Week 6 Assignment:  EBP Change Process

Type: BSN Capstone Project

Subject: EBP Nursing Change Process Assignment

Subject area: Nursing

Education Level: Undergraduate/College

Length: 6 pages

Referencing style: APA

Preferred English: US English

School: Chamberlain University

Spacing Option: Double

Week 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 Nurse Daniel information for your topic, nursing intervention, or change project.  Nurse Daniel serves as an example only to illustrate the change process.

Name: _____________________

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 choice is the rise in the number of surgical infections cases. It is the mandate of any healthcare facility to ensure that an infection does not occur during a surgical procedure. Many healthcare facilities at all times have measures to avoid infections during the surgical procedure. Several problems are associated with surgical infections or diseases. Among them are new infections and, in some cases, treatment failure. Due to the issues, healthcare professionals are tasked with coming with ways to encounter surgical infections. 

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

The crucial role of healthcare professionals is to ensure the safety of their patients at all times. The healthcare facilities have to ensure that the patients' services are offered professionally. To achieve this, they have to ensure that the patient's outcomes are performed efficiently and effectively. Surgical infections go against the main objective of healthcare provision by making the treatment process complicated. The conditions are vital and, in some cases, can lead to death. The surgical infections need to be solved to avoid the consequences associated with the issues. To achieve this, it is essential to identify the cause and source of the problem to devise an appropriate way to handle it. Identifying the source of the problem is pretty simple to initiate a change process to avoid such cases from happening.

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

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

A doctor or a health professional must be very keen and careful to deliver the best patient outcome during surgery. However, some do not follow the required pre-operative procedures, such as the use of Chlorhexidine. Some healthcare officers fail to use Chlorhexidine, which is one of the guidelines to be followed during surgery. Some of the causes of surgical infections are; standard error, negligence, carelessness, and unprofessionalism. Even though surgical infections are a severe issue in healthcare provision, a few mechanisms have been put in place to handle the problem.

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

De Luca, A., Green, W., Canobbio, M., & Hopley, C. (2017). Strategies To Effectively Prevent Surgical Site Infections In Italian Hospitals: Economic Benefits. Value in Health, 20(9), A782. doi:10.1016/j.jval.2017.08.2273

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.

Blake, D. P. (2019). Key Ways to Prevent Infection When There Is No “Building”: Aspects for the Field. Surgical Infections, 20(2), 115-118. doi:10.1089/sur.2018.290 

Spear, M. (2019). Evidence-Based Prevention Strategies for Surgical Site Infections. Plastic Surgical Nursing, 29(3), 175-178. doi:10.1097/psn.0b013e3181b3e94f

Weiser, T. G., Forrester, J. D., & Forrester, J. A. (2019). Tactics to Prevent Intra-Abdominal Infections in General Surgery. Surgical Infections, 20(2), 139-145. doi:10.1089/sur.2018.282

Theories of behavior change indicate that an analysis of barriers to change is helpful when trying to influence professional practice. This study aimed to assess the perceived barriers to practice change by eliciting nurses' opinions about barriers and device a mechanism to facilitate the change process.

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

From the reviews, it is pretty evident that any health professional and healthcare facility needs to put first above anything else the safety of their patients. The services offered to the patients need to be of high quality, and as such, the healthcare centers can significantly reduce such problems as surgical infection. Therefore, there is a need for necessary and relevant prevention measures to maximize the patient's safety and minimize errors during surgical procedures.

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

Application of Chlorhexidine – Reduction of surgical infection during surgery can immensely reduce if the healthcare professional uses the Chlorhexidine. This reduces and, in some ways, also prevents surgical infections if administered during the pre-operative procedures.

Avoid removing hair during surgery – Removal of hair within the surgical sites by a certain percentage raises the chances of exposing irritations and even cuts to infections. One way to avoid it would be to use hair clippers.

Evidence-based solution

Hand hygiene protocol for medical personnel caring for admitted patients. 

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 the other sources listed in your Summary section in Star Point 2).

Hand-washing before and after dealing with the patient.

Hand-washing using the most effective sanitizing agent

The CDC SSI prevention guideline category IA provides the necessary guidelines for healthcare providers to prevent and reduce surgical infections.

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

Management – responsible for coming up with policies designed to ensure that the patient's safety is guaranteed. Provide the needed environment for professionalism and care by healthcare professionals. 2. 

Physicians and Nurses – this includes surgeons who are directly involved in the surgical procedures and are assisted by the nurses in the surgical site. Both are required to follow the set guidelines and procedures to ensure patient safety.

The patients are being operated on; hence, they need to cooperate with the surgical teams to guarantee their safety fully. This information includes but is not limited to existing infections and allergies.

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

As a nurse, one is directly involved in providing all the needed support and assistance to the physician during a surgical procedure. This means that a nurse should be fully aware of all safety procedures that we must follow. Any discrepancy should be identified and reported.

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

Physician (4) – responsible for ensuring that the utmost levels of professionalism and care are observed during a surgical procedure 

Supervisors (6) – responsible for ensuring that surgical safety guidelines are set as adhered to and followed. This also means providing the staff with the required equipment to perform their duties effectively.

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

Training will be the primary cost. Seven nurses and nine physicians will undergo training during the trial period. The training will involve the creation of awareness on the subject of surgical infections.
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?

The head physician and nurse manager will write a joint letter addressed to the hospital's management. The letter will be seeking approval and permission to undertake the trial. It will outline the problem, causes, change need, impact, and proposed measures of intervention.

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

The training plan will seek to explore the following;

1. The problem of increasing surgical infections cases 

2. The need to make changes 

3. Recommended or proposed measures of interventions or prevention strategies 

In essence, the process of training will be both practical and participatory.

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

15/10/2021 – 30/10/2021	Need change training
01/11/2021 – 31/11/2021	Develop communication materials
01/12/2021 – 15/12/2021	Develop an understanding of strategies to prevent and reduce surgical infections
16/12/2021 – 01/01/2022	Evaluate all training skills and concepts

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

Reduce surgical infections cases by at least 50 percent 

Ensure prevention of surgical infections through enhanced capacity building of nurses and physicians 

We will measure these outcomes through clinical reports

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

The use of Electronic Records Management (ERM) proof. This will provide an easier and faster approach to recording and managing all recorded information.

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

Flashcards 

Checklists 

Posters

Electronic Records Management

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

The meeting will be held twice per month. The forum's primary purpose will be to assess the success of the change process that we have initiated on the surgical infection problem.

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

To report the outcome of the trial, we will use;

Histograms

Pie charts

Frequency tables

Line and bar graphs

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

If the information in the change process indicates a reduction in the cases of surgical infections; then, the change process will be ready for implementation and vice versa.