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Educating Staff: Implementing Change Guidelines

The purpose of this assignment is to create the Educating Staff: Implementing Change Project PowerPoint presentation. Your plan is to educate the staff that will be involved in the pilot program. You will need to educate them on the problem, show the supporting evidence, and how your pilot plan will be implemented.

  1. Create an educational presentation for staff before the launch of your change project. This should inform the staff of the problem, your potential solution, and their role in change project.
  2. The format for this proposal will be a PowerPoint presentation.
  3. Below are the main topics or bullet points for your slides:
    1. Title slide
    2. Description of the Ace Star change model that you have used for this project.
    3. Practice Issue (Using the one of the required articles)
    4. Scope of the problem—use basic statistics from what you know of the problem in your work area.
    5. Your team/stakeholders
    6. Evidence to support your need for change—from your Evidence Summary
    7. Action Plan
    8. Timeline for the plan
    9. The nurse’s role and responsibility in the pilot program
    10. Procedure (what steps are to be taken to complete this change process, from start to finish?)
    11. Forms that will be used (if applicable)
    12. Resources available to the staff—including yourself
    13. Summary
    14. References

    This is my topic:Health-Associated Infections (HAI)Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic Reviews 2015Issue 2Art. No.: CD004985. doi:10.1002/14651858.CD004985.pub5.

    Practice Issue Worksheet

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    List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support):Health-Associated Infections (HAI)Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD004985. doi:10.1002/14651858.CD004985.pub5.
    What is the nursing practice issue you have identified related to the topic you have chosen?The nursing issue identified is a study about the preoperative infections. Precisely, the problem involves the investigation on whether bathing with the antiseptics before surgery can prevent the occurrence of the surgical site infections. Besides, the issue aims at identifying whether bathing with antiseptic reduces the risk of contracting a surgical disease.
    Fully describe the scope of the practice issue: Despite the increased advancement in healthcare-related technology and know-how, the surgical site infections have remained a threat in most of the countries around the world. As a result, scholars and researchers have embarked on the intensive task of investigating the best method of eradicating the infections. However, this effort has not yet generated any fruit, and hence, the topic continues to demand more research. The surgical site infections have continued to threaten the well-being of the patient as a result of increased health complications upon contamination or occurrence. Firstly, the diseases have proven to affect the healing period of the patient substantially. Secondly, the surgical site infections can lead to reduced immunity in the body of the host and hence exposing the patient to other opportunistic infection. Finally, surgical infections can trigger resistance to antibiotics leading to incurability of the wounds and other diseases. Thus, nurses and physician have been recommending their patients to thoroughly embrace the use of antiseptic soaps when bathing to minimize the risk of surgical infections. However, the merit of showering with antiseptic soap with the aim of preventing the SSE infection continues to be disputed. Besides, the idea attracts divided mixed reactions with a segment of the scholars supporting the concept and the later arguing against it and claiming that ordinary soap and antiseptic soap do not influence SSE infections whatsoever.Most of the studies conducted across board point out the merit and contribution of the antiseptic soaps in preventing the SSE infections. Notably, the scholars and health practitioners supporting the idea attribute the antiseptics soaps to many advantages. Firstly, the antiseptic soaps contain vital antimicrobial substances with the ability to prevent the wound from infection during and shortly after the surgery. Examples of antimicrobial traces found in antiseptic soaps include Benzalkonium chloride and Triclosan. The debate on the reliability of the antiseptic soap in preventing the SSE infection creates the need for this study with the aim of having evidence-based research which is vital for legislation and decision making in the short and long term.
    What is the practice area?__x_ Clinical__x_ Education__x_ Administration__x_ Other (List): Policymakers
    How was the practice issue identified?(check all that apply)_x__ Safety/risk management concerns_x__ Unsatisfactory patient outcomes_x__ Wide variations in practice_x__ Significant financial concerns _x__ Difference between hospital and community practice_x__ Clinical practice issue is a concern___ Procedure or process is a time waster_x__ Clinical practice issue has no scientific base_x_ Other: Increased rate of readmission of patients due to SSI, continued development of resistance of the SSI
    Describe the rationale for your checked selections: There are various advantages associated with addressing the issues identified above in the effortto address the challenge of SSI across the globe. Firstly, settling the dispute on whether the antiseptic soap can prevent the SSI will reduce the cost of healthcare. Secondly, the gap and variation in practice will be bridged significantly. The health standards will be raised at a great extent and hence, reduce the mortality rate, opportunistic diseases and guarantee the safety of the patients. Finally, the checked selection will help address the issue and come up with concrete scientific proof of whether or not antiseptic soap should be considered the better option of preventing surgical infections.
    What evidence must be gathered? (check all that apply)
    _x__ Literature search_x__ Guidelines_x__ Expert Opinion___ Patient Preferences _x__ Clinical Expertise_x__ Financial Analysis_x__ Standards (Regulatory, professional, community)_x__ Other: Studying and comparing the scholar’s opinion.
    Describe the rationale for your checked selections:

    Evidence Summary Worksheet Directions: Please type your answers directly into the worksheet.

    Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms: The challenge handling the surgical site infections continue to deteriorate especially in the wards where I work. Notably, the primary cause of the worsening is the absence of standards stipulating the method of preventing surgical infection. In quantify the challenge, it is good to compare result based on an annual survey. The policy to use antiseptic in the ward that I work was enacted in 2016. In 2016, the number of patients diagnosed with SSI was 2094. In 2017 after passing the policy, the number dropped to 1460. Notably, among the diagnosed patients, about 51 percent comprised of people in the age bracket above 50 years.
    Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA reference for any additional optional supplemental scholarly source related to the review you wish to use.Jakobsson, J., Perlkvist, A., & Wann‐Hansson, C. (2011). Searching for evidence regarding using preoperative disinfection showers to prevent surgical site infections: a systematic review. Worldviews on Evidence‐Based Nursing8(3), 143-152.Kamel, C., McGahan, L., Polisena, J., Mierzwinski-Urban, M., & Embil, J. M. (2012). Preoperative skin antiseptic preparations for preventing surgical site infections: a systematic review. Infection Control & Hospital Epidemiology33(6), 608-617.Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD004985. doi:10.1002/14651858.CD004985.pub5.
    Identify the objectives of the article:The materials aim to identify the contribution of the antiseptic soap in preventing the surgical site infection. Secondly, the report seeks to compare result from surveys carried out on patient involving the use of antiseptic and ordinary soaps. Finally, the articles aim at setting a new pace by summarizing the main findings, giving the recommendations necessary for decision making policing. Provide a statement of the questions being addressed in the work and how these relate to yourpractice issue: The primary account of the problem addressed by the survey includes explaining whether the antiseptic soaps prevent surgical infections. Another statement of the question is how the antiseptic soap prevents SSI infections. Finally, the paper also addresses other issues such as assessment of the extent of efficiency of the antiseptic soap, the diffusion of the information and the opinion of other scholars regarding the topic.
    Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.The authors suggest various interventions aimed at improving the patient’s outcome. The suggestion include;• Conduction of more research on the topic and other issues of concern. • The authors acknowledge the need for designing better ways of controlling SSI infections as opposed to the use of antiseptic soaps.• The author also recognizes the need to improve the cure and care for the people with the SSI infection to reduce the suffering of the patients with the SSI infection.• The scholars also identify the need for the development of more effective drugs with the ability to overcome the challenge of resistance with the aim of reducing the cases of admission and re-admission in the hospital due to SSI infections.Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome. Consider the relevance to your project proposal for the Milestone 2 project paper. (If an optional supplemental source is also used, include a statement of relevance to it as well.)The research on whether antiseptic is efficient in reducing the risk of contracting the SSI infection continue to raise disparity due to variation in the authors’ opinions and findings.According to Jakobsson, Perlkvist & Wann (2011), a survey on a random and unbiased sample of patients proved that bathing with antiseptics reduces contraction of SSI infection with up to 30 percent. However, the credibility of the finding is disputable due to the failure of explanation of the type of antiseptics that are more effective than others. On the other hand, Kamel 2012 concludes by saying that bathing with antiseptic does not guarantee protection from SSI infection. The author defends his arguments by saying that to prevent the SSI infections completely; physician should also play a central role in safeguarding the wounds from bacterial exposure during surgery. Finally, Webster & Osborne (2015) endorses the effectiveness of the antiseptic soaps in preventing not on only the SSI infections but also other related skin infections.
    Outline evidence-based solutions that you will consider for your project.In increase the efficiency and effectiveness of this project, it is paramount to change it into an evidence-based solution. Firstly, it is critical to enhance the evidence found in this project by linking it with other researches with similar findings and conclusion. Connecting the project to previous surveys will increase the confidence of various stakeholders regarding the accuracy of the project. Consequently, the increased endorsement will boost the possibility of adopting the ideas of the project and changing it into law. Another important method of strengthening the project evidence base is conducting a thorough results analysis. After certifying the use of antiseptics as a method of controlling the SSI infections, it is also critical to review and analyze the result and performance over time. Besides, to improve the evidence of the project findings, it is essential to conduct a hypothesis test.The main aim of the hypothesis test is to reject the claims that the use of antiseptics does not reduce the chances of contracting SSI infections. Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project. Various stabling blocks can reduce the ability to utilize this research. Firstly, the sources of information which facilitated the study are limited and thus, there is a possibility of omission, distortion or understating of facts and information. The infrastructure and resources required to implement this research are inadequate. Notably, the technical, technological, capital and human resources necessary to implement the recommendations and findings of this research are limited. The study was carried out within a limited geographical region thus missing out information from other parts of the world. Besides, the implementation and interest of this research may be destabilized by the existing institutional and national policies. Finally, the study was conducted within a limited period thus limiting the period to carry more research out and look for supportive information.

    Health-Associated Infections (HAI)In spite of advances in healthcare-related technology and technical knowledge, surgical site infections (SSI) remain a major health care problem across many countries in the world (Kamel et al., 2012). As a consequence, nursing researchers and scholars have, in recent years, sought to investigate the most appropriate strategies for eradicating these infections. However, these efforts have barely resulted in substantial success, thereby highlighting the need for further research in the area (Webster & Osborne, 2015). SSIs significantly undermine the well-being of hospitalized patients. For instance, they can reduce a patient’s immunity and hence expose him/her to other opportunistic infections (Webster & Osborne, 2015). They can also result in antibiotic resistance which can undermine the healing process of wounds and other conditions. The use of antiseptic agents has been largely recommended as an effective strategy of minimizing the risk of surgical infections, although their effectiveness in preventing SSIs has been a major source of debate among researchers. Change Model Overview The ACE Star Model of Knowledge Transformation helps nurses to understand the cycles, nature and characteristics of information that is used in the various elements of evidence-based practice (EBP) (Orta et al., 2016). The model provides a framework for organizing EBP processes and approaches by grouping together both new and old ideas about improving patient care. In addition, the model situates previous nursing literature and research in the context of EBP (Orta et al., 2016). Hence, it provides nurses with a framework for systematically implementing processes of evidence-based practice. The ACE Star Model documents research evidence as it moves through the various cycles of knowledge transformation, knowledge discovery, synthesis of evidence, translation into practice recommendations, integration into practice and evaluation (Ortaet al., 2016).The Scope of the EBP The identified practice issue related to HAIs concerns preoperative infections and the role that bathing with antiseptic plays in reducing the risk of contracting a surgical disease and in infection control pertinent to the provision of safe patient care. According to Webster and Osborne (2015) nosocomial infections or HAIs are among the most common healthcare complications impacting hospitalized patients. Of these nosocomial infections, surgical-site infections (SSIs) comprise about 20%. Statistics by the Centers for Disease Control and Prevention (CDC) indicate that, in 2010, about 16 million operations were conducted in acute care hospitals across the United States (Webster & Osborne, 2015). Recent prevalence studies have also determined that SSIs account for about 31% of all nosocomial complications among hospitalized patients (Pyrek, 2015). Recent technological advancements in health care practices notwithstanding, SSIs remain a significant cause of mortality and morbidity across healthcare facilities in the country. Stakeholders Issues of infection control and patient safety are the responsibility of all members of the healthcare team. Stakeholders for this project will include hospital directors and managers, an infection control nurse, an infection control physician, a nurse manager, an infection prevention expert and an antimicrobial pharmacist. Responsibility of Team MembersHospital managers and directors will be responsible for ensuring that the goals and objectives of the project are met. Infection control nurses will be responsible for assessing the effectiveness of current practices and, thereby, recommending appropriate changes. The nurse manager will be responsible for ensuring the incorporation of best infection prevention services, such as hand hygiene, in hospital policies and procedures. The infection control physician will serve as the champion of antimicrobial stewardship in the facility, in addition to advising clinicians and pharmacists on the most appropriate way of prescribing antibiotics on the basis of identified patterns of resistance. The infection prevention expert will be responsible for offering in-service training and personalized mentoring to other members of the team with the aim of improving adherence and comprehension of effective infection prevention practices. The antimicrobial pharmacist will be responsible for reporting on antimicrobial use and trends, in addition to tracking drug mismatches. Evidence Besides the evidence summary, I found additional evidence in an article by Pyrek (2015) that sought to examine the challenges of implementing bathing interventions in the prevention of SSIs. The author stressed the significance of complying to suggested bathing interventions. Thus, the article provided an extensive overview of the barriers to compliance in infection control. Summary of the EvidenceRecent evidence-based scientific and clinical studies on the effectiveness of antiseptic in reducing the risk of contracting SSIs continues to be a source of controversy, given the variation in the opinions and findings of the authors. For instance, JakobssonPerlkvist and Wann (2011) found that bathing with antiseptic reduced the chances of contracting SSIs by about 30%. The study does not, however, explain which antiseptics are more effective for this purpose — a fact that undermines the credibility of the finding above. On the contrary, Kamel et al. (2012) dispute the claim that bathing with antiseptic agents prior to surgical operations hardly guarantees protection against SSIs. They defend their argument by insisting that the only sure way of completely preventing SSIs is by preventing exposure of surgical wounds to bacteria during surgery (Kamel et al., 2012). Webster and Osborne (2015) argue that antiseptic soaps are quite effective in the prevention of both skin-related infections and SSIs. Recommendations for Change Based on Evidence Based on the research, several recommendations are available for healthcare providers to help them reduce the prevalence and rate of HAIs such as SSIs in the clinical care setting. The first recommendation is that healthcare providers must clean their hands with soap and water or an alcohol-containing preoperative skin preparatory agent prior to and after providing care to patients (Anderson et al., 2014). Despite the effectiveness of alcohol in preoperative skin antisepsis, it is imperative to combine it with chlorhexidine gluconate or an iodophor to increase its efficiency in SSI prevention (Pyrek, 2015). Another pertinent recommendation is the use of impervious plastic wound protectors in gastrointestinal and biliary tract surgical operations. Studies have demonstrated that plastic wound protectors are capable of reducing the rates of SSIs by about 45% (Kamel et al., 2012). Another recommendation concerns increasing surgical site surveillance. Translation Action Plan The implementation plan for this project will involve four primary stages — engagement, education, execution and evaluation. Activities under engagement include obtaining support from senior leadership such as the hospital’s governing board as well as highly engaged physicians (Anderson et al., 2014). Other activities include adopting evidence-based practice guidelines and the promotion of a safety culture. The second stage of the implementation plan will involve educating nurses, physicians, patients and families on the effective practices of preventing SSIs. The third stage is execution where the focus is on reducing barriers and consequently improving adherence. Activities in this regard include the harmonization of care processes as well as the creation of independent or redundancy checks (Anderson et al., 2014). Evaluation is the last stage of the plan. Activities in this regard include the use of performance improvement tools, direct observation of recommended practices and the longitudinal analysis of the rates of SSI and compliance (Anderson et al., 2014).Process, Outcomes Evaluation and ReportingThe desired outcomes for this project are to achieve a significant reduction in surgical site infections for patients who have undergone surgery. The outcomes will be measured using performance improvement tools such as root-cause analysis and failure modes and effects analysis. Another outcome measure involves evaluating the rates of SSI and compliance with evidence-based practices over time. The results will be communicated to key stakeholders through an organizational memo. Next StepsI will implement the plan on a large scale by using both military and marketing style strategies in winning the support of everyone in the organization. The military strategies involve tightening the formal accountabilities of managers whereas marketing style strategies involve the mobilization of self-directed change in the organization (Anderson et al., 2014). This strategy will be applicable to the facility as a whole. I will ensure the implementation becomes permanent by building leadership capacity for change through mentoring, coaching and development programs. Dissemination of FindingsThe findings of the project will be communicated internally through memos and one on one meetings with key stakeholders. To others outside the organization, the findings can be published either online or in a peer-reviewed relevant journal. Overall, this paper has comprehensively examined SSIs as one of the major healthcare complications that affect hospitalized patients. The paper specifically examines the role that bathing with antiseptic agents plays in reducing patients’ risk of developing surgical site infections. The reviewed evidence for the project has highlighted several important recommendations such as cleaning hands with antiseptic agents containing alcohol as well as increasing surgical site surveillance. It has also been determined that these recommendations can be implemented successfully by mobilizing all members of the healthcare team towards the elimination of SSIs.ReferencesAnderson, D. J., Podgorny, K., Berrios-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., … Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology35(S2), S66-S88.Jakobsson, J., Perlkvist, A., &WannHansson, C. (2011). Searching for evidence regarding using preoperative disinfection showers to prevent surgical site infections: Asystematic review. Worldviews on Evidence-Based Nursing8(3), 143-152.Kamel, C., McGahan, L., Polisena, J., Mierzwinski-Urban, M., &Embil, J. M. (2012). Preoperative skin antiseptic preparations for preventing surgical site infections: Asystematic review. Infection Control & Hospital Epidemiology33(6), 608-617.Orta, R., Messmer, P. R., Valdes, G. R., Turkel, M., Fields, S. D., & Wei, C. C. (2016). Knowledge and competency of nursing faculty regarding evidence-based practice. The Journal of Continuing Education in Nursing47(9), 409-419.Pyrek, K. (2015). Experts address the promise and challenges of CHG bathing interventions. Retrieved from http://www.infectioncontroltoday.com/articles/2015…Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic Reviews2015, Issue 2. Art. No.: CD004985. doi:10.1002/14651858.CD004985.pub5.