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2.2019 Update. DLP

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.

Name: __________Lishan Brown___________

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 hospital acquired infections. The nursing practice issue is catheter associated urinary tract

infections and the high incidence on an acute rehabilitation unit.

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

The nursing practice issue I would like to investigate is healthcare associated infections (HAI),

particularly catheter associated urinary tract infection (CAUTI). CAUTI is very important to

investigate because I believe HAI’s can be decreased, if not prevented. Being that nurses are

educated on the possible causes or symptoms of HAI’s, we can be more proactive in our

treatment plans. If a patient falls, that can be an unpredictable event but HAI’s are more so

predictable. With CAUTI, making sure that the perineal area is cleaned on a regular, consistent

basis is important. Providing proper interventions to not keep an indwelling catheter in longer

than necessary is also important.

Urinary tract infections are one of the most common hospital acquired infections. At least 80%

of urinary tract infections an be attributed to an indwelling urinary catheter. There are

approximately 13,000 annual deaths associated with catheter associated urinary tract infections

(CAUTI). CAUTIs can lengthen hospital stays, increase morbidity and mortality, and raise

healthcare costs.

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 members of the healthcare team are not properly cleaning the perineal

area of patients who have indwelling catheters and indwelling catheters are placed for unnecessary longer

periods of time.

PICOT question- In (P) patients with an indwelling catheter on an acute rehabilitation unit, does

(I) cleansing the perineal area every eight-hour period compared to (C) routine daily cleansing of the

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2.2019 Update. DLP

perineal area (O) decrease the catheter associated urinary tract infection with patients over a (T) six month

period?

List the systematic review chosen from the Cochrane Database of Systematic Reviews from the

Chamberlain library. Type the complete APA reference for the systematic review selected.

Interventions to improve professional adherence to guidelines for prevention of device‐related infections.

Reference

Flodgren G, Conterno LO, Mayhew A, Omar O, Pereira CR, Shepperd S. Interventions to improve

professional adherence to guidelines for prevention of device‐related infections. Cochrane Database of

Systematic Reviews 2013, Issue 3. Art. No.: CD006559. DOI: 10.1002/14651858.CD006559.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 my search for evidence, I found an article about nurse-driven CAUTI prevention. This evidence is

relevant to my PICOT because I would like to find a way to decrease or eliminate the instances of CAUTI

in a hospital setting. The article gives a history of prevalence of CAUTI then goes into costs related to

CAUTI. The article also mentions ways of preventing CAUTI. The article also discusses an algorithm

used to decrease the prevalence of CAUTI.

I also found an article about the causes of CAUTI and how to properly clean the perineal area as an

educational tool.

Reference

Russell, J. A., Leming-Lee, T. ‘Susie,’ & Watters, R. (2019). Implementation of a Nurse-Driven CAUTI

Prevention Algorithm. Nursing Clinics of North America, 54(1), 81–96. https://doiorg.chamberlainuniversity.idm.oclc.org/10.1016/j.cnur.2018.11.001

Memorial Sloan Kettering Cancer Center (2018). Caring for Your Urinary (Foley®) Catheter. Retrieved

from https://www.mskcc.org/cancer-care/patient-education/caring-your-urinary-foley-catheter

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

strength of the evidence.

The main findings from the systemic review were that there weren’t sufficient evidence to properly

corroborate the research. The trials were too small and there was inadequate reporting of information.

Because the findings were too small, it was difficult to determine which intervention would be optimal in

CAUTI care. The strength of the evidence was weak for the change process.

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

An evidence-based solution would be the CAUTI Prevention Tool by the American Nurses Association.

This streamlined evidence-based tool is used to reduce CAUTI by fewer catheters being used, timely

removal, and insertion, maintenance and post removal care.

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