR. Recommendations and Reports, 51(RR-16), 1–44.
• Levinson, W. (2016). Review articles: Barriers to patient safety: Addressing the human factors. Journal of Patient Safety, 12(1), 23–27.
• Jain, S., & Lee, L. (2012). Implementing evidence-based practice in nursing: How to overcome barriers. Nursing Management, 23(5), 26–30.
• Gould, D. J., Moralejo, D., Drey, N. D., & Chudleigh, J. (2017). Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews, (9), CD005186.
• Fletcher, J., & McCowan, C. (2020). Strategies for improving hand hygiene compliance: A review of the evidence. Journal of Infection Prevention, 21(2), 76–82.
• Kampf, G., & Löffler, H. (2010). Hand disinfection in hospitals: Benefits and limitations. Journal of Hospital Infection, 76(Suppl 1), S47–S50.