Outcomes and Implications to Nursing Practice

Outcomes and Implications to Nursing Practice

Outcomes and Implications to Nursing Practice

Increasing staff compliance in adopting and implementing evidence-based catheter-associated urinary tract (CAUTI) prevention practices is my practicum project with the ultimate goal of preventing and/or reducing the CAUTI rate in the intensive care/intermediate care unit (ICU/IMU) of my practicum facility. Participating in various quality council meetings and other leadership meetings with my field preceptor (ICU/IMU Clinical Director), reducing the CAUTI rate was identified as one of the areas that need improvement. The staggering results of CAUTI rate in the ICU/IMU and at the dashboard quality metrics was a major concern among the organizational leaders, most importantly with the nursing leaders.

Through retrospective data analysis from chart review and chart audit from the first quarter of fiscal year (FY) 2017 up to the second quarter of FY 2017, the unit’s CAUTI rate has been below the intended goal of zero occurrence rate. A weekly chart audit was continued prior to project implementation which resulted in staff’s poor compliance with evidence-based CAUTI prevention practices as evidenced by less than 50% EHR (electronic health record) documentation. An on-going chart audit is currently being conducted and will end until project completion to evaluate the project’s effectiveness. A collaborative unit based education and refresher course regarding CAUTI prevention practices that includes urinary catheter indications, maintenance care, and removal protocol were discussed during the implementation phase.

Powerpoint presentation and poster board display are two methods used for unit based education. The daily one to one conversation with the frontline staff nurses during clinical rounds was identified as a great opportunity for teaching about CAUTI prevention practices through shared ideas, one on one feedback, and promptly addressing any issues regarding CAUTI prevention practices. The effectiveness of this project is reflected on the daily chart review and chart audit where an increase in nursing documentation is evident. The post-implementation knowledge test and survey will be conducted in the next few weeks to evaluate staff’s understanding of this evidence-based practice (EBP). Outcomes and Implications to Nursing Practice.

The implications of this project for nursing leadership is to convey that adoption and implementation of any EBP can be successfully done through transparency, dedication, and providing a learning and supportive environment. To be able to increase nurse engagement in adhering to new practice change, nurse leaders must be able to convey to staff members the reason for the change, the action plans needed, the availability of resources, and his/her required expectations from frontline staff nurses. Transparency from nurse leaders is an important aspect of practice change (Milton, 2009). Providing a learning environment demonstrates the nurse leader’s commitment for practice change. Creating a supportive workplace environment is a reflection of nurse leader’s soft skills were it conveys the catchphrase of “we’re all in this together”.

Project Dissemination

Dissemination of evidence-based practice findings to stakeholders and other health care professionals is vital for practice improvement (Matchar as cited in Forsyth, Wright, Scherb, & Gaspar, 2010). The dissemination of EBP findings through knowledge synthesis, translation, and exchange of ideas is important to strengthen health care, inform policy and improved practice decisions based on current clinical evidence (Waters & Armstrong as cited in Forsyth, et al., 2010). The importance of disseminating this practicum project is to share the issues and challenges of practice improvement, convey the different methods and approaches that were used, and to impart the outcome of the project so others can replicate or applied it in their current setting (Price, 2010).

The target audience for dissemination includes nurse leaders and frontline staff nurses, quality council members, clinical educators, and other members of healthcare team since CAUTI prevention is everyone’s responsibility. The method of dissemination is through poster board display that is visible at the nursing station, unit’s quality dashboard, and in the staff’s break room. Posters broadly disseminate practice change, findings, outcomes, or policies to a variety of people (Forsyth et al., 2010). Another method of project dissemination is through power point presentation, the hospital newsletter, journal article, and conference presentation. The conference offers a good opportunity to share best practice and can be an excellent place to start networking (Price, 2010). Outcomes and Implications to Nursing Practice.

Publication in a nursing journal is another great way of disseminating the findings and the outcomes of the practicum project. The American Journal of Critical Care (AJCC) is an excellent journal for project publication since it aligns with the journal’s mission of providing readers with clinically relevant content to achieve its ultimate goal of improving the care of critically ill patients and families (AACN, 2017). The Nurse Leader is another journal to consider since it centers on effective leadership styles, knowledge, and skills for current and aspiring nurse leaders seeking to implement a successful practice change (Elsevier, 2013).

References

American Association of Critical Care Nurses (AACN). (2017). American journal of critical

care. Retrieved from http://ajcc.aacnjournals.org/site/misc/about.xhtml

Elsevier. (2013). Nurse leader. Retrieved from http://www.nurseleader.com/content/aims

Forsyth, D.E., Wright, T.L., & Scherb, C.A., & Gaspar, P.M. (2010). Disseminating evidence-

based practice projects. Poster design and evaluation. Clinical Scholars Review, 3(1),

14-21. Retrieved from Walden Library databases.

Price, B. (2010). Disseminating best practice at conferences. Nursing Standard, 24(25), 35-41.

Retrieved from Walden Library databases.

Milton, C.L. (2009). Transparency in nursing leadership: A chosen ethic. Nursing Science

Quarterly, 22(1), 23-6. doi: 10.1177/0894318408329159. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/19176856