cWeek 6 Assignment: EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson. Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.
Name:
June 2020
Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)
The selected topic for this change process is the prevention of surgical site infection.
Based on the above topic for this change process, the underlying nursing practice issue is preoperative bathing. This entails the use of antiseptics in bathing.
Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.
Infections after surgery are usually common among many patients. Such infections are caused by a wide range of bacteria including, but not limited to Streptococcus, Staphylococcus, and Pseudomonas. According to Webster and Osborne (2015), infections at surgical sites are linked to poor health outcomes particularly due to the increased length of hospital stay. Additionally, these infections usually increase health costs, which may significantly put the unnecessary financial burden on the patients and their families. From this point of view, findings ways of reducing these infections can play a fundamental role when it comes to enhancing positive outcomes among patients who have undergone surgery.
Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate your PICOT question.
According to Berríos-Torres et al. (2017), surgical site infections are wound infections that normally occur after surgical procedures. Due to their moist nature as well as exposure, surgical sites are usually prone to a plethora of infections. Nonetheless, a myriad of past studies has established that preoperative bathing can play a huge role in reducing skin bacteria. On this understanding, the developed PICOT question for this change process is:
For patients who have undergone surgical surgery (P), does the preoperative bathing (I) in comparison with no bathing (C) helps in reducing surgical site infection (O) within a period of 6 weeks (T)?
List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.
Webster, J., & Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. The Cochrane database of systematic reviews, (2), CD004985. https://doi.org/10.1002/14651858.CD004985.pub5
List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.
Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., Itani, K. M., Dellinger, E. P., Ko, C. Y., & Duane, T. M. (2017). American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. Journal of the American College of Surgeons, 224(1), 59–74. https://doi.org/10.1016/j.jamcollsurg.2016.10.029
Edmiston, C. E., Jr, & Leaper, D. (2017). Should preoperative showering or cleansing with chlorhexidine gluconate (CHG) be part of the surgical care bundle to prevent surgical site infection? Journal of infection prevention, 18(6), 311–314. https://doi.org/10.1177/1757177417714873
This source provided guidelines for surgical site infection. Therefore, by leveraging on the article, it is possible to have a deeper understanding of the role of preoperative bathing in the prevention of surgical site infections.
The second source talk about using 2% or 4% aqueous chlorhexidine gluconate (CHG), to reduce skin contamination prior to surgery. The objective of the pre-admission shower regimen is to achieve a high and sustainable level of skin antisepsis on the surface of the skin to further reduce the risk of intraoperative wound contamination.
Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.
The study by Webster, and Osborne (2015) revealed that in three trials comprising of 1192 patients compared bathing with no bathing with antiseptics (Chlorhexidine), there was a statistically substantial difference in favor of bathing with antiseptics in relation to the reduction of surgical site infections. Nonetheless, the smaller studies did not find any difference between patients who washed with antiseptic and those who did not wash. Based on the general findings, the authors of this study concluded that antiseptics could help in reducing surgical site infections
Outline one or two evidence-based solutions you will consider for the trial project.
An evidence-based solution for this study would involve the use of preoperative bathing in reducing incidences of surgical site infection among patients who have undergone surgery
Star Point 3: Translation (Action Plan)
Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).
Clinical guidelines by Kristen A Ban et al. (2017) on the prevention of surgical site infection articulate that before surgery, there is a substantial need for patients to shower or bathe with an antiseptic agent. Ideally, this should be the night before the operating day. This, in turn, can ensure that there no bacteria on the skin, which would otherwise lead to surgical site infection.
List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).
