Change in practice is essential in nursing because it enables medical practitioners to identify the best practices that can help them to offer better medical care to the patients. Many patients are diagnosed with various infections which require to be treated in order to enhance a healthy living. One of the major infections affecting people is Catheter Association Urinary Tract Infections (CA-UTI). This infection is common in acute care settings and thus measures are required in order to address such a problem. CA-UTI is known to occur after three months of postintervention. If this postintervention program is sustained for more than three months, the rate of CA-UTI is known to decrease more drastically. Doctors can place stickers on the medical records of all patients in order to remember to remove the unnecessary catheters. In addition, both the preintervention and postintervention program resulted in a sharp increase in the number of properly retained catheters at three months (57%) and at six months (87%), respectively. Accordingly, Bruminhentet al (2010) concluded that the use of a sticker placed on medical record binder of all patients is a simple intervention that could be highly effective in promoting the proper utilization of urinary catheter and consequently keep low the rates of CA-UTI. Doctors can avoid the use of indwelling catheters in order to prevent health related UTIs. According to the Association for Professionals in Infection Control and Epidemiology, bacteria can establish colonization of a patient’s bladder within three days of their introduction onto the inner or outer surface of urinary catheters ("Apic spreading knowledge," 2008). In this connection, the early removal of a urinary catheter can significantly decrease the risk of developing a UTI or other complication.
An evidence based solution is needed to address the problem of CA-UTI among many patients. This evidence based solution will help to guide nurses and other healthcare practitioners to follow a systematic process for the treatment of CA-UTI (Apic spreading knowledge preventing infection, 2008). The use of the evidence based solution to address the identified problem will help to achieve various outcomes. One of the anticipated outcomes includes the use of indwelling catheters when they are appropriate. The other anticipated outcome is the decrease of hospital stay of the patients which will help to cut down the cost of medical care. This is because, UTI associated healthcare results to excess cost of healthcare for the affected people. In this connection, the evidence based solution will help to reduce medical costs for many people and enhance effective healthcare.
The steps of evidence based solution implementation have to be followed in order to ensure that effective results are obtained. Before the start of this evidence based solution, the practitioners must ensure that they have enough skills to comprehend and synthesize the practice to other health practitioners. This is because, the outcomes of the practice need to reflect a certain discipline and interdisciplinary accountabilities (Larrabee & Rosswarm 1999). As a result, there should be a good collaboration between researchers and practitioners in order to increase the use of the evidence based solution. The steps of the implementation of the evidence based solution starts with assessment of the need for change and ends with the integration of an evidence-based protocol (Larrabee & Rosswarm 1999).
The nurses have to assess the need for a change in evidence based solution in the nursing practice. In the given case, a change is required to ensure the proper use of catheters in order to avoid UTIs. This need is then discussed with other nurse managers in order to identify a way in which it can be implemented. Assessment of the need for change can be done by benchmarking the relevant information collected from the nurses (Larrabee & Rosswarm 1999). The second step in the implementation of an evidence based solution is linking the identified problem with the interventions. The problem of catheter use can be linked with the suggested intervention which involves improvement on the use of catheters. This helps in enhancing good communication among practitioners and helps to provide standards which will help to determine the effectiveness of the evidence based solution. The other step that is required in the implementation of this evidence based solution to CA-UTI involves synthesizing best evidence for the project (Larrabee & Rosswarm 1999). This will include looking at the literature related to the evidence based solution. In addition, it should also consider the benefits of the implementation to the patients with the identified problem. After synthesizing the best evidence, the nurses will now design a change in practice. This will help them to design how the new practice will be implemented in nursing practice. A pilot study and its evaluation will also help the nurses to design a better change in practice.
Nurse practitioners will also describe the process and detailed sequence of healthcare activities in the change in practice which will help to enhance the effectiveness of the evidence based solution (Larrabee & Rosswarm 1999). The other step in the change in practice is implementing and evaluating change in practice. The nurses will implement the pilot study by making sure that there is a close monitoring of the entire process. In addition, there should also be a coordinator who will be there to answer the questions that will arise during the implementation of the change in practice. Moreover, a follow-up of the change in practice is also essential in order to ensure greater success. This shows that in the implementation of change in practice in catheter use, there should be a coordinator who will help the nurses to have a better comprehension of the process (Larrabee & Rosswarm 1999). The last step in the implementation of a change in practice in catheter use is integrating and maintaining change in practice. The results of the pilot study should be used to determine the start of the change in strategies. Nurse practitioners should consider the cultural climate of their organizations before they attempt to integrate practice innovations. In this connection, the nurse practitioners must ensure that the change in use of catheter is accepted in the organization before they start integrating practice innovations.
The implementation of a change in evidence based solution is crucial in the healthcare organizations because it will help to ensure proper use of catheters. It will also help to minimize the use of catheter to patients who are at a greater risk of UTIs. The other advantage of this change in practice is that it will reduce the length of the use of the indwelling catheter. In this connection, a change in practice on the use of catheters is essential in order to enhance better and less expensive medical care (Apic spreading knowledge preventing infection, 2008). In conclusion, there is sufficient available literature from evidence based studies which supports the use of appropriate interventions in healthcare institutions in order to reduce CA-UTIs.
References:
Apic spreading knowledge preventing infection. (2008). Retrieved on 2nd February 2012 from http://www.apic.org/Content/NavigationMenu/PracticeGuidance/APICEliminationGuides/CRBSI_Elimination_Guide_logo.pdf
Bruminhent, J., Keegan, M., Lakhani, A., Roberts, I.M. & Passalacqua, J. (2010). Effectiveness of a simple intervention for prevention of catheter-associated urinary tract infections in a community teaching hospital. American Journal of Infection Control 38(9): 689-93.
Larrabee J. & Rosswarm M. (1999). A model for change in evidence based practice. Image-Journal of Nursing scholarship, Vol 31(4), pp 317-322
