PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

I work with a tertiary hospital. The hospital has been providing its services for the last 50 years. The hospital provides a wide range of services to its populations. The services include inpatient, outpatient, surgeries, maternity, and psychiatric care services. The organization has an effective culture that promotes excellence. The culture of the organization is characterized by teamwork in the provision of patient care. The leadership and management encourages open communication to ensure that the needs of the healthcare providers are prioritized in patient care. The organization also utilizes transformation leadership styles to ensure that employees develop the competencies that they need in addressing the actual and potential needs of their populations. There is also the provision of rewards and incentives to motivate the employees engage in activities that contribute to the optimum care outcomes in the organization. Based on the above, the organization is ready to implement change that addresses the issue of the increasing prevalence of CLABSI .

The current problem in the organization is the high prevalence of CLABSI in patients admitted in the acute care settings. CLABSI  rates have been rising over the past translating into low quality and safety of patient care. The high rate of CLABSI  could be attributed to the low level of awareness among the healthcare providers on the interventions used in the prevention of CLABSI (Scheier et al., 2021). The low level of awareness and skills imply that evidence-based interventions may not be utilized in providing the needed patient care. CLABSI  is associated with a number of adverse outcomes. The adverse outcomes include the increased risk of complications, increased care costs, hospital stay, and reduced quality of life. Evidence-based interventions exist for CLABSI (Reynolds et al., 2021). Therefore, the problem can be addressed to ensure high quality, safe and efficient care in the organization.

The scope of the proposed issue is the prevention of CLABSI  in acute care patients. The aim is to reduce the prevalence of CLABSI among hospitalized patients. The healthcare providers will be involved in the implementation of the change. It is expected that the implementation of the change will reduce the negative effects of CLABSI  and promote safety, quality and efficiency in patient care. The stakeholders will include nurses, physicians, managers and nurse leaders. Nurses will be involved in the implementation of the change. They will administer the chlorhexidine baths to reduce CLABSI (Zerr et al., 2021). Physicians and nurses will work together to implement the intervention. Managers and nurse leaders will coordinate the implementation process of the change. They will ensure that the implementation is done according to the developed plan. They will also oversee the use of the resources in the implementation of the change.

Implementation of change is associated with a number of risks. The first risk is resistance to change. There is an increased risk of the healthcare providers and other stakeholders declining to embrace the change. The resistance could be attributed to lack of knowledge or inadequate preparedness for the change. The other risk is the lack of support from the hospital. A lack of support will result in poor implementation due to scarcity in resources (Greenhalgh, 2017). The other risk is misuse of resources. Ineffective or poor implementation of change may lead to resource wastage. Lastly, it increases the risk of adverse patient outcomes. Poor implementation of the change may lead to patient harm due to safety issues with the adopted interventions (Chletsos & Saiti, 2020). Therefore, interventions should be implemented to enhance the adoption process of the change.

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The proposed evidence-based idea is the use of chlorhexidine bathing to reduce the risk and rate of CLABSI  in acute care settings. The existing evidence shows that chlorhexidine is effective in reducing and destroying disease causing bacteria on the skin. The reduction implies that the risk of patients CLABSI  is reduced significantly. There is also the improvement in the safety and quality of care that patients receive. The use of chlorhexidine in preventing CLABSI is feasible because it does not require the extensive use of organizational resources and skills (Zerr et al., 2021). The proposed intervention can produce sustainable outcomes, hence, the need for its adoption in the organization.

The plans for knowledge transfer will be varied. One of them will be the promotion of the active involvement of the stakeholders in the change initiatives. Active stakeholder involvement will ensure that the stakeholders have developed the needed competencies for the implementation and sustainability of the change. The second strategy will be the promotion of open communication. Open communication will be used to foster trust and honesty among the stakeholders. Open communication will also enable the stakeholders to express their needs and ideas related to the change. The third strategy will be training. Training will be offered to the stakeholders to minimize resistance to change. Lastly, regular assessments will be offered to ensure that the stakeholders receive frequent feedback on their abilities, challenges and opportunities for achieving outcomes in the implementation of the intervention (Greenhalgh, 2017).

Several dissemination plans will be used in the project. The first one will be the presentation of the results to the healthcare providers in the organization. Dissemination to the healthcare providers will create awareness among them and increase their understanding of the need for the change in promoting optimum outcomes of care. The second dissemination plan is publishing the results of the intervention in reputable journals of nursing and healthcare. Publishing will create an extensive reach and awareness of the other healthcare providers about the ways of promoting quality, safety and efficiency in patient care. The other strategy will be presenting the results in scientific conferences. This will create awareness and facilitate discussions about the ways in which the intervention can be improved further. The last dissemination approach will be implementing the use of the intervention across the organization (Wensing et al., 2020). This will ensure the uniform implementation of the change for improved outcomes in the organization.

One of the measurable outcomes that will be associated with the proposed change is the reduction of the rate of CLABSI in the hospital. The reduction will be attributable to the use of chlorhexidine baths to eliminate disease causing bacteria on the skin. The other measurable outcome is the reduction in the hospital stay and costs by patients admitted in the acute care settings. The reduction will be attributed to the effectiveness of the intervention. The other outcome is the incorporation of the intervention into clinical policies of safety and quality. The incorporation will ensure sustained and consistent use of chlorhexidine baths in reducing CLABSI .

I learned a number of lessons from the critical appraisal of evidence and completing the evaluation table. One of the lessons learned is that CLABSI is a critical health concern in acute care settings. The risks of patients developing CLABSI  are high. I also learned that CLABSI  is associated with negative outcomes to patients and healthcare systems. They include increasing costs of care, complications, poor quality of life, and increased utilization of resources. I also learned that CLABSI  are preventable. Healthcare providers have the essential role of exploring evidence-based interventions that can be used to prevent and reduce the risk of CLABSI . The experience also showed that the use of chlorhexidine baths is highly feasible in preventing and reducing CLABSI . Therefore, the implementation of the proposed change should aim at utilizing best practices to ensure the realization of optimum outcomes in the process.

REFERENCES

uChletsos, M., & Saiti, A. (2020). Strategic Management and Economics in Health Care. Springer Nature.

uGreenhalgh, T. (2017). How to Implement Evidence-Based Healthcare. John Wiley & Sons.

uReynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): A stepped wedge cluster randomized trial. Implementation Science, 16(1), 45. https://doi.org/10.1186/s13012-021-01112-4

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