Mimi

1

• Preventing Urinary Tract Infections in Patients
  With Catheters During Their Hospital Stay
• Hortense Kingue
• Master of Science in Nursing - Walden University
• NURS 6052N-35 Essential of Evidence-Based
  Practice
• Dr. Wilson Amy
• May 10, 2021

2
My Healthcare Organization, its Culture and
Readiness for Change

• Hospitals are health care settings that consist
  of skilled nurses who thrive to provide safe and
  efficient care to patients. Nurses use the
  materials and equipment provided by the employers
  to deliver care. Nursing embraces the promotion
  of health, prevention of illness, and the care of
  ill, disabled, and dying people, so do nurses
  pledge to "do no harm" principle in caring for
  the patient. I work in a hospital site, and it
  grows well with an intercultural and
  interdisciplinary team approach. My organization
  has an open-minded attitude and welcomes
  experimental changes that will improve patients'
  outcomes. My assignment will address the risks
  associated with indwelling catheters and address
  the evidence-based practices (EBP) to improve
  patients' outcomes.

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The Current Problem or Opportunity for Change.
The Circumstances Surrounding the Need for
Change, the Scope of the Issue, the Stakeholders
Involved, and the Risks Associated With Change
Implementation in General.

• A study reveals that in the United States of
  America, catheter-associated urinary tract
  infections (CAUTIs) are the fourth leading cause
  of healthcare-associated infections in acute care
  and hospitals site (Ferguson, 2018). CAUTIs are a
  threat to my workplace and must be tackled. A
  recurrence of CAUTIs and a quality improvement
  team must intervene in implementing a new kit
  that will reduce the incidence of CAUTIs, reduce
  the cost and improve the patients outcomes.
  Implementing this new kit calls for a new
  practice in the insertion of the catheter. Hence,
  patient safety is the responsibility of all
  staff, and nurses need to be at the paramount,
  trained, and coached and their acceptance is
  critical for the progression and the success of
  the project (Sharma, 2017).

4
An Evidence-Based Idea for a Change in Practice
Using an EBP Approach to Decision Making.

• On the nephrology, floor nurses care for
  patients with bladder defects, and nurses insert
  few catheters. Nurses have to follow the most
  updated practice and revised tools to ensure
  patient safety. The hospital has a new vendor who
  brought a new catheter kit, but in-services were
  done only with the first shit staff. The second
  and third shifts were not trained yet thus, the
  effect of the new practice is not yet noticeable.
  Staffs education, training, and coaching
  constitute a delay to the effectiveness of this
  implementation of evidence-based practice (EBP).
  EBP is a means that fosters nursing by promoting
  patient outcomes, enhancing the science of
  nursing, and keeping leadership current and
  suitable (Melnyk Fineout-Overholt, 2018). An
  EBP research revealed that using the new kit
  called a Bard Tray was a safe and efficient
  method to insert the urinary catheter (UC). The
  technique promoted quality improvement, increase
  patients outcomes, and reduce CAUTIs. Thus, this
  study proved the practices oriented to guide the
  infection prevention and control (IPC) and the
  quality improvement (QI) teams to decrease the
  risks of infection caused by urinary catheters
  (Palmer Dixon, 2019).

5
Plan for Knowledge Transfer of this Change,
Knowledge Creation, Dissemination, and
Organizational Adoption and Implementation.

• Implementing change requires explaining to the
  audience why and how this EBP change system will
  merge clinical experience, clinical evidence, and
  the best patient standard of care. To get the
  audience to participate and accept the changes
  actively, it has to understand its risks or
  effectiveness in their practices and its effects
  on the patients outcomes. Therefore, the
  audience will not misunderstand that EBP is too
  challenging, overwhelming, time-consuming, and
  present an obstacle to its implementation (Wonder
  et al., 2017). A permanent link between the
  contents of the project and the audience carries
  over the realization of the system change. For
  example, Palmer Dixon revealed that to
  implement the Bard Tray practice, the IPC and QI
  teams were on board to motivate the stakeholders.
  The audiences acceptance will control the
  success of the project. I will use a powerpoint
  presentation to disseminate my project (Grech,
  2018).

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How I Would Disseminate the Results of my Project
to an Audience. A Rationale for why I Selected
the Dissemination Strategy Powerpoint
Presentation

• I want the results of my project to be known by
  a targeted audience, and I will utilize a method
  accordingly. I will use a powerpoint (PP)
  presentation because it will help me get the
  reaction and the response of my audience. I will
  use essential simplified words in the slide to
  keep the audience on alert and engaging. I will
  include diagrams and infographics to reinforce my
  message and adjust the style and the materials
  accordingly (Grech, 2018).

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The Measurable Outcomes I Hope to Achieve With
the Implementation of this Evidence-Based Change.

• Through this EBP, I want the audience to
  acknowledge that the current practice is outdated
  and that the best practice is reached using the
  Bard Tray. Eagerly I hope to educate the
  stakeholders and that they all opt for the best
  method and assent with my project in implementing
  this experimental safe practice using the Bard
  Tray to insert the UC. I hope for an
  interdisciplinary effort to reduce CAUTIs, lower
  the cost and improve the patients outcomes
  (Sharma, 2017).

8
Lessons Learned Section From A summary of the
Critical Appraisal of the Peer-Reviewed Articles
I Previously SubmittedExplanation About What I
Learned From Completing the Evaluation Table
Within the Critical Appraisal Tool Worksheet
Template

• The summary of the critical appraisal of the
  peer-reviewed articles enhances my critical
  thinking in selecting my articles for further
  coursework, assessing the validity of the
  research, and identifying their potential bias
  articles. This exercise expanded my scrutiny
  approach when picking the correct pieces to
  sustain my stand relevant to my topic of
  interest. By completing the evaluation table
  within the critical appraisal tool worksheet, I
  developed a comparative analytical approach which
  helps me to discern relevant articles and judge
  their credibility to measure their transparency.
  This worksheet is a tool to retrieve the
  quantified evaluation results from many articles
  or journals to produce an overall quality piece
  for my assignment. It allows me to determine the
  level of evidence of an article, to distinguish
  whether its result was an evidence or an opinion
  (Long et al., 2020).

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• In conclusion, this course built my aptitude and
  my skills to be more oriented and selective in
  choosing my articles for the references. Equipped
  with an evidence-based practice approach, Im
  prepared to accept and adjust to constructive
  changes to improve my proficiencies and stay
  current in my practice to provide my patients
  with holistic and safe care. The critical
  appraisal worksheet showed me a comparative
  method of evaluating an article to judge its
  reliability!

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References

• Ferguson, A. (2018). Implementing a CAUTI
  prevention program in an acute care hospital
  setting. Urologic Nursing, 38(6), 273302.
  https//doi-org.ezp.waldenulibrary.org/10.7257/105
  3-816X.2018.38.6.273
• Grech, V. (2018). The application of the Mayer
  multimedia learning theory to medical powerpoint
  slide show presentations. Journal of Visual
  Communication in Medicine, 41(1), 3641.
  https//doi-org.ezp.waldenulibrary.org/10.1080/174
  53054.2017.1408400
• Melnyk, B. M., Fineout-Overholt, E. (2018).
  Evidence-Based Practice in Nursing Healthcare
  A Guide to Best Practice (4th ed.). Philadelphia,
  PA Wolters Kluwer.
• Palmer, S., Dixon, R. (2019). Reducing
  catheter-associated urinary tract infections
  through best practice Sherwood Forest Hospitals
  experience. British Journal of Nursing, 28(1),
  1115. https//doi-org.ezp.waldenulibrary.org/10.1
  2968/bjon.2019.28.1.11
• McGonigle, D., Mastrian, K. G. (2018). Nursing
  Informatics and the Foundation of Knowledge.
  Jones Bartlett Learning.
• Sharma, M. K. (2017). A study of SDLC to develop
  well engineered software. International Journal
  of Advanced Research in Computer Science, 8(3),
  520523.
• Wonder, A. H., Martin, E. K., Jackson, K.
  (2017). Supporting and empowering direct-care
  nurses to promote EBP An example of
  evidence-based policy development, education, and
  practice change. Worldviews on Evidence-Based
  Nursing, 14(4), 336338. https//doi-org.ezp.walde
  nulibrary.org/10.1111/wvn.12239
• Yatim, J., Wong, K., Ling, M., Tan, S., Tan, K.,
  Hockenberry, M. (2016). A nurse-driven process
  for timely removal of urinary catheters.
  International Journal of Urological Nursing,
  10(3), 167172. https//doi-org.ezp.waldenulibrary
  .org/10.1111/ijun.12113