Download the?EBP Change Process form?(Links to an external site.)?during Week 1.?The use of this specific form is REQUIRED? Identify a clinical topic and r

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cWeek 6 Assignment: EBP Change Process form

ACE Star Model of Knowledge Transformation

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.

Name:

June 2020

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 selected topic for this change process is the prevention of surgical site infection.

Based on the above topic for this change process, the underlying nursing practice issue is preoperative bathing. This entails the use of antiseptics in bathing.

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

Infections after surgery are usually common among many patients. Such infections are caused by a wide range of bacteria including, but not limited to Streptococcus, Staphylococcus, and Pseudomonas. According to Webster and Osborne (2015), infections at surgical sites are linked to poor health outcomes particularly due to the increased length of hospital stay. Additionally, these infections usually increase health costs, which may significantly put the unnecessary financial burden on the patients and their families. From this point of view, findings ways of reducing these infections can play a fundamental role when it comes to enhancing positive outcomes among patients who have undergone surgery.

Star Point 2: Summary (Evidence to support need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

According to Berríos-Torres et al. (2017), surgical site infections are wound infections that normally occur after surgical procedures. Due to their moist nature as well as exposure, surgical sites are usually prone to a plethora of infections. Nonetheless, a myriad of past studies has established that preoperative bathing can play a huge role in reducing skin bacteria. On this understanding, the developed PICOT question for this change process is:

For patients who have undergone surgical surgery (P), does the preoperative bathing (I) in comparison with no bathing (C) helps in reducing surgical site infection (O) within a period of 6 weeks (T)?

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. The Cochrane database of systematic reviews, (2), CD004985. https://doi.org/10.1002/14651858.CD004985.pub5

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., Itani, K. M., Dellinger, E. P., Ko, C. Y., & Duane, T. M. (2017). American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. Journal of the American College of Surgeons, 224(1), 59–74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029

Edmiston, C. E., Jr, & Leaper, D. (2017). Should preoperative showering or cleansing with chlorhexidine gluconate (CHG) be part of the surgical care bundle to prevent surgical site infection? Journal of infection prevention, 18(6), 311–314. https://doi.org/10.1177/1757177417714873

This source provided guidelines for surgical site infection. Therefore, by leveraging on the article, it is possible to have a deeper understanding of the role of preoperative bathing in the prevention of surgical site infections.

The second source talk about using 2% or 4% aqueous chlorhexidine gluconate (CHG), to reduce skin contamination prior to surgery. The objective of the pre-admission shower regimen is to achieve a high and sustainable level of skin antisepsis on the surface of the skin to further reduce the risk of intraoperative wound contamination.

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

The study by Webster, and Osborne (2015) revealed that in three trials comprising of 1192 patients compared bathing with no bathing with antiseptics (Chlorhexidine), there was a statistically substantial difference in favor of bathing with antiseptics in relation to the reduction of surgical site infections. Nonetheless, the smaller studies did not find any difference between patients who washed with antiseptic and those who did not wash. Based on the general findings, the authors of this study concluded that antiseptics could help in reducing surgical site infections

Outline one or two evidence-based solutions you will consider for the trial project.

An evidence-based solution for this study would involve the use of preoperative bathing in reducing incidences of surgical site infection among patients who have undergone surgery

Star Point 3: Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).

Clinical guidelines by Kristen A Ban et al. (2017) on the prevention of surgical site infection articulate that before surgery, there is a substantial need for patients to shower or bathe with an antiseptic agent. Ideally, this should be the night before the operating day. This, in turn, can ensure that there no bacteria on the skin, which would otherwise lead to surgical site infection.

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).

RN Nurse- Two Registered nurses will take the role of ensuring that patients have preoperative birth a night before the operating day

Dr Physician- One physician will conduct a physical assessment on the patient before the operation to determine whether they have bathed with antiseptics

Pharm D- One pharmacist will provide the best available medications for the involved patients

What specifically is your nursing role in the change process? Other nursing roles?

The role of the nurses in this change process will be to ensuring that before the operation day, the patients will have a preoperative birth with antiseptics. The nurses will also follow up on the patients after surgery in order to evaluate their status in relation to surgical site infection.

List your stakeholders by position titles (charge nurse, pharmacist, etc.).-Why are the members chosen (stakeholders) important to your project?

• A qualified physician

• Registered nurses

• A Pharmacist

All these stakeholders will work together in the project in order to ensure that it is implemented successfully

What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?

Prior to the trial, there is a need to consider logistics costs for the nurses as they monitor the patients before and after the surgery. There is also a need to consider allowances for stakeholders who will take part in the project. The organization chief financial officer needs to be involved in this.

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?

To gain permission to plan and begin the trial, the stakeholders will hold a meeting with the organization management. The management needs to be informed about the benefits associated with the project when it comes to promoting positive patient outcomes among patients who have undergone surgery.

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

In any change process, educating the staff is considered imperative given to the fact that it helps in providing a description of what the project entails. In turn, they are able to provide the required support in the project, which consequently results in effective implementation. As such, in this project, the staff will be educated through various ways including group discussions, lectures, and workshops.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).

Activity	Time Frame
Conducting background search	20th -30th June 2020
Permission from management	1st -7h July 2020
stakeholders Meetings	8th -15th July 2020
Project implementation Stakeholders continues to hold meetings throughout the process.	16th July -16th August 2020

List the measurable outcomes based on the PICOT. How will these be measured?

Based on the PICOT question, the measurable outcome for the change project will be incidence rates of surgical site infections compared by previous rates before the implementation of the project.

What forms, if any, might be used for recording purposes during the pilot change process. Describe.

Prevalence rates of surgical site infection form will be used in recording the pilot change process. The recordings provide the information needed for the actual implementation of the project.

What resources are available to staff (include yourself) during the change pilot?

During the change process, resources available for the staff include incentives, as well as data relating to previous rates of surgical site infections

Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they meet?

Stakeholders meeting will be fundamental in ensuring that concerns about the project are being handled. It is through the meetings the stakeholders will be in a position of determining the best strategies for effective implementation of the project. The stakeholders will be meeting twice a week in this regard.

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

After the project is completed and incidence rates have been recorded and compared with previous rates, a report will be compiled and a report will be presented to the organizational management.

What would be the next steps for the use of the change process information?

The next step of the change process will highly be determined by the outcome. Specifically, if the project confirms that preoperative bathing with antiseptics can help in the reduction of surgical site infections, there will be a need to implement the project long term in the organization. Additionally, positive results will mean recommendation of implementation of these strategies to other healthcare faculties in the country.

9.2019 Update. DLP

,

1

cWeek 6 Assignment: EBP Change Process form

ACE Star Model of Knowledge Transformation

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.

Name:

June 2020

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 selected topic for this change process is the prevention of surgical site infection.

Based on the above topic for this change process, the underlying nursing practice issue is preoperative bathing. This entails the use of antiseptics in bathing.

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

Infections after surgery are usually common among many patients. Such infections are caused by a wide range of bacteria including, but not limited to Streptococcus, Staphylococcus, and Pseudomonas. According to Webster and Osborne (2015), infections at surgical sites are linked to poor health outcomes particularly due to the increased length of hospital stay. Additionally, these infections usually increase health costs, which may significantly put the unnecessary financial burden on the patients and their families. From this point of view, findings ways of reducing these infections can play a fundamental role when it comes to enhancing positive outcomes among patients who have undergone surgery.

Star Point 2: Summary (Evidence to support need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

According to Berríos-Torres et al. (2017), surgical site infections are wound infections that normally occur after surgical procedures. Due to their moist nature as well as exposure, surgical sites are usually prone to a plethora of infections. Nonetheless, a myriad of past studies has established that preoperative bathing can play a huge role in reducing skin bacteria. On this understanding, the developed PICOT question for this change process is:

For patients who have undergone surgical surgery (P), does the preoperative bathing (I) in comparison with no bathing (C) helps in reducing surgical site infection (O) within a period of 6 weeks (T)?

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. The Cochrane database of systematic reviews, (2), CD004985. https://doi.org/10.1002/14651858.CD004985.pub5

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., Itani, K. M., Dellinger, E. P., Ko, C. Y., & Duane, T. M. (2017). American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. Journal of the American College of Surgeons, 224(1), 59–74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029

Edmiston, C. E., Jr, & Leaper, D. (2017). Should preoperative showering or cleansing with chlorhexidine gluconate (CHG) be part of the surgical care bundle to prevent surgical site infection? Journal of infection prevention, 18(6), 311–314. https://doi.org/10.1177/1757177417714873

This source provided guidelines for surgical site infection. Therefore, by leveraging on the article, it is possible to have a deeper understanding of the role of preoperative bathing in the prevention of surgical site infections.

The second source talk about using 2% or 4% aqueous chlorhexidine gluconate (CHG), to reduce skin contamination prior to surgery. The objective of the pre-admission shower regimen is to achieve a high and sustainable level of skin antisepsis on the surface of the skin to further reduce the risk of intraoperative wound contamination.

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

The study by Webster, and Osborne (2015) revealed that in three trials comprising of 1192 patients compared bathing with no bathing with antiseptics (Chlorhexidine), there was a statistically substantial difference in favor of bathing with antiseptics in relation to the reduction of surgical site infections. Nonetheless, the smaller studies did not find any difference between patients who washed with antiseptic and those who did not wash. Based on the general findings, the authors of this study concluded that antiseptics could help in reducing surgical site infections

Outline one or two evidence-based solutions you will consider for the trial project.

An evidence-based solution for this study would involve the use of preoperative bathing in reducing incidences of surgical site infection among patients who have undergone surgery

Star Point 3: Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).

Clinical guidelines by Kristen A Ban et al. (2017) on the prevention of surgical site infection articulate that before surgery, there is a substantial need for patients to shower or bathe with an antiseptic agent. Ideally, this should be the night before the operating day. This, in turn, can ensure that there no bacteria on the skin, which would otherwise lead to surgical site infection.

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).

RN Nurse- Two Registered nurses will take the role of ensuring that patients have preoperative birth a night before the operating day

Dr Physician- One physician will conduct a physical assessment on the patient before the operation to determine whether they have bathed with antiseptics

Pharm D- One pharmacist will provide the best available medications for the involved patients

What specifically is your nursing role in the change process? Other nursing roles?

The role of the nurses in this change process will be to ensuring that before the operation day, the patients will have a preoperative birth with antiseptics. The nurses will also follow up on the patients after surgery in order to evaluate their status in relation to surgical site infection.

List your stakeholders by position titles (charge nurse, pharmacist, etc.).-Why are the members chosen (stakeholders) important to your project?

• A qualified physician

• Registered nurses

• A Pharmacist

All these stakeholders will work together in the project in order to ensure that it is implemented successfully

What type of cost analysis will be needed prior to a trial? Who needs to be involved with this?

Prior to the trial, there is a need to consider logistics costs for the nurses as they monitor the patients before and after the surgery. There is also a need to consider allowances for stakeholders who will take part in the project. The organization chief financial officer needs to be involved in this.

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?

To gain permission to plan and begin the trial, the stakeholders will hold a meeting with the organization management. The management needs to be informed about the benefits associated with the project when it comes to promoting positive patient outcomes among patients who have undergone surgery.

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

In any change process, educating the staff is considered imperative given to the fact that it helps in providing a description of what the project entails. In turn, they are able to provide the required support in the project, which consequently results in effective implementation. As such, in this project, the staff will be educated through various ways including group discussions, lectures, and workshops.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).

Activity	Time Frame
Conducting background search	20th -30th June 2020
Permission from management	1st -7h July 2020
stakeholders Meetings	8th -15th July 2020
Project implementation Stakeholders continues to hold meetings throughout the process.	16th July -16th August 2020

List the measurable outcomes based on the PICOT. How will these be measured?

Based on the PICOT question, the measurable outcome for the change project will be incidence rates of surgical site infections compared by previous rates before the implementation of the project.

What forms, if any, might be used for recording purposes during the pilot change process. Describe.

Prevalence rates of surgical site infection form will be used in recording the pilot change process. The recordings provide the information needed for the actual implementation of the project.

What resources are available to staff (include yourself) during the change pilot?

During the change process, resources available for the staff include incentives, as well as data relating to previous rates of surgical site infections

Will there be meetings of certain stakeholders throughout the trial? If so, who and when will they meet?

Stakeholders meeting will be fundamental in ensuring that concerns about the project are being handled. It is through the meetings the stakeholders will be in a position of determining the best strategies for effective implementation of the project. The stakeholders will be meeting twice a week in this regard.

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

After the project is completed and incidence rates have been recorded and compared with previous rates, a report will be compiled and a report will be presented to the organizational management.

What would be the next steps for the use of the change process information?

The next step of the change process will highly be determined by the outcome. Specifically, if the project confirms that preoperative bathing with antiseptics can help in the reduction of surgical site infections, there will be a need to implement the project long term in the organization. Additionally, positive results will mean recommendation of implementation of these strategies to other healthcare faculties in the country.

9.2019 Update. DLP

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