NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Synthesis is excellent. The paper organizes paragraphs in a logical sequence and connects ideas or overreaching concepts. The paper is well-developed, fluid, and cohesive.

Synthesis is evident. The paper organizes paragraphs in a logical sequence and connects ideas or overreaching concepts. Overall, the paper applies transitions and the paper is fluid and cohesive.

Synthesis is generally evident. The paper organizes most paragraphs in a logical sequence and generally connects ideas or overreaching concepts. Some paragraphs require better transitions to create a fluid and cohesive paper.

Synthesis is sporadic. Overall, the paper fails to organize paragraphs in a logical sequence and connect ideas or overreaching concepts in a fluid and cohesive paper.

Synthesis is not evident. The paper consists of a cut-and-paste of the previous assignments. Revision based on instructor feedback is not included.

The organizational culture and readiness are thoroughly discussed and insight into the organization challenges is presented. Clear strategies for communication, stakeholder involvement, and the implementation of the evidence-based practice project proposal are presented. Thorough explanations and strong supporting evidence are provided.

The organizational culture and readiness are discussed and information on the organizational challenges is presented. Strategies for communication, stakeholder involvement, and the implementation of the evidence-based practice project proposal are presented. Adequate explanations and supporting evidence are provided.

An incomplete description of the organizational culture, readiness, and some organizational challenges is presented. Strategies for the overall implementation of the evidence-based practice project proposal are incomplete.

The organizational culture, readiness, and some organizational challenges, are summarized. General strategies for the overall implementation of the evidence-based practice project proposal is presented, but there are inaccuracies. Some additional information is needed.

A description of the organizational culture and readiness is not included.

The problem statement is consistent throughout the paper and concisely describes the issue using strong evidence-based support to rationalize and justify the problem.

The problem statement is consistent throughout the paper and describes the issue using evidence-based support to rationalize and justify the problem.

The problem statement is mostly consistent throughout the paper and, in most instances, uses evidence-based support to rationalize and justify the problem.

The problem statement is inconsistently presented throughout the paper. Evidence-based support to rationalize and justify the problem is missing in many aspects.

The problem statement is not used throughout the paper. In general, evidence-based support to rationalize and justify the problem is not provided.

The supporting literature from the literature review is organized and synthesized strategically throughout the paper to provide convincing evidence. The main components of the articles are used to provide substantial rationale for how the research supports the PICOT.

The supporting literature from the literature review is used throughout most of the paper to provide evidence. The articles are used to provide general rationale for how the research supports the PICOT.

The supporting literature from the literature review is synthesized and used throughout the paper to provide evidence. The main components of the articles are used to provide rationale for how the research supports the PICOT.

The supporting literature from the literature review is inconsistently used in the paper to provide evidence. The articles do not provide clear rationale for how the research supports the PICOT.

Supporting literature from the literature review is not evident. Clear rationale for how the research supports the PICOT is not presented.

The selected model or framework and its application for the proposed implementation are thoroughly described.

The selected model or framework and its application for the key aspects of the proposed implementation are described.

The selected model or framework and its general application for implementation are outlined.

The selected model or framework and its application for implementation are incomplete.

The selected model or framework and its application for implementation are not described.

The implementation plan is thoroughly described and provides the details for the various aspects. Thorough explanations and strong supporting evidence are provided.

The implementation plan is described and provides key information for the various aspects. Adequate explanations and supporting evidence are provided.

The implementation plan is generally described. Information for some key aspects is presented, but there are inaccuracies. Some additional information is needed.

The implementation plan is incomplete.

The implementation plan is not described.

The evaluation plan is thoroughly described and provides the details for the various aspects. Thorough explanations and strong supporting evidence are provided.

The evaluation plan is described and provides key information for the various aspects. Adequate explanations and supporting evidence are provided.

The evaluation plan is generally described. Information for some key aspects is presented, but there are inaccuracies. Some additional information is needed.

The evaluation plan is incomplete.

The evaluation plan is not described.

The resources are accurate and attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was effectively used in development of the paper.

The resources are revised accordingly and attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper.

The resources have been revised, but there are one or two minor errors. The resources are attached in the appendix. It is apparent that the APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality.

The required resources are attached, but an appendix has not been created. Some resources contain errors and have not been revised. The paper does not reflect the use of the APA Writing Checklist during development.

The appendix and required resources are omitted.

The final paper clearly adheres to ethical research standards and demonstrates a strong ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice.

The final paper observes ethical research standards and demonstrates an ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice.

The final paper observes ethical research standards, but there are some aspects of the paper that need more detail or information. A general ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice is demonstrated.

The final paper is inconsistent in its adherence to ethical research standards. The ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice is not consistently demonstrated.

The final paper does not adhere to ethical research standards. The ability to translate research and knowledge gained from practice to the improvement of patient outcomes and clinical practice is not demonstrated.

Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

Number of required sources is met, but sources are outdated or inappropriate.

Number of required sources is only partially met.

Sources are not included.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is insufficiently developed or vague. Purpose is not clear.

Paper lacks any discernible overall purpose or organizing claim.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Writer is clearly in command of standard, written, academic English.

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

Template is fully used. There are virtually no errors in formatting style.

All format elements are correct.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. The organizational culture and the degree to which it supports change is thoroughly discussed. The various aspects of the culture are included. Thorough explanations and strong supporting research are provided.

Template is used, and formatting is correct, although some minor errors may be present.

Template is not used appropriately, or documentation format is rarely followed correctly.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

A Sample Answer 2 For the Assignment: NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Title: NUR 550 Benchmark – Evidence-Based Practice Project Proposal Final Paper

The healthcare sector, healthcare professionals, and other stakeholders have, in the past and present, focused on improving patient outcomes using various strategies. Such strategies aim at improving the efficiency of patient care and the safety of patients while in the patient care environment. The efforts and initiatives aimed at improving care outcomes are usually triggered by a host of incidences happening in the care settings, such as patient falls, patient injuries, pressure ulcers, and healthcare-acquired infections, among other incidences. (Jaul et al.,2018) Among the most common healthcare-acquired infections are catheter-associated urinary infections (CAUTIs). CAUTIs have been shown to cause various negative impacts, such as increased healthcare spending, longer hospital stays, and other adverse impacts, such as death. Therefore, this evidence-based practice project focuses on lowering the rates of CAUTI among patients in admission settings and using indwelling catheters(Shadle et al.,2021). As such, the purpose of this paper is to formulate aproposal for the EBP. Various aspects which will be explored include the problem statement, the organizational culture, the literature review, the change framework, and the implementation and evaluation plans.

Problem Statement

Hospital-acquired infections have been shown to be on the rise in the past and present. One of the most common types of such infections is catheter-acquired urinary tract infections caused by the use of urinary catheters, especially indwelling ones. According to Flores-Mireles.(2019), CAUTIs lead to various adverse impacts. Even though the condition is largely preventable, it continues to cause havoc as it leads to increased patient morbidity and mortality, longer hospital stay, and increased healthcare spending (Kranz et al.,2020). This problem can, however, be prevented by applying various nursing interventions. It is important to note that, while various nursing interventions have been implemented, especially single activity-based interventions, the problem still persists hence calling for the use of more robust approaches which can integrate various interventions such as the use of CAUTI bundle.

Organizational Culture and Readiness

The process of evidence-based practice is impacted by various aspects, some of which are organizational aspects. The implication is that the EBP implementers should take their time and assess the nature of the organization, such as its culture related to EBP implementation and the readiness of various staff. Such a step is key in determining how easy or difficult the process of implementing an EBP project can be since a positive culture is needed for a successful implementation to occur (Cleary‐Holdforth et al.,2021). The assessment revealed that the organization’s leaders support patient improvement initiatives such as the EBP process for better patient outcomes. The organization also focuses on gaining magnet status, which has made them support various change initiatives. The assessment of the organization’s aim and mission showed that it focuses on offering exemplary and excellent patient services by using the latest care strategies at affordable costs. In addition, it was also noted that the organization adores interprofessional collaborations and teams in the provision of care. Therefore, it is evident that the organization’s culture is ready for change and also supports EBP.

The organization’s culture and readiness were assessed using a chosen tool, the System-Wide Integration of the EBP survey tool. This tool has widely been applied, especially to assess an organization’s capacity to adapt to and cope with change (Melnyk et al.,2022). This tool was used to explore the staff’s and the leader’s understanding of the proposed change of application of the CAUTI bundle to control the CAUTI rates. The survey tools showed that up to 91% of the staff support the proposed change, which is a majority. In addition, the majority of the leaders also supported the initiative, as up to 80% indicated that they were ready for the change. Therefore, this tool also revealed that the organization’s culture could support and sustain the proposed change.

Even though the culture supports the proposed change, it is worth noting that there are potential barriers and weaknesses that may derail implementation. For example, lack of support by minority leaders as staff can be a major drawback. The assessment will also be key in exploring the staff knowledge in using the proposed CAUTI bundle, which will then help to formulate strategies for improving their knowledge. The leaders supporting the initiative will play an important role in availing the required resources and supporting the project through making effective decisions and formulating change champions who can then help on driving the change initiative as appropriate. It was also important to identify the relevant stakeholders (Melnyk et al.,2022). Therefore, various stakeholders were identified, stakeholders include physicians, nurses, unit leaders, nurse managers, patients, and their families

Literature Review

The identified problem which informed the formulation of this project is increased rates of CAUTI in patient care settings. Therefore, the use of CAUTI bundles has been proposed as a potential EBP intervention. As such, it was important to perform a literature review to explore the existing evidence on the use of CAUTI bundles to reduce the rates of CAUTIs among patients admitted to the hospital and using indwelling urinary catheters. A PICOT question formulated earlier was used in the literature search. The formulated PICOT was: Among patients using indwelling urinary catheters, what is the efficacy of using CAUTI bundle care as compared to no intervention in lowering the rates of CAUTI by at least 60% within six months?

An article search strategy was also used to access the most relevant articles and evidence as appropriate. The search was accomplished in various article databases such as PubMed, google scholar, CINHAL, and Cochrane databases. The search also focused on peer-reviewed articles published in the last five years. Various search terms were also used in the search for relevant articles, including CAUTI, CAUTI bundles, intervention, and prevalence. Even though the search yielded several articles, the most relevant was chosen, and the literature review of the ten articles was performed and presented in the next section.

Elkbuli et al.(2018) conducted a study on the prevention of CAUTI among the trauma population. This study aimed at determining the efficacy of using a 5-S CAUTI bundle in the reduction of CAUTI rates among trauma patients. In a quantitative study, the researchers recruited a total of 2926 trauma patients. The analysis of the data showed that the use of the 5-S bundle led to a significant reduction in CAUTI rates among trauma patients (p-value of 0.002).

Davies et al.(2018) also conducted a study to explore the impact of using a CAUTI bundle. In a pre-and-post-study design, the researchers recruited a total of 6236 patients to take part in the study. The analysis of the data compared the rates of infections before the application of the CAUTI bundle and after its implementation. The results showed that the rates of CAUTI after the implementation of the CAUTI bundle were significantly lower compare as compared to the rates before, showing the efficacy of the CAUTI bundle.

Recently, Reynolds et al. (2022) conducted research that aimed at exploring the impact and sustainability of a multifaceted intervention in lowering CAUTI rates. This study was conducted in three large adult intensive care units among patients using urinary catheters. The analysis of the data showed a significant impact of bundle care. For example, the researchers noted a drop in CAUTI rates and the use of indwelling catheters. The positive impacts were directly associated with the implementation of the CAUTI bundle care as a strategy.

In a similar study, Mundle et al. (2020) explored the effectiveness of implementing a CAUTI bundle in preventing CAUTI incidences. The researchers conducted the study in internal medicine units where every patient admitted during the study took part in the study. The analysis of the data showed significant results relevant to this study as the researchers observed a 79% reduction in the rates of CAUTI among the patients, showing that the implementation of the CAUTI bundle care positively impacted CAUTI rates.

Sultan et al. (2022) explored the effect of using a CAUTI bundle to help prevent CAUTI occurrence among critically ill patients. In a quantitative study, the researcher recruited a total of eighty patients admitted to the intensive care units. The analysis of the data showed that the implementation of the CAUTI bundle led to a significant reduction in CAUTI rates. For example, they noted that upon the implementation of the CAUTI bundle, the CAUTI rates among the ICU patients were reduced by 50%, showing the efficacy of the intervention.

Another relevant study was conducted by Tyson et al. (2020), which focused on implementing a nurse-driven protocol designed to support catheter removal approaches to help reduce CAUTI rates. The aim of the study was to compare the CAUTI rates and the use of indwelling urinary catheters before and after implementing a nurse-driven CAUTI bundle among patients admitted to the surgical trauma intensive care unit. The analysis of the collected data led to significant results. For example, upon the implementation of the protocol, the researchers noted a significant reduction in the rates of catheter use. In addition, they also found that the protocol led to a reduction in CAUTI rates.

Shadle et al. (2021) also conducted a study to determine the impact of using a CAUTI bundle to reduce CAUTI rates. In a quantitative study design, the researchers collected data using electronic health records. The analysis of the collected data also showed relevant results. For example, the researchers realized that during the study, no CAUTI cases or incidences were reported showing that the CAUTI bundle implemented was highly effective in preventing and controlling the CAUTI rates.

More recently, Pajerski et al. (2022) carried out research that explored the impact of using CAUTI bundles in controlling the rates of CAUTI. This study was conducted in a trauma brain injury rehabilitation unit. Upon the analysis of the data, the researchers noted that there was a reduction in the CAUTI rates when the CAUTI bundle care approach was implemented. Soundaram et al. (2020) also carried out research with the aim of exploring the impact of implementing a CAUTI bundle in the control and prevention of CAUTI rates and incidence. The researchers carried out the study in adult intensive care units. The analysis of the data showed that upon the use of the CAUTI bundles, the cases of CAUTI were observed to reduce significantly by sixty percent. As such, this is another study that shows the efficacy of using a CAUTI bundle in controlling and preventing CAUTI incidences and rates.

Another study was conducted by Ravi and Joshi (2018). This study was conducted with the major aim of exploring the efficacy of a CAUTI care bundle in lowering CAUTI rates. The researchers used a bundle care approach which included training and educating the nursing staff on how to appropriately use and manage the indwelling catheters. Upon the analysis of the data, the researchers also noted a significant reduction in the rates of CAUTI among admitted patients. Therefore, this is another study that shows the efficacy of using CAUTI bundles in the prevention and control of CAUTI.

Change Model or Framework

Change models play a crucial role in the implementation of evidence-based practice projects since they offer foundations upon which the project is implemented (Jayatilleke & Lai, 2018). As such, the selected change model for this project is Kurt Lewin’s change model. According to Lewin change occurs in three distinct faces, and there are two major forces involved in a change process, the driving and restraining forces. The driving forces are known to enhance the change process, while the restraining forces oppose the change. As such, the driving forces have to overcome the restraining forces for the change process to occur successfully.

The three phases include unfreezing, change, and refreezing. In the first phase, which is refreezing, the major activity is creating an urgent need for change by pointing out the evidence of why the change should urgently be undertaken (Hussain et al.,2018). Letting the stakeholders know that there is a need for change requires effective communication.  The second phase, which is the change phase, is associated with the implementation of the proposed intervention, where the change implementers implement the initiatives to help solve the identified clinical issue. The third phase is known as refreezing. This stage entails using various efforts to ensure that the implemented change becomes part of the organization’s culture and supporting the staff to accept and sustain the change.

The stages of the model will be applied to implement the CAUTI bundles. In the unfreezing stage, the stakeholders will be alerted to the urgent need for change to help reduce the rates of CAUTI in the care setting. Appropriate communication channels will be used to inform the staff of the need to address the issue of rising CAUTI cases. The second phase, which is the change phase, will involve training the nursing staff on the proposed new bundle and how to use it. The process will then be followed by the implementation of the CAUTI bundle to help reduce the rates of CAUTI. Effective communication will also be key in this phase(Hussain et al.,2018). The last phase, which is the refreezing stage, will entail sustaining the implemented change and ensuring that the CAUTI bundle becomes part of the organization’s protocol for preventing CAUTI incidence.

Implementation Plan

Implementation is one of the most important phases of an EBP project cycle. Therefore, a conducive environment should be created to enhance the implementation process. It is also important to explore various aspects, such as the setting and how to access the potential subjects. As discussed earlier, this project involves using CAUTI bundles to reduce or lower the rates of CAUTI among patients using indwelling urinary catheters (Elkbuli et al.,2018). Therefore, the targeted setting for the project is the admission wards with patients who used indwelling urinary catheters. The patients to be considered are those who will be admitted to the admission units and using the indwelling catheters. The other targeted population is the nurses who offer nursing care to the patients in these settings. The data for evaluating the project will be obtained from electronic health records. Therefore, there will be no need to obtain informed consent. Nonetheless, the organization leaders will need to offer permission to allow the implementation process.

It is also important to consider a suitable timeline for the proposed project. A timeline acts as a guide to knowing when particular activities should be accomplished (Melnyk & Fineout-Overholt, 2019). Therefore, a period of six months has been proposed for the project. It is hoped that this duration will be sufficient to cover various project phases such as project, initiation, literature review, project implementation, monitoring, and evaluation. This duration will also be used in obtaining project feedback from the stakeholders, such as indications of carrying out corrective measures to help solve various identified problems.

The Budget and Resource List

The success of a project heavily depends on the availability of needed resources; therefore, it is important to procure the necessary resources in time. There will be a need to train the staff on the use of the new CAUTI bundle. Therefore, both material and financial resources will be required to support such an education and training process (Melnyk & Fineout-Overholt, 2019). Besides, additional resources will also be needed to help in the development of the CAUTI bundle protocol to be used in controlling and preventing the CAUTI rates. Human resources will also be required to help accomplish the project goals. The budget implication is that the project team will need to get sufficient resources that can help in training and educating the nursing staff, purchasing the training materials, hiring the educators, collecting data, data analysis, project monitoring, and well as outcome evaluation. It has been projected that the cost of the project will be $36,000, and the detailed budget and resource list have been included in the appendix.

The Study Design

A study design is important in guiding a project; therefore, it is important to choose various aspects of study design appropriately. As such, the design chosen for this project is the quantitative design which will be used in both data collection and analysis. This design has been chosen since the targeted project data is quantitative. Statistical tests will also be used as part of the project to analyze the project data, which further corroborates the use of the quantitative study design as compared to the qualitative study approach (Jolley, 2020). The quantitative study approach also supports easier data collection and analysis. The quantitative study approach is also relatively cheaper in comparison to the qualitative study design and approaches.

Methods and Instruments

            Instruments and methods are a crucial part of the implementation plan, and they are important for various activities such as data collection, data analysis, and data evaluation. One of the instruments to be used in this project is the questionnaire. Questionnaires will be applied to test the nurse’s knowledge of CAUTI prevention and management. The nurses’ knowledge will be assessed before and after the education (Gunawan et al.,2021). The rationale for choosing questionnaires is that they are easier to use in collecting data. Another instrument is electronic health records which will be used to obtain the baseline data on CAUTI rates. The same instrument will also be used to obtain data on CAUTI incidences after the implementation of the proposed CAUTI bundle care.

The Process of Delivering the Intervention

The success of the implementation process hinges on the process of delivering the intervention. As part of the plan, the intervention will be delivered in various phases. In the initial phase, an assessment of the clinical setting is to be undertaken through a needs assessment approach to explore the nature of the needs (Grove & Gray, 2018). The assessment involves studying the CAUTI statistics within the organization, including the impacts and trends among patients admitted to the facility. The assessment also involves assessing the nurses’ levels of knowledge and awareness regarding CAUTI and control of CAUTI using CAUTI bundles. The process will be key in coming up with relevant strategies to use in the project. The next step will entail educating and training the nurses on the use of the proposed CAUTI bundles to help reduce the rates of CAUTI. The next step will then involve the implementation of the intervention, where the efficacy of the intervention will be tested. As part of the plan, the staff will be closely supervised for a considerable duration to ensure that they are correctly and adequately implementing the bundle elements. The next part involves collecting the data associated with the intervention and analyzing the data to determine the efficacy of the intervention in reducing the CAUTI rates.

The Stakeholders Required to Complete the Project

Stakeholders form a crucial part of the project. As such, it is crucial that they be identified in time so that they can be involved from the onset of the project (Lehane et al.,2018). Early involvement of stakeholders helps in limiting the chances of resistance. The following stakeholders have been identified; the chief executive officer, the nurse manager, the unit managers, the hospital finance officer, the nursing staff working in the admission wards, and the physicians. The hospital’s chief executive officer will give permission to accomplish the project in the organization. The nurse manager will play a critical role in coordinating the unit activities related to the project implementation. The unit managers will discharge duties related to each unit. The finance officer will also help with feasibility assessment, financial viability, and the best ways to acquire the needed resources. The nurses are at the forefront of the project and will help in the active implementation of the intervention. The physicians also take part in the treatment of the patients admitted to the wards and, therefore, will support the nursing team in implementing the proposed CAUTI bundle.

Potential Barriers or Challenges to The Plan

Implementing an evidence-based practice project may face various challenges or barriers which may need to be mitigated if the project implementation process is to be a success. The implication is that appropriate strategies should be formulated in time to help overcome the challenges or barriers. Among the potential challenges are potential difficulties in obtaining the resources needed, especially financial resources (Lehane et al.,2018). Project failure may be the result if sufficient funds are not obtained. Therefore, a solution should be explored. One of the solutions is writing funding proposals to potential sponsors or financiers. The other expected barrier or challenge is resistance by the leadership or the nursing staff. The nursing staff may offer resistance to the use of the proposed bundle since it may need more time. The resistance can be reduced by training the nurses to help them have a better understanding of the proposed initiative to reduce the chances of resistance.

Evaluation Plan

Evaluation is one of the most important stages and the last stages of evidence-based practice project initiatives. As such, it is crucial to come up with an evaluation plan which can be applied in assessing the impact of the implemented intervention. This phase is also crucial in exploring how effective the strategies or methods used in the project have been (Dang et al.,2021). As part of the evaluation plan, it is important to explore the expected outcomes as far as the project is concerned. In the previous sections, it was indicated that the nursing staff would need training regarding the use of the proposed CAUTI bundle. Therefore, among the expected outcomes is improved nurse knowledge and skills in the use of CAUTI bundles to control the rates of CAUTI (Elkbuli et al.,2018). The next expected project outcome is the reduction in CAUTI rates. It is hoped that the implementation of the CAUTI bundle will lead to a reduction in CAUTI rates by at least 60%. Such a feat will be used as a reflection of the efficacy of the intervention. Another expected outcome is that the organization will adopt the CAUTI bundle protocol as a standard intervention for preventing and managing CAUTI in the organization. Such an expectation will be made easier by positive project outcomes.

The Data Collection Tools

Data collection tools are important in the project phases, especially the evaluation phase in obtaining project data to be used in evaluating the efficacy of the implemented intervention. One of the data collection tools is electronic health records. The electronic health records will be applied to obtain data on the rates of CAUTI after implementing the CAUTI bundle protocol. This data will then be compared with the baseline data which was obtained at the start of the project. Such a comparison will ventilate more on whether the intervention has been effective or not.

The next targeted tool is the questionnaires. The questionnaires will be used to assess the nurses’ skills and knowledge concerning the use of the CAUTI bundle to prevent and control CAUTI. The knowledge gained after education will be compared with the baseline knowledge to determine the efficacy of the education program. Questionnaires will also be used to assess the attitude of patients and nurses concerning the implementation of the new CAUTI bundle. Questionnaires will be appropriate as the project utilizes a quantitative design approach. The tool is also valid as they have been validated and shown to be effective in measuring knowledge (Yaddanapudi& Yaddanapudi, 2019). The tool is reliable since the same set of questions will be used

The Statistical Tests

Statistical tests are used in the data analysis process to help determine the efficacy of the intervention. The major thrust of this project is to compare the rates of CAUTI in the admission units before and after the implementation of a CAUTI bundle. Therefore, one of the most appropriate statistical tests to use in this case is paired t-test. The paired t-test has been chosen since it has been shown to be effective in measuring the variation between a set of paired samples. This project will focus on the pre and post-test rates scores and CAUTI rates. Therefore, the chosen statistical test will help in determining the significance of the considered set of scores. Mean will also be used, especially in the nurse knowledge scores regarding the use of CAUTI bundles to control the rates of CAUTI.

The Methods of Use and the Evaluation of the Outcomes

            Methods and strategies used in the project may impact project outcomes; hence it is important to explore them. The questionnaire to be applied in the project, as part of the plan, is expected to have scaling questions, multiple-choice questions, and dichotomous questions. It is important to use different formats and approaches to questions since the project should determine various changes associated with the implemented initiative. Various validated scales will be used in formulating the scaling questions and use scales, such as 1 to 5. On the other hand, the dichotomous questions require the research subjects to either answer a yes or a no. It is important to use these kinds of questions for a complete evaluation of the project (Melnyk & Fineout-Overholt, 2022).

Strategies to Be Taken If the Outcomes Do Not Provide Positive Results.        

Quality improvement projects and evidence-based practice projects are usually designed with the hope and aim of positive outcomes. Indeed, positive outcomes are usually achieved under normal circumstances (Linsely et al.,2019). It is important to note that in some cases, positive outcomes may not be the results observed. Hence the project team should always put measures in place that can be used as part of the mitigation process in the event that the results obtained are not positive. As part of the plan, among the strategies to be used in the event that the results are not positive is the do a reexamination of the implemented intervention. Reexamination can be vital in offering insights into particular or specific areas which might have led to the observed failure. Another expected strategy is the extension of the project timeline. Extending the project timeline can be necessary to help the project team identify areas of weakness, revise vital parts of the project and implement corrective measures to help in improving the chances of the project succeeding.

The Plans to Maintain, Extend, Revise, and Discontinue the Proposed Solution

An implemented evidence-based practice project can lead to various outcomes; in some cases, the outcomes can be desirable, while in other cases, the outcomes may not be desirable. Therefore, it is important to put in place an appropriate plan to maintain, extend, revise, or discontinue the implemented solution or initiative as part of the overall plan; the project will be maintained if the outcomes turn out to be as expected. In other words, the project will be maintained if the outcomes are positive and the implemented solution is positively affecting or impacting the patients.

As part of the plan, the project will also be maintained if it is cost-effective. Healthcare cost has recently become an important point in the healthcare environment as the costs have been going up. As such, any quality improvement projects or evidence-based practice projects should be cost-effective. Therefore, this project will not be different and will, therefore, be maintained if it is cost-effective. In some cases, the evaluation phase may produce or give results that are not conclusive. In such cases, there may be a need to get appropriate results that can be used in evaluating the project outcomes. Such cases require that the project be extended. Therefore, the project will be extended if the outcomes and inconclusive (Melnyk & Fine-Overholt, 2022). The major purpose of extending the project is to obtain appropriate additional data that can then be applied to determine the effectiveness of the project.

Under certain conditions, the project may need to be revised. A revision will be pursued if the strategies do not align with the project outcomes. The revision will be undertaken to get more time which can be used in adopting improvement interventions. Such improvement interventions will increase the chances of the project succeeding. As part of the plan, the project may also be discontinued under particular instances or circumstances. For example, discontinuation will occur in the case that the project causes harm to the patients and the staff. The solution will also be discontinued if it pauses a risk to the lives of the staff and the patients.

Conclusion

The adverse impacts of CAUTI have led to research efforts over the years to help control and prevent these infections. Therefore, various evidence-based interventions exist. However, it is worth noting that these evidence-based interventions have shown varied efficacy; in addition, the problem still persists in the patient care setting. As such, the proposed evidence-based approach or intervention is the use of a CAUTI bundle. As opposed to single interventions which can be applied to prevent and reduce the rates of CAUTI, a bundle-based care approach entails combining or integrating various interventions for better outcomes. Therefore, the bundle care approach chosen entails various activities that can have a synergistic effect of reducing CAUTI rates or preventing them. It is expected that the proposed evidence-based practice solution of using a CAUTI bundle will lead to a significant reduction in the number of patients acquiring CAUTI in hospital settings. The literature review performed showed that the use of CAUTI bundles in controlling the rates of CAUTI could largely be effective when appropriately applied. This write-up has also explored various aspects of the project, such as literature review, organizational culture and readiness for change, the change framework, project implementation, and project evaluation.

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he APA format of writing provides a standard form of writing among Nursing professionals at the graduate and doctoral levels. Adherence to the APA checklist has been a challenging learning experience but it has helped to avoid plagiarism errors and provided a more professional tone to my writing. I have learned that the title page is centered and double-spaced, including the blank lines left at the top before the title. Information such as the student’s name, the course title, and the instructor’s name should be written below in descending order using the standard font. I have also learned that the references should start on a new page with the title “References,” a section label hanging indented, double spaced, and authors should be alphabetized in descending order. Checklists serve as reminders to reinforce knowledge and skills. In general, I have been able to meet the checklist’s standard, despite a few areas where I need to improve. I sometimes forget that if there are more than three authors, I must use et al. 

Citation mechanisms are one such area that I need to improve. Although I have improved on the fundamentals of APA in-text citations, I still make some minor errors when determining when to use (Grand Canyon University, 2022) where the date is unavailable. I sometimes make mistakes when citing journal articles on the reference page. I often forget to include the volume and issue number on a few occasions. Practicing and getting feedback has definitely helped me improve at this.