Week 6 Assignment: EBP Change Process Form ACE Star Model ✓ Solved

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1 Week 6 Assignment: EBP Change Process form ACE Star Model

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.

Star Point 1: Discovery (Identify topic and practice issue) Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.) The topic of my nursing practice issue is reducing surgical infection rate by prohibiting artificial nails among clinical staff members. Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

Star Point 2: Summary (Evidence to support need for a change) Describe the practice problem in your own words and formulate your PICOT question. List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected. Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence. Outline one or two evidence-based solutions you will consider for the trial project.

Star Point 3: Translation (Action Plan) Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning. List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process. What specifically is your nursing role in the change process? Other nursing roles? List your stakeholders by position titles. Why are the members chosen (stakeholders) important to your project? What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?

Star Point 4: (Implementation) Describe the process for gaining permission to plan and begin a trial. Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate. Outline the implementation timeline for the change process. List the measurable outcomes based on the PICOT. How will these be measured? What forms, if any, might be used for recording purposes during the pilot change process. What resources are available to staff during the change pilot? Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they meet?

Star Point 5: (Evaluation) How will you report the outcomes of the trial? What would be the next steps for the use of the change process information?

Paper For Above Instructions

The nursing practice issue I have identified focuses on the need to reduce surgical infection rates by prohibiting artificial nails among clinical staff members. According to the Center for Disease Control and Prevention (CDC), healthcare-associated infections (HAIs) affect approximately one in 31 hospital patients daily (CDC, 2018). Surgical infections present a significant challenge, given that they can lead to extended hospital stays, increased healthcare costs, and even mortality. Thus, examining the role of staff hygiene practices, specifically regarding the use of artificial nails, addresses a critical component of infection control in healthcare settings.

My rationale for selecting this topic is rooted in data regarding HAIs and their impact on patient outcomes and hospital organizations. The practice problem stems from evidence indicating that artificial nails may harbor pathogens that contribute to surgical site infections (Kirkland et al., 2012). With artificial nails being breeding grounds for bacteria, there is a pertinent need to investigate the impact of banning these enhancements among surgical staff. The proposed PICOT question is: "Among surgical staff members, would banning artificial nail enhancements lead to a decrease in surgical site infections in postoperative adult patients over a three-month period?" This question serves as the foundation for investigating the efficacy of such a policy on patient outcomes.

The systematic review selected for this project is Winslow and Jacobson's (2001) analysis titled "The case against artificial nails," which discusses the potential risks associated with artificial nails among healthcare providers. This systematic review synthesizes evidence that links artificial nails to infections and emphasizes the need for stringent protocol adherence. Its findings reaffirm the critical contact between artificial enhancements and pathogen transmission in surgical environments. Additionally, a supporting source is the CDC guideline stating healthcare providers should avoid wearing artificial nails to minimize infection risks (CDC, 2020).

My proposed evidence-based solution includes the enforcement of CDC recommendations for short, clean fingernails without enhancements for all surgical team members. This protocol aims to reduce the surface area available for pathogen accumulation, thereby minimizing the risk of infection transmission. Implementing this policy requires an action plan that aligns with current care standards and regulations within our healthcare organization.

In planning the intervention, institutions typically have regulations that dictate safe practice standards, which would support this change. Stakeholders in the change process include staff nurses, operating room technicians, nurse managers, and the Director of Nursing, each responsible for ensuring compliance with infection control practices, facilitating communication, and providing education to staff members regarding policy changes. Their roles in supporting evidence-based practices are essential in reinforcing successful interventions.

As the assistant nurse manager, my role will involve facilitating discussions, compliance audits, and addressing staff concerns about the new policy during in-service meetings. It is also pivotal to document compliance rates and infection rates during the trial as a form of evidence supporting the policy. I intend to engage stakeholders by providing them with resources and data to understand the necessity of the changes being implemented. The cost analysis will involve examining the financial impact of HAIs versus the cost of implementing the policy and potentially hiring additional staff for compliance oversight. The Compliance Manager will play a crucial role in evaluating costs and reporting on the financial implications of HAIs.

Implementing this change requires a trial initiation process that includes obtaining necessary approvals from senior management and discussing the policy with all relevant parties. Educational initiatives will need to highlight how the new regulations are aimed at protecting not only patients but also healthcare practitioners by establishing a clear understanding of the method behind the policy adjustments.

Throughout the implementation process, tangible timelines must be established for compliance checks, educational sessions, and monitoring infection rates. Baseline data concerning surgical infection rates prior to ban implementation will provide a comparison to evaluate efficacy post-policy. Outcomes will be measured through patient surveys reflecting occurrences of postoperative infections, supplemented by review of reports on compliance with the no artificial nail policy. A systematic approach to documentation will ensure that all interactions and educational efforts are recorded accurately, providing necessary insights for compliance evaluations.

During the evaluation phase, outcomes will be reviewed with upper management to assess the success of the initiative, followed by distributing findings in a manner that encourages staff adherence to policies. The information gleaned from this process will not only inform ongoing hand hygiene protocols but will aid in developing comprehensive onboarding procedures for newly hired staff, addressing the dress code policies relative to nail enhancements.

References

  • Brekke, M., Edwardson, N., & Soderberg, M. (2008). Hospital admissions among older people due to medication errors. Journal of Gerontology, 63(2), 152-157.
  • Centers for Disease Control and Prevention. (2018). Healthcare-associated Infections (HAIs). Retrieved from https://www.cdc.gov/hai
  • Centers for Disease Control and Prevention. (2020). Critical Care Guidelines: Artificial nails removal in healthcare settings. Retrieved from https://www.cdc.gov/criticalcare
  • Kirkland, L., Klevens, R., Loo, S., & Mermel, L. (2012). The Impact of Healthcare-Associated Infections on Hospital Costs and Patient Outcomes. American Journal of Infection Control, 40(10), 1032-1035.
  • Marchetti, A., & Rossiter, R. (2013). Economic burden of healthcare-associated infection in US acute care hospitals: societal perspective. Journal of Medical Economics, 16(12), 1430-1438. doi:10.3111/13696998.2013.842922.
  • Winslow, E., & Jacobson, A. (2001). The case against artificial nails. In Combating Infection. Retrieved from https://www.journalofinfections.com

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