NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Sample Answer for NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper Included After Question

Assessment Description

Learners will select a valid nursing practice problem for an evidence-based practice project proposal. The
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project will be completed in sections, beginning in NUR-550 and culminating in a fnal written paper detailing
the evidence-based practice proposal in NUR-590.

The purpose of this assignment is to select a relevant nursing practice problem for your evidence-based
practice project proposal. To identify a relevant problem, consider problems generally faced in nursing
practice (coordination of health care, assessment, education, patient support, trauma prevention, recovery,
health screenings, etc.). Use the “PICOT Draft” template to complete this assignment.

Use a national, state or local population health care database to research indicators of disparity. Choose a
mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a
population of focus. Use this indicator to begin to formulate a PICOT statement.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of
the evidence-based practice project proposal assignments.

You are required to cite one peer-reviewed source to complete this assignment. Sources must be published
within the last 5 years and appropriate for the assignment criteria and nursing content.
While APA style is not required for the body of this assignment, solid academic writing is expected, and
documentation of sources should be presented using APA formatting guidelines, which can be found in the
APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar
with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.

A Sample Answer For the Assignment: NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Title: NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

In the past and at present, various diseases have caused suffering, pain, and death among the population, prompting healthcare professionals to come up with appropriate measures or strategies that can be used to contain the spread of such diseases. Recently, the Covid-19 pandemic brought the world to a standstill resulting in various negative impacts, cutting across health and finances (Wang et al., 2021). The implication is that scientists had to work around the clock and come up with suitable vaccines in record time. During the middle of the pandemic, various measures were used, such as wearing masks in public spaces, sanitization, and handwashing, were used as short-term measures to prevent the spread of the virus; however, it has been evident that a longer-term solution lies in the use of appropriate vaccines.

 Even though vaccines for the Covid-19 virus are present and in use, a lot of effort is still needed to ensure that individuals take the vaccine. Millions of people remain skeptical regarding taking any of the Covid-19 vaccines, which has brought down the rates of vaccine use. As such, it is important to use proven and appropriate strategies that can lead to individuals taking the covid-19 vaccine. One of the strategies that have gained prominence in health promotion is health education; hence it provides a suitable route to improving the covid-19 vaccine uptake (Rutten et al., 2021).

Therefore, the purpose of this project is to explore if the use of health education will increase people’s willingness to take the Covid-19 vaccines. As such, various aspects will be discussed, including the problem statement, organizational culture and readiness, literature review, the change model or framework, implementation plan, and evaluation plan.

Problem Statement

Covid-19 vaccines were made at the height of the Covid-19 pandemic to help contain the virus. Millions of people have since been vaccinated, leading to an incredible reduction in the rates of spread of Covid-19. However, it has not been easy getting so many people to get the vaccine due to a combination of reasons, ranging from conspiracy theories to being skeptical about the record times used in coming up with the vaccines. Therefore, there is a need to use various strategies, such as health education, to increase willingness to take the vaccine.

Organizational Culture and Readiness

The success of the implementation of an evidence-based practice project heavily depends on the organizational culture and readiness. As such, it is important to assess the organizational culture and readiness to determine how ready the organization is in terms of the implementation of the project (Cleary‐Holdforth et al., 2021). It is also important to use well-known and well-established assessment tools to assess the organization’s culture and readiness. As such, a tool was chosen, and the summary of results regarding the organization’s culture and readiness is presented in this section.

The Organization’s Culture and the Degree It Supports Change

A positive organizational culture is known to foster the process of change implementation (Cleary‐Holdforth et al., 2021). Therefore, upon the assessment of the organization, it was noted that the leaders lean towards supporting EBP initiatives which are key to the improvement of the organization’s performance as well as the quality of patient care services. The organization also hopes to gain magnet status in the near future; hence the leaders support change initiatives. The organization’s aim and mission also focus on offering excellent and appropriate patient services and making the services accessible to patients as much as possible.

NUR 550 Benchmark - Evidence-Based Practice Project Proposal Final Paper
NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

As part of the culture, the leaders encourage the employees to gear their actions towards supporting the vision and mission of creating positive change that steers the organization forward. The organization also focuses on improving patient outcomes by encouraging various aspects, such as collaboration among staff and interprofessional teams. Based on this evidence, the organization’s culture points to an organization that is ready for change and supports EBP.

The Selected Organizational Readiness Tools and Summary of Results

An assessment tool was used in assessing organizational readiness. The chosen tool was the System-Wide Integration of the EBP survey tool. This tool has widely been used in EBP and has shown its potential in the assessment of an organization’s ability to deal with and adapt to potential changes (Melnyk et al., 2022). This tool was used to assess the staff and the leaders’ understanding of the proposed change of introducing health education to improve the willingness to take covid-19 vaccine. The survey revealed that up to 90% of the staff and 80% of the leaders were ready for the proposed change. The implication is that a majority of the staff and leaders supported the proposed change. The implication is that the existing culture will be able to support and sustain EBP and change.

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As part of the organizational culture and readiness assessment, it is important to identify potential weaknesses or barriers that may negatively impact the implementation process and formulate strategies to overcome them. One of the identified barriers is the potential lack of support, as shown by a few staff and leaders. It will be important to obtain their buy-in as the project progress to enhance chances of success. The individuals who have shown a willingness to support the proposed change will form an important part of the project by helping to avail the needed resources and help in times of crucial decision-making.

Strategies to Facilitate the Readiness

It is important for the project team to help facilitate readiness. Such readiness can help in improving the chances of the project succeeding. There is a need to initiate an aggressive health education program to help improve the willingness of individuals to take the covid-19 vaccines, hence a need for change. The statistics show that many people are still hesitant regarding taking the covid-19 vaccine, facts which can be used to convince the staff to get fully involved in the health education initiative.

As part of the process, the staff will also be educated on how to carry out the health education program as a way of facilitating readiness (Melnyk et al., 2022). It is also important to identify the key stakeholders who are to play key roles in the project. The identified key stakeholders include the nurse educator, nurse managers, unit leaders, nurses, physicians, patients, and their families.

The Information and Communication Technologies Needed For Implementation

It is also important to identify various strategies that can be used to support the implementation process. Key among such is the information and communication technologies. Therefore, one of the tools to be used is electronic health records (Melnyk et al., 2022). Electronic health records are important in revealing the vaccination status of patients. In addition, this tool will also be key in revealing other patient data, such as demographic data, which form an important part of the project.

Literature Review

The following formulated PICOT question was used to guide the literature review process: PICOT statement: Among the general population and individuals at risk of covid-19, will the use of health education about covid-19 vaccination plans, as compared to no intervention, lead to a 50% increased willingness to take covid-19 vaccine within six months?

The Search Methods Used

The search strategy forms an integral part of a good literature search as it allows the researcher to obtain the most relevant article which is in line with the issue at hand. Therefore, a search method was employed to assist with the literature review. Various databases formed the basis of the literature search. The article databases used include Google scholar, the Cochrane Database of Systematic Reviews, Ovid, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Medline. Keywords used as part of the search strategy include “risk of Covid-19”, “health education,” “vaccine uptake,” and “willingness to take the vaccine.” Since the pandemic occurred within the last five-year time frame, the publication dates were not used as exclusion criteria.

The Synthesis of Literature

The literature search yielded several research articles, and eight of the articles have been reviewed, and their relevance to the PICOT question is presented in this section. In one of the research efforts, Motta et al. (2021) carried out a research with the major aim of determining the effect of educational messages in increasing people’s willingness to take the Covid-19 vaccine. This study employed a qualitative design where a total of 7064 participants took part. As part of the intervention, the researcher sent pro-vaccine messages to the participants. The analysis of the data showed that pro-vaccine messages significantly improved the participant’s willingness to go for the covid-19 vaccine. Hence this source supports the formulated PICOT question.

In another recent study, James et al. (2021) focused on exploring the impact of persuasive messages in improving the Covid-19 vaccine uptake. As opposed to the first study, these researchers employed a quantitative study design, and the participants were educated on the benefits of taking covid-19 vaccine. The researchers used regression analysis for data analysis and found that the use of persuasive messages resulted in the participants’ increased willingness to take the vaccine. They were also more willing to influence others to go for the vaccine. Therefore, this source also supports the PICOT question as it shows the efficacy of health education in improving the willingness to take vaccines.

More recently, Jensen et al. (2022) carried out a study exploring the application of health education based on video messages in fighting hesitancy in taking the covid-19 vaccine. The researchers employed a quantitative research design and recruited 1620 participants to take part in the study. Upon analysis of the data, the research found that the video-based messages increased people’s confidence in the vaccine hence improving their willingness to take the Covid-19 vaccine. As such, this source also supports the PICOT question as it shows that health education was effective.

In another research effort, Piltch-Loeb et al. (2021) carried out a research that focused on determining the impacts of using health education passed through different chances on the willingness to take the covid-19 vaccine. Using a quantitative study design, the researchers recruited a total of 2650 participants to take part in the study. Various channels such as social media, newspapers, and national TV were used to pass information regarding the vaccine. The analysis of the data showed that the use of both social media and traditional media resulted in an increased likelihood of accepting the Covid-19 vaccine. This study supports the proposed study as it shows the importance of educating people about the vaccine using different channels.

Li et al. (2022) also conducted a study that explored the impact of health education on Covid-19 vaccine hesitancy. The researchers employed a quantitative study design and recruited a total of 500 study subjects. While the survey was used as part of data collection, the researchers completed data analysis using regression analysis and chi-square. The analyzed data showed that the education program led to a significant lowering of vaccine hesitancy among the participants hence improving their willingness to take the vaccine.

Another relevant research was conducted by Davis et al. (2022). This research aimed to determine if the provision of information that contrasts the high effectiveness of covid-19 vaccine with the lower effectiveness of the annual flu vaccine could improve the covid-19 uptake. The researcher recruited a total of four hundred and eighty-one research subjects to participate in the study. The analysis of the collected data showed that providing such information had a positive impact as it improved the participant’s willingness and intention to take the covid-19 vaccine.

Argote et al. (2021) also conducted a study aimed at determining the effect of education carried out through vaccine campaigns in increasing people’s willingness to take the covid-19 vaccine. The researcher recruited a total of two thousand people to participate in the study. Vaccine survey was used as the main tool for data collection. As part of the educational initiative, the researchers provided the participants with various information regarding the effectiveness of the vaccine; analysis of the data showed that such information led to an improved willingness to take the covid-19 vaccine.

Another relevant study was conducted by Santos et al. (2021), which focused on determining the effectiveness of messages that target behavior concerning vaccination registration as well as acceptance. The researchers used a quantitative study design and recruited a total of 9723 individuals to take part in the study. The researchers collected data through email and surveys. Upon the implementation of the program, the researchers found out that the number of individuals who were willing to register for the vaccine and take it considerably increased. Therefore, this article also supports the proposed intervention of using health education to increase people’s willingness to accept the covid-19 vaccine.

Change Model or Framework

Implementation of interventions to improve patient outcomes usually requires the implementation of various change initiatives. It is important to note that implementation of change is usually a complicated process as individuals tend to resist suggestions for change implementation. As such, it is important to use proven and effective change management strategies to minimize the potential for failures. This is where the model or framework for change comes in.

Such models have steps or phases of change management that the project team can follow to ensure that the proposed change initiative is appropriately implemented (Harrison et al., 2021). There are several change management models in existence today. Therefore, it is upon the project implementers to choose the most befitting model which can help achieve the project goals.

The Selected Change Model

The change model that was chosen for the implementation of this project is Kurt Lewin’s change model. According to Lewin, change takes place in three major phases or stages, including the unfreezing, change, and refreezing phases. In addition, Lewin argued that there are two major forces involved in the change process, the driving forces that support the change and the restraining forces which oppose the change effort. The implication is that a successful change process only occurs when the driving forces exceed the restraining forces.

The Stages in the Change Model

As earlier stated, Lewin’s change model has three major stages or phases of change, which include unfreezing, change, and refreezing. In the unfreezing stage, the project team has to create an awareness of the need for an urgent change. As part of the plan, the change leaders used data such as organizational data to prove that there was an urgent need for change. As such, the leaders have to use effective communication to ensure that their message is home and well received (El-Sayed, 2023).

The next phase is the change phase which entails the implementation of the proposed change. The change leaders use their expertise to implement the intervention and test its effectiveness. The refreezing stage is the final stage of change based on this model. This phase is characterized by change sustenance and ensuring that the implemented change becomes part and parcel of the organization’s operations and normal practice.

How Each Stage of the Model Will be Applied in the Proposed Implementation

Lewin’s model has three major phases of change implementation; hence all three phases will be used in the implementation of the proposed project. In the first stage, the project team will take it upon themselves to inform the staff at the facility and those who visit the facility about the need to improve people’s willingness to take the covid-19 vaccine. It is important to use the current statistics on covid-19 vaccine hesitancy to convince individuals. The next phase of the project will entail educating the staff on the health education strategy to be used to convince individuals visiting the facility to take the vaccine. In the last stage of the model, the willingness to take the covid-19 vaccine will be sustained through frequent educational initiatives.

The Implementation Plan

The implementation phase of an EBP project is perhaps the most important phase as the proposed intervention is put into use and tested. The implication is that an appropriate plan is required that details the aspect of the implementation and all activities that must be accomplished to ensure that the process is a success. As part of the plan, the project team should use appropriate and effective methods that can enhance the chances of the project’s success while incorporating ideas from different people. Considering other stakeholders’ ideas is important since it can help minimize the chances of resistance (Melnyk& Fineout-Overholt, 2019).

The Setting and Accessing the Potential Research Subjects

It is important to obtain the research subjects from a relevant setting. Therefore, the setting for the project is a healthcare facility providing outpatient and inpatient care services to patients. Therefore, the research subjects are those who visit the facility for the services and are at risk of contracting the covid-19 virus (Dror et al., 2020). In addition, those who have not received the covid-19 vaccine will be the major target. The data obtained from these participating individuals will be used in determining the impact of the proposed health education intervention in improving people’s willingness to take the vaccine. It will not be necessary to obtain informed consent as the project will not deal with identifiable data. However, approval will have to be obtained from the facility to complete the project.

The Proposed Project Timeline

As part of the plan, it is important to note that this project will take a total of six months. It is projected that this time will be sufficient for all the project activities. In addition, this time will also be used in implementing any corrective actions as needed to ensure that the project is a success. A detailed project timeline has been included in the appendix.

The Budget and Resource List

Resources will be needed to help accomplish the project goals and aims. As such, both financial and human resources will be needed (Hopp & Rittenmeyer, 2021). For example, the human resources required for this project include hospital management, trainers, and nurse educators. The financial resources will be needed to help in coming up with the educational material to be used to convince people to take the covid-19 vaccine. In addition, the finance will also be used to cater for data collection, project evaluation, and monitoring of the project. A detailed project budget and resource list has been included in the appendix section.

The Selected Study Design

A quantitative study design has been chosen for the project. The design will be used in data collection, data analysis, and even evaluation of the efficacy of the proposed health education program. It has been chosen since it supports the use of numbers as opposed to the qualitative design, which mainly uses narration (Jolley, 2020). It is also easier and simpler to collect and analyze data using quantitative design through the use of well-known statistical tools.

The Methods and Instruments

Methods and instruments play a key role in the EBP project. As such, one of the instruments to be used in this project is questionnaires. Questionnaires will be used at different stages or parts of the project. For example, they will be used to gain an insight into the participant’s attitude towards covid-19 vaccine and their willingness to take the vaccine. They will also be used to assess the same parameters after the health education initiative. Questionnaires have been chosen since they are easier to compose and administer. The data obtained from such questionnaires are also easier to organize and analyze (Melnyk& Fineout-Overholt, 2019).

The Process of Delivering the Intervention

The intervention should be delivered in an appropriate way to ensure that it is a success. As such, the intervention is to be delivered in stages. Stage one will entail a needs assessment. Such a needs assessment exercise will be key in exploring the participant’s willingness to take the vaccine and their knowledge regarding the same. The next phase involved educating the staff regarding the material to be used for educating the participants. The last stage involves rolling out the health education initiative to help increase individuals’ willingness to take covid-19 vaccine.

The Stakeholders Needed For the Implementation Process

It is important to timeously identify the stakeholders since they can impact the implementation of the project. It is also key to incorporate them in the project early enough to limit the possibility of resistance (Triplett et al., 2022). As such, several stakeholders were identified to be part of the project implementation. Among the stakeholder include the nurses handling patients in the outpatient unit, the nurse educator, the nurse leader, the finance officer, and the nurse manager of the outpatient unit.

The nurses attending to patients in the outpatient unit will take an active role in the whole implementation process. The nurse leader will be tasked with the project implementation coordination. As such, they will give necessary feedback regarding the challenges that have been experienced and the project milestone. The nurse educator will lead the other staff in developing the education material. Besides, the finance officer will give financial advice upon the completion of the cost-benefit analysis and after carrying out an analysis of the financial implications.

Potential Barriers and Strategies for Overcoming Them

The implementation of evidence-based practice projects may face various barriers which can be difficult to overcome. However, it is important to identify such barriers in time and come up with potential solutions for them. Among the identified potential barriers is insufficient support from the organization (Cullen et al., 2020). In some cases, the leaders may fail to offer adequate or needed support to make the implementation process a success.

One of the strategies for overcoming this barrier is ensuring that the project’s objectives and goals are well aligned with the organizational goals, vision, and mission to help trigger support from the leaders. Another potential barrier is less interest or lack of interest by the staff. Some staff may resist vaccine education due to having a contrary opinion hence putting less effort into the proposed intervention. One of the strategies that can be used to help overcome this barrier is the use of effective and open communication, which will encourage them to share their views and how they can be incorporated to better participate in the project (Cullen et al., 2022).

Evaluation Plan

Evaluation is another important phase of the evidence-based practice project cycle. This is one of the last phases where the project team explores the efficacy of the implemented intervention. In addition, as part of the evaluation phases, the project team also found out how effective the methods used in the project were or have been. Therefore, it is important to measure the outcomes and compare them with the expected outcomes to determine the effectiveness of the implemented project. Therefore, this section discusses the evaluation plan.

The Expected Outcomes

As earlier indicated, this evidence-based practice project deals with the application of a health education program on covid-19 vaccine to help increase the willingness to take the vaccine among people at risk of covid-19 virus. As such, among the expected outcomes is enhanced willingness by the participants to take covid-19 vaccine. Another expected outcome is a willingness to turn up for the education to receive appropriate education regarding covid-19 vaccine (James et al., 2021). It is also expected that the education initiative will lead to an actual increase in the covid-19 vaccine uptake.

Data Collection Tools

It is also important to use the most appropriate tools to collect data for analysis and evaluation. Therefore, among the tools that will be used for data collection is questionnaires. The questionnaires will play a major role in determining the level of knowledge of the target population regarding the covid-19 vaccine and their attitude toward taking the vaccine. Similar data will also be collected after implementing the program to help determine the efficacy of the health education program. This tool is also important since it supports the use of the selected quantitative study approach. Questionnaires are also known to be valid and reliable since they have been used in obtaining similar data in research efforts similar to the proposed study. The same set of questions will be used before and after the intervention, which makes it a reliable tool (Yaddanapudi& Yaddanapudi, 2019).

The Chosen Statistical Test

Statistical tests play a significant role as part of the analysis as they give values for the measurements used in determining the effectiveness of the project. As such, paired T-test will be used as part of the analysis. This test is appropriate since it helps measure the difference in willingness to take the vaccine before and after the implementation of the proposed health education program. The test will be key in revealing if the use of the health education intervention has led to a significant difference which is a key measure of the success of the intervention.

Strategies to be Taken If the Outcomes Do Not Provide Positive Results

It is important to put in place plans to follow if the project fails to yield positive results as expected. As such, in the case that the project results are not positive, then one of the strategies that will be used is a re-examination of the intervention used to explore if it was correctly implemented. Such a strategy will be key to enabling the project team to identify what went wrong and how to improve them for success (Melnyk& Fineout-Overholt, 2022). The strategy of extending the project timeline will also be used to allow the project team to take corrective measures

Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution

It is important to have an appropriate plan in place for maintaining, extending, revising, and discontinuing the proposed solution. As part of the plan, the proposed solution will be maintained if the outcomes are positive and enhance clinical outcomes. In addition, the project will be maintained in the case where it is cost-effective. On the other hand, an extension will be sought if the conclusions are found to be inconclusive (Linsley et al., 2019). Such an extension may help in obtaining additional data, which can then be used for further project evaluation. The proposed solution will also be revised if the strategies do not align with the outcomes. Finally, discontinuation is considered if it turns out that the project is causing harm to the subjects or investigators.

Conclusion

The covid-19 pandemic came with a lot of deaths, suffering, and losses. Even though various strategies, such as masks and sanitization, were used in the early stages to help prevent the rapid spread of the virus, various vaccines were later formulated to help fight the spread of the virus. Even though many people have since taken the vaccine, there are still millions of people who remain skeptical about the vaccine, which ends up exposing them to the virus.

Various strategies have been used to increase or improve the covid-19 vaccine uptake, but the desired results have not been achieved. Therefore, there is a need to use more effective strategies, such as the use of health education to persuade the masses to increase their willingness to take the covid-19 vaccine. Therefore, this proposed EBP focuses on the use of health education to help increase the willingness to take the covid-19 vaccine and improve the vaccine uptake. Various aspects of the project phase have been discussed.

References

Argote, P., Barham, E., Daly, S. Z., Gerez, J. E., Marshall, J., & Pocasangre, O. (2021). The shot, the message, and the messenger: COVID-19 vaccine acceptance in Latin America. NPJ Vaccines6(1), 118. https://doi.org/10.1038/s41541-021-00380-x

Cleary‐Holdforth, J., O’Mathúna, D., & Fineout‐Overholt, E. (2021). Evidence‐based practice beliefs, implementation, and organizational culture and readiness for EBP among nurses, midwives, educators, and students in the Republic of Ireland. Worldviews on Evidence‐Based Nursing18(6), 379–388. https://doi.org/10.1111/wvn.12543

Cullen, L., Hanrahan, K., Farrington, M., Tucker, S., & Edmonds, S. (2022). Evidence-based Practice in Action: Comprehensive Strategies, Tools, and Tips from University of Iowa Hospitals & Clinics. Sigma Theta Tau.

Davis, C. J., Golding, M., & McKay, R. (2022). Efficacy information influences the intention to take the COVID‐19 vaccine. British Journal of Health Psychology27(2), 300–319. https://doi.org/10.1111/bjhp.12546

Dror, A. A., Eisenbach, N., Taiber, S., Morozov, N. G., Mizrachi, M., Zigron, A., … & Sela, E. (2020). Vaccine hesitancy: the next challenge in the fight against COVID-19. European Journal of Epidemiology35, 775-779. Doi: 10.1007/s10654-020-00671-y

El-Sayed, N. M. (2023). Managing change in inpatient units using Lewin’s theory. Damanhour Scientific Nursing Journal1(1), 1-24. https://dx.doi.org/10.21608/dsnj.2023.299981

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 85-108. Doi: 10.2147/JHL.S289176

Hopp, L., & Rittenmeyer, L. (2021). Introduction to Evidence-Based Practice: A Practical Guide for Nursing. F.A. Davis

James, E. K., Bokemper, S. E., Gerber, A. S., Omer, S. B., & Huber, G. A. (2021). Persuasive messaging to increase COVID-19 vaccine uptake intentions. Vaccine39(49), 7158-7165. https://doi.org/10.1016/j.vaccine.2021.10.039

Jensen, U. T., Ayers, S., & Koskan, A. M. (2022). Video-based messages to reduce COVID-19 vaccine hesitancy and nudge vaccination intentions. PloS One17(4), e0265736. https://doi.org/10.1371/journal.pone.0265736

Jolley, J. (2020). Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals. Routledge.

Li, P. C., Theis, S. R., Kelly, D., Ocampo, T., Berglund, A., Morgan, D., … & Burtson, K. (2022). Impact of an education intervention on COVID-19 vaccine hesitancy in a military base population. Military Medicine187(Special Issue_13), e1516-e1522. https://doi.org/10.1093/milmed/usab363

Linsley, P., Kane, R., & Barker, J. H. (2019). Evidence-based Practice for Nurses and Healthcare Professionals. SAGE.

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.

Melnyk, B. M., Hsieh, A. P., & Mu, J. (2022). Psychometric properties of the Organizational Culture and Readiness Scale for System‐Wide Integration of Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing19(5), 380-387. https://doi.org/10.1111/wvn.12603

Motta, M., Sylvester, S., Callaghan, T., & Lunz-Trujillo, K. (2021). Encouraging COVID-19 vaccine uptake through effective health communication. Frontiers in Political Science3, 630133. https://doi.org/10.3389/fpos.2021.630133

Piltch-Loeb, R., Savoia, E., Goldberg, B., Hughes, B., Verhey, T., Kayyem, J., … & Testa, M. (2021). Examining the effect of information channels on COVID-19 vaccine acceptance. Plos One16(5), e0251095.https://doi.org/10.1371/journal.pone.0251095

Rutten, L. J. F., Zhu, X., Leppin, A. L., Ridgeway, J. L., Swift, M. D., Griffin, J. M., … & Jacobson, R. M. (2021, March). Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. In Mayo Clinic Proceedings (Vol. 96, No. 3, pp. 699–707). Elsevier. https://doi.org/10.1016/j.mayocp.2020.12.024

Santos, H. C., Goren, A., Chabris, C. F., & Meyer, M. N. (2021). Effect of targeted behavioral science messages on COVID-19 vaccination registration among employees of a large health system: A randomized trial. JAMA Network Open4(7), e2118702-e2118702. Doi: 10.1001/jamanetworkopen.2021.18702

Shih, H. I., Wu, C. J., Tu, Y. F., & Chi, C. Y. (2020). Fighting COVID-19: A quick review of diagnoses, therapies, and vaccines. Biomedical Journal43(4), 341-354. https://doi.org/10.1016/j.bj.2020.05.021

Triplett, N. S., Woodard, G. S., Johnson, C., Nguyen, J. K., AlRasheed, R., Song, F., … & Dorsey, S. (2022). Stakeholder engagement to inform evidence-based treatment implementation for children’s mental health: A scoping review. Implementation Science Communications3(1), 1–16. 10.1186/s43058-022-00327-w

Wang, C., Wang, D., Abbas, J., Duan, K., & Mubeen, R. (2021). Global financial crisis, smart lockdown strategies, and the COVID-19 spillover impacts: A global perspective implications from Southeast Asia. Frontiers in Psychiatry12, 643783. https://doi.org/10.3389/fpsyt.2021.643783

Yaddanapudi, S., & Yaddanapudi, L. N. (2019). How to design a questionnaire. Indian Journal of Anesthesia63(5), 335–337. https://doi.org/10.4103/ija.IJA_334_19

A Sample Answer 2 For the Assignment: NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Title: NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

The healthcare sector, healthcare professionals, and other stakeholders have, in the past and present, focused on improving patient outcomes using various strategies. Such strategies aim at improving the efficiency of patient care and the safety of patients while in the patient care environment. The efforts and initiatives aimed at improving care outcomes are usually triggered by a host of incidences happening in the care settings, such as patient falls, patient injuries, pressure ulcers, and healthcare-acquired infections, among other incidences. (Jaul et al.,2018) Among the most common healthcare-acquired infections are catheter-associated urinary infections (CAUTIs). CAUTIs have been shown to cause various negative impacts, such as increased healthcare spending, longer hospital stays, and other adverse impacts, such as death. Therefore, this evidence-based practice project focuses on lowering the rates of CAUTI among patients in admission settings and using indwelling catheters(Shadle et al.,2021). As such, the purpose of this paper is to formulate aproposal for the EBP. Various aspects which will be explored include the problem statement, the organizational culture, the literature review, the change framework, and the implementation and evaluation plans.

Problem Statement

Hospital-acquired infections have been shown to be on the rise in the past and present. One of the most common types of such infections is catheter-acquired urinary tract infections caused by the use of urinary catheters, especially indwelling ones. According to Flores-Mireles.(2019), CAUTIs lead to various adverse impacts. Even though the condition is largely preventable, it continues to cause havoc as it leads to increased patient morbidity and mortality, longer hospital stay, and increased healthcare spending (Kranz et al.,2020). This problem can, however, be prevented by applying various nursing interventions. It is important to note that, while various nursing interventions have been implemented, especially single activity-based interventions, the problem still persists hence calling for the use of more robust approaches which can integrate various interventions such as the use of CAUTI bundle.

Organizational Culture and Readiness

The process of evidence-based practice is impacted by various aspects, some of which are organizational aspects. The implication is that the EBP implementers should take their time and assess the nature of the organization, such as its culture related to EBP implementation and the readiness of various staff. Such a step is key in determining how easy or difficult the process of implementing an EBP project can be since a positive culture is needed for a successful implementation to occur (Cleary‐Holdforth et al.,2021). The assessment revealed that the organization’s leaders support patient improvement initiatives such as the EBP process for better patient outcomes. The organization also focuses on gaining magnet status, which has made them support various change initiatives. The assessment of the organization’s aim and mission showed that it focuses on offering exemplary and excellent patient services by using the latest care strategies at affordable costs. In addition, it was also noted that the organization adores interprofessional collaborations and teams in the provision of care. Therefore, it is evident that the organization’s culture is ready for change and also supports EBP.

The organization’s culture and readiness were assessed using a chosen tool, the System-Wide Integration of the EBP survey tool. This tool has widely been applied, especially to assess an organization’s capacity to adapt to and cope with change (Melnyk et al.,2022). This tool was used to explore the staff’s and the leader’s understanding of the proposed change of application of the CAUTI bundle to control the CAUTI rates. The survey tools showed that up to 91% of the staff support the proposed change, which is a majority. In addition, the majority of the leaders also supported the initiative, as up to 80% indicated that they were ready for the change. Therefore, this tool also revealed that the organization’s culture could support and sustain the proposed change.

Even though the culture supports the proposed change, it is worth noting that there are potential barriers and weaknesses that may derail implementation. For example, lack of support by minority leaders as staff can be a major drawback. The assessment will also be key in exploring the staff knowledge in using the proposed CAUTI bundle, which will then help to formulate strategies for improving their knowledge. The leaders supporting the initiative will play an important role in availing the required resources and supporting the project through making effective decisions and formulating change champions who can then help on driving the change initiative as appropriate. It was also important to identify the relevant stakeholders (Melnyk et al.,2022). Therefore, various stakeholders were identified, stakeholders include physicians, nurses, unit leaders, nurse managers, patients, and their families

Literature Review

The identified problem which informed the formulation of this project is increased rates of CAUTI in patient care settings. Therefore, the use of CAUTI bundles has been proposed as a potential EBP intervention. As such, it was important to perform a literature review to explore the existing evidence on the use of CAUTI bundles to reduce the rates of CAUTIs among patients admitted to the hospital and using indwelling urinary catheters. A PICOT question formulated earlier was used in the literature search. The formulated PICOT was: Among patients using indwelling urinary catheters, what is the efficacy of using CAUTI bundle care as compared to no intervention in lowering the rates of CAUTI by at least 60% within six months?

An article search strategy was also used to access the most relevant articles and evidence as appropriate. The search was accomplished in various article databases such as PubMed, google scholar, CINHAL, and Cochrane databases. The search also focused on peer-reviewed articles published in the last five years. Various search terms were also used in the search for relevant articles, including CAUTI, CAUTI bundles, intervention, and prevalence. Even though the search yielded several articles, the most relevant was chosen, and the literature review of the ten articles was performed and presented in the next section.

Elkbuli et al.(2018) conducted a study on the prevention of CAUTI among the trauma population. This study aimed at determining the efficacy of using a 5-S CAUTI bundle in the reduction of CAUTI rates among trauma patients. In a quantitative study, the researchers recruited a total of 2926 trauma patients. The analysis of the data showed that the use of the 5-S bundle led to a significant reduction in CAUTI rates among trauma patients (p-value of 0.002).

Davies et al.(2018) also conducted a study to explore the impact of using a CAUTI bundle. In a pre-and-post-study design, the researchers recruited a total of 6236 patients to take part in the study. The analysis of the data compared the rates of infections before the application of the CAUTI bundle and after its implementation. The results showed that the rates of CAUTI after the implementation of the CAUTI bundle were significantly lower compare as compared to the rates before, showing the efficacy of the CAUTI bundle.

Recently, Reynolds et al. (2022) conducted research that aimed at exploring the impact and sustainability of a multifaceted intervention in lowering CAUTI rates. This study was conducted in three large adult intensive care units among patients using urinary catheters. The analysis of the data showed a significant impact of bundle care. For example, the researchers noted a drop in CAUTI rates and the use of indwelling catheters. The positive impacts were directly associated with the implementation of the CAUTI bundle care as a strategy.

In a similar study, Mundle et al. (2020) explored the effectiveness of implementing a CAUTI bundle in preventing CAUTI incidences. The researchers conducted the study in internal medicine units where every patient admitted during the study took part in the study. The analysis of the data showed significant results relevant to this study as the researchers observed a 79% reduction in the rates of CAUTI among the patients, showing that the implementation of the CAUTI bundle care positively impacted CAUTI rates.

Sultan et al. (2022) explored the effect of using a CAUTI bundle to help prevent CAUTI occurrence among critically ill patients. In a quantitative study, the researcher recruited a total of eighty patients admitted to the intensive care units. The analysis of the data showed that the implementation of the CAUTI bundle led to a significant reduction in CAUTI rates. For example, they noted that upon the implementation of the CAUTI bundle, the CAUTI rates among the ICU patients were reduced by 50%, showing the efficacy of the intervention.

Another relevant study was conducted by Tyson et al. (2020), which focused on implementing a nurse-driven protocol designed to support catheter removal approaches to help reduce CAUTI rates. The aim of the study was to compare the CAUTI rates and the use of indwelling urinary catheters before and after implementing a nurse-driven CAUTI bundle among patients admitted to the surgical trauma intensive care unit. The analysis of the collected data led to significant results. For example, upon the implementation of the protocol, the researchers noted a significant reduction in the rates of catheter use. In addition, they also found that the protocol led to a reduction in CAUTI rates.

Shadle et al. (2021) also conducted a study to determine the impact of using a CAUTI bundle to reduce CAUTI rates. In a quantitative study design, the researchers collected data using electronic health records. The analysis of the collected data also showed relevant results. For example, the researchers realized that during the study, no CAUTI cases or incidences were reported showing that the CAUTI bundle implemented was highly effective in preventing and controlling the CAUTI rates.

More recently, Pajerski et al. (2022) carried out research that explored the impact of using CAUTI bundles in controlling the rates of CAUTI. This study was conducted in a trauma brain injury rehabilitation unit. Upon the analysis of the data, the researchers noted that there was a reduction in the CAUTI rates when the CAUTI bundle care approach was implemented. Soundaram et al. (2020) also carried out research with the aim of exploring the impact of implementing a CAUTI bundle in the control and prevention of CAUTI rates and incidence. The researchers carried out the study in adult intensive care units. The analysis of the data showed that upon the use of the CAUTI bundles, the cases of CAUTI were observed to reduce significantly by sixty percent. As such, this is another study that shows the efficacy of using a CAUTI bundle in controlling and preventing CAUTI incidences and rates.

Another study was conducted by Ravi and Joshi (2018). This study was conducted with the major aim of exploring the efficacy of a CAUTI care bundle in lowering CAUTI rates. The researchers used a bundle care approach which included training and educating the nursing staff on how to appropriately use and manage the indwelling catheters. Upon the analysis of the data, the researchers also noted a significant reduction in the rates of CAUTI among admitted patients. Therefore, this is another study that shows the efficacy of using CAUTI bundles in the prevention and control of CAUTI.

Change Model or Framework

Change models play a crucial role in the implementation of evidence-based practice projects since they offer foundations upon which the project is implemented (Jayatilleke & Lai, 2018). As such, the selected change model for this project is Kurt Lewin’s change model. According to Lewin change occurs in three distinct faces, and there are two major forces involved in a change process, the driving and restraining forces. The driving forces are known to enhance the change process, while the restraining forces oppose the change. As such, the driving forces have to overcome the restraining forces for the change process to occur successfully.

The three phases include unfreezing, change, and refreezing. In the first phase, which is refreezing, the major activity is creating an urgent need for change by pointing out the evidence of why the change should urgently be undertaken (Hussain et al.,2018). Letting the stakeholders know that there is a need for change requires effective communication.  The second phase, which is the change phase, is associated with the implementation of the proposed intervention, where the change implementers implement the initiatives to help solve the identified clinical issue. The third phase is known as refreezing. This stage entails using various efforts to ensure that the implemented change becomes part of the organization’s culture and supporting the staff to accept and sustain the change.

The stages of the model will be applied to implement the CAUTI bundles. In the unfreezing stage, the stakeholders will be alerted to the urgent need for change to help reduce the rates of CAUTI in the care setting. Appropriate communication channels will be used to inform the staff of the need to address the issue of rising CAUTI cases. The second phase, which is the change phase, will involve training the nursing staff on the proposed new bundle and how to use it. The process will then be followed by the implementation of the CAUTI bundle to help reduce the rates of CAUTI. Effective communication will also be key in this phase(Hussain et al.,2018). The last phase, which is the refreezing stage, will entail sustaining the implemented change and ensuring that the CAUTI bundle becomes part of the organization’s protocol for preventing CAUTI incidence.

Implementation Plan

Implementation is one of the most important phases of an EBP project cycle. Therefore, a conducive environment should be created to enhance the implementation process. It is also important to explore various aspects, such as the setting and how to access the potential subjects. As discussed earlier, this project involves using CAUTI bundles to reduce or lower the rates of CAUTI among patients using indwelling urinary catheters (Elkbuli et al.,2018). Therefore, the targeted setting for the project is the admission wards with patients who used indwelling urinary catheters. The patients to be considered are those who will be admitted to the admission units and using the indwelling catheters. The other targeted population is the nurses who offer nursing care to the patients in these settings. The data for evaluating the project will be obtained from electronic health records. Therefore, there will be no need to obtain informed consent. Nonetheless, the organization leaders will need to offer permission to allow the implementation process.

It is also important to consider a suitable timeline for the proposed project. A timeline acts as a guide to knowing when particular activities should be accomplished (Melnyk & Fineout-Overholt, 2019). Therefore, a period of six months has been proposed for the project. It is hoped that this duration will be sufficient to cover various project phases such as project, initiation, literature review, project implementation, monitoring, and evaluation. This duration will also be used in obtaining project feedback from the stakeholders, such as indications of carrying out corrective measures to help solve various identified problems.

The Budget and Resource List

The success of a project heavily depends on the availability of needed resources; therefore, it is important to procure the necessary resources in time. There will be a need to train the staff on the use of the new CAUTI bundle. Therefore, both material and financial resources will be required to support such an education and training process (Melnyk & Fineout-Overholt, 2019). Besides, additional resources will also be needed to help in the development of the CAUTI bundle protocol to be used in controlling and preventing the CAUTI rates. Human resources will also be required to help accomplish the project goals. The budget implication is that the project team will need to get sufficient resources that can help in training and educating the nursing staff, purchasing the training materials, hiring the educators, collecting data, data analysis, project monitoring, and well as outcome evaluation. It has been projected that the cost of the project will be $36,000, and the detailed budget and resource list have been included in the appendix.

The Study Design

A study design is important in guiding a project; therefore, it is important to choose various aspects of study design appropriately. As such, the design chosen for this project is the quantitative design which will be used in both data collection and analysis. This design has been chosen since the targeted project data is quantitative. Statistical tests will also be used as part of the project to analyze the project data, which further corroborates the use of the quantitative study design as compared to the qualitative study approach (Jolley, 2020). The quantitative study approach also supports easier data collection and analysis. The quantitative study approach is also relatively cheaper in comparison to the qualitative study design and approaches.

Methods and Instruments

Instruments and methods are a crucial part of the implementation plan, and they are important for various activities such as data collection, data analysis, and data evaluation. One of the instruments to be used in this project is the questionnaire. Questionnaires will be applied to test the nurse’s knowledge of CAUTI prevention and management. The nurses’ knowledge will be assessed before and after the education (Gunawan et al.,2021). The rationale for choosing questionnaires is that they are easier to use in collecting data. Another instrument is electronic health records which will be used to obtain the baseline data on CAUTI rates. The same instrument will also be used to obtain data on CAUTI incidences after the implementation of the proposed CAUTI bundle care.

The Process of Delivering the Intervention

The success of the implementation process hinges on the process of delivering the intervention. As part of the plan, the intervention will be delivered in various phases. In the initial phase, an assessment of the clinical setting is to be undertaken through a needs assessment approach to explore the nature of the needs (Grove & Gray, 2018). The assessment involves studying the CAUTI statistics within the organization, including the impacts and trends among patients admitted to the facility. The assessment also involves assessing the nurses’ levels of knowledge and awareness regarding CAUTI and control of CAUTI using CAUTI bundles. The process will be key in coming up with relevant strategies to use in the project.

The next step will entail educating and training the nurses on the use of the proposed CAUTI bundles to help reduce the rates of CAUTI. The next step will then involve the implementation of the intervention, where the efficacy of the intervention will be tested. As part of the plan, the staff will be closely supervised for a considerable duration to ensure that they are correctly and adequately implementing the bundle elements. The next part involves collecting the data associated with the intervention and analyzing the data to determine the efficacy of the intervention in reducing the CAUTI rates.

The Stakeholders Required to Complete the Project

Stakeholders form a crucial part of the project. As such, it is crucial that they be identified in time so that they can be involved from the onset of the project (Lehane et al.,2018). Early involvement of stakeholders helps in limiting the chances of resistance. The following stakeholders have been identified; the chief executive officer, the nurse manager, the unit managers, the hospital finance officer, the nursing staff working in the admission wards, and the physicians. The hospital’s chief executive officer will give permission to accomplish the project in the organization. The nurse manager will play a critical role in coordinating the unit activities related to the project implementation. The unit managers will discharge duties related to each unit. The finance officer will also help with feasibility assessment, financial viability, and the best ways to acquire the needed resources. The nurses are at the forefront of the project and will help in the active implementation of the intervention. The physicians also take part in the treatment of the patients admitted to the wards and, therefore, will support the nursing team in implementing the proposed CAUTI bundle.

Potential Barriers or Challenges to The Plan

            Implementing an evidence-based practice project may face various challenges or barriers which may need to be mitigated if the project implementation process is to be a success. The implication is that appropriate strategies should be formulated in time to help overcome the challenges or barriers. Among the potential challenges are potential difficulties in obtaining the resources needed, especially financial resources (Lehane et al.,2018). Project failure may be the result if sufficient funds are not obtained. Therefore, a solution should be explored. One of the solutions is writing funding proposals to potential sponsors or financiers. The other expected barrier or challenge is resistance by the leadership or the nursing staff. The nursing staff may offer resistance to the use of the proposed bundle since it may need more time. The resistance can be reduced by training the nurses to help them have a better understanding of the proposed initiative to reduce the chances of resistance.

Evaluation Plan

Evaluation is one of the most important stages and the last stages of evidence-based practice project initiatives. As such, it is crucial to come up with an evaluation plan which can be applied in assessing the impact of the implemented intervention. This phase is also crucial in exploring how effective the strategies or methods used in the project have been (Dang et al.,2021). As part of the evaluation plan, it is important to explore the expected outcomes as far as the project is concerned. In the previous sections, it was indicated that the nursing staff would need training regarding the use of the proposed CAUTI bundle. Therefore, among the expected outcomes is improved nurse knowledge and skills in the use of CAUTI bundles to control the rates of CAUTI (Elkbuli et al.,2018). The next expected project outcome is the reduction in CAUTI rates. It is hoped that the implementation of the CAUTI bundle will lead to a reduction in CAUTI rates by at least 60%. Such a feat will be used as a reflection of the efficacy of the intervention. Another expected outcome is that the organization will adopt the CAUTI bundle protocol as a standard intervention for preventing and managing CAUTI in the organization. Such an expectation will be made easier by positive project outcomes.

The Data Collection Tools

Data collection tools are important in the project phases, especially the evaluation phase in obtaining project data to be used in evaluating the efficacy of the implemented intervention. One of the data collection tools is electronic health records. The electronic health records will be applied to obtain data on the rates of CAUTI after implementing the CAUTI bundle protocol. This data will then be compared with the baseline data which was obtained at the start of the project. Such a comparison will ventilate more on whether the intervention has been effective or not.

The next targeted tool is the questionnaires. The questionnaires will be used to assess the nurses’ skills and knowledge concerning the use of the CAUTI bundle to prevent and control CAUTI. The knowledge gained after education will be compared with the baseline knowledge to determine the efficacy of the education program. Questionnaires will also be used to assess the attitude of patients and nurses concerning the implementation of the new CAUTI bundle. Questionnaires will be appropriate as the project utilizes a quantitative design approach. The tool is also valid as they have been validated and shown to be effective in measuring knowledge (Yaddanapudi& Yaddanapudi, 2019). The tool is reliable since the same set of questions will be used

The Statistical Tests

Statistical tests are used in the data analysis process to help determine the efficacy of the intervention. The major thrust of this project is to compare the rates of CAUTI in the admission units before and after the implementation of a CAUTI bundle. Therefore, one of the most appropriate statistical tests to use in this case is paired t-test. The paired t-test has been chosen since it has been shown to be effective in measuring the variation between a set of paired samples. This project will focus on the pre and post-test rates scores and CAUTI rates. Therefore, the chosen statistical test will help in determining the significance of the considered set of scores. Mean will also be used, especially in the nurse knowledge scores regarding the use of CAUTI bundles to control the rates of CAUTI.

The Methods of Use and the Evaluation of the Outcomes

Methods and strategies used in the project may impact project outcomes; hence it is important to explore them. The questionnaire to be applied in the project, as part of the plan, is expected to have scaling questions, multiple-choice questions, and dichotomous questions. It is important to use different formats and approaches to questions since the project should determine various changes associated with the implemented initiative. Various validated scales will be used in formulating the scaling questions and use scales, such as 1 to 5. On the other hand, the dichotomous questions require the research subjects to either answer a yes or a no. It is important to use these kinds of questions for a complete evaluation of the project (Melnyk & Fineout-Overholt, 2022).

Strategies to Be Taken If the Outcomes Do Not Provide Positive Results.        

            Quality improvement projects and evidence-based practice projects are usually designed with the hope and aim of positive outcomes. Indeed, positive outcomes are usually achieved under normal circumstances (Linsely et al.,2019). It is important to note that in some cases, positive outcomes may not be the results observed. Hence the project team should always put measures in place that can be used as part of the mitigation process in the event that the results obtained are not positive. As part of the plan, among the strategies to be used in the event that the results are not positive is the do a reexamination of the implemented intervention. Reexamination can be vital in offering insights into particular or specific areas which might have led to the observed failure. Another expected strategy is the extension of the project timeline. Extending the project timeline can be necessary to help the project team identify areas of weakness, revise vital parts of the project and implement corrective measures to help in improving the chances of the project succeeding.

The Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution

            An implemented evidence-based practice project can lead to various outcomes; in some cases, the outcomes can be desirable, while in other cases, the outcomes may not be desirable. Therefore, it is important to put in place an appropriate plan to maintain, extend, revise, or discontinue the implemented solution or initiative as part of the overall plan; the project will be maintained if the outcomes turn out to be as expected. In other words, the project will be maintained if the outcomes are positive and the implemented solution is positively affecting or impacting the patients.

As part of the plan, the project will also be maintained if it is cost-effective. Healthcare cost has recently become an important point in the healthcare environment as the costs have been going up. As such, any quality improvement projects or evidence-based practice projects should be cost-effective. Therefore, this project will not be different and will, therefore, be maintained if it is cost-effective. In some cases, the evaluation phase may produce or give results that are not conclusive. In such cases, there may be a need to get appropriate results that can be used in evaluating the project outcomes. Such cases require that the project be extended. Therefore, the project will be extended if the outcomes and inconclusive (Melnyk & Fine-Overholt, 2022). The major purpose of extending the project is to obtain appropriate additional data that can then be applied to determine the effectiveness of the project.

 Under certain conditions, the project may need to be revised. A revision will be pursued if the strategies do not align with the project outcomes. The revision will be undertaken to get more time which can be used in adopting improvement interventions. Such improvement interventions will increase the chances of the project succeeding. As part of the plan, the project may also be discontinued under particular instances or circumstances. For example, discontinuation will occur in the case that the project causes harm to the patients and the staff. The solution will also be discontinued if it pauses a risk to the lives of the staff and the patients.

Conclusion

The adverse impacts of CAUTI have led to research efforts over the years to help control and prevent these infections. Therefore, various evidence-based interventions exist. However, it is worth noting that these evidence-based interventions have shown varied efficacy; in addition, the problem still persists in the patient care setting. As such, the proposed evidence-based approach or intervention is the use of a CAUTI bundle. As opposed to single interventions which can be applied to prevent and reduce the rates of CAUTI, a bundle-based care approach entails combining or integrating various interventions for better outcomes. Therefore, the bundle care approach chosen entails various activities that can have a synergistic effect of reducing CAUTI rates or preventing them. It is expected that the proposed evidence-based practice solution of using a CAUTI bundle will lead to a significant reduction in the number of patients acquiring CAUTI in hospital settings. The literature review performed showed that the use of CAUTI bundles in controlling the rates of CAUTI could largely be effective when appropriately applied. This write-up has also explored various aspects of the project, such as literature review, organizational culture and readiness for change, the change framework, project implementation, and project evaluation.

References

Cleary‐Holdforth, J., O’Mathúna, D., & Fineout‐Overholt, E. (2021). Evidence‐based practice beliefs, implementation, and organizational culture and readiness for EBP among nurses, midwives, educators, and students in the Republic of Ireland. Worldviews on Evidence‐Based Nursing18(6), 379-388. https://doi.org/10.1111/wvn.12543

Davies, P. E., Daley, M. J., Hecht, J., Hobbs, A., Burger, C., Watkins, L., … & Brown, C. V. (2018). Effectiveness of a bundled approach to reduce urinary catheters and infection rates in trauma patients. American Journal of Infection Control46(7), 758-763   Https://doi.org/10.1016/j.ajic.2017.11.032

Elkbuli, A., Miller, A., Boneva, D., Puyana, S., Bernal, E., Hai, S., & McKenney, M. (2018).   Targeting catheter-associated urinary tract infections in a trauma population: a 5-S bundle preventive approach. Journal of Trauma Nursing| JTN25(6), 366–373. 10.1097/JTN.0000000000000403

Flores-Mireles, A., Hreha, T. N., & Hunstad, D. A. (2019). Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Topics in Spinal Cord Injury Rehabilitation25(3), 228-240. https://doi.org/10.1310/sci2503-228

Grove, S. K., & Gray, J. R. (2018). Understanding nursing research e-book: Building an evidence-based practice. Elsevier health sciences.

Gunawan, J., Marzilli, C., & Aungsuroch, Y. (2021). Establishing an appropriate sample size for developing and validating a questionnaire in nursing research. Belitung Nursing Journal7(5), 356-360. https://doi.org/10.33546/bnj.1927

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002

Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatrics18(1), 1-11. https://doi.org/10.1186/s12877-018-0997-7

Jayatilleke, S., & Lai, R. (2018). A systematic review of requirements changes management. Information and Software Technology93, 163-185. https://doi.org/10.1016/j.infsof.2017.09.004

Jolley, J. (2020). Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals. Routledge

Kranz, J., Schmidt, S., Wagenlehner, F., & Schneidewind, L. (2020). Catheter-associated urinary tract infections in adult patients: Preventive strategies and treatment options. Deutsches Ärzteblatt International117(6), 83. https://doi.org/10.3238%2Farztebl.2020.0083

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … & Hegarty, J. (2018). Evidence-based practice education for healthcare professions: an expert view. BMJ Evidence-Based Medicine. http://dx.doi.org/10.1136/bmjebm-2018-111019

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.

Melnyk, B. M., Hsieh, A. P., & Mu, J. (2022). Psychometric properties of the Organizational Culture and Readiness Scale for System‐Wide Integration of Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing19(5), 380-387. https://doi.org/10.1111/wvn.12603

Mundle, W., Howell-Belle, C., & Jeffs, L. (2020). Preventing catheter-associated urinary tract infection: A multipronged collaborative approach. Journal of Nursing Care Quality35(1), 83-87. Doi: 10.1097/NCQ.0000000000000418

Pajerski, D. M., Harlan, M. D., Ren, D., & Tuite, P. K. (2022). A clinical nurse specialist–led initiative to reduce catheter-associated urinary tract infection rates using a best practice guideline. Clinical Nurse Specialist36(1), 20-28. Doi: 10.1097/NUR.0000000000000643.

Ravi, P. R., & Joshi, M. C. (2018). Role of “bladder care bundle” and “infection control nurse” in reducing catheter-associated urinary tract infection in a peripheral hospital. Journal of Marine Medical Society20(2), 116. Doi: 10.4103/jmms.jmms_8_18

Reynolds, S. S., Sova, C. D., Lewis, S. S., Smith, B. A., Wrenn, R. H., Turner, N. A., & Advani, S. D. (2022). Sustained reduction in catheter-associated urinary tract infections using multifaceted strategies led by champions: a quality improvement initiative. Infection Control & Hospital Epidemiology43(7), 925-929. https://doi.org/10.1017/ice.2021.135

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit. Critical Care Nurse41(2), 62-71.https://doi.org/10.4037/ccn2021934

Soundaram, G. V., Sundaramurthy, R., Jeyashree, K., Ganesan, V., Arunagiri, R., & Charles, J. (2020). Impact of care bundle implementation on the incidence of catheter-associated urinary tract infection: A comparative study in intensive care units of a tertiary care teaching hospital in South India. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine24(7), 544. https://doi.org/10.5005%2Fjp-journals-10071-23473

Sultan, M. A., Ahmed, H., & Kandeel, N. A. (2022). The Effect of Implementing CAUTIs Bundle on Prevention of Hospital-Acquired Urinary Tract Infections among Critically Ill Patients. Mansoura Nursing Journal9(1), 141-153. https://mnj.journals.ekb.eg/article_259013_7bf12c0832ee68848bd1ddcedfa1e4f7.pdf

Tyson, A. F., Campbell, E. F., Spangler, L. R., Ross, S. W., Reinke, C. E., Passaretti, C. L., & Sing, R. F. (2020). Implementation of a nurse-driven protocol for catheter removal to decrease catheter-associated urinary tract infection rate in a surgical trauma ICU. Journal of Intensive Care Medicine35(8), 738-744. https://doi.org/10.1177/0885066618781304

Yaddanapudi, S., & Yaddanapudi, L. N. (2019). How to design a questionnaire. Indian Journal of Anesthesia63(5), 335–337. https://doi.org/10.4103/ija.IJA_334_19

After finishing this course and gaining vital insights into evidence-based practice (EBP), I have established three strategies I will integrate into my practice to improve the implementation of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as an intervention in the pediatric emergency department for addressing early traumatic injuries among pediatric patients. The first strategy is to prioritize employing the best available evidence in my practice (Sherwood & Barnsteiner, 2021). This entails staying updated on current research findings, conducting thorough literature reviews, and employing evidence-based protocols and guidelines. Depending on EBP, I will ensure that TF-CBT integration correlates with the latest clinical and research best practices. This will improve the quality of care offered to pediatric patients experiencing trauma, enhancing the effectiveness and efficiency of the intervention and promoting better outcomes. 

The other strategy I will incorporate is collaborating with interdisciplinary team members. I acknowledge the significance of working with and collaborating with interdisciplinary team members. This involves professionals from social work, child life services, psychology, and other relevant disciplines (Sherwood & Barnsteiner, 2021). Furthermore, I will collaborate with these team members to help me learn from their perspectives, expertise, and diverse skills. Also, this collaborative approach permits a comprehensive and holistic approach to trauma care, ensuring that the pediatric patient’s unique needs are addressed efficiently. Moreover, collaboration enables coordinated care sharing of knowledge and offers a multidisciplinary support system for patients and their families.  

Furthermore, the third strategy I will incorporate is continuous quality improvement (CQI). According to Hill et al. (2020), continuous quality improvement is a significant strategy for improving the implementation of TF-CBT in the pediatric emergency department. In accomplishing this, I will actively participate in CQI activities such as conducting audits, quality improvement committees, and collecting data on outcomes and processes (Hill et al.,2020). In systematically monitoring and assessing the implementation of TF-CBT, I can measure the efficiency of the intervention and make vital adjustments to ensure ongoing success. This data-driven approach allows for evidence-based decision-making and supports a culture of continuous learning and improvement. 

References 

Hill, J. E., Stephani, A., Sapple, P., & Clegg, A. J. (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: A systematic review. Implementation Science, 15(1). https://doi.org/10.1186/s13012-020-0975-2 

Sherwood, G., & Barnsteiner, J. (Eds.). (2021). Quality and safety in nursing: A competency approach to improving outcomes. John Wiley & Sons.