BENCHMARK: ASSIGNMENT: IMPLEMENTATION OF CAUTI/NURS 590

BENCHMARK: ASSIGNMENT: IMPLEMENTATION OF CAUTI/NURS 590

BENCHMARK: ASSIGNMENT: IMPLEMENTATION OF CAUTI/NURS 590

Assessment Traits

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Assessment Description

In 1,250-1,500 words, discuss the implementation plan for your evidence-based practice project proposal. When required, create the appropriate form, table, image, or graph to fully illustrate that aspect of the intervention plan and include them in an appendix of your paper. You will use the implementation plan, including the associated documents in your appendices, in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

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Include the following:

Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Include a draft of the form as an appendix at the end of your paper.

Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Based on the timeline you created, describe the amount of time needed to complete this project. Include a draft of the timeline as an appendix at the end of your paper.

Develop a budget and resource list. Consider the clinical tools or process changes that would need to take place. Based on the budget and resource list you developed: (a) describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution; (b) outline the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Include a draft of the budget and resource list as an appendix at the end of your paper.

Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Provide rationale to support your selection.

Describe the methods and instruments (questionnaire, scale, or test) to be used for monitoring the implementation of the proposed solution. Include the method or instrument as an appendix at the end of your paper.

Explain the process for delivering the intervention and indicate if any training will be needed.

Discuss the stakeholders that are needed to implement the plan.

Consider all of the aspects of your implementation plan and discuss potential barriers or challenges to the plan. Propose strategies for overcoming these.

Establish the feasibility of the implementation plan.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite a minimum of five 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.

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 an appendix at the end of your paper.

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.

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EBP Implementation Plan
The implementation of evidence-based practice (EBP) entails actualization of ideas or identified best practices by institutions and providers through research findings. The implementation process has particular components that should be followed in a systematic manner to integrate best practices in improving patient care and safety (Barber, 2018). In this case, the proposed EBP intervention is training of nurses on best practices to reduce and prevent the occurrence of CAUTIs in the healthcare facility. Training is essential as it will enhance knowledge and skills of the providers about the causes, effects and prevention of CAUTIs. The training will empower nurses to deploy innovative strategies, including care bundle to prevent CAUTIs as a public health concern. The purpose of this paper is to discuss the implementation plan for the EBP intervention based on the PICOT question and other components at this stage of the EBP process.
Setting and Access to Potential Subjects
The setting is a 60-bed medical unit. The facility has seventy registered nurses (RNs) working as the healthcare providers and the target for the EBP intervention to reduce and prevent the occurrence of CAUTIs. The medical unit offers services to patients getting care based on their different procedures with rising safety concerns due to the increase in the prevalence of CAUTIs. The potential subjects in this case are the 70 registered nurses (RNs) administering care to the patients in the unit at any particular time. The 70 RNs will all undertake training on the best practices to manage CAUTIs and ensure that patient safety is improved. However, it would be critical that they offer their consent to the training by communicating to them about the benefits of the training based on the use of appropriate change model like Kotter’s eight-step approach.
Timelines
The implementation time frame for the proposed EBP would be four months. The timeframe has different components that include identification and constitution of change agents and team, planning and requirement definition, design, analysis, actual rollout or implementation, and evaluation. The timeline will also entail segmentation to ensure that each project activity attains the expected outcomes. The entire activities and components of the timeline are attached in the appendix of the paper.
Budget and Resource List
Proper implementation of the proposed EBP project needs resources and accessibility to funding through preparation of a budget. The team will create a proposed budget and list of resources and submit it for approval from the organizational leaders and managers. The cost may entail additional staff hours for planning, creating awareness, ensuring that all people are on board and implementing the project in different aspects, including its overall evaluation (Ratnapalan, 2019). The setting will allow the EBP team to access tools and resources that include plenary hall, audiovisual materials and experts on the subject area. The facility is one of the biggest in Santa Ana, California and will benefit from resources offered not just by the organization but also its stakeholders like the community.
Aside from the cost of the project itself, resources will also be required to meet the cost of certain interventions like allowing nurses to have breaks and time off for the sessions, reworking the unit environment to include temporary measures like having nurse assistants help patients while the nurses are in training session. The human resource for the project will entail having nurse leaders, nurse managers and the trainers on being aware about the best practices in use of Foley catheters and catheterization process (Khasal, 2022). Nurses will need resources for production of informational sheets, record data on the prevalence of infections during the trial phase before the eventual rollout of the initiative in the unit. The budget for the project and resource list are attached in the appendix.
Project Design and Data Collection
The project will apply a non-experimental mixed method approach. The selected design comprises qualitative and quantitative aspects in one study to enable the providers have sufficient answers to the research question instead of using just one design; either qualitative or quantitative. The EBP will have interviews and surveys with the collected data before and after the implementation informing the effectiveness of the intervention (Khasal, 2022). For instance, while training will target nurses, the facility will compare pre-and post-implementation data to ascertain the effectiveness of the suggested intervention. Observation will also be a critical approach as the project team will observe how nurses conduct the entire catheterization process while handling patients Rebekah et al., 2018). The use of the mixed design is appropriate since the method allows implementation of both qualitative and quantitative approaches to attain the set research goals.
Methods & Instruments
The proposed EBP project will deploy different methods and instruments to monitor overall outcomes on the prevalence of CAUTIs in the medical unit. Based on the values and vision of Cedar Sinai Hospitals, the main method would be having a pre-and-post implementation data to ascertain the efficacy of the intervention. The use of surveys on nurses and patients will allow the team to know what may be working in the proposed best practices after training and what needs changes to meet the safety needs of the facility. An additional baseline assessment of data from the unit’s records on the rate of CAUTIs before implementation will be deployed to assess the overall effect of the implementation of the intervention (Ratnapalan, 2019). The data collected on the reduction in CAUTIs and perception of nurses’ knowledge on using the suggested best practices will be analyzed using inferential and descriptive statistics, especially the t-test (Kayem et al., 2023). The implication is that based on its design, the project will deploy an array of tools to attain the expected outcomes.
Process for Delivering Intervention & Training
The delivery of the proposed intervention would be key to attaining a reduction in the prevalence of CAUTIs in the medical unit. The delivery of the intervention will entail use of an EBP project team consisting of professionals from different areas of nursing specialties and healthcare. At the core of the delivery would be training of project team and later on dissemination to all staff in the unit. All the 70 RNs will be expected to participate in the intervention based on the program that will be developed by the team and the selected trainers (Barber, 2018). Involving staff to design and implement the EBP project will enhance its overall acceptance and success. Training sessions will target all the RNs, their leaders and in some instances, nurse assistants based on the level of acute patients that they handle. The training sessions will help educate staff on all aspects of the implementation process. Nurse leaders and managers will ensure that all nurses attend the sessions by generating staff schedule that is accommodative during the entire implementation stage.
Stakeholders
Stakeholders are the key to the overall success of any EBP project. Stakeholders have the ability to decide if a project will be executed or not. They also determine the success or failure of the initiative. Imperatively, key stakeholders in this project include the nurses and nursing administration, patients, and clinical partners, epidemiologists, and nurse change champions. These stakeholders are key to ensuring that the implementation follows the set processes and has supporters and those to benefit (Gray et al., 2021). The organization’s management is also a critical player since it will approve the required resources and aspects of the project in the facility based on the current structures and processes.
Aspects of the Implementation Plan: Barriers & Strategies to Overcome Them
The implementation plan of this EBP intervention may encounter several aspects; either facilitators or barriers that may require strategies and effective approaches from the stakeholders and the EBP team in the facility. Nursing projects encounter barriers that exist or appear to derail the overall processes and effectiveness of the intervention. These include lack of skills and competencies, limited time and its management, communication, and resource limitation due to the competing needs and concerns in the facility (Kayem et al., 2023). The implication is that the EBP team and other stakeholders should offer solutions based on the approaches and strategies that they deploy. These include ensuring involvement, engagement, and participation of all stakeholders, especially the nurses who are expected to implement all these practices while caring for patients.
The second strategy is to ensure optimal resource allocation by organizational leaders to meet the different needs presented through the EBP and its implementation. Resource allocation entails even having sufficient time set aside for the sessions based on the developed program by the EBP implementation team. Effective communication will also be key to ensuring that all stakeholders are engaged and participate in the implementation. Through effective communication, nurses as the key implementers will feel encouraged and motivated to participate in the project with minimal or no resistance (DeNisco, 2019). The use of change models like Kotter’s eight step can ease any possible resistance as it will ensure effective communication and involvement of all stakeholders in the project.
Feasibility of the Project
Evidence-based projects may offer the evidence required to adopt changes in practice and process. However, the implementation may be hindered by several reasons like limited resources, sufficient time and lack of expertise as well as change resistance. However, the fit and feasibility of this EBP project at Cedar Sinai to reduce CAUTIs is high because of the organizational culture and readiness as demonstrated by the assessment. The facility has a Magnet status which places emphasis on the use of EBP and such interventions to improve patient safety and quality of care (Decker et al., 2021). A shared governance culture exists in the facility with a transformational leadership that are key to implementation of EBP interventions. The expected patient outcomes are also key to addressing the current issue of increased prevalence of CAUTIs as they pose a serious safety concern and risk.
Conclusion
The paper describes the implementation of the proposed EBP project to reduce and prevent CAUTI at Cedar Sinai Hospital and improve overall patient safety. The implementation explores the timelines and the budget plan, resources and design. It also focuses on the possible barriers and significance of identified shareholders and possible barriers. It also proposes the use of mixed method approach to ensure that the project captures all aspects of research for increased effectiveness in the facility. The implementation plan considers the EBP suitable for the organization as it improves nurses’ awareness and knowledge about best practices to tackle CAUTIs and improve patient safety and quality of care.

References
Barber, B. (2018). Research on human subjects: Problems of social control in medical
experimentation. Routledge.
DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:
Essential Knowledge for the Profession. Jones & Bartlett Learning.
Decker, S. G. V., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection
reduction in critical care units: A bundled care model. BMJ Open Quality, 10(4), e001534. https://doi.org/10.1136/bmjoq-2021-001534
Gray, J., Rachakonda, A., &Karnon, J. (2023). Pragmatic review of interventions to prevent
catheter-associated urinary tract infections (CAUTI) in adult inpatients. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2023.03.020
Kayem Al refey, A. B., & Hassan, H. S. (2022). Nursing Practices toward Prevention of
Indwelling Catheter Associated Urinary Tract Infection: An Interventional Study for nursing staff. Mosul Journal of Nursing, 10(3), 182–187. https://doi.org/10.33899/mjn.2022.175551
Khasal, Q. A. (2022). Knowledge of Nurses toward Prevention for Catheter-Associated Urinary
Tract Infection in Intensive Care Unit at Al Nasiriyah General Hospital. HIV Nursing, 22(2), 1516–1522.
Ratnapalan, S. (2019). 37 Leading and managing change in healthcare organizations. BMJ
Leader, 3(Suppl 1), A14-A14. http://dx.doi.org/10.1136/leader-2019-FMLM.37
Rebekah, G., & Ravindran, V. (2018). Statistical analysis in nursing research.
Indian Journal of Continuing Nursing Education, 19(1), 62-70. https://www.ijcne.org/text.asp?2018/19/1/62/28649
Tang, K. N. (2019). Change management. In Leadership and Change Management (pp. 47–55).
Springer, Singapore.

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Appendices
Appendix 1: Timelines
Time Task Name Sub-Task Status Assigned Start
Date End
Date Duration
First Month/Week
Creation of a multidisciplinary team
Requirements identification Training Week 1 Week 2 2 Weeks
First Month
Week 2-3 Identification of Barriers
Stakeholder Engagement Resources of allocation Week 3 Week 4 2 Weeks
Second Month Implementation Risk assessment
Training Sessions for nurses Week
2 Week 2 1 Week
Third Month Implementation Rolling out of pilot trial Week
2 Week
3 1 Week
4 Month
Week 3 & 4
Fourth Month Evaluation of the Intervention Assessing changes in numbers based on collected data Week 3 Week
4 6 Weeks

Appendix 2: Draft Budget and Resource List
a). Budgetary Estimates:
Item Cost (U.S. $)
Trainer’s Fee 2,000
Vote heads for different interventions 5,000
Training Sessions Implementation 8,000
Education campaign and awareness 3,000
Total 18,000

b). Required Human Resources
1. Administrator/ unit manager
2. Nurse/Project Manager
3. Epidemiologist
4. Nurse Practitioners
5. Trainers

Appendix 3: Survey Questionnaire
Catheter-associated Urinary Tract Infection (CAUTI) Baseline Questionnaire
Please complete the following background questions regarding your facility’s current status.
1. What is the total number of staff currently working in infection control at your facility? Please describe using full-time
equivalents of people working directly in infection control, do not include support staff (for example, if a facility had one
full-time person and one half-time person, this would equal 1.5 staff members).____
2. Currently, how many active acute care hospital beds does your facility have? ____
3. Currently, how many active adult Intensive Care Unit beds (ICU) does your facility have? ____
4. Currently, how many active pediatric beds (including nursery, NICU beds, etc.) does your facility have? ____
5. Currently, how many post-acute care (such as rehabilitation or assisted living) beds does your facility have? ____
6. Is your facility a teaching facility (i.e., your facility has physicians-in-training and/or nurses-in-training providing care to
patients)?
Yes
No
Please indicate whether your facility provides the following with respect to urinary catheters:
Yes, hospital-wide Yes, service or unit-specific No
7. Guidelines on appropriate indications for urinary catheter
use
8. Guidelines on proper techniques for urinary catheter
insertion
9. Guidelines on proper techniques for urinary catheter
maintenance
10. System of documenting urinary catheter insertions
11. System of documenting urinary catheter removals
12. Regular in-service training for appropriate healthcare
personnel on techniques and procedures for urinary catheter insertion, maintenance, and removal
13. Readily available supplies necessary for aseptic urinary
catheter insertion

For each item below, please check the answer that best applies, on a scale from Never to Always, regarding urinary catheter policies and practices at your facility.
Never
(1) Rarely
(2) Sometimes
(3) Often
(4) Always
(5)
14. Urinary catheters used for management of incontinence
15. Urinary catheters removed postoperatively within 24-48 hours unless there are appropriate indications for continued use
16. Alternatives to indwelling catheters (e.g.,
intermittent catheters, condom catheters) used when appropriate
17. Urinary catheters inserted using aseptic
technique and sterile equipment
18. Portable bladder ultrasounds used to assess urine volume
19. Urinary drainage systems with pre-connected, sealed catheter-tubing junctions used
20. Catheters changed at routine, fixed intervals
21. Nitrofurazone-releasing catheters used
22. Silver alloy catheters used
23. Systemic antimicrobial prophylaxis for urinary catheters used
24. Urinary drainage bags kept below level of bladder
25. Urinary drainage bags instilled with antiseptics or antimicrobials
26. Urinary catheters disconnected from collecting systems (e.g., for irrigation)
27. Screening for asymptomatic bacteriuria (ASB) performed
28. CAUTI rates fed back to providers
29. Adherence to hand hygiene policies measured in at least one patient care area
30. Adherence to proper aseptic insertion of
urinary catheters measured in at least one patient care area
31. Adherence to documentation of catheter
insertion and removal dates measured in at least one patient care area
32. Adherence to documentation of indication for
urinary catheter place

Appendix 4: APA Writing 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 the 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 the assignment and APA style, and the format is free of error.
Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and are 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.