Central Line-Associated Bloodstream Infection (CLABSI)
Step 1: Review the assigned EBP model (based on your last name)
Group C: Iowa Model of Evidence based Practice (Titler et al., 2001). Last name K – O.
Step 2: Select a practice problem that interest you from the list provided
Include a figure of the assigned model(Iowa Model of Evidence based practice)
Step 3: Complete the discussion assignment meeting all criteria outlined in rubric
e)
Group C: Iowa Model of Evidence based Practice (Titler et al., 2001). Last name K – O.
Sample Paper
Central Line-Associated Bloodstream Infection (CLABSI)
Evidence-based practice (EBP) is a problem-solving approach applied in nursing practice by healthcare professionals to address various issues affecting the patients and nursing practices and develop effective interventions to enhance quality care offered to patients and improve patient outcomes. It entails the use of best evidence obtained from the research, clinical experience, opinions from experts, and patient values and preferences, to develop a well-informed decision concerning patient care (Christenbery, 2018). Nurses can implement the EBP in nursing practice by following various steps. They will begin by forming a clinical question to identify the problem. After that, the nurse collects the best evidence from diverse sources, including scientific research from randomized controlled trials, expert opinions, and personal experience. Then, they will analyze the evidence and apply it to clinical practice. Lastly, nurses assess the outcomes to determine whether the expected result has been achieved (Christenbery, 2018). EBP benefits patients by allowing nurses to identify and implement more effective nursing interventions that help achieve better patient outcomes. Besides, EBP enables nurses to achieve their goals and greater satisfaction with their caregiving role (Christenbery, 2018). The purpose of the essay is to discusse the Iowa Model of Evidence-Based Practice and how the EBP model can be applied to address the issue of Central line-associated bloodstream infections (CLABSI).
IOWA Model
Iowa Model of Evidence Based Practice is an example of EBP models applied nursing practice. The model was developed at the University of Iowa Hospitals and Clinics in the 1990s (Coleman, et al., 2018). It provides a theoretical framework for nurses to implement best evidence practice to improve patient care. This EBP model focuses on the whole healthcare system, which comprises patients, healthcare professionals, and the healthcare organization, to guide practice decisions based on the best available research and evidence (Coleman, et al., 2018).
Iowa model comprises various steps which a healthcare professional can follow to identify a problem, research solutions, and implement evidence-based interventions or changes in healthcare. The first step entails identifying the trigger that will generate the need for a practice change. This can either be to create knowledge or address a problem. The second step involves confirming whether the problem identified is a priority for the practice, unit, or organization (Christenbery, 2018). In the third step, a team is established, responsible for searching, assessing, and synthesizing the best evidence collected and implementing it to create change. The team should comprise members from diverse professionals and the nursing profession to embrace an interdisciplinary approach. This will promote creativity in the team hence enhancing the achievement of better evaluation and implementation of the change (Gomez & Bernet, 2019). In the fourth step, the selected group will gather and analyze the research associated with identified desired practice change. Besides, the team will be required to develop a good research question using the PICO(T) method and conduct a literature search exploring research studies associated with the problem identified (Christenbery, 2018). In the fifth step, the team will critique and synthesize the research discovered during the literature search to determine its credibility and reliability (Christenbery, 2018). The sixth step is the decision-making stage. Here, the team decides if the evidence generated from research is sufficient to implement a practice change. If not, more research will be gathered and analyzed before the team proceeds to the seventh step. The seventh step is where the proposed change is piloted (Christenbery, 2018). The last step entails the evaluation of the pilot program to determine whether the proposed change is feasible and contributes to improved outcomes. If the proposed change is appropriate for full adoption within the organization or unit, the team gathers the necessary resources to ensure the EBP change is successful (Christenbery, 2018).
DNP’s role in different steps of the model
The DNP nurse can play various roles in the Iowa Model. For instance, the nurse can help identify the issue that will create the need for a practice change. The DNP nurse is well-equipped with research skills and leadership skills. This allows them to investigate the various problems affecting nursing practice and utilize their leadership experience to identify diverse factors creating the need for practice change (Christenbery, 2018). Also, the DNP nurse takes part in step three. For instance, they can lead the team members formed to implement the EBP change at this phase. In addition, the DNP nurse can play a vital role in step five by conducting evidence-based research and establishing interventions that improve health outcomes (Christenbery, 2018). Lastly, the DNP nurse has the necessary skills to perform the leadership role in healthcare. Thus, they can utilize the skills to guide the interdisciplinary team in the implementation of the EBP change in a healthcare organization by providing them with necessary resources and guiding them through the implementation process (Christenbery, 2018).
Model Application
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Central line-associated bloodstream infections (CLABSI)
Central line-associated bloodstream infections (CLABSI) are health conditions that hospitalized patients develop while receiving care in a healthcare facility. They occur when germs penetrate a bloodstream through a central line (Haddadin et al., 2020). US experiences about 250 000 CLABSIs annually. About 28 000 patients die from this health issue in the US every year. It is estimated the treatment for CLABSI can last for about seven days to six weeks, and the average cost per individual is about $46 000 (CDC, 2020).
CLABSI is a preventable health issue that can be addressed using various interventions, including handwashing (Curry et al., 2021). The Iowa model can be applied to address this issue. Thus, when using this model, the first step will entail determining whether the health issue triggers EBP change (Christenbery, 2018). After that, it is determined whether the problem of CLABSI is a priority for a healthcare organization, department, or practice. If yes, there will be a need to create a team responsible for developing, evaluating the success of the EBP change pilot, and implementing the EBP change to the whole unit or organization. Here, healthcare professionals from diverse professions will be selected to form an interdisciplinary team to enhance the ability of the team to evaluate and implement the change. In the fourth step, the selected team members will gather and analyze the research associated with the issue of CLABSI and the efficacy of handwashing in reducing the cases of CLABSI among hospitalized patients. Also, the team will be required to develop a good research question using the PICO(T) method at this step (Christenbery, 2018). In the fifth step, the team will critique and synthesize the evidence for handwashing obtained during the research. After that, the team will determine there is enough research to support the implementation of handwashing to reduce the rate of CLABSI in the healthcare facility. If yes, the team will proceed to implement the EBP intervention into a pilot program (Christenbery, 2018). The last step involves the evaluation of the results. Here, the EBP team will assess the result of the pilot program to determine whether the change is feasible and contributes to reduced cases of CLABSI in the healthcare facility. Thus, if the pilot program generates positive outcomes, the EBP team will introduce the change the handwashing program across the department or the whole healthcare organization and then keep on observing the change to ensure sustainable change.
References
Centers for Disease Control and Prevention (CDC) (2020). Central Line-associated Bloodstream Infections: Resources for Patients and Healthcare Providers. Retrieved from https://www.cdc.gov/hai/bsi/clabsi-resources.html#:~:text=What%20is%20a%20central%20line%2Dassociated%20bloodstream%20infection%3F,bloodstream%20through%20the%20central%20line.
Christenbery, T. L. (2018). Evidence-Based Practice in Nursing: Foundations, Skills, and Roles. Springer Publishing Company.https://www.sciencedirect.com/science/article/pii/S0027968418303584
Coleman, D. E., Kamai, S., & Davis, K. F. (2018). Impact of collaborative evidence-based practice nursing education program on clinical operations. Journal of Hospital Librarianship, 18(4), 323-330.https://www.tandfonline.com/doi/abs/10.1080/15323269.2018.1509194
Curry, S., Mallard, E., Marrero, E., Walker, M., Weeks, R., Harrison, H. A., … & Brandon, K. (2021). The Impact of a Dedicated Nurse on the Prevention of Central Line-Associated Bloodstream Infections in the NICU. Neonatal Network, 40(2), 88-97.https://connect.springerpub.com/content/sgrnn/40/2/88.abstract
Haddadin, Y., Annamaraju, P., & Regunath, H. (2020). Central line associated blood stream infections (CLABSI). StatPearls [Internet].https://www.ncbi.nlm.nih.gov/books/NBK430891/
