Assignment: Model of Knowledge Transformation

Assignment: Model of Knowledge Transformation

Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)

Ventilator-Associated Pneumonia (VAP) is a perfect example of healthcare-associated infection (HAI) in healthcare facilities particularly among adult hospitalized patients in ICU settings. As a gradually emerging concept, it remains to be an important problem among critically ill patients that results in serious complications. Therefore, the subject of evaluation is the increasing incidence of ventilator-associated pneumonia (VAP) among adult hospitalized patients under intubation or mechanical ventilation in ICU settings ACE Star Model Of Knowledge Transformation: EBP Change Process.

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.

Ventilator-Associated Pneumonia is a leading cause of mortality, morbidity, increased medical costs, prolonged hospital stays and poor health outcomes across healthcare settings in the United States. It particularly occurs among hospitalized patients in the ICU between 48-72 hours after mechanical ventilation or intubation. Its primary characteristics include signs of systemic infection, sputum changes, and continuous infiltration.  As the contributor of half of all the hospital-acquired pneumonia infections, its prevalence has been estimated to be between 8-40% with the highest risk occurring within the 1^st five days of admission.  It has contributed to a reduction in patient safety and made healthcare organizations inefficient to execute the role of providing high quality, efficient and effective care. This explains why it is vital to define the clinical issue and its causes to develop effective intervention measures to prevent or reduce the incidences of Ventilator-Associated Pneumonia.

Star Point 2:  Summary (Evidence to support the need for a change)

Describe the practice problem in your own words and formulate your PICOT question.

Critically ill patients who might be under sedation or unconscious while receiving treatment in the ICU/CCU setting require the support of ventilator machines to breathe properly.  However, using these machines (mechanical ventilation) or intubation for more than 48 hours can lead to ventilator-associated pneumonia (VAP) which is a serious complication among critically ill patients. It is associated with prolonged stays in the hospital, prolonged periods of mechanical ventilation, additional medical costs, increased morbidity, and double mortality risk. Therefore, considering the risks associated with VAP, reduction or prevention should be a priority for nursing care.

PICOT Question-In adult patients aged 40 years or older under intubation or mechanical ventilation in ICU settings (P) will the use of 0.2% oral chlorhexidine (I) compared to the use of normal saline(C) decrease the rate of Ventilator-Associated Pneumonia(O) from 16% to 10%  within 6 weeks(T)?

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

Klompas, M., Speck, K., Howell, M. D., Greene, L. R., & Berenholtz, S. M. (2014). Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis. JAMA internal medicine, 174(5), 751-761.

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

1. 1. Alimi, M., Manzari, Z. S., Bagheri Moghadam, A., & Rouhani, H. (2016). Evaluation of the Effects of Oronasal Versus Oral Disinfection with Chlorhexidine on Clinical Criteria of Ventilator-associated Pneumonia. Evidence-Based Care, 6(3), 19-30.
2. Zhang, T. T., Tang, S. S., & Fu, L. J. (2014). The effectiveness of different concentrations of chlorhexidine for prevention of ventilator‐associated pneumonia: a meta‐analysis. Journal of clinical nursing, 23(11-12), 1461-1475.
3. Villar, C. C., Pannuti, C. M., Nery, D. M., Morillo, C. M., Carmona, M. J. C., & Romito, G. A. (2016). Effectiveness of intraoral chlorhexidine protocols in the prevention of ventilator-associated pneumonia: a meta-analysis and systematic review. Respiratory care, 61(9), 1245-1259.

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

One of the major roles of healthcare providers is to prevent patient harm by enhancing safety. Based on the high incidences of VAP, nurses must implement effective measures to promote health outcomes. The rise in VAP infections has been attributed to oral hygiene due to the use of mechanical ventilators and intubation. The findings from the systematic review revealed that 0.2% oral chlorhexidine is effective in preventing VAP among adult patients in ICU settings as compared to normal saline ACE Star Model Of Knowledge Transformation: EBP Change Process. Thus its use should continuously be encouraged in ICU settings and be integrated into the management of patients.

Outline one or two evidence-based solutions you will consider for the trial project.

Using 0.2% oral chlorhexidine to maintain oral hygiene is vital in preventing and reducing Ventilator-Associated Pneumonia. 0.2% oral chlorhexidine decreases colonization of the oral cavity by bacteria which are the major pathogens that cause infection. Chlorhexidine decreases the risk of respiratory infections before, during and after intubation or mechanical ventilation.

An alternative solution is the use of normal saline and tooth brushing to maintain oral hygiene. However, there is limited evidence that supports their effectiveness in VAP prevention and related health outcomes. On the other hand, existing evidence recommends it as part of the VAP care bundle that should be given to patients alongside the use of oral chlorhexidine.

Star Point 3:  Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or the other sources listed in your Summary section in Star Point 2).

The 2003 Centers for Disease Control Guidelines for Preventing Healthcare-Associated Pneumonia and the 2004 CDC Guidelines for the Management of Adults With Hospital-Acquired, Ventilator-Associated, and Healthcare-Associated Pneumonia give recommendations and guidelines that should be followed by healthcare providers to prevent, reduce and manage Ventilator-Associated Pneumonia.

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).

Management: development of practice guideline, care protocols, and policies to promote quality, safety and effectiveness in patient care. It also plans for seminars, conferences, and training for staff on basic standard operating procedures ACE Star Model Of Knowledge Transformation: EBP Change Process.

Physicians: directly involved in patient care by recommending ways and procedures to improve patient outcomes

Critical Care Nurses: directly involved in patient care by recommending ways and procedures to improve patient outcomes, coordinate patient care, administer medications and nurse patients.

Patients: Collaborate with all healthcare providers by providing relevant medical information that can be used in decision making at the point of care.

What specifically is your nursing role in the change process? Other nursing roles?

Nurses are first-line communication managers who ensure coordination of care with families and other healthcare providers for all patients in the ICU. They administer medications, monitor the patient for potential adverse effects and institute appropriate intervention measures where necessary to safeguard patients from harm.

List your stakeholders by position titles (charge nurse, pharmacist, etc.).-Why are the members chosen (stakeholders) important to your project?

Critical Care Nurses-4-Should implement the proposed care protocol and guidelines in terms of administration and care coordination with families and other healthcare providers

Critical Care Physicians-3 should ensure that all decisions made in prevention or management of patients with VAP follow the prescribed guidelines and protocol.

What type of cost analysis will be needed before a trial?  Who needs to be involved with this?

Before the implementation of a trial, cost-effectiveness analysis and cost-benefit analysis will be needed. The primary costs will be incurred in the training of staff and the purchase of 0.2% oral chlorhexidine. Close to 8 physicians and 10 nurses will undergo the training in the trial period. Besides, there will be ongoing education to sensitize and increase awareness of other staff on the prior trial. This education will be conducted using flashcards, checklists, and brochures ACE Star Model Of Knowledge Transformation: EBP Change Process.

Star Point 4: (Implementation)

Describe the process for gaining permission to plan and begin a trial.  Is there a specific group, committee, or nurse leader involved?

The critical care nurse head and the critical care physician head will write to the hospital’s leadership to seek permission to conduct the trial. This should include the clinical problem identified, its impacts on patients, staff and the organization and why change is essential. A detailed description of the proposed intervention measures to be implemented in the change process and the expected outcomes should also be included.

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

All the staff directly and indirectly involved in the change process will be educated on the change through a training program that will take place for one week. Staff will be asked to participate by availing themselves for training, recommending alternative changes and to propose measures for intervention. Staff will also be asked to provide feedback which will be used to make improvements in other areas of practice.

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Assignment: Model of Knowledge Transformation

Purpose
The purpose of this assignment is:

To apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue.
The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.
Course Outcomes
This assignment enables the student to meet the following course outcomes:

CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO#2)
CO8: Selects evidence for best practices when planning professional nursing care involving systems, processes, and devices for individuals, families, aggregates and communities. (PO#8)

Directions
Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.

Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
View a short tutorial with tips for completing this assignment: Evidence-Based Practice Change Process Assignment Tutorial (Links to an external site.) or by reading the transcript (Links to an external site.).
Download the EBP Change Process form (Links to an external site.) during Week 1. The use of this specific form is REQUIRED
Identify a clinical topic and related nursing practice issue you think needs to be changed.
Locate a systematic review on your topic from the CCN Library databases. Be sure this involves nursing actions.
Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.
Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).
Work on a portion of the process each week, as the illustration unfolds.
Best Practices
Please reach out to your instructor for feedback or assistance with your PICOT question as needed.
Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.
Please see the grading criteria and rubrics on this page.
Please use your browser’s File setting to save or print this page.
Scholarly Sources and Citations
Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed.
Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!
**Academic Integrity**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Rubric
Week 6: EBP Change Process Assignment Grading RubricWeek 6: EBP Change Process Assignment Grading RubricCriteriaRatingsPts. This criterion is linked to a Learning OutcomeSelected Systematic ReviewA systematic review from the CCN Library databases was selected, identified, and was appropriate for the selected nursing change process.25.0 pts

One systematic review from the CCN Library databases was identified and was clearly appropriate.22.0 pts

A systematic review was selected from the CCN Library databases and was mostly appropriate for a nursing change process.20.0 ptsA systematic review was selected from the CCN Library databases and was fairly appropriate for a nursing change process.10.0 ptsA systematic review was selected, but not from the CCN Library databases and/or was not appropriate for this assignment.0.0 ptsNo systematic review selected or used.25.0 pts
This criterion is linked to a Learning OutcomeStar Point 1 (Discovery)The topic, nursing practice issue, rationale and scope of the problem were clearly identified and described.25.0 ptsStar Point 1 elements in the first column were thoroughly addressed.22.0 ptsStar Point 1 elements in the first column were mostly well addressed.20.0 ptsStar Point 1 was missing one element in the first column or one lacked detail.10.0 ptsStar Point 1 was missing more than one element in the first column and others lacked detail.0.0 ptsThe ACE Star Model Star Point 1 was not completed.25.0 pts
This criterion is linked to a Learning OutcomeStar Point 2 (Summary)The NURSING practice problem, NURSING related PICOT question, a systematic review from any database in the Chamberlain Library, and other optional references, evidence summary, strength, and solutions, are listed and described.35.0 ptsStar Point 2 elements in the first column were thoroughly addressed.31.0 ptsStar Point 2 elements in the first column were mostly well addressed.28.0 ptsStar Point 2 was missing one element in the first column or one lacked detail.13.0 ptsStar Point 2 was missing more than one element in the first column and others lacked detail. or were inappropriate.0.0 ptsThe ACE Star Model Star Point 2 was not completed.35.0 pts
This criterion is linked to a Learning OutcomeStar Point 3 (Translation)Care standards, practice guidelines, or protocols; stakeholders and their roles and responsibilities; the nursing role; rationale for including certain stakeholders, and cost analysis plan are addressed.35.0 ptsStar Point 3 elements in the first column were thoroughly addressed.31.0 ptsStar Point 3 elements in the first column were mostly well addressed.28.0 ptsStar Point 3. was missing one element in the first column or one lacked detail.13.0 ptsStar Point 3 was missing more than one element in the first column and others lacked detail.0.0 ptsThe ACE Star Model Star Point 3 was not completed.35.0 pts
This criterion is linked to a Learning OutcomeStar Point 4 (Implementation)Permission process, education plan, timeline, measurable outcomes, forms, resources, and stakeholder meetings, are addressed.35.0 ptsStar Point 4 elements in the first column were thoroughly addressed.31.0 ptsStar Point 4 elements in the first column were mostly well addressed28.0 ptsStar Point 4 was missing one element in the first column or one lacked detail.13.0 ptsStar Point 4 was missing more than one element in the first column and others lacked detail.0.0 ptsThe ACE Star Model Star Point 4 was not completed.35.0 pts
This criterion is linked to a Learning OutcomeStar Point 5 (Evaluation)Reporting results, process and next steps are addressed.35.0 ptsStar Point 5 elements in the first column were thoroughly addressed.31.0 ptsStar Point 5 elements in the first column were mostly well addressed28.0 ptsStar Point 5 was missing one element in the first column or one lacked detail.13.0 ptsStar Point 5 was missing more than one element in the first column and others lacked detail.0.0 ptsThe ACE Star Model Star Point 5 was not completed.35.0 pts
This criterion is linked to a Learning OutcomePresentationInformation was presented clearly and thoughts were well organized and logical.20.0 ptsInformation was presented clearly and thoughts were well organized and logical throughout.18.0 ptsInformation was presented clearly and thoughts were mainly organized and logical throughout.16.0 ptsInformation was presented clearly and thoughts were somewhat organized and logical throughout.8.0 ptsInformation was not consistently clear and/or was not consistently organized and logical.0.0 ptsInformation was disorganized and difficult to understand.20.0 pts
This criterion is linked to a Learning OutcomeMechanics/APAThe systematic review and any other scholarly resources were properly listed in APA format.
The writing includes error free grammar and spelling, and complete sentence structure.15.0 ptsExcellent mechanics and APA formatting with minimal errors in grammar, spelling, and sentence structure.13.0 ptsGood mechanics and formatting considering the elements listed in the first column12.0 ptsFair mechanics and formatting considering the elements listed in the first column6.0 ptsPoor mechanics and formatting considering the elements listed in the first column0.0 ptsVery poor mechanics and formatting such that information is difficult to read.15.0 pts
This criterion is linked to a Learning OutcomeAssignment Form Used0.0 pts0 points deductedCorrect assignment form used0.0 pts22.5 points (10%) deductedIncorrect form used resulting in point deduction0.0 pts
This criterion is linked to a Learning OutcomeLate Deduction0.0 pts0 points deductedSubmitted on time0.0 ptsNot submitted on time – Point deduction1 day late =11.25 deduction; 2 days=22.5 deduction; 3 days=33.75 deduction; 4 days =45 deduction; 5 days = 56.25 deduction; 6 days =67.5 deduction; 7 days =78.75 deduction; Score of 0 if more than 7 days late0.0 pts

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Assignment: Model of Knowledge Transformation

Assignment: Model of Knowledge Transformation

Assignment: Model of Knowledge Transformation

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.