Share An Example From Your Nursing Practice Setting

Share An Example From Your Nursing Practice Setting Of How A Decision

Share an example from your nursing practice setting of how a decision was made to change a procedure or practice. What steps were used in the decision-making process? What evidence was considered for decision-making? Was the change effective? Provide rationale Submission Instructions: Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

Paper For Above instruction

In nursing practice, decision-making is a critical component that directly impacts patient safety, care quality, and the efficiency of healthcare delivery. An illustrative example of a decision to change a procedure involves the modification of infection control protocols related to central line-associated bloodstream infections (CLABSIs). This change was motivated by emerging evidence and institutional quality improvement initiatives aimed at reducing infection rates among hospitalized patients.

The decision-making process commenced with the recognition of a rising trend in CLABSIs within the facility, despite adherence to existing protocols. The interdisciplinary infection control team conducted a comprehensive review of current practices, literature, and national guidelines, such as those from the Centers for Disease Control and Prevention (CDC). The team engaged in a structured decision-making approach, employing the Plan-Do-Study-Act (PDSA) cycle, a well-established quality improvement framework in healthcare (Taylor et al., 2014).

The first step involved planning, where the team identified potential changes, such as enhanced hand hygiene, use of chlorhexidine for skin antisepsis, and the implementation of checklists during line insertion and maintenance. Evidence was gathered through a review of recent scholarly articles demonstrating the effectiveness of chlorhexidine compared to other antiseptics in reducing CLABSI rates (Mimoz et al., 2019). The team also consulted institutional data indicating a protocol for chlorhexidine use was not uniformly followed, primarily due to variability in staff training and process adherence.

Next, the team moved to the do phase by initiating a pilot program that included targeted staff education, revised insertion checklists, and real-time feedback sessions. The pilot aimed to evaluate whether these interventions would lead to a measurable reduction in infection rates. During the study phase, data were collected and analyzed, showing a significant decrease in CLABSI incidents following the intervention. The analysis considered compliance rates with new procedures, staff feedback, and infection data over a three-month period.

Based on these findings, the team proceeded to the act phase, where the revised procedures were adopted across the facility. An institutional policy update was implemented, and staff training was standardized. Continuous monitoring ensured sustainability of the change.

The effectiveness of this decision was evident in the subsequent reduction of CLABSIs, meeting the national benchmarks for patient safety. Regular audits confirmed high compliance with the new protocols, and patient outcomes improved markedly, including shorter hospital stays and decreased antibiotic use, which are critical indicators of quality care (O'Grady et al., 2014).

This example underscores the importance of a systematic, evidence-based approach in clinical decision-making. It highlights the role of interdisciplinary collaboration, consistent staff education, and ongoing quality assurance in successfully implementing practice changes that enhance patient safety. In conclusion, carefully evaluating current data, embracing best practices, and monitoring outcomes are essential steps in effective clinical decision-making impacting nursing practice positively.

References

• Centers for Disease Control and Prevention. (2019). Management of healthcare-associated infections. Atlanta, GA: CDC.
• O'Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Lipsett, P. A., ... & Bonomo, R. A. (2014). Summary of the CDC guideline for prevention of intravascular catheter-related infections. Infection Control & Hospital Epidemiology, 35(8), 753-772.
• Mimoz, O., et al. (2019). Effectiveness of chlorhexidine-alcohol vs. povidone-iodine for prevention of catheter-related bloodstream infections: A meta-analysis. Critical Care Medicine, 47(4), e382-e389.
• Taylor, M. J., McNicholas, C., Nicolay, C., & Darzi, A. (2014). Systematic review of the application of the Plan-Do-Study-Act method to improve quality in healthcare. BMJ Quality & Safety, 23(4), 290-298.
• Institute for Healthcare Improvement. (2020). Science of improvement: PDSA cycles. IHI.org.