Change Proposal Nursing Assignment

Details:
In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Change Proposal Nursing Assignment

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Background
Problem statement
Purpose of the change proposal
PICOT
Literature search strategy employed
Evaluation of the literature
Applicable change or nursing theory utilized
Proposed implementation plan with outcome measures
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Background

Nursing practice is intended to improve patient outcomes by identifying and meeting their needs in a controlled environment where new incidences of illness are preempted. Despite this being the ideal, it is not always the case with nursing practice presenting opportunities for new infections. The implication is that errors are not uncommon in nursing practice. This is especially noted when intrusive drug administration equipment are used where they increase the possibility of pathogens gaining entry into the body and causing an infection. This has been noted when central line is used to administer medication and they introduce pathogens that result in facility-acquired infection. Still, these infections can typically be preempted through the application of best industry practices that are based on the latest evidence (Aloush & Alsaraireh, 2018). As such, the present project postulates that relying on the latest evidence from peer-reviewed nursing research would reduce the incidence of central line infection by identifying best practices to ensure that the patient does not get any secondary infection even when a central line is used.Change Proposal Nursing Assignment

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Problem statement

Central line use in nursing practice has on occasion being linked with secondary infection resulting from pathogens using the central line as a vector to gain entry into the body. Still, applying best industry practices such as operating in a sterile environment and disinfecting medical equipment and hands before using the central line has been shown to reduce the infection incidence. Nevertheless, these interventions are only partially effective since their application only addresses some of the infection incidences. Still, there is a possibility that identifying the best industry practices and applying them would go a long way in improving outcomes (Page et al., 2016). Based on this awareness, the present project intends to identify the best central line management approaches and compare their application against standard nursing practice to determine if they would reduce the incidence of central line infection. The main objective is to identify the best nursing management strategy for central line administration that results in the most reduction in infection incidence. This is based on the awareness that central line infection add to the burden on patients and nursing personnel.

Purpose of the change proposal

The proposed change is to determine if matching nursing management of central line with the latest available evidenced results in the least incidence of central line infection. This will be determined by comparing the infection incidence reported by nursing personnel who use standard practice against nursing personnel who use the latest best available evidence. In this respect, the purpose of the change proposal is to improve central line management and reduce incidence of infection by identifying and applying best available evidence.

PICOT

The PICOT question is framed as: “Among patients using central line (P), does matching nursing practice for central line nursing management with evidence drawn from nursing research (I) versus central line management without considering evidence from research (C) have an effect on the incidence of bloodstream infections associated with central line use (O) measured over a two-month trial period (T)?” The question identifies the population of interest, the proposed intervention that is then compared against standard practice with the intended outcome that would then act as a measure of effectiveness. The project is intended to run for two months, during which time it is anticipated that statistically significant results shall have been collected to determine if the intervention is effective when compared to standard practice.

Literature search strategy employed

The literature used in the project will be collected from peer-reviewed publications. The specific search terms employed in the search include central line infection, nursing practice, secondary infection, and nursing procedures. These search terms were identified based on the topic to be addressed and project purpose whereby the research intended to determine if relying on the current best available evidence to inform nursing management of central lines would reduce the incidence of secondary infection. To enable the identification of relevant peer-reviewed publications, three databases were identified and used to include Google Scholar, MEDLINE Plus Full Text, and CINAHL Plus Full Text. These three databases were identified as the sources of the relevant publications because of three reasons Firstly, they are reliable sources of nursing research publications. Secondly, they contain peer-reviewed publications thus identifying them as an important source of information. An initial search determined that the three databases contained extensive publications on the research topic. As a result there was a need to refine the search terms since not all the publications could be used thus creating a need for a logical plan to identifying the specific number of publications that would add the most value to the research. Refining the search terms determined that the search would be restricted to materials published after 2013 since these sources would present the latest evidence.Change Proposal Nursing Assignment

Evaluation of the literature

Although nursing practices are intended to improve the health of the patient, there are occasions when this does not occur when the opposite being the case. This is noted in the case of central line infection where nursing practices are thought to cause the differential infection rates as noted. This means that there is a possibility of reducing central line infection rates by using the latest evidence to identify best practices that would then be applied by nursing to reduce infection rates. An initial review of available literature from the three previously identified databases based on the refined search terms revealed that certain nursing practices are relevant in reducing central line infection rates by reducing opportunities for the central line or nursing personnel to be used as pathogen vectors. Aloush and Alsaraireh (2018) noted that although best practices for nursing management have been identified and presented as guidelines, not all nurses apply them thereby introducing opportunities for infection. Page et al. (2016) mentioned that the best practices for reducing infection incidence are already known with the next step being to educate stakeholders on how to apply these strategies so that they are better prepared to apply them. Marschall et al. (2014) had similar sentiments by noting that there are strategies that can be applied to prevent central line infection. Esposito, Guillari, and Angelillo (2017) were more circumspect in noting that the most important step in reducing the incidence of central line infection was to ensure that nursing personnel had the right attitude to accept and apply change where necessary. Conley (2016) mentioned that there are best practice guidelines that nursing personnel can apply to ensure that central line administration does not result in secondary infection. Perin et al. (2016) made similar observations in noting that there are best strategies for preventing central line infection within medical facilities. Hina and McDowell (2017) similarly noted that there are procedural features that can be applied to minimize the risk of central line infection. Al Qadire, Tawalbeh and Suliman (2017) determined that nurses’ knowledge levels concerning prevention of central line infection limited their influence on the infection rates. Based on the information presented by these eight literature sources, it can be accepted that reducing incidence of central line infection can be achieved by identifying the best strategies then getting nursing personnel to apply these strategies while improving their awareness and knowledge levels.Change Proposal Nursing Assignment

Applicable change or nursing theory utilized

The evidence presented in the eight identified publications make two points clear. One, there are specific strategies that nursing personnel can apply to intentionally reduce the incidence of central line infection. Secondly, nurses’ knowledge levels differ thereby limiting the strategies they can apply in central line management. Based on the two points, it is clear that identifying the best central line management strategies from the latest evidence then getting nursing personnel to apply them could significantly reduce infection incidence when compared to standard practice.

Proposed implementation plan with outcome measures

The project that entails applying the latest best central line nursing management practices will be applied in four phases. Firstly, central line infection rates will be collected for the period when standard practice is applied. Secondly, the latest best central line nursing management practices will be identified based on research conducted on peer-reviewed publications. Thirdly, these latest best central line nursing management practices will be applied for two months with the infection incidence recorded. The final phase entails comparing the central line infection rates for the standard practice and best practice after which the strategy that results in the least amount of central line infection would then be identified and recommended for application in standard nursing practice.

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

There are two potential barriers that could have a negative impact on the project. The first barrier is the nursing personnel having the wrong attitude and being resistant to practice change since it could increase their workload. This barrier will be addressed by convincing the nursing personnel that the project is necessary to improve their practice outcomes thereby making them more efficient. The second barrier is resistance from facility administrators who may feel that the current practice approaches are adequate without a need to present new experimental strategies that may or may not work. This barrier will be addressed by collected the later best available evidence and presenting it to the facility administrators to show them that better strategies have been identified after extensive research that could improve nursing outcomes while reducing infection incidence. Change Proposal Nursing Assignment

References

Al Qadire, M., Tawalbeh, L. & Suliman, M. (2017). Student nurses’ knowledge of guidelines for preventing central venous catheter-associated infections. International Journal of Advanced Nursing Studies, 6(1), doi: 10.14419/ijans.v6i1.7295. Retrieved from https://www.sciencepubco.com/index.php/IJANS/article/download/7295/2635

Aloush, S. & Alsaraireh, F. (2018). Nurses’ compliance with central line associated blood stream infection prevention guidelines. Saudi Medical Journal, 39(3), 273-279. doi: 10.15537/smj.2018.3.21497. Retrieved from https://europepmc.org/articles/PMC5893917;jsessionid=2BDDD0B7C9C65AD5DE7B19F56C07CB73

Conley, S. (2016). Central line–associated bloodstream infection prevention: standardizing practice focused on evidence-based guidelines. Clinical Journal of Oncology Nursing, 20(1), 23-26. doi: 10.1188/16.CJON.23-26. Retrieved from https://cjon.ons.org/file/24791/download

Esposito, M., Guillari, A. & Angelillo, I. (2017) Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLoS ONE, 12(6), e0180473. doi: 10.1371/journal.pone.0180473. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180473

Hina, H. & McDowell, J. (2017). Minimising central line‐associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units. Journal of Clinical Nursing, 26(23-24), 3962-3973. doi: 10.1111/jocn.13824

Marschall, J., Mermel, L., Fakih, M., Hadaway, L., Kallen, A., O’Grady, N. … & Yokoe, D. (2014). Strategies to prevent central line–associated bloodstream infections in acute care hospitals: 2014 update. Infection Control and Hospital Epidemiology, 3(7), 753-771. doi: 10.1086/676533. Retrieved from https://www.jstor.org/stable/10.1086/676533

Page, J., Tremblay, M., Nicholas, C. & James, T. (2015). Reducing oncology unit central line–associated bloodstream infections: initial results of a simulation-based educational intervention. Journal of Oncology Practice, 12(1), e83-e87. doi: 10.1200/JOP.2015.005751. Retrieved from http://ascopubs.org/doi/full/10.1200/jop.2015.005751

Perin, D., Erdmann, A., Higashi, G. & Sasso, G. (2016). Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review. Revista Latino-Americana De Enfermagen, 24, e2787. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016007/

Change Proposal Nursing Assignment

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