In our organization we offer patient-centered care, always keep ourselves updated on the latest practices, practices staff diversity and we are ready to adapt to new change.

Evidence-Based Practice Change

Walden University

NURS 6052- Essentials of Evidence-Based Practice

November 01, 2020

ORGANIZATION CULTURE

My organization seeks diversity in their employees

Value the possibility of enhancing patient communication.

We provide patient-centered care

We treat patient based on their decisions

Members are kept updated with new technology

Readiness to face and adapt to any new changes

In our organization we offer patient-centered care, always keep ourselves updated on the latest practices, practices staff diversity and we are ready to adapt to new change. As members of the facility we make sure that we keep ourselves updated to ensure that the organization is able to develop and advance. The organization is ready to face and adapt to any new changes since it is predicted that the healthcare system will undergo change through implementing current technologies.

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CURRENT ISSUE OF INTEREST

My chosen clinical issue of interest involves UTI

Evidenced-based in treating of uncomplicated UTI

Nitrofurantoin, best practice in uncomplicated UTI treatment.

A common infection among women due to their anatomy

Treating UTI is paramount to avoid further complications.

Nitrofurantoin is the best practice in UTI treatment.

Urinary tract infection (UTI) occurs when a bacteria infect the urethra, ureters, kidneys or bladder. UTI is one of the most common hospital acquire infection among women due to our anatomy, shorter urethra making it quicker for the bacteria to travels to the bladder. Treating this infection important to avoid further complications.

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PICOT

Guides and clarify essential element of question

Important step towards finding the right information

P- Adult women aged 18-65 years diagnosed with UTI in ABC clinic

I- Nitrofurantoin, 100mg orally twice daily for 7 days

C- No intervention

O- Complete UTI signs and symptoms resolution

T- One month

PICOT is used to guide and clarify the essential part of question and its important towards finding the right information to answer the question.

In women aged 18-65 years with uncomplicated UTI, how does nitrofurantoin compared to no interventions affect urinary tract within 30 days?

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CHANGE OPPORTUNITY

Change is driven by complications experienced.

Workers have made themselves ready for change

Workers ready to apply evidence-based strategy

Workers ready to apply advanced practices that may be implemented.

Change in the organization is driven by some of the complications that we have been experiencing as well as the implementation of a new healthcare system (Ritchie & Straus, 2019). Other than the implementation of new healthcare system our organization has been experiencing issues which requires changes. Most of the employees are ready to apply evidence based strategy and advanced practices.

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RISK INVOLVED WITH IMPLEMENTING NEW CHANGES

Implementation of new changes may lead to adverse results

Changes may affect employee’s performance and commitment.

Poor change management may hinder growth

Failure to consider culture may lead to failure

Some of the risks that may arise due to implementing changes is negative outcomes such as reduced employee commitment, poor organization growth, and transformation period may fail. Poor change management can lead to my organization transforming and growing poorly after the changes have been implemented. Failure of the organization putting into consideration their culture during the change implementation period may lead to failure of the process.

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EVIDENCE-BASED IDEA PROPOSAL

Implementation of Hopkins evidence-based model is recommended.

Model allows fast and appropriate application

Latest research and best practices.

Organization will be able to simplify the EBP process

Encourage a culture of evidence-based care (Dang & Dearholt, 2017).

An evidence-based practice that I would propose for the organization is the Hopkin nursing evidence-based model since this model enables fast and appropriate application of latest research as well as best practices and simplify EBP activities.

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EVIDENCE-BASED IDEA PROPOSAL

Steps involved in the Hopkin model include:

Practice question

Evidence

Translation

EBP model tool will assist workers

Enhance collaboration with other care providers

Hopkin nursing evidence-based practice has three steps which are evidence, practice question, and translation. This model helps physicians in the organization to work personally and collaborate with other physicians to counter major issues.

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KNOWLEDGE TRANSFER

The Plan is to create, transfer and implement knowledge

Creation process will be to develop training

Creation process will include developing training manuals

Intervention plan occur based on knowledge gained

knowledge implemented will be used to develop solutions

knowledge dissemination plan will involve training staff

In the organization knowledge transfer will involve: supporting employee as they change to new role in the organization, collect the require knowledge, make sure that knowledge is shared and stored for future use and reference, the knowledge will be shared through paired working and E-learning training , implementation will be carried out step by step to assist employees to easily adapt.

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EXPECTED RESULTS

Increased patient safety and positive health outcome.

organization will be able to have problem-solving strategies

Eliminate challenges that prevent current research

After implementing the Hopkin model the organization will have problem solving strategy for providing care that combines diligence to the current best practices. The expected outcome after implementing the Hopkin model is that the organization will be able to have problem-solving strategies, increased patient safety and positive health outcome.

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SUMMARY OF CRITICAL APPRAISAL

UTI occurs when organs are affected by a bacteria.

Nitrofurantoin; best practice in treating UTI.

Researchers show that nitrofurantoin prevents UTI

More effective than other antibiotics such as methane.

Nitrofurantoin is the best practice.

No negative effect caused by nitrofurantoin.

UTI occurs when urethra, ureter, kidney and bladder are affected by a bacteria and nitrofurantoin is the best practice in treating UTI. The difference research show that 5 days nitrofurantoin results to positive results among females with UTI at 28 days after completing therapy. Additionally the research also shows that nitrofurantoin prevents UTI more than any other antibiotic such as methane. Nitrofurantoin is the best practice since it has no negative effect caused by nitrofurantoin.

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APA citations

Huttner, A., Verhaegh, E. M., Harbarth, S., Muller, A. E., Theuretzbacher, U., &Mouton, J. W. (2015). Nitrofurantoin revisited: a systematic review and meta-analysisof controlled trials. Journal of Antimicrobial Chemotherapy, 70(9), 2456-2464. DOI:https://doi.org/10.1093/jac/dkv147

Price, J. R., Guran, L. A., Gregory, W. T., & McDonagh, M. S. (2016). Nitrofurantoin vsother prophylactic agents in reducing recurrent urinary tract infections in adultwomen: a systematic review and meta-analysis. American journal of obstetrics andgynecology, 215(5), 548-560. DOI: 10.1016/j.ajog.2016.07.040

Muller, A. E., Verhaegh, E. M., Harbarth, S., Mouton, J. W., & Huttner, A. (2017).Nitrofurantoin’s efficacy and safety as prophylaxis for urinary tract infections: asystematic review of the literature and meta-analysis of controlled trials. ClinicalMicrobiology and infection, 23(6), 355-362. DOI:https://doi.org/10.1016/j.cmi.2016.08.003

Mitrani-Gold, F. S., Raychaudhuri, A., & Rao, S. (2020). Systematic Review and Meta-analysis to Estimate the Antibacterial Treatment Effect of Nitrofurantoin for a Non-Inferiority Trial in Uncomplicated Urinary Tract Infection. Journal of GlobalAntimicrobial Resistance, 22, 68-77. DOI: https://doi.org/10.1016/j.jgar.2020.01.027

LESSON LEARNED FROM THE CRITICAL APPRAISAL

Nitrofurantoin is the best practice to treat UTI

Nitrofurantoin treatment has no negative effect

Women are more prone to UTI due to their anatomy

From the critical appraisal I have come to understand that through the evidence-based research care providers are able to understand problems better, and the evidence based model shows how a problem is recognized, analyzed, and provides strategies for solving a problem. Despite the preferred model evidence-based research should show how a problem is identified, analyzed, and strategies of how to enhance the problem. Through carrying out an evidence-based research clinicians will be able to understand current problems more clearly.

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REFERENCE

Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.

Ritchie, L. M. P., & Straus, S. E. (2019). Assessing Organizational Readiness for Change: Comment on” Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT”. International Journal of Health Policy and Management, 8(1), 55.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Finding Relevant Evidence to AnswerClinical Questions. In Evidence-based practice in nursing & healthcare: A guide to bestpractice (4th ed.). Philadelphia, PA: Wolters Kluwer.