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NR451 Capstone Course Preventing Central Venous Catheter Infections (Research Paper Sample)


My project is based on skin antisepsis in reducing central venous catheter-related infections.
The identified practice issues are: inconsistent catheter care guidlines, poor practice, poor financial support, staff resistance to change in nursing practice, lack of time, workload pressure, not enough education.
Design for Change Proposal Guidelines
You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet 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.
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)
Milestone 2 consists of the proposal for your Design for Change Capstone Project. Submit this assignment to the Dropbox by the end of Week 4.
Milestone 2 is worth 225 points.
1. Create a proposal for your Design for Change Capstone Project. Open the NR451_Milestone2_Design_Proposal_ template in Course Resources to create your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.
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 Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.
c. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.
d. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.
e. Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.
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.


Preventing Central Venous Catheter-Related Infections
Chamberlain College of Nursing
NR451 RN Capstone Course
Term and Year
Preventing Central Venous Catheter-Related Infections
Central venous catheters are essential tools used to assist patients in several ways. The most common function of a CVC is to administer intravenous medication during chemotherapy and antibiotics safely. CVC is also used for blood transfusion and dialysis among patient with renal problems. Catheters are effective because they allow patients to live a more optimal life outside the hospital. Despite the numerous benefits, the central venous catheters are the leading cause of nosocomial bloodstream infections (Denny, 2016).
Aseptic technique is commonly used to care for central line catheter and reduce the chances of contamination. The aseptic technique involves the hand hygiene using alcohol, betadine or chlorhexidine. The surrounding skin surface can influence the likelihood of infection that is why the skin surface needs to be disinfected with a solution (Denny, 2016). Several studies have proved that chlorhexidine bath can improve patient outcomes, this serves as evidence to nursing practice.
Poor nursing practices have adverse effects on patient health outcomes, causing a longer hospital stay. Staff education on adherence to aseptic technique and strict guideline are important to minimize blood stream infections. Implementing chlorhexidine baths will help reduce central-line associated bloodline infections will help reduce bloodline infection, but the outcome greatly depends on care practices by health care providers (Denny, 2016).
Overview of the ACE Star Model Evidence-Based Practice Process.
The ACE Star Model will be adopted during the implementation of the Aseptic technique to minimize nosocomial bloodstream infections. The ACE Star Model consist of five stages that depict various forms of knowledge in a sequence as research evidence moving from several cycles combined with the general knowledge that is integrated into practice (Aarons, Hurlburt & Horwitz, 2011).
The ACE Star Model offers a framework for putting evidence-based practices into operation. To use ACE star model in implementing chlorhexidine bath, the following phases will be carefully addressed as a requirement of the model. Discovery of research followed by summarizing the evidence, translation of evidence combined with guidelines into an intervention, integration of knowledge into clinical practice and evaluating the outcome (Aarons, Hurlburt & Horwitz, 2011).
Change Model Overview
Several preventive measures have been studied over time in an attempt to minimize infection incidence using catheters; however, the most effective measure that reduces colonization within the catheter skin insertion site or the infusion line (Climo et al., 2013). Studies suggest that implementing measures like chlorhexidine bath can improve patient outcomes, making an impact in nursing care and can serve as the best evidence of the nursing practice. Poor nursing practices are associated with longer hospital stay and increase mortality among hospitalized patients (Climo et al., 2013).
The Scope of the EBP
Use of central venous catheters forms part of modern medical practice whereby these devices are inserted to assist patients to cope with certain illness, CVC comes with greater risk of device-related infection than any other medical devices. CVC infections are the major causes of both mortality and morbidity among patients (Karki & Cheng, 2012). CVC are the main sources of bacteremia and septicemia among hospitalized patients. Organisms linked to Catheter-related bloodstream infections are commonly found on the skin within the insertion site, hence leading to colonization of the inserted catheter (Karki & Cheng, 2012).
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