NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

 Name

Capella University 

NURS_FPX6011

Instructor’s Name 

October 2024

Implementing Evidence-Based Practice

The process of realizing evidence-based practice (EBP) enables delivering modern clinical evidence to enhance patient care results. Hospital-acquired infections (HAIs) have always been of concern with ICU patients forming the most vulnerable group of patients in a health facility (Kerr et al., 2021). This assessment is based on the ICU of a teaching hospital. The project shall involve comparing adherence efficiency to strict hand hygiene measures, as informed by the literature. By adopting best practices and technologies, the plan targets to translate the changes in clinical areas sustainably. The future success of these practices to permanently improve healthcare and patient safety will relate to engaging healthcare professionals and members of the community.

Develop a PICOT question for a chosen clinical problem

PICOT Question: In adults in the ICU (P), how does having a Nurse Implemented Hand Hygiene Protocol (I) compared with usual practice (C) reduce Hospital Acquired Infections (O) within 6 months (T)?

Background Information

For that reason, this paper aims to discuss hospital-acquired infections (HAIs) in the context of Intensive Care Units (ICUs). This can be through lines used for giving patients intravenous fluids, parenteral nutrition, or medications, high-touch surfaces, and the patients themselves when using broad-spectrum antibiotics which expose patients to hospital-acquired infections such as bloodstream infection and ventilator-associated pneumonia (Clarke et al., 2021). The research evidence has established empirical support that increasing adherence to hand hygiene standards will significantly decrease the rates of HAIs. As a result, the application of scientifically proven approaches to the most important aspects of hand hygiene in ICUs is crucial for improving patient outcomes and decreasing the expenses of the healthcare system.

Action Plan For Implementing The Evidence-Based Practice

On the organization level, the following concepts are key components of the action plan to consider while implementing the evidence-based practice project to mitigate HAIs in the ICU: First, the recommendation for practice change underpinning the Procedure for Hand Hygiene, based on WHO standards, to be fully adopted by the practice (Kumah et al., 2022). Some of the strategies in this protocol are the use of hand washing with approved alcohol-based hand sanitizer, staff training, and hand hygiene audits. 

The timeline for this implementation starts with the first month involved in preparation and sensitization of the workforce on the right way of washing their hands. In the second and third months, a pilot of the protocol will be tested in one of the ICU units evaluating compliance and infection rates (Torres et al., 2023). In the fourth and fifth months, the protocol will be up and running in all the ICU units, with ongoing training and staff evaluation. Last, in the sixth month, conclusions will be made, and the effectiveness of the implementation will be analyzed to recommend the changes that should be made.

One of the requirements for the project is tools and resources including handout materials,, pictures, and instructional videos to help teach the workers proper hand-washing techniques (Catarelli et al., 2023). Alcohol-based hand sanitizers, gloves, and hand-washing soap dispensers will be placed in strategic areas within the ICU. In addition, the established and implemented precautions and measures include the use of audit sheets/electronic tracking systems. A feedback channel will also be put in place so that staff can record any difficulties they experience while implementing the plan. This way, the further manner of implementation is well-considered reasonable, and realistic and can be adjusted according to the feedback or the outcomes.

Identifies the Stakeholders, Opportunities for Innovation, and Potential Barriers 

In enhancing the unique evidence-based practice project of reducing hospital-acquired infections, stakeholders should be defined. Some of these stakeholders are the ICU healthcare providers including nurses, physicians, and other employees performing direct patient care and hygiene duties (Sessions et al., 2024). They are also important stakeholders because they supply logistical, supervisory, and political backing for the new protocol. Both infection control specialists and quality improvement teams will be responsible for overseeing measurements and evaluating the effects this practice change has on infection rates.

There are following opportunities for innovation in this project. usually electronic tracking or alert through a touch link to a mobile device to remind staff to wash their hands (Sessions et al., 2024). The other unique strategy is engaging patients and their families as partners in infection control by encouraging them to speak to the staff about the correct hand hygiene practices. In the same region, more features such as live feedback and data analyzing tools can also help to reinforce the refinement of hygiene practices.

Nevertheless, it is recognized that there may be many issues that could act as barriers to the introduction of this clinical practice change. Some of these are; staff resistance arising from being forced to work harder or work inefficiency, lack of desire to implement the measures to the affected section, cost of buying new anti-bacterial chemicals and equipment as well as the costs of hiring or developing new talents in monitoring compliance (Redeker, 2020). As for these barriers and their neutralization, the following measures can be taken. First, one can eradicate resistance by involving the clinical staff right from the outset of the process, offering adequate training, and explaining why hand washing and sanitizing will lower infection rates. Other ways to encourage the staff include putting in place reward power, for instance, promotions for high compliance.

Outcome Criteria for Evaluating the Evidence-Based Practice

The outcome criteria for assessing the evidence-based practice project of decreasing HAIs will include the following: We will measure improvement in at least one modifiable parameter of HAIs, including VAP, BSIs, and UTIs in the ICU setting as our primary outcome (Watkins et al., 2024). The infection rate before integration, as well as the infection rate after the integration of the new hand hygiene protocol, will be taken and compared for six months. It is, therefore, expected that an overall HAI reduction of 20% after the first six months of implementing the interventions will be the key measure of success.

Secondary outcomes will consist of a change in staff hand hygiene compliance in the ICU and will be accomplished by counting the numbers using electronic systems or by audits (Lane et al., 2024). Furthermore, the effectiveness of acquired knowledge regarding infection prevention at increasing patient outcomes and satisfaction as well as the general health of the patient will be assessed by surveys and health records as overall care should be improved due to better hygiene practices.

Such outcome measures will feed into evidence-based practice, guidelines as well as policies in a direct manner (Hoyem et al., 2019). If the results show a reduction in infection rates by a large percentage it would be easier to present the model to other units in the hospital to adopt the hand hygiene protocol modeled by this project. The information gathered is useful for modifying policies in the hospitals so that hand washing becomes routine in all wards. Moreover, these findings can extend to other spheres of a hospital, from changing organizational principles to the introduction of local legislation regulating the fight against HAIs and increasing patient safety.

Value And Relevance Of Evidence Used To Support The Need For A Practice Change

The validity and applicability of the evidence that can be used to justify the necessity of a practice change in decreasing events of HAIs are essential for the successful implementation of an intervention (Haahr et al., 20220). A plethora of studies and clinical trials have shown that improved guidelines and measures of hand sanitation cut the incidence rate of HAIs in intensive care areas. For example, research by The Lancet Infectious Diseases; and the American Journal of Infection Control proved that just maintaining proper hand washing protocol can reduce the cases of HAI by 30-50% (Haahr et al., 20220). This evidence is highly relevant since it links squarely with the particular area of focus of the proposed practice change which is infection control.

To collect this evidence, a general search strategy was used. Credible peer-reviewed articles were identified from PubMed, CINAHL, and the Cochrane Library databases as these databases provide comprehensive databases in the medical and healthcare domain (Van et al., 2024). Only those articles published in the last 10 years were considered, and the following keywords were employed for screening; hospital-acquired infection, hand hygiene compliance, ICU infection control, and evidence-based practice.

NURS FPX 6011 Assessment 3 Conclusion

Collectively, the present study emphasizes the importance of evidence-based practices to prevent HAIs in ICUs as a way of enhancing patient care and ensuring the quality of healthcare. The presented research carried out on understanding specific hand hygiene protocols suggests a possible solution to this problem (King et al., 2021). This shows that if the right stakeholders are engaged, staff are adherent to the changes proposed, and the use of technology for monitoring is adopted; the changes can markedly reduce infection incidences. The practices will also be conducted consistently with evaluation and adjustments of the practices being done based on the results it obtained, which will ensure long-term success and sustainability to enhance safer healthcare environments.

NURS FPX 6011 Assessment 3 References

Clarke, V., Lehane, E., Mulcahy, H., & Cotter, P. (2021). Nurse Practitioners’ implementation of evidence-based practice into routine care: A scoping review. Worldviews on Evidence-Based Nursing, 18(3), 180–189. https://doi.org/10.1111/wvn.12510

Catarelli, B., Nobles, P., Scarton, L., Duckworth, L., Ezenwa, M. O., & Booker, S. Q. (2023). Care, lead, and inspire: Infusing innovation into nursing research and evidence-based practice course. Worldviews on Evidence-Based Nursing, 20(3), 281–284. https://doi.org/10.1111/wvn.12654

Hoyem, R. L., Quraishi, J. A., Jordan, L., & Wiltse Nicely, K. L. (2019). Advocacy, research, and anesthesia practice models: Key studies of safety and cost-effectiveness. Policy, Politics & Nursing Practice, 20(4), 193–204. https://doi.org/10.1177/1527154419874410

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing Ethics, 27(1), 258–272. https://doi.org/10.1177/0969733019832941

King, R., Taylor, B., Talpur, A., Jackson, C., Manley, K., Ashby, N., Tod, A., Ryan, T., Wood, E., Senek, M., & Robertson, S. (2021). Factors that optimize the impact of continuing professional development in nursing: A rapid evidence review. Nurse Education Today, 98, 104652. https://doi.org/10.1016/j.nedt.2020.104652

Kumah, E. A., McSherry, R., Bettany-Saltikov, J., & van Schaik, P. (2022). Evidence-informed practice: simplifying and applying the concept for nursing students and academics. British Journal of Nursing (Mark Allen Publishing), 31(6), 322–330. https://doi.org/10.12968/bjon.2022.31.6.322

Kerr, H., & Rainey, D. (2021). Addressing the current challenges of adopting evidence-based practice in nursing. British Journal of Nursing (Mark Allen Publishing), 30(16), 970–974. https://doi.org/10.12968/bjon.2021.30.16.970

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ (Clinical research ed.), 384, e077310. https://doi.org/10.1136/bmj-2023-077310

Redeker N. S. (2020). Sensor technology for nursing research. Nursing Outlook, 68(6), 711–719. https://doi.org/10.1016/j.outlook.2020.03.009

Sessions, J., Marsden, J., Bringloe, L., & Gilsenan, I. (2024). Changing the culture around hospital-based nutrition. British Journal of Nursing (Mark Allen Publishing), 33(8), S18–S25. https://doi.org/10.12968/bjon.2024.33.8.S18

Torres, C. P., Mendes, F. J., & Barbieri-Figueiredo, M. (2023). Use of “The Knowledge-to-Action Framework” for the implementation of evidence-based nursing in child and family care: Study protocol. PloS One, 18(3), e0283656. https://doi.org/10.1371/journal.pone.0283656

Watkins, S., & Rappleyea, M. (2024). Improvement opportunities for the achievement of reciprocal nursing academic-practice partnerships. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing, 51, 97–100. https://doi.org/10.1016/j.profnurs.2024.02.002

Van, S., Drenth, H., Hobbelen, H., Finnema, E., Teunissen, S., & de Graaf, E. (2024). Non-pharmacological interventions are feasible in the nursing scope of practice for pain relief in palliative care patients: A systematic review. Palliative Care and Social Practice, 18, 26323524231222496. https://doi.org/10.1177/26323524231222496

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