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Pages:
5 pages/β‰ˆ1375 words
Sources:
5 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
Document:
MS Word
Date:
Total cost:
$ 21.6
Topic:

PICO Question: Care Patients With Indwelling Urinary Catheters

Essay Instructions:

My PICO question
P- (Patient, population, or problem) Acute care patients with indwelling urinary catheters
I- (Intervention or treatment) Utilizing a catheter insertion and care bundle 
C- (Comparison intervention or treatment) Not using a catheter insertion and care bundle
O- (Outcome) To decrease the occurrence of CAUTIs by 50%.
In acute care patients with indwelling urinary catheters, will utilizing a catheter insertion and care bundle versus not using a catheter insertion and care bundle reduce the number of CAUTI occurrences by 50%?
Guidelines:
Design for Change Proposal Guidelines
PURPOSE
You are to create a Design for Change proposal inclusive of your PICO and evidence appraisal information from your Capstone Project Milestone #1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program. 
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes. 
CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO #1)
CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO #2)
DIRECTIONS
1. Create a proposal for your Design for Change Capstone Project. Open the template in Doc Sharing. You will include the information from Milestone #1, your PICO question, and evidence appraisal, as you compose this proposal. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. 
2. The format for this proposal will be a paper following the Publication manual of APA 6th edition.
3. The paper is to be four- to six-pages excluding the Title page and Reference page.
4. As you organize your information and evidence, include the following topics.
a. Introduction: Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.
b. Change Plan: Write an overview using the Johns Hopkins Nursing EBP Model and Guidelines (2012)
i. Practice Question 
ii. Evidence
iii. Translation
c. Summary
5. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
6. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.
Example Essay
This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so you cannot use first person. Remember that you will keep all the bolded headings and just remove the non-bolded content when you start your paper. 
Change Model Overview
In this first paragraph, provide an overview of the John Hopkins Nursing Evidence-Based Practice Process. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the John Hopkins EBP Process.
Practice Question
Step 1: Recruit Interprofessional Team
You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Do not list your team members by name but instead by position (pharmacists, charge nurse etc)
Step 2: Develop and Refine the EBP Question
Restate your question. Include the PICO elements but make sure you write them in paragraph form and not in list format.
Step 3: Define the Scope of the EBP 
Why is this a problem? Give statistics and information to back the scope of the problem. How does this problem impact healthcare on a broader scale? 
Steps 4 and 5: Determine Responsibility of Team Members
Why are the members chosen important to your project? What are their roles?
Evidence
Steps 6 and 7: Conduct Internal/ External Search for Evidence and Appraisal of Evidence
What type of evidence did you find? EBP guidelines? Quality improvement data? Position statements? Qualitative research? Quantitative research? Briefly discuss the strength of this research. This is not where you describe the results of your studies. This is done in the following steps. 
Steps 8 and 9: Summarize the Evidence 
Synthesize the information that you obtained from your sources. You will need at least four sources. Of these four sources, three must be from peer-reviewed articles. The other source can be from a reputable source. See page 44 of your text for examples of sources you can use. 
In this section, you need to synthesize the information from the articles. Feel free to cite multiple articles within one sentence. This section should be one paragraph that is a summation of information from the multiple articles. Be sure and cite all of your references, in proper APA format, from the articles into this one paragraph.
Step 10: Develop Recommendations for Change Based on Evidence
What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program. 
Translation
Steps 11, 12, and 13, 14: Action Plan
You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study? What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results. 
Steps 16 and 16: Evaluating Outcomes and Reporting Outcomes
What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders?
Steps 17: Identify Next Steps
How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent? 
Step 18: Disseminate Findings
How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)?
Conclusion
Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the three levels of change for the John Hopkins EBP process. 

Essay Sample Content Preview:
PICO Question
Student:
Professor:
Course title:
Date:
PICO Question
In this paper, a Design for Change proposal is created which includes the PICO question as well as evidence appraisal information. The identified problem is that at the moment, in acute care patients with indwelling urinary catheters, catheter insertion and care bundle are not used in treatment and for this reason, the occurrence rate of catheter-associated urinary tract infections (CAUTIs) among this population is high. The potential solution is to use a catheter insertion and care bundle so as to reduce the occurrence of CAUTIs by more than fifty percent.
Change Model Overview: John Hopkins Nursing Evidence-Based Practice Process 70
This model is a great problem-solving approach to clinical decision-making. Nurses should utilize this model as it provides a framework for guiding the synthesis as well as translation of evidence into practice. Moreover, it should be used as it ensures that the most recent best practices and research findings are appropriately and quickly incorporated into patient care (Johns Hopkins Medicine, 2016).
Practice Question
In acute care patients with indwelling urinary catheters, will utilizing a catheter insertion and care bundle versus not using a catheter insertion and care bundle reduce the number of catheter-associated urinary tract infections (CAUTIs) occurrences by 50%?
Step 1: Recruiting Inter-professional Team
The inter-professional team is made up of the following key stakeholders: a pharmacist, physician, charge nurse, registered dietician, therapist, pastoral care provider, individual patient’s nurse and social worker. The members of this team are from different professions.
Step 2: Develop and Refine the EBP Question
In acute care patients with indwelling urinary catheters (P), will utilizing a catheter insertion and care bundle (I) versus not using a catheter insertion and care bundle (C) reduce the number of CAUTI occurrences by 50%? (O)
Step 3: Defining the Scope of EBP
At the moment, the problem is that catheter insertion and care bundle are not being used in acute care patients with indwelling urinary catheters. As a result, there are high occurrence rates of CAUTI. The urinary system makes up an estimated 40 percent of all hospital-acquired infections (HAI). In rehabilitation wards, critical care units and medical-surgical units, urinary tract infections are the most common kinds of HAIs, and roughly 80% are linked to using an indwelling urinary catheter (Elpern, 2016). Long-term and acute care facilities should optimally utilize indwelling catheters and avert complications like CAUTI.
Steps 4 and 5: Determining Responsibility of Team Members
The 8 team members were chosen since they have a wide range of expertise and experience from different professions and multiple health disciplines. They possess diverse skills and knowledge and share an integrated set of goals and can make use of mutually dependent collaboration involving coordination of services, knowledge sharing and communication so as to offer services to the patients. Their roles are to maximize patient safety and limit adverse events; optimize and enhance quality and positive outcomes for the patients; i...
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