Benchmark – Evidence-Based Practice Project Proposal Final Paper
Benchmark – Evidence-Based Practice Project Proposal Final Paper
For this assignment, you will synthesize the independent evidence-based practice project proposal assignments from NUR-550 and NUR-590 into a 4,500-5,000-word professional paper.
Final Paper
The final paper should:
Incorporate all necessary revisions and corrections suggested by your instructors.
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Synthesize the different elements of the overall project into one paper. The synthesis should reflect the main concepts for each section, connect ideas or overreaching concepts, and be rewritten to include the critical aspects (do not copy and paste the assignments).
Contain supporting research for the evidence-based practice project proposal.
Main Body of the Paper
The main body of your paper should include the following sections:
Problem Statement
Organizational Culture and Readiness
Literature Review
Change Model, or Framework
Implementation Plan
Evaluation Plan
Appendices
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The appendices at the end of your paper should include the following:
All final changes or revisions for the drafts that will be included in the appendices of your paper.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper. In each preceding course you have been directed to the Student Success Center for assistance with APA style, and have submitted the APA Writing Checklist to help illustrate your adherence to APA style. This final paper should demonstrate a clear ability to communicate your project in a professional and accurately formatted paper using APA style.
General Requirements
You are required to cite 10-12 peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines 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 required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
1.1: Translate research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice.
5.1: Design ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care.
Evidence-Based Practice Proposal
The provision of care that promote optimum outcomes is crucial in nursing practice. Nurses often adopt evidence-based interventions to ensure outcomes that include safety, quality, and efficiency. Healthcare problems such as catheter associated urinary tract infections (CAUTIs) have an immense impact on the health of the admitted patients. Evidence shows that CAUTIs increase healthcare-related costs, hospital stay, and predispose patients to complications such as bacteremia. CAUTIs are preventable in healthcare. Nurses are expected to adopt evidence-based interventions that minimize the risk of patients with urinary catheters developing CAUTIs. The practice site has witnessed and increase in the rates of CAUTIs over the past months. Despite this, no intervention has been adopted to address the problem. Therefore, this project’s focus is on the adoption of an evidence-based intervention that will address the problem.
Problem Statement
The use of urinary catheters is a common practice in healthcare settings. This is despite it being associated with health risks such as CAUTIs. CAUTIs are associated with increased care costs to patients from prolonged hospitalization and complex health needs (Abdelmoaty et al., 2022). The practice site currently experience a high rate of CAUTIs beyond the set benchmark. Despite the increase, interventions to address the problem have not been explored. Nurses are involved in the implementation of best practices to prevent and reduce CAUTIs. However, their role depends largely on their competencies in the prevention of CAUTIs. Interventions such as offering nurses educational opportunities are effective in building the required competencies for CAUTIs prevention and reduction (Amaral et al., 2023). However, this has not been adopted in the practice site, hence, the focus of this project.
Organizational Culture and Readiness
Effective organizational culture is important for the realization of the desired outcomes of the change. The culture encompasses the values, beliefs, and practices that guide employee actions and decisions. The assessment of our organization showed that it has a culture of teamwork where employees are involved in organizational activities. The organization supports the personal and professional development of the staff by offering mentorship and training opportunities. There is open communication where employees give feedback about organizational strategies and share their knowledge and insights without fear of intimidation by the management. The leadership supports collectivism in undertaking organizational tasks.
The World of Work Project (2019) was employed to assess the organization’s readiness for the change. The assessment demonstrated a high level of readiness for change in the organization. The organization scored highly in strong emphasis on employees, teamwork, team communication, shared decision-making, customer-centeredness, and consumer relationship. The identified weaknesses include the existence of competitive rather than cooperative culture, which may affect performance. The opportunities to be explored include the organization’s focus on care coordination, patient-centered models of care, and health informatics systems such as the Practice Management Software and Clinical Decision Support systems (Dixon, 2021).
It is imperative for the organization to adopt strategies that will enhance its readiness for change. Some of the strategies that should be considered include motivation, employee engagement and strengthening group cohesion. The provision of intrinsic and extrinsic motivators is crucial to inspire employees identify efficient strategies to address organizational issues. Strengthening group cohesion is important to ensure teamwork in the execution of the organization’s tasks. Group cohesion improves social relationships, minimizing resistance to change (Roos & Nilsson, 2020). Employee engagement promotes their empowerment and adoption of strategies that will enhance the success of change.
Several stakeholders will be involved in the project implementation. They will include human resource officer, hospital administrator, clinical nurse educator and nurses. Each of these stakeholders will play unique roles. For example, the administrator will allocate resources and oversee the project. The human resource officer will be responsible for competency development among staff through training opportunities. A clinical nurse educator will train nurses about CAUTIs and their prevention (Tsarfati & Cojocaru, 2022). Nurses will be mainly involved in implementing the project.
The implementation of the project will require information and communication technologies. They will include computers, internet, projectors, and LCD to facilitate the training. The Laboratory Information System will be integrated into the existing system for coordinating microbiology tests. In addition, patient information will be collected and stored in the Electronic Health Records. It will also store other information such as lab works and results and any new orders made by the physicians.
Literature Review
As noted above, the proposed project seeks to address the issue of CAUTIs using nurse education in the practice site. According to evidence, CAUTIs form part of the hospital acquired infections associated with high disease burden. It causes to poor outcomes in the care process, high costs of healthcare for the patients, and prolonged hospitalization. Nurses should be able to appraise the existing evidence to identify best practices that can be used to improve outcomes. By appraising, nurses select the best available evidence that can be utilized to inform their care approaches. Therefore, this section explores the developed PICOT statement and question and review of relevant literature that informs the need for the project.
PICOT Statement
The use of urinary catheters is among the most common practices in healthcare. Practice guidelines recommend that acutely ill patients who cannot void without assistance or those undergoing surgical procedures may be catheterized. However, the catheterization duration should not be prolonged due to increased risk of patients developing CAUTIs. The risk of patients developing CAUTIs increase significantly with prolonged catheterization or the use of practices that predispose patients to developing CAUTIs. CAUTIs are preventable with the adoption of best practices by the healthcare providers. Nurses are primarily involved in the insertion and care of patients with in-dwelling urinary catheters. They are responsible for the use of aseptic techniques in urinary insertion and following institutional guidelines in urinary catheter care. Interventions such as the provision of educational opportunities for nurses have proven effective in reducing the rate and risk of CAUTIs among patients with urinary catheters. The education helps nurses to develop the competencies needed to ensure quality and safety in the care of catheterized patients (Abdelmoaty et al., 2022; Amaral et al., 2023). Consequently, providing health education opportunities to the nurses in the practice site is likely to lower the increasing rates of CAUTIs in the practice site.
PICOT Question
Among hospitalized patients with indwelling urinary catheter (P), does training nurses on prevention of prevention of catheter-associated urinary tract infections (I) compared to no intervention (C) reduce its prevalence (O) within six months (T)?
Search Methods
Systematic methods for obtaining the required sources of evidence were used in this project. The adopted strategies included searching relevant sources of evidence in various databases and libraries. They included Google Scholar, PubMEd, Cochrane, and CINHAL. The search words used in the search included “peer reviewed articles,” “CAUTIs,” in healthcare and their effects, “nursing interventions to reduce CAUTIs,” and “prevalence of CAUTIs.” The articles must have been published over the last five years to ensure relevance of the evidence. Ten articles were selected for the review.
Literature Synthesis
The first article that was included in the review is the research by Abdelmoaty et al., (2022), which investigated the effects of improving nurses’ knowledge on preventing CAUTIs in the intensive care units. The researchers recruited 42 nurses to obtain data about the effectiveness of education and training on the prevalence of CAUTIs. The study demonstrated that training nurses improved their knowledge and understanding about CAUTIs prevention. The second article included in the review is the research by Blondal et al., (2017). This study examined the impact of a short educational intervention on the use urinary catheters. The sample comprised 244 nurses. The study findings showed that nurse education increased nurses’ knowledge on the use of urinary catheters. The increase in knowledge improved outcomes such as the length of hospital stay among hospitalized patients.
The other study is the research by Mohammed and Hamza (2019), which evaluated the effectiveness of an educational program on improving nurses’ knowledge on the prevention of CAUTIs among female patients. The researchers adopted a quasi-experimental study design where 40 nurses were involved. The findings revealed that educational programs improve nurses’ knowledge on the prevention of CAUTIs. The other study is the research by Seyhan Ak and Özbaş (2018), which investigated the effects of nurse education on prevention of CAUTIs among patients who had undergone hip fracture surgery. The results obtained fr0m 60 nurses demonstrated that the education program reduced catheterization duration and prevalence of CAUTIs.
The study by Shadle et al., (2021) also demonstrated the effectiveness of a bundle-based intervention that involved nurses’ education on CAUTIs prevention. The findings showed that the bundled-based approach, which incorporates nurses’ education reduced CAUTIs in the critical care settings. In another study, Zurmehly (2018) found that a nurse-led protocol reduced CAUTIs among hospitalized patients in a long-term acute hospital. Similar findings are evidence in the studies by Haimour (2020) and Kbaysi et al., (2020). The studies found that besides nursing education interventions increasing nurses’ knowledge on the prevention of CAUTIs among catheterized patients, the intervention also promotes sustainable outcomes in improving the quality and safety of the patient care process. Cumulatively, the evidence from the above reviewed studies support the project intervention in that the provision of education and training opportunities for nurses reduces the rate of CAUTIs among catheterized patients in all the healthcare settings. The improvements in outcomes translate into the need for educational programs in nursing practice to address the issue.
Comparison of Articles
It can be seen from the above articles that the use of nurse-targeted education has a positive effect on reducing the risk and rate of CAUTIs. The articles agree that nurse education increase the knowledge level and competencies of the nurses in the prevention of CAUTIs. The studies also recommend health organizations to support nurse-led interventions to improve outcomes such as those related to the prevention of CAUTIs. The other similarity seen in the articles is that they are all peer-reviewed. This means that the findings can be used to influence clinical decisions. Apart from the study by Shadle et al., (2021), which utilized bundled-care interventions, the other studies focused mainly on the effect of nurse education programs on CAUTIs. In addition, the article by Haimour, (2020) integrated simulation-based learning while the rest focus on education interventions offered by experts on the subject area. while Zurmehly (2018) implemented a nurse-led protocol for CAUTI while the rest focus on the overall education on CAUTIs. None of the articles identified any controversies in the use of nurse education programs to prevent CAUTIs.
Suggestions for Future Research
The reviewed studies provide recommendations for future research as well as practice. One of the recommendations by the studies is the need for future studies to focus on approaches such as randomization and control in the investigations. Randomization and control would enhance the validity and reliability of the findings reported in these studies. The other recommendation is the need for future studies to adopt large sample sizes. Large sample sizes will increase the generalizability of the study findings to different settings. Nurses would confidently incorporate the findings from the different studies into their practice to improve outcomes. The articles also recommended the need for future studies to compare the effectiveness of bundled-interventions and nurse-education alone in the prevention of CAUTIs. The last recommendation is the need for future studies to examine the sustainability of outcomes associated with nurse education on CAUTIs. The studies would inform any improvements that may be needed to ensure optimum outcomes with nurse education programs in CAUTIs prevention.
Change Model or Framework
The proposed project requires the adoption of new behaviors by nurses involved in the care of patients with indwelling or being inserted urinary catheters. This implies that strategies to facilitate the change process should be adopted. Change models and frameworks are crucial in such situations, as they guide the implementation of change. The models provide the benchmarks for evaluating the success of the change process and any required changes or modifications to improve outcomes. Therefore, nurses should select an appropriate model that aligns with the proposed change and the desired outcomes.
The proposed project will adopt the transtheoretical model, which was developed in the 1970s to enable managers understand the factors that drive behavioral change among employees. The model examines how people make decisions to adopt a change and the steps that must occur for the change to be successful. The model recognizes the need for change implementers to create an enabling environment for change. The needs of the adopters should be prioritized in the process. The trans-theoretical model identifies six stages of change that must occur for change to be successful in an organization.
According to the transtheoretical model of change, the first step in the change process is precontemplation. This is the stage where the adopters of the proposed initiative in the project are not ready to change their practices, beliefs, and values. Their rigidity does not alter the existing culture in their organization. Their lack of interest to change is because they do not understand the ways in which their current behaviors contribute to high rate of CAUTIs among hospitalized patients (Wen et al., 2019). This step is applicable to the proposed project in its initial stages. Nurses in the practice site may be not willing to adopt best practices to prevent CAUTIs since they believe that their current practices are effective. In addition, they may have fear towards the unknown benefits or risks associated with the proposed change.
The second step in the transtheoretical model of change is contemplation. This is the stage where the adopters of the proposed change demonstrate some willingness to change. They are ready to implement the proposed strategies in the near future. Their willingness to change is because they understand the effect of the status quo on the patient care outcomes (Selçuk-Tosun & Zincir, 2019). This stage applies to the proposed project. It is expected that nurses may show some readiness to change should they understand the effect of their behaviors on the current high rate of CAUTIs. Their understanding will stimulate them to research more about the proposed intervention and its effects on care outcomes.
The third step in the transtheoretical model of change is preparation. Preparation is the stage where the adopters are ready for change. They engage in activities that support the change since they understand its benefits on care outcomes. The adopters are no longer demonstrating any resistance to change. The implementers of change should ensure that the adopters receive the support they need in forms such as coaching and mentorship. Supervision and provision of feedback also ensures the consistent use of change practices by the adopters of change (Boff et al., 2020). This stage will be applicable to the proposed project in that nurses in the practice site will be ready to implement best practices learned from the educational session to reduce and prevent CAUTIs. They will demonstrate readiness to implement the strategies on incremental basis with a focus being on the use of strategies that have improved outcomes among catheterized patients.
The fourth step in the transtheoretical model is action. This step is characterized by the already change in the behavior of the adopters of the change. They demonstrate high willingness to maintain their new behaviors. The adopters believe that sustained change will result in optimum outcomes in the organization. The adopters’ high level of motivation encourages them to explore other ways to achieve the desired change outcomes and prevent relapse to their earlier behaviors (Boff et al., 2020). Nurses in the practice site will be ready to implement the daily use of the new behaviors to prevent and reduce the risk of CAUTIs among hospitalized patients in this step. They will engage in activities that sustain the new culture and eliminate the possibility of relapse to their old ways of catheter care and insertion.
The fifth step in the transtheoretical model is maintenance. This is the stage where the adopters of the change are actively involved in sustaining the new change. They explore strategies such as incorporating the change into the organization’s culture for its sustained use. They also build the change on best practices that have proven effective for the change. Nurses in the practice site will be exploring strategies to prevent behavioral relapses in this stage. The last step in the transtheoretical model is termination. Termination is the stage where the desired change has successfully been adopted. The adopters are no longer willing to use their earlier behaviors in the provision of the required care services. They advocate the use of best practices introduced by the change to improve outcomes (Selçuk-Tosun & Zincir, 2019). The adopters of the proposed change in the practice site are no longer willing to use their earlier behaviors in catheter insertion and care in this stage. As a result, they sustain evidence-based practices to ensure optimum outcomes in nursing practice.
Implementation Plan
Implementation is a crucial step in evidence-based practice projects. Implementation entails putting into action a developed plan to achieve the desired outcomes. Implementation of evidence-based practice projects is a collaborative activity. The aim is to incorporate inputs from different stakeholders into the plan as a way of minimizing any potential issues such as resistance from change adopters. Therefore, this section examines the implementation plan that would be adopted for the evidence-based practice project.
The Setting and Access to Potential Subjects
The setting for the proposed project will be admission suites where patients with indwelling urinary catheters reside. This setting is appropriate to determine the impact of the training program on CAUTIs rates. The subjects for the project will be nurses who care patients with indwelling urinary catheters. Patients with be the indirect project subjects since data about the effectiveness of the project will not be obtained from them. Informed consent will not be obtained from nurses since the project will be part of initiatives to improve the quality, safety, and efficacy of care in the practice site. An approval for the project will be obtained from the practice site before the implementation process.
The Chosen Timeline
The selected timeline for evidence-based practice projects should be adequate to enable its assessment, planning, implementation, and evaluation. The estimated time needed for the proposed project is six months. The timeline will be enough for all the project activities, including its evaluation and communicating findings to the stakeholders. The proposed project timeline has been attached to the appendix section.
The Budget and Resource List
Successful implementation of the project will require adequate budgetary allocation and human resources support. The budget will be approved by the organization’s senior management. Some of the interventions for the proposed project are training nurses about best practices about urinary catheter care, monitoring, data collection, analysis, and presentation of findings. As a result, financial and human resources are crucial for the success of the project. The anticipated human resources for the project include nurse educators, nurses, management, and other healthcare providers. The required financial resources will be utilized for training nurses, hiring nurse educators, purchasing training materials, collecting, analyzing and presenting data, and managing any unforeseen expenses. The estimated cost of the proposed project is $33500. Detailed information about the developed budget is attached in the appendix section (Appendix B).
The Selected Study Design
The proposed project will adopt a quantitative study design. The quantitative study design will be the most appropriate for the project based on the numerical data that would be obtained. The design will also provide an accurate analysis of the project efficacy based on numerical data. Unlike qualitative design, quantitative design will be easier and cheaper to undertake (Jolley, 2020).
Methods and Instruments
The proposed project will adopt questionnaires for data collection. The nursing staff will be administered with questionnaires before the project to obtain baseline data about their knowledge on the prevention of CAUTIs and at the end to determine the impact of the educational intervention. The need for questionnaires use arise from the ease of administration, data collection, organization, and analysis (Gunawan et al., 2021).
The Process of Delivering the Intervention
The implementation process will occur in stages. The first stage will be needs assessment, which will provide insights into the current rate of CAUTIs in the organization, level of knowledge among nurses on their prevention, and relevance of the project to the organization. The information obtained from needs assessment will guide the development of the project plan (Hopp & Rittenmeyer, 2020). The second step will be the provision of education to the nursing staff. The education will focus on aspects such as catheter insertion, care, signs of CAUTIs and management. The next step will be implementation where nurses will apply the knowledge gained from the training into the care of patients undergoing catheterization or those with indwelling urinary catheters. The next step will be monitoring to determine any needs or challenges experienced by the nursing staff in utilizing the best practices to address the needs of their patients. The other step will be data collection analysis. Data about the rates of CAUTIs will be obtained for comparison with those recorded before the project. Questionnaires will be administered before and after the training to determine its effectiveness. The last step will be communicating findings to the stakeholders.
Stakeholders
The implementation of the project will involve various stakeholders. They will include the nurse manager, the hospital finance officer, nurses working in the admission units, and other healthcare providers such as physicians. Nurses will be primarily involved in the project implementation process. Nurse managers will coordinate the project implementation process and seek feedback from the implementers for using in improving the outcomes of the process. The finance manager will undertake cost-benefit analysis and the financial implications of the project to the organization.
Potential Barriers and Strategies to Overcome
Some potential barriers may be experienced during the project implementation process. One of them is lack of enough support from the organization in terms of financial, human resource, leadership, and management support. The strategy that will be adopted to address this challenge is aligning the project aims, objectives, and focus with the vision, goals, and mission of the organization. The other potential barrier is inadequate resources for project implementation (Hopp & Rittenmeyer, 2020). Timely procurement of the resources will be adopted to address this barrier. The last barrier is lack of interest among nurses towards the project, which will be addressed by ensuring their active participation in the project and strengthening open communication. The proposed project is highly feasible since the organization is dedicated towards adopting strategies that improve care outcomes. As a result, the proposal aligns with its mission of ensuring safety, quality, and efficiency outcomes in the patient care process.
Evaluation Plan
Evaluation is an important phase in evidence-based practice projects. Evaluation seeks to provide information about the effectiveness of the different interventions that were utilized to achieve projected outcomes. Evaluation outcomes also inform any improvement strategies that may be needed in evidence-based practice projects and forms the basis of future projects in an organization. Like implementation, evaluation should be done collaboratively to provide a balanced view of the project’s efficacy and effectiveness. Therefore, this section explores the evaluation approaches that would be adopted for the evidence-based practice project.
Expected Outcomes for the Evidence-Based Practice Project Proposal
The proposed project is expected to achieve several outcomes. One of them is increasing the knowledge of nurses on CAUTIs and prevention. The knowledge gained is expected to improve care outcomes for patients with indwelling urinary catheters (Abdelmoaty et al., 2022). The other expected outcome with the project is the reduction in the rate of CAUTIs in the hospital by 50% within six months of project implementation. The consistent use of practices such aseptic techniques in catheter insertion is expected to facilitate this outcome. Lastly, the project is expected to reduce hospital length of stay and medical costs that patients incur due to CAUTIs.
Data Collection Tool that Would be Effective for the Research Design
The selected data collection for the project is questionnaire. Questionnaires will be administered to the nurses to determine their knowledge on CAUTIs and its prevention. They will be administered before the project to obtain baseline data and after the education to determine their knowledge. The use of questionnaires is ideal for the project because of it being quantitative. It will also enhance the reliability of the obtained outcomes since uniform questions are asked. The costs incurred alongside efficiency of data collection also increases with the use of questionnaires (Jolley, 2020). The collected data can be organized and analyzed easily, hence, suitability for the project.
Statistical Test for the Project
A paired t-test will be used in the evidence-based practice project. A paired t-test examines the variation between a set of paired samples such as pre and post-test scores. The project examines the knowledge of nurses before and after nurses’ education about CAUTIs, making the use of the paired t-test appropriate. Paired t-test also provides an estimation of the significance of difference between means of two samples from similar subjects (Mishra et al., 2019). The test will offer accurate understanding of the impact of nurses’ education on CAUTIs rate in the hospital.
Methods to Apply to the Data Collection Tool
Closed-ended questions will be used with multiple questions in the questionnaire. Dichotomous questions will also be asked alongside scaling questions. Open-ended questions will not asked since the project is quantitative. The analysis will entail the comparison of nurses’ knowledge scores before and after the intervention. The mean scores before and after the intervention will also be compared.
Strategies That Will Be Taken if Outcomes Do Not Provide Positive or Expected Results
One of the proposed strategies that will be considered if the project does not provide expected or positive results is conducting a quality improvement project. The other strategy would be conducting an evidence-based research to identify effective interventions to prevent CAUTIs (Kbaysi et al., 2020). These alternatives will also help determine the crucial factors that affect nurses’ ability to translate evidence into practice.
Plans To Maintain, Extend, Revise, and Discontinue the Proposed Solution After Implementation
The proposed nurse training on CAUTI prevention will be maintained by carrying out similar training programs yearly. This will help to ensure sustainable change and continuous improvement in systems and processes used to prevent CAUTIs The project will be extended by training other healthcare professionals outside the nursing discipline, like physicians, infection preventionists, and clinical pharmacists. The training program will be revised by getting feedback from the nurses on areas that need more focus during training. The course teachings will be revised yearly to ensure they are up to date with the current guidelines. The training program will be lifelong and will not be discontinued because it is essential for preventing CAUTIs in the hospital.
Conclusion
In summary, the proposed project intends to reduce CAUTIs in the practice site through the provision of nurse education. The organization’s culture supports the proposal. The organization is ready to implement the change. The transtheoretical model of change will guide the project. Literature review performed supported the use of nurse education to prevent and reduce CAUTIs. Structured processes will be used in the implementation and evaluation of the project.
References
Abdelmoaty, A. M., Abdelghany, E. O., Soliman, M., Kenawy, A. M., & Doa’a, A. S. (2022). Improving Nurses’ Knowledge about Prevention of Catheter Acquired Urinary Tract Infections in Intensive Care Units. Open Access Macedonian Journal of Medical Sciences, 10(E), 638–642.
Amaral, C., Sequeira, C., Albacar-Riobóo, N., Coelho, J., Pinho, L. G., & Ferré-Grau, C. (2023). Patient Safety Training Programs for Health Care Professionals: A Scoping Review. Journal of Patient Safety, 19(1), 48. https://doi.org/10.1097/PTS.0000000000001067
Blondal, K., Ingadottir, B., Einarsdottir, H., Bergs, D., Steingrimsdottir, I., Steindorsdottir, S., Gudmundsdottir, G., & Hafsteinsdottir, E. (2017). The effect of a short educational intervention on the use of urinary catheters: A prospective cohort study. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 28(6), 742–748. https://doi.org/10.1093/intqhc/mzw108
Boff, R. de M., Dornelles, M. A., Feoli, A. M. P., Gustavo, A. da S., & Oliveira, M. da S. (2020). Transtheoretical model for change in obese adolescents: MERC randomized clinical trial. Journal of Health Psychology, 25(13–14), 2272–2285. https://doi.org/10.1177/1359105318793189
Dixon, J. (2021). Improving the quality of care in health systems: Towards better strategies. Israel Journal of Health Policy Research, 10(1), 15. https://doi.org/10.1186/s13584-021-00448-y
Gunawan, J., Marzilli, C., & Aungsuroch, Y. (2021). Establishing appropriate sample size for developing and validating a questionnaire in nursing research. Belitung Nursing Journal, 7(5), 356–360.
Haimour, A. (2020). Simulation-Based Learning to Reduce CAUTI Rates among ICU Patients. https://www.academia.edu/66997394/Simulation_Based_Learning_to_Reduce_CAUTI_Rates_among_ICU_Patients
Hopp, L., & Rittenmeyer, L. (2020). Introduction to Evidence Based Practice: A Practical Guide for Nursing. F.A. Davis.
Jolley, J. (2020). Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals (3rd ed.). Routledge. https://doi.org/10.4324/9780429329456
Kbaysi, M., Kavuran, E., Tassi, A., & Fawaz, M. (2020). THE EFFECT OF EDUCATIONAL INTERVENTION ON THE KNOWLEDGE OF NURSES REGARDING CATHETER INDICATIONS AND CATHETER ASSOCIATED URINARY TRACT INFECTION PREVENTIVE MEASURES. BAU Journal – Health and Wellbeing, 2(1). https://doi.org/10.54729/2789-8288.1025
Mishra, P., Singh, U., Pandey, C. M., Mishra, P., & Pandey, G. (2019). Application of Student’s t-test, Analysis of Variance, and Covariance. Annals of Cardiac Anaesthesia, 22(4), 407–411. https://doi.org/10.4103/aca.ACA_94_19
Mohammed, H. T., & Hamza, R. A. H. (2019). Effectiveness of educational program on nurses’ knowledge toward preventing female catheter-associated urinary tract infections. Prof. RK Sharma, 13(1), 230.
Roos, J., & Nilsson, V. O. (2020). Driving Organizational Readiness for Change through Strategic Workshops. International Journal of Management and Applied Research, 7(1), 1–28. https://doi.org/10.18646/2056.71.20-001
Selçuk-Tosun, A., & Zincir, H. (2019). The effect of a transtheoretical model-based motivational interview on self-efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus: A randomized controlled trial. International Journal of Nursing Practice, 25(4), e12742. https://doi.org/10.1111/ijn.12742
Seyhan Ak, E., & Özbaş, A. (2018). The effect of education of nurses on preventing catheter-associated urinary tract infections in patients who undergo hip fracture surgery. Journal of Clinical Nursing, 27(5–6), e1078–e1088. https://doi.org/10.1111/jocn.14160
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 Nurse, 41(2), 62–71. https://doi.org/10.4037/ccn2021934
Tsarfati, B., & Cojocaru, D. (2022). The Importance of Receiving Training in Computerized Technology for Nurses to Maintain Sustainability in the Health System. Sustainability, 14(23), Article 23. https://doi.org/10.3390/su142315958
Wen, S.-L., Li, J., Wang, A.-N., Lv, M.-M., Li, H.-Y., Lu, Y.-F., & Zhang, J.-P. (2019). Effects of transtheoretical model-based intervention on the self-management of patients with an ostomy: A randomised controlled trial. Journal of Clinical Nursing, 28(9–10), 1936–1951. https://doi.org/10.1111/jocn.14731
Zurmehly, J. (2018). Implementing a Nurse-Driven Protocol to Reduce Catheter-Associated Urinary Tract Infections in a Long-Term Acute Care Hospital. The Journal of Continuing Education in Nursing, 49(8), 372–377. https://doi.org/10.3928/00220124-20180718-08
Appendices
Appendix A: APA Checklist
APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.
☒ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.
☒ The title page is present. APA format is applied correctly. There are no errors.
☒ The introduction is present. APA format is applied correctly. There are no errors.
☒ Topic is well defined.
☒ Strong thesis statement is included in the introduction of the paper.
☒ The thesis statement is consistently threaded throughout the paper and included in the conclusion.
☒ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.
☒ All sources are cited. APA style and format are correctly applied and are free from error.
☒ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.
Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.
Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.
Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.
Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.
Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
☒ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.
Appendix B: PICOT Question
Among hospitalized patients with indwelling urinary catheter (P), does training nurses on prevention of prevention of catheter-associated urinary tract infections (I) compared to no intervention (C) reduce its prevalence (O) within six months (T)?
Appendix C: Timeline
Feb 2023March 2023April 2023May 2023June 2023July 2023
Proposal development
Submission of proposal for approval and obtaining approval
Formulation of the stakeholder team
Training and implementation, monitoring
Project Evaluation
stakeholder feedback
Appendix D: Budget
Item Cost ($)
Development and purchase of training materials $10,000
Training and Education $7,000
Project stationeries $2,000
Hiring trainers and educators $2,500
Data collection, analysis, and presentation for project evaluation $4,000
Extraneous $8,000
Total $33,500
Appendix E: Trans-theoretical Model of Change
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