Week 6 Assignment: EBP Change Process Form

Week 6 Assignment: EBP Change Process Form

Week 6 Assignment: EBP Change Process Form

Listed Stakeholders

Nurse leaders and managers: They will oversee the implementation of the proposed change. They will also advocate for the adoption of change strategies that promote the implementation of the initiative to reduce surgical site infections. They will also lobby for resource support for the initiative.

Physicians: the physicians will be part of the change. They will be involved in prescribing the intervention, assessing patients for infection risks, and initiating necessary treatments for the affected.

BUY A CUSTOM PAPER HERE ON; Week 6 Assignment: EBP Change Process Form

Nurses: Nurses will be directly involved in the implementation of the project. They will provide rewarming procedures to patients before surgical procedures. They will also undertake patient assessment pre and post-surgery to facilitate early detection and management of complications. I will be part of the nurses involved in undertaking these roles. I will also educate them about the change and its need in the organization.

My Nursing Role in the Change Process

            My other roles in the change process will include obtaining feedback from the nursing staff. I will use the feedback to propose improvement strategies for the change. I will also oversee the implementation process to ensure it is according to the developed plan.

Position Titles of the Stakeholders

            As noted, the stakeholders will include nurse leaders and managers, physicians, nurses, and I. These stakeholders are involved in the provision of direct patient care both preoperatively and postoperatively. As a result, they are the main implementers of the proposed initiative.

Cost Analysis

            A cost-benefit analysis will be needed prior to a trial. The accountant and finance offer will need to be involved in undertaking the analysis. The analysis will provide the projections of the anticipated outcomes of the change and its significance to the organization.

Star Point 4: Implementation

Process of Gaining Permission

            The proposed initiative will be submitted to the quality assurance committee in the hospital. The committee will analyze the proposal and either approve, request for revisions, or reject it.

Plan for Educating Staff

            The staff will be trained about the proposed initiative. The training will offer them insights into the effectiveness of the proposed initiative in reducing and preventing surgical site infections. They will be encouraged to be actively involved in the change initiatives for their competencies and project sustainability.

Implementation Timeline

            The following is the timeline that will guide the project.

Activity	January 2023	February 2023	March 2023-August 2023	September 2023	October 2024
Proposal submission
Training
Implementing
Monitoring
Evaluation and communicating findings

Measurable Outcomes

            The measurable outcomes for the project will be varied. They will include changes in surgical site infections, average hospital stays by post-surgical patients, and costs incurred by patients undergoing anterior hip approach surgeries.

Forms if Any

            The forms that will be used for recording purposes will mainly be those on surgical site infections in the hospital. The hospital’s database for hospital acquired infections will be used to extract data for use in analyzing the potential causes of infection to provide insight into the effectiveness of the project.

Resources

            The resources available during the change period will include myself, nurse practitioners, nurse managers and leaders, and physicians. The other resource will be the support from the organization.

Meetings

            Meetings will be held after every two weeks during the trial period. The meetings will involve the leaders of the team and myself. They will discuss on the project process, challenges, and strategies that may be needed to enhance outcomes.

Star Point 5: (Evaluation)

Reporting Outcomes

            I will report both process and outcome measures of the trial. The process measures will focus on the effectiveness or ineffectiveness of the methods adopted in the trial. It will include aspects such as training, collaboration, and resource support and availability for the project. Outcome measures will focus on the impact of the trial (Harris et al., 2022). It will include outcomes such as changes in surgical site infections following anterior hip procedures, hospital stays for patients and the costs incurred by them.

Next Steps

            The next steps will largely depend on the outcomes of the change initiative. If positive, the change will be incorporated into the existing processes and procedures. If inconclusive, the project timelines will be extended and new strategies introduced to improve outcomes. If negative, the change initiative will not be adopted as part of patient care interventions in the organization.

References

Harris, J. L., Roussel, L. A., Dearman, C., & Thomas, P. L. (2022). Project Planning, Implementation, and Evaluation: A Guide for Nurses and Interprofessional Teams. Jones & Bartlett Learning.

ORDER A PLAGIARISM-FREE PAPER HERE ON; Week 6 Assignment: EBP Change Process Form

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

Name:      JT                               

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 is Healthcare Associated Infections (HAI), to be more precise Surgical Site Infections (SSI). An SSI occurs in the part of the body where the surgery took place. I chose this topic as there has been a 45 percent increase of SSIs in my practiced area, over the last quarter. Review of the patient data revealed that the involved patients had a recorded subnormal temperature on their arrival to PACU and that they had all undergone surgery via the Anterior Hip Approach. I’m unsure of the cause but suspect that the nurses have not been adhering to the recommended policies on prewarming surgical patients.

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

The occurrence of SSIs concerns me as an infection at the surgery site customarily requires the patient to return to the operating room, lengthens the hospital stay, subjects the patient to extended, corporal antibiotic therapy, impairment of their mobility, increased expense for the patient and the hospital, increased mortality/morbidity. The noted increase in SSIs intrigues me as it has been mostly in patients that had procedure via the Anterior Hip Approach. One particular revisionist declines any warming devices until implants are placed: as a result of this the recommendation had been made to prewarm these patients. The positioning and surgical draping of the operative site in these procedures also allow exposure of most of the lower torso. SSIs can occur from 30 days postprocedural up to a year. I want to be able to gather information on the subject to establish if a simple nursing intervention, like placing a warming device for a period of an hour prior to the scheduled surgical procedure, could reduce the incidence of SSIs. I understand that surgical site infections are a multifactorial process, but the placement of a warming device in the per-op area is a straightforward and uncomplicated nursing intervention that could lead to a new process and practice, better patient outcomes and a reduction in the incidence of SSIs, and be cost efficient.

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

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

The practice problem is that members of the surgical service team are not adhering to the policy on prewarming patients scheduled for anterior hip approach surgeries.

The PICOT question is:

In anterior hip approach surgery patients (P), could the placement of a warming device for at least 1 hour prior to surgery (I), compared to not applying a warming device to other surgery patients pre-op( C), lead to a reduction of SSIs by 40 percent (O), over a period of 6 months (T).

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

Madrid, E., Urrutia, G., Rogue-Figuls., Pardo-Hernandez, H., Campos, J. M., Paniagua,P., Maestre, L., Alonso-Coello, P., & Madrid, E. (2016). Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults. Cochrane Database of Systematic Reviews. 2016(4), CD009016-CD009016. https://doi.org?10.1002/14651858.CD009016.pub2

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.

In searching for evidence, I found another article on the comparison of applying a warming device preoperatively, and is nurse driven. It further supports my PICOT question as it defines the role of pre- warming in decreasing the risks of untoward post-surgery outcomes, including SSI.

Cengiz, O., Ucar, S., & Yilmaz, M. (2021). The role of perioperative hypothermia in the development of surgical site infection: a systemic review. AORN Journal, 113(3), 265-275. https://doi.org/10.1002/aorn.13327

Briefly summarize the main findings (in your own words) from the systematic review and the

strength of the evidence.

I chose the above systemic review study as it inaugurates the influence subnormal body temperature perioperatively can have on the part of the brain that regulates our temperature. It clearly outlines the correlation of large body area exposure, cold room temperatures that exist in surgical suites and other surfaces, to the predisposition to hypothermia. The study is a peer-reviewed, systematic study that was conducted within the past 5 years, wherein controlled trials from 1964-2015 were reviewed from Cochrane Central Register, Medline Embase and CINAHL. The included studies had relevant clinical outcomes, not only the measurement of temperatures. In total 67 trials that involved over 5,000 participants were included. The conclusion supported my PICOT question, that maintaining normothermia aided in the prevention of the untoward effects of surgery, including SSIs. The placement of a warming device is entirely a nursing action and does not require a physicians order.

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

An evidence-based solution would be the AORN Toolkit for hypothermia prevention. The toolkit is symmetrical and based on proven evidence-based rationale. It provides nurse driven interventions that can reduce the incidence of hypothermia and thus SSIs. It strongly recommends preoperative warming of surgical patients.

Link, T. (2020). Guidelines in practice: hypothermia prevention. AORN Journal, 111(6), 653-666. https://doi.org/10.1002/aorn.13038

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

Built into the pre-op surgical intake documentation are aspects of the AORN Toolkit for hypothermia prevention in surgery. The 2022 Lippincott that is adapted for my healthcare system also sets basic standards for prevention of perioperative hypothermia.

Reference

Lippincott Procedures. (2022). Hypothermia in the OR. https://procedures.iww.com/inp/view.do?pld=1507337&hits=hypothermia&a=truead=false&q=hypother mia

Describe the plan for educating the staff about the change process trial and how they will be

impacted or asked to participate.

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

occur along the timeline).

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

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

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

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