NR451 RN Capstone


Define the EBP scope

Restate your practice issue.

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What’s the problem?

You can provide statistics and information to support the extent of the problem within your facility or work area.

How does this affect healthcare on a larger scale

Because this is your team, you will be its leader.

Who will you include in the team?

Select the relevant stakeholders.

Your team should not have more than eight members.

Don’t list your team members by their name, but by their position (pharmacists charge nurse etc. ).

Why is your project important?

What are their roles

Find evidence by conducting an internal or external search.

What other evidence did you find, in addition?

EBP guidelines

What data can you use to improve quality?

Position statements

Clinical Practice Guidelines

Please briefly describe the strength of this study.

Do not go on to describe the findings of your study.

These steps are followed.

This section is where you will synthesize information from the systematic overview article.

What evidence-based intervention did you discover in your Evidence Summary, and which ones are you planning to use?

You must cite all of the references you found in your Evidence Summary, in proper APA format.

Use Evidence to Develop Recommendations For Change

What recommendation is based on the research findings?

Your evidence should be sufficient to allow you to move forward with your pilot program.

This section assumes that you have not yet implemented the project.

Create your plan of implementation.

What are the steps to implement your pilot project?

What is the plan’s timeline?

Be sure to include a plan that will allow you to evaluate and report on the outcomes.

What are your desired outcomes?

How will these outcomes be measured?

What will you do to report the results on the key stakeholders’ part?

How will you make the plan work on a larger scale.

Do you think this plan would be applicable to the whole facility or other units?

What will you do in order to ensure that this implementation is permanent

How will you communicate the results internally within your organization and externally with others outside your organization?

Provide a brief summary.

You should review the key elements of the problem, as well as the proposed solution.

You should include the important points and methods to maintain the change plan in the ACE Star EBP model change model EBP process.

Answer to Question: NR451 RN Capstone

Hospital acquired diseases are an increasing problem in the health sector. They have a negative impact on patient health.

Hospital acquired diseases include catheter associated infections.

The common central venous cath is used to treat many conditions in hospitalized patients. It is also a common device that can cause infection at the site.

Numerous studies have previously shown that there are ways to reduce mortality and morbidity associated with catheter infections.

These interventions involve the use of antiseptics on the skin and the assessment of skin antisepsis.

There are significant uncertainties in the estimates due to low quality evidences and underpowered analysis (Bouk et. al., 2016,).

It is therefore necessary to review all existing evidences regarding the issue and to identify possible solutions.

A plan of action would be developed to address the issue.Change Model Overview

The ACE STAR model of information transformation is a system that helps integrate evidences into practice.

The five major stages of the model include knowledge discovery, evidence summary and translation into practice recommendations. Integration into practice is then evaluated.

The current issue requires that we review the previous work done and look at what is needed to fix it.

To do this, the ACE STAR modeling is one of best to be considered to integrate evidences into practice. It will lead to the integration and best possible changes (Bondmass 2012.

EBP: A Guide to Understanding It

According to Lai, et al. (2016), the evidence for the best antiseptic medications to prevent catheter-associated infections is low.

Unfortunately, these small-scale interventions did not produce good outcomes.

Therefore, this information does not allow for the administration of interventions to patients.

A thorough review of the literature is necessary and a plan for reducing catheter-related infections should be developed.

The incidence rate for central venous catheter-associated infection is very high at 2-7 episodes per 1000 catheter days (Deatherage 2016, 2016).

It is also affecting the health care industry by increasing patient mortality and morbidity.

The estimated net cost to infected patients in ICUs is $34,508 to $56,000 for each episode, which is significant burden on the sector (Lai and al., 2015).


The team leader must select and define the roles of the members. This will allow them to prior delegate tasks.

The current project team will include a pharmacist, skin specialist (registered nurse), charge nurse practioner (GP), HSC staff and a financial analyst.

Determining the Responsibility of Team Members

The team leader would manage the tasks of team members while monitoring their progress.

For example, the pharmacist may search for the most effective skin remedies to reduce catheter-associated injuries.

However, the registered nurse and the skin specialist will review the incidence of catheter-related infection among hospital patients.

The nurse practitioner and GP would search for relevant literatures and then review them.

The HSC staff would search for the right way to conduct and develop the action plan.

The budget plan is developed through financial analysis.

All members of the team will participate in the creation of the action plan.

We have the evidence

The central venous cath is one of many devices that can monitor hemodynamics as well as administer intravenous drugs.

This includes blood products, parental nourishment, and fluids.

This can result in catheter-related blood stream infection if micro-organisms colonize foreign substances.

It can also increase mortality rates, health care costs, and morbidity.

The language barrier was not an issue for research. However, data is only available from randomized controlled trials.

This review is based on the evidence-based practices, which is the standard for healthcare practice.

The research includes both the clinical practice guidelines and the quality improvement data.

Staff education, hand hygiene, effective skin antisepsis at the insertion site, and staff education are some of the evidence-based interventions (Lai and co., 2016).

Furthermore, the report explains the quality control that monitors the compliances systematically to set up guidelines as properly as evaluate the issues.

It also provides information about aseptic techniques used during insertion and the use of CVCs.

Use sterile gloves. Masks, caps, sterile gown, and large sterile drapes to ensure maximum sterilization.

Skin antisepsis can help prevent microbial contamination.

In this way, the risk associated with the catheter can either be avoided or decreased.

However, the contamination may lead to colonization of the external catheter infection. Therefore, skin antisepsis is recommended to reduce the BSIs.

CVCs can also be used for short-term purposes.

Galeon (2014) explains that the antiseptic agent prevents infection by the inhibition of the growth micro-organism.

After the antiseptic is injected into the living tissue, it starts working immediately.

This includes the presence of small blood cells and can be very effective against pathogenic bacteria.

Chen (2015) found that it should not be toxic to the living cells. It can also be safely used on all parts of the body repeatedly.

You can reduce the possibility of infection by washing your hands with soaps and drinking water. The deeper layers of your skin can also be susceptible to the effects of residential flora.

It is possible to treat the skin with antisepsis by using both the resident and temporary flora.

Additionally, the CVC infection can be treated with both mechanical and chemical methods.

Cheung (2015) noted that there is an inhibition of both transient and resident flora.

The three types of evaluation strategies are identified when accessing baseline data, pilot implementation data, and interim information.

The CAUTI Program can help to decrease the problem.

Therefore, it is essential to verify the strength and fragility of the project before you implement the plan.


Initially, the action plan goals will be established based on the information and knowledge of the team members.

Action Plan


Take action


Reduce catheter-associated complications

It is important to conduct a skin exam. Evidence shows that catheter-associated infections can be caused by skin density and microbiota.

This is why it is crucial to determine the parameters of the area where the catheter will be inserted (Chen, et al. 2015).

In accordance with CDC guidelines for catheter-associated patient’s healthcare, constant surveillance, use femoral venous, avoiding unnecessary cath, introducing advance stage sterilization into patient’s room to prevent infection colonization.

It takes three months to reach this goal.Developing efficient workforce

Staffs receive advanced training on catheter-related infection control. They are trained to change the position of patients frequently, remove catheter as soon it is no longer needed, change the catheter location as soon there is any inflammation or sign infection.

Staff education and hand hygiene workshops for nursing staff; staff training for catheter insertions and prevention strategies for bloodstream infection; hiring experienced staff (Deatherage (2016)

This goal takes 6 months.

Offering the best medication to patients

Looking through the literature, it was determined that the best medication for treating a skin infection, i.e.

The patient’s skin type and the current status of the condition should determine which skin antiseptic is best.

The evidence regarding the most effective antiseptic skin medication to reduce catheter-associated infection is lacking. Aqueous chlorhexidine and povidone iodine, along with alcohol, would be tested in this setting (Denny & Munro 2017, 2017).

This goal takes 3 months.


The actions plan will result in lower incidences of catheter-associated infection among patients and a decrease in mortality.

After exceeding the timeline, the outcome would be measured by estimating how many catheter-associated fatalities there are in the hospital. The reports will be disseminated to the stakeholders through email, meetings and publishing the report on the hospital website (Fasugba, et al. 2016).

Based on this pilot study, it would be possible to determine if the interventions can be applied in a larger scale.


We can conclude that the central vein catheter associated infection is the most frequent problem found in hospital. This significantly affects patients’ well-being.

There are not many evidences to support the idea of the best antiseptic options.

The current project utilized the ACE STAR model to create a change plan that would resolve the problem.

Reference ListBondmass, M. D. (2012).

Application of ACE Star Model and Essential Competencies to a DNP Programme.Bouk, M., Mutterer, M., Schore, M., & Alper, P. (2016).

A hand hygiene compliance program that uses electronic technology to improve hand hygiene, reduce MRSA and increase financial performance.

American Journal of Infection Control, 44(6). S100-S101.Chen, W. T., Wang, C. Y., Huang, H. R., Tseng, H. C., & Shih, C. C. (2015).

The implementation of a central venous catheter bundle across all hospitals at a cancer facility reduced catheter-related bloodstream disease.

Journal of Microbiology, Infection, and Immunology, 48(2),S155-S156.Cheung, C. W. Y., Wong, Y. Y., Lau, S. S., Ching, P. T. Y., Li, K. H., & Seto, W. H. (2015).

Implementation of the catheter-associated urologic infection (cauti), bundle with the support and assistance of infection control nurse practitioners auditors and infection control link nurses.

Journal of Microbiology, Infection, 48(2),S95.Deatherage, N. (2016).

Impact of Reduced Contact Prevention and Isolation on Infection Rates at a Non Profit Acute Care Hospital.

American Journal of Infection Control. 44(6).Denny, J., & Munro, C. L. (2017). Chlorhexidine Bathing Effects on Health-Care-Associated Infections.

Biological research for nursing, 19(2). 123-136.Fasugba, O., Koerner, J., Mitchell, B. G., & Gardner, A. (2016).

Systematic review and meta analysis of the effectiveness o antiseptic agents used for meat cleaning in the prevention catheter-associated urinary system infections.

Journal of Hospital Infection.Galeon, C. P., & Romero, I. (2014).

Implementing a Performance Improvement Project in a Multilevel Teaching Facilities on Reducing Catheter Associated Urinary Tract Infections.

American Journal of Infection Control (42(6), S130-S131.Lai, N. M., Lai, N. A., O’Riordan, E., Chaiyakunapruk, N., Taylor, J. E., & Tan, K. (2016).

Skin antisepsis for central venous catheter?related infected.

The Cochrane Library.Lai, Y. H., Tsai, G. H., Liou, Y. S., Shih, M. L., Tsaig, S. S., Hung, Y. P., … & Yang, Y. C. (2015).

Bundled care reduces the likelihood of central line-associated bleeding stream infections in a regional hospitals.

Journal of Microbiology, Infection, and Immunology, 48(2),S95.Regagnin, D. A., da Silva Alves, D. S., Cavalheiro, A. M., Camargo, T. Z. S., Marra, A. R., da Silva Victor, E., & Edmond, M. B. (2016).

Sustainable program for the continuous reduction of catheter-associated bladder infection.

American journal on infection control, 44(6) 642-646.Walters, E. (2016).

The use of process measures to improve compliance with evidence-based infection prevention activities.

American Journal of Infection Control. 44(6). S10