Project Translation and Planning

Project Translation and Planning

There are 2 parts to this summative assessment. Complete Part 1 this week and submit it with Part 2 in Week 4.(Project Translation and Planning)

In this assessment, you will work through the planning and implementation stages of the project. This will require you to determine goals and resources needed and to select an evidence-based practice (EBP) model.

Part 1 – Literature Review

Research best practices to identify an effective intervention for your selected problem. Your goal is to gather evidence from scholarly literature to support the most effective intervention strategy.

The performance appraisal tools in this week’s learning activities will help you determine appropriate scholarly sources of evidence to cite.

Locate at least 3 original research articles that support your proposed solution to your selected problem.

• The articles must be peer-reviewed, published within the past 5 years, and statistically significant.

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To begin, write a 350-word summary of each article in which you:

• Identify current guidelines or best practices relating to your proposed solution, or if there are protocols, the current standard of care.
• Define your proposed intervention(s) to address the problem.
• Explain how the intervention will result in a solution to the problem

Sample Solution

Project Translation and Planning: CLABSI in ICU

The central line-associated bloodstream infection (CLABSI) is an Intensive Care Unit clinical problem globally. CLABSI is considered one of the leading causes of hospital-associated infection deaths in the United States. According to Haddadin et al. (2020), CLABSIs have the highest direct medical cost burden at about $46,000 per case. Significantly, CLABSI leads to prolonged hospital stays, significant morbidity, and mortality. CLABSIs are laboratory-acquired bloodstream infections that develop following central line placement in the ICU, usually within a window of 48 hours. The CLABSI rate in U.S. intensive care units stands at 0.8/1000 central line days.

Intervention Goals

1. Increase awareness and knowledge of nurses on CLABSI prevention guidelines. Higher CLABSI incidences are due to a lack of awareness and application of evidence-based prevention guidelines. The project team will create and pin clinical management guidelines on CLABSIs prevention and reduction guidelines in the ICU’s bulletin board. An increase in awareness and knowledge will be measured by evaluating nurse’s perceptions, and knowledge of CLABSIs mitigation and application guidelines will be evaluated.
2. Increase patient’s awareness and understanding of their role in preventing CLABSIs. Patients are directly affected, and their role in preventing the CLABSI is clinically significant. The project team will create and pin CLABSI prevention guidelines at the patient’s bedside table notice board. An increase in awareness and understanding of CLABSI prevention among patients will be determined by assessing their knowledge and contribution to CLABSI prevention.
3. Reduce the rate of CLABSIs in the hospital’s ICU. Having inadequate knowledge on adequate care provision, monitoring, and maintenance of central lines unintentionally contributes to high CLABSI cases. Train nurses on exiting EBP CLABSI mitigation practices and reduce the number of CLABSIs in a hospital’s ICU. Reduction of the rate of CLABSIs in ICU will be measured by determining the number of CLABSIs after the intervention, compared with those before intervention.

Part I: Implementation Plan

1. Pinned CLABSIs clinical management guidelines in the ICU.

Create and pin clinical management guidelines on CLABSIs prevention and reduction guidelines in the ICU’s bulletin board. The nursing staff will be tasked with pinning the CLABSI clinical management guidelines (for the patient and healthcare personnel) at the ICU, while managers of the ICU units will delegate responsible nurses to pin the guidelines on the unit’s bulletin board. The unit manager will encourage nurses to study the guidelines during meeting sessions to increase their awareness. In this regard, the project team will communicate the project needs for this outcome and formally request the ICU unit manager and nursing staff for consent and participation in the study.

2. Patient education program.

Nursing staff will conduct the patient education program following patient admission into the ICU. The patients will be educated on their contribution to preventing CLABSI. The nursing staff will evaluate the patent’s understanding of their roles related to CLABSI prevention. The nursing staff will ask the following questions; what do you know about CLABSI? Do you know the signs/symptoms of infection? How do you prevent yourself from infections?  The project team will inform the current and incoming ICU patients of the intended study, including their role, research procedure, and confidentiality actions. The project team will provide nurses with printed guidelines and education material to educate the patients with the nursing staff. Equally, for every patient with a central line catheter, the attending nursing staff will educate them on their contribution to preventing CLABSI. The education program will constitute patient responsibilities, including:

• Speaking up about concerns to the healthcare personnel. This will remind the personnel to follow CLABSI prevention guidelines keenly.
• Avoid touching /letting a visitor touch the tubing/catheter
• Alert the healthcare personnel if the area around the catheter is wet, dirty, sore/red, or if the bandage is coming off.
• Avoid wetting the insertion site.
• Encourage visitors to wash their hands before and after the visit.
• Ask for clarification on how to manage the catheter.

3. Nurse training program.

Nurse educators will train nurses on various aspects (preparation for insertion, insertion, monitoring, and maintenance) of CLABSI management. Questions such as, how should you prepare for central line insertion? What central line kits do you need? How do you identify the right insertion site? What are the signs/symptoms of CLABSI? How frequently should CLABSI bandages be changed? What are the appropriate hygiene conditions for CLABSI insertion and maintenance?  The project team will collaborate with the ICU unit manager and nurse educators in facilitating the nurse training program. The project team will provide the nurse educators with the training component, requirements, and a video guideline. The educators will demonstrate a routine catheter insertion procedure, dress, and sanitized appropriately. One or more nurses will be asked to demonstrate the procedure, and the video will be presented. The demonstration will be done in a quiet training room, and necessary equipment includes different catheters, sanitizers/antiseptic skip prep agent, gloves, gowns, cap, mask, and sterile drape. The nurse educators will answer any question relevant to the procedure.

Part II: Establish budget, roles, and responsibilities

The study will be cost-effective. The budget will include the costs of mock code material, printing, and pinning guidelines. The project team will use the hospital’s training room and equipment, including a projector for video and virtual training conferences. The personnel involved in the project include the hospital’s directors, ICU unit manager, nurse educators, and the nursing staff/healthcare personnel involved in the ICU operations. The project team will involve the personnel in various aspects and stages of the project.

Personnel Roles

Nursing staff: Ensure that guidelines are pinned on the ICU bulletin board.

ICU unit manager: Ensure that CLABSI management guidelines are pinned in the unit’s offices.

Nurse Educators: Conduct nurse training sessions on CLABSI guidelines.

Hospital Director: Authorize the project activities within the hospital.

Milestones

The project will be conducted in 6 months. The guidelines should be pinned at the appropriate location by the first week. The project team will submit questionnaires to evaluate the awareness of CLABSIs among patients and nursing staff within the first two weeks. Three learning sessions will be conducted every month to ensure nursing staff is knowledgeable on CLABSI guidelines.

Potential Setbacks

Potential limitations of the program are noncompliance from the nursing staff and inadequate participation from the patients. According to the Association for Professionals in Infection Control and Epidemiology (APICE), more than 70% of infections associated with central lines can be prevented through adherence to institutionalized, local, or federal evidence-based practices (APICE, 2016). Therefore, lack of adherence can affect the intervention outcomes. The project will be evaluated every month to monitor its progress. A dashboard will be used to keep track of activities and timelines.

Risk management plan

The assessment of patient and nursing staff awareness and knowledge of CLABSI management guidelines and their role in preventing CLABSIs will precede training and education interventions. This will provide the project team with the foundation awareness and idea of integrating the education and training program within the institution activities.

EBP Model

The project will adopt the Johns Hopkins, Evidence-Based Practice Model. The model is appropriate for this project because it focuses on maintaining EBP through education and safe clinical environments. The model is a useful problem-solving method in a clinical setting and has versatile tools to guide its application (Dang et al., 2021). The model has a three-step process, including practice question, evidence, and translation. In this case, the practice question involves researchers evaluating existing clinical practices, while the evidence step involves evaluating the best evidence that supports a given intervention. The translation step involves translating the evidence to practices.

References

Association for Professionals in Infection Control and Epidemiology (APICE). (2016). States targeting a reduction in infections via engagement (STRIVE) program. Prevention Strategist, 1-16. Retrieved from http://apic.org/Resource/TinyMceFileManager/Periodicalimages/STRIVEsup plementCDCWinter2016.pdf

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines. 4th ed. Indianapolis, IN: Sigma Theta Tau International.

Haddadin, Y., Annamaraju, P., & Regunath, H. (2020). Central line-associated bloodstream infections (CLABSI). StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK430891/

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