NUR 590 Evidence Based Project Proposal Evaluation Plan

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Benchmark - Capstone Project Change Proposal

Amanda James

Professor Letisha Hardy

Grand Canyon University

NRS-493

May 17, 2023

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Introduction

In the modern healthcare system, which is constantly evolving, practitioners must address

the difficulties of delivering exceptional patient care while simultaneously satisfying the wants of

laws and regulations and displaying mastery of processes supported by evidence. Suppose

scientific professionals want to acquire the highest level of success in their practice. In that case,

it is fundamental that they remain current on scientific research and the most effective methods for

treating patients. The problem or issue that will serve as the focal factor of this final project will

have a medical orientation and require a change proposal. We are going to address the problem or

worry by the use of research approaches that are backed with the aid of evidence.

Background

One of the greatest threats to public health these days is sepsis, a medical emergency that

is tough and complicated to treat. It places a heavy load on healthcare systems, especially in places

where such establishments are already stretched thin due to other reasons for mortality. A delay in

treatment and an improved risk of death are the consequences of a missed or incorrect analysis of

sepsis (Meulenbroeks et al., 2021). Although sepsis is more common among people who have

previously been ill or had surgery, healthy humans can also get the illness. Antibiotics and other

supportive care must be given to sepsis patients very away to prevent worsening their condition

into septic shock, which may be deadly due to irreparable organ damage.

Since sepsis may negatively impact patient outcomes, healthcare providers must be extra

careful to spot the signs and symptoms and act quickly to treat them (Cardwell, 2020).

Improvements in patient outcomes and death costs may be achieved through promptly diagnosing

and remedying sepsis. More education and publicity regarding the warnings symptoms and

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symptoms of sepsis, as well as the want for prompt medical attention, are urgently needed. In order

to higher manage sepsis and lower the morbidity and loss of life rates associated with it, higher

diagnostic technologies and treatment regimens are required.

Ultimately, sepsis is an important problem in public health that wants constant study. When

trying to avoid complications from sepsis, healthcare providers should be diligent in their attempts

to diagnose and treat the circumstance as soon as possible. Improving patient consequences and

lowering the cost of dealing with sepsis requires the development of better diagnostic equipment

and treatment methods.

Clinical Problem Statement

In order to avoid the improvement of severe sepsis or septic shock, both of which may

additionally result in substantial morbidity and death, a correct diagnosis of sepsis must be made

as quickly as possible. As a significant contributor to rising healthcare expenses, more extended

hospital stays, and extra deaths, sepsis diagnosis delays constitute a significant difficulty in

hospitals and other healthcare facilities. According to research, patient outcomes may be improved

and death costs reduced by up to 50% with early detection and care of sepsis (Rhodes et al., 2017).

However, in clinical practice, sepsis is tricky to diagnose on time, especially in patients

with comorbidities, the elderly, and those with impaired immune systems. Due to the absence of

well-defined symptoms, sepsis regularly goes undiagnosed and untreated for too long, with

potentially fatal results. Another issue is the incapacity or unwillingness of healthcare providers to

diagnose sepsis and institute suitable treatment promptly.

Therefore, enhancing healthcare facilities' capacity for early sepsis detection and diagnosis

is vital. Implementing sepsis detection techniques, healthcare issuer education programs, and

clinical selection support systems can also bring about this shift (Cardwell, 2020). Better patient

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effects and lower healthcare costs might also be achieved by previous and more accurate analysis

of sepsis and subsequent fast implementation of suitable therapies.

Purpose of the Change Proposal

The want for prompt and accurate analysis of sepsis is one of the most significant

boundaries facing the healthcare industry today. By growing awareness among healthcare

specialists about the symptoms of sepsis, implementing a standardized screening tool, and creating

an evidence-based intervention plan for the timely administration of sepsis, the change that is being

proposed has the potential to enhance patient outcomes and reduce mortality rates.

Early sepsis diagnosis is critical to prevent the sickness from becoming extra severe.

Having a standardized screening method in place might also assist in this regard. An evidence-

based intervention plan may additionally be used to offer medical specialists with guidelines for

the treatment of sepsis. These suggestions include the administration of critical antibiotics, the

resuscitation of fluids, and the provision of additional supportive care measures.

If the endorsed alteration were carried out, medical professionals' capability to diagnose

and treat sepsis would be improved. Extended stays in the hospital and admissions to intensive

care gadgets are expensive for healthcare systems. However, they may also not be necessary if

sufferers have better outcomes due to their treatment.

Before agreeing to the alteration that has been suggested, it is critical to evaluate how

effective it will be. Healthcare practitioners can investigate the modification's effectiveness by

using indicators such as sepsis diagnosis rates, antibiotic administration timings, and affected

person outcomes. This allows them to identify areas the place improvements may be made.

PICOT Question

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Improved identification and therapy of adult patients with sepsis in acute care settings is

the primary goal of the PICOT question posed in this proposal. Without speedy diagnosis and

treatment, sepsis is a significant fitness issue that may result in high fatality rates. One way to

better realize sepsis in its early stages is by using a standardized screening instrument.

Since grownup patients are more possibly to be diagnosed with sepsis in an intensive care

unit, our plan goals for this demographic. The intervention will introduce a standardized sepsis

screening instrument to detect sepsis in its earliest stages in patients. A standard therapy will be

provided to patients in the manipulated group without adding a screening device for comparison.

The critical result of interest is using a screening method to detect sepsis as quickly as

possible. Timely intervention and higher patient outcomes are possible thanks to early detection

of sepsis. Secondary goals are improving patient happiness, decreasing healthcare expenses, and

decreasing death rates.

Within six months of execution, this diagram would be ideal. A screening tool, healthcare

provider education, and the intervention's success evaluation may be accomplished within this time

frame. The overarching reason for this PICOT inquiry is to enhance the early recognition and cure

of sepsis in adult patients in acute care settings to increase patient outcomes and decrease

healthcare costs.

Literature Search Strategy Employed

Boolean operators like "AND" and "OR" were used to combine search phrases for a more

excellent exhaustive investigation. To locate any new research that fulfilled our inclusion criteria,

we manually searched relevant journals' reference lists.

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After retrieving 148 publications from the digital libraries, we culled the list down to 34

that handed our first title and abstract screening. Following a comprehensive assessment of these

papers, 15 research met our inclusion criteria and were included in our proposal.

Studies that examined the application of screening instruments, therapies, and results of

sepsis management in acute care settings were blanketed in this proposal. These studies were

randomized controlled trials, observational studies, or systematic reviews. Patient outcomes such

as death, length of hospital stay, and healthcare expenditures have been examined, and insights

into the efficacy of screening techniques and redress for early detection and management of sepsis

were presented.

Overall, the literature search approach for this proposal enabled a thorough examination of

the existing facts concerning the diagnosis and cure of sepsis in hospital emergency rooms. The

included lookup provides solid proof for the planned change software to enhance healthcare

facilities' ability to discover and treat sepsis.

Evaluation of the Literature

In this proposal, we performed a literature study to demonstrate the importance of

recognizing and treating sepsis as quickly as possible to enhance affected patient outcomes in

intensive care units. The analyzed studies all agreed that using standardized screening techniques

to better notice sepsis early on would result in more on-the-spot and effective treatment. Several

studies have proven that screening methods decrease death prices and enhance patient effects,

including shorter hospital stays and decreased healthcare expenses.

Evidence-based therapies, in addition to standardized screening measures, are

indispensable in the management of sepsis. According to various studies, patients with sepsis have

a better chance of survival if they get antibiotics and intravenous fluids as soon as possible.

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Additional measures, including vasopressors and mechanical ventilation, may also be required in

severe sepsis and septic shock.

The research implies that higher patient outcomes can also result from using a standardized

screening tool for sepsis in acute care settings in conjunction with evidence-based therapies.

Healthcare professionals, medical institution management, and quality improvement groups must

all work together to apply these initiatives efficaciously. For these methods to be profitable and

long-lasting in clinical practice, the literature also emphasizes the want for constant assessment

and improvement.

Adaptation to New Paradigms or Nursing Theories

As a nursing theory, the Transtheoretical Model of Behavior Change highlights the value

of recognizing people's several transitional states earlier than achieving a lasting behavioral shift.

The health promotion, disorder prevention, and chronic disease administration tenets of the model

created by Prochaska and DiClemente in the Eighties have found widespread software in nursing.

Precontemplation, musing, planning, doing, and keeping on doing are the five pillars of the

Transtheoretical Model of Behavior Change. Individuals in the pre-contemplation stage are often

resistant to change (Curtin et al., 2020) and unaware of the necessity for change. The contemplation

stage is characterized by an awareness of the want for change without an accompanying readiness

to take decisive action. At this point, humans start making deliberate plans for making a change.

In the third and remaining phase, known as "action," people certainly put effort into altering their

circumstances. Individuals' efforts to sustain their newly acquired behaviors symbolize this

maintenance phase.

The suggested screening device and intervention plan will incentivize healthcare

practitioners to follow the Transtheoretical Model of Behavior Change steps and undertake the

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new practices. In order to support the acceptance of the new screening instrument and intervention

plan, healthcare professionals should be familiar with the phases of change so that they may better

reflect on their attitudes and actions about the proposed change. To maintain the positive aspects

made in the early detection and treatment of sepsis, the model will additionally offer a framework

for regular overview and upkeep of the improvements made.

The following are the measures that are deliberate to be taken to accomplish this proposal:

Step 1: Education and Training

Step one in implementing the recommended intervention method is teaching clinical staff

how to use the standardized screening instrument and recognize the signs of sepsis in their patients.

This will be achieved using a mixture of classroom instruction, online tutorials, and printed

materials.

Success will be determined by how many medical workforce members take the education

and by the responses to pre- and post-training questionnaires that test their sepsis- and screening-

tool-related knowledge.

Step 2: Screening Tool Implementation

Standardized screening for sepsis in acute care placing (Curtin et al., 2020) will be

implemented next. This tool will be included in the electronic medical file system and completed

through nursing staff upon admission, every 12 hours, and each time there is a change in the

patient's condition.

The number of sufferers who undergo screening with the instrument and the timeliness

with which they undergo screening will serve as consequence measures for this phase's success.

Information gathered will be utilized for screening tool evaluation and enhancement planning.

Step 3: Early Intervention and Management

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In the third phase of the plan's execution, sepsis sufferers are treated immediately after

diagnosis. This will require giving the affected person therapy like antibiotics and intravenous

fluids as soon as viable and keeping a careful eye on how they are doing to ensure they respond.

The number of sepsis patients who get early care, as correctly as patient outcomes along

with death, duration of hospital stay, and readmission prices, will be used to evaluate the efficacy

of this step.

Evaluation of the Intervention Strategy's Use of Available Research Evidence

The recommended intervention method to better recognize and deal with sepsis in

healthcare was grounded in the best accessible data. A literature review found quite a few studies

supporting standardized screening tools and evidence-based interventions for sepsis administration

(Curtin et al., 2020). These studies were used to inform the following elements of an intervention

plan:

The suggested intervention strategy includes using a standardized screening instrument to

detect sepsis at an early stage. Better early detection of sepsis in health facility settings is possible

using this evidence-based technique.

The recommended intervention strategy includes educational and education opportunities

for healthcare providers to increase their familiarity with sepsis and its symptoms and the best

practices for treating sepsis primarily based on scientific data.

As part of the planned intervention, clinicians will be given entry to clinical decisions to

assist tools to aid in the fast and precise diagnosis and cure of sepsis.

Care Coordination and Communication Enhancement: The recommended intervention

approach consists of process improvement things to do, including the creation of sepsis-specific

approaches and the usage of multidisciplinary teams.

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This suggested intervention method is grounded on evidence-based practice principles and

pursuits to enhance sepsis diagnosis and remedy in healthcare facilities. In order to be successful,

the strategy must be practical, well-received, and broadly adopted by the intended audience, all of

which have been considered in its development.

Plan for Evaluating the Proposed Nursing Intervention

Quantitative measures:

Tracking the incidence of sepsis and evaluating it to data collected earlier than the

screening tool and intervention strategy had been put into place is a vital part of this study.

In order to decide whether or not the intervention approach was successful, we will track

deaths from sepsis and evaluate them to data collected earlier than we began treatment.

Adoption of the screening tool will be monitored using gauging how well healthcare

practitioners adhere to the screening tool's established guidelines.

The size of time it takes for patients with sepsis to begin remedy will be tracked and

compared to data amassed before any interventions were made.

Qualitative measures:

Using questionnaires and focal point groups, healthcare providers will be asked for their

ideas on the success of the screening tool and intervention method.

Patient feedback will be gathered via interviews and questionnaires to decide how satisfied

sepsis patients and their households are with the treatment they received.

To determine what is standing in the way of the widely implemented screening device and

intervention plan, we will conduct behavior surveys and hold focus groups.

T-tests and chi-square analyses, amongst others, will be used for the quantitative

information gathered. In order to extract meaningful insights from the qualitative data, a content

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material analysis will be performed. After the assessment, any required changes will be made to

the intervention strategy, and best practices will be recommended.

References

Cardwell, K. (2020). Reducing medication errors and transitions of care. Age and Ageing, 49(4),

537-539. Retrieved from: https://doi.org/10.1093/ageing/afaa065.

Curtin, D., Jennings, E., Daunt, R., Curtin, S., Randles, M., Gallagher, P., & O' Mahony,

D.

(2020). Deprescribing in older people approaching the end of life: a randomized controlled

trial using STOPPFrail criteria. Journal of the American Geriatrics Society, 68(4), 762-

769. Retrieved from: https://doi.org/10.1111/jgs.16278.

Meulenbroeks, I., Epp, J., & Schroeder, L. (2021). The value of caregiver-inclusive practices

in

Geriatric transitions of care: A systematic review. Health Policy, 125(7), 888-898.

Retrieved from: https://doi.org/10.1016/j.healthpol.2021.05.001.