APA format Design of Proposal Paper.

I need a Design for change proposal paper in APA format. The PICOT question I ‘m working on it is: What is the impact of using surgical hand antisepsis in preventing infections after surgery? and I will submit my milestone 1 for you to guide yourself. The main citation that you need to use is on the Milestone 1.Please type on the template paper and let me know if you have any question.Here the instructions:You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program.


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Your Name
Chamberlain College of Nursing
NR451 RN Capstone Course
Term and Year
Your title here
This paragraph(s) is to introduce the paper. State the problem and potential solutions
backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly
APA assignment so you cannot use first person. Remember also that you will keep all the
bolded headings and just remove the non-bolded content when you start your paper.
Change Model Overview
In this first paragraph, provide an overview of the ACE Star model Evidence-Based
Practice Process. Feel free to state why nurses should use this model as a guide to facilitate
change. Under each of the second level headers listed below, you now link your identified topic
to the ACE Star model EBP Process.
Define the Scope of the EBP
Restate your practice issue. Why is this a problem? Give statistics and information to
back the scope of the problem at your facility/work area. How does this problem impact
healthcare on a broader scale?
You will be the leader of the team since this is your project. Who will you also include in
your team? Make sure you choose relevant stakeholders. You should have no more than eight
members. Do not list your team members by name but instead by position (pharmacists, charge
nurse, etc.).
Determine Responsibility of Team Members
Why are the members chosen important to your project? What are their roles?
Conduct internal/ external search for evidence. What type of evidence did you find in
addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position
statements? Clinical Practice Guidelines? Briefly discuss the strength of this research. This is
not where you describe the results of your studies. This is done in the following steps.
Summarize the Evidence
In this section, you need to synthesize the information from the systematic review article.
What are some of the evidence-based interventions you discovered in your Evidence Summary
that do you plan to use? Be sure and cite all of your references, in proper APA format, from any
and all articles into this one paragraph.
Develop Recommendations for Change Based on Evidence
What is your recommendation based on the research? Ideally, you will have found
enough support in your evidence to proceed with implementing your pilot program.
Action Plan
You have not implemented your project yet, therefore, this section will be hypothetical.
Develop your plan for implementation. What are the specific steps you will take to implement
your pilot study? What is the timeline for your plan? Make sure you include a plan for
evaluation of outcomes and method to report the results.
Process, Outcomes Evaluation and Reporting
What are the desired outcomes? How will they be measured? How will you report the
results to the key stakeholders?
Identify Next Steps
How will you implement the plan on a larger scale? Will this be applicable to other units
or the facility as a whole? What will you do to ensure that the implementation becomes
Disseminate Findings
How will you communicate your findings internally (within your organization) and
externally (to others outside of your organization)?
Provide a clear and concise summary. Review the key aspects of the problem as well as
the change model. Be sure to include important aspects of the five points of the ACE Star change
model EBP process and ways to maintain the change plan.
Chamberlain College of Nursing
NR451 RN Capstone Course
Capstone Project Milestone 1:
Practice Issue and Evidence Summary Worksheets
For Use May 2018
Student Name: Lianet Suarez
Date: May 19, 2018
Refer to the guidelines for specific details on how to complete this assignment.
Type your answers directly into the worksheets below.
Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.
Post questions about this assignment to the Q & A Forum. You may also email
questions to the instructor for a private response.
Practice Issue Worksheet
List the topic and include the citation for the systematic review you have selected from our
approved list (optional: an additional scholarly source of support):
Health associated infections
Tanner, J., Dumville, J. C., Norman, G., & Fortnam, M. (2016). Surgical hand antisepsis to reduce
surgical site infection. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD004288.
DOI: 10.1002/14651858.CD004288.pub3.
What is the nursing practice issue you have identified related to the topic you have chosen?
The nursing practice issue is patient safety.
Fully describe the scope of the practice issue:
The role of nurses is to promote the well-being of patients. Knee and hip surgeries are common
operation procedures that require care so that the patient recovers faster. Nursing hygiene plays a
critical role in enhancing patient recovery after an operation procedure. Infections lead to delay in
healing of the wound, increased re-admission rates and in some extreme cases; they cause the death of
the patient. The role of nurses in enhancing patient safety during and after a hip or knee operation is to
use hand antisepsis which sanitizes the surface and reduces the risk of surgical site infections after the
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
Chamberlain College of Nursing
NR451 RN Capstone Course
What is the practice area?
__x_ Clinical
___ Education
___ Administration
___ Other (List):
How was the practice issue identified?
(check all that apply)
___ Difference between hospital and community practice
_x__ Safety/risk management concerns
___ Clinical practice issue is a concern
___ Unsatisfactory patient outcomes
___ Procedure or process is a time waster
___ Wide variations in practice
___ Clinical practice issue has no scientific base
_x__ Significant financial concerns
__ Other:
Describe the rationale for your checked selections:
Surgical site infections affect the safety of patients in various ways. They may cause delays in the
healing of wounds and increase the hospital readmission rates. The patient may also remain disabled
for a longer duration thereby affecting their productivity. This being the case, financial concerns set in.
The more extended period at the hospital increases the cost of care, and in some cases, families are
forced to sell their property so that the patient remains in hospital.
What evidence must be gathered? (check all that apply)
_x__ Literature search
_x__ Clinical Expertise
___ Guidelines
___ Financial Analysis
___ Expert Opinion
__x_ Standards (Regulatory, professional, community)
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
Chamberlain College of Nursing
___ Patient Preferences
NR451 RN Capstone Course
___ Other
Describe the rationale for your checked selections:
A literature search is necessary for determining the prevalence of surgical site infections and similar
procedures of reducing the infections using hand antisepsis. Clinical expertise is essential for
determining the right way to conduct the process including what hand antisepsis is active and the
duration of treatment. Regulatory standards are critical to ensuring that the setting for the procedure is
safe enough to prevent infections. They will also help in determining the qualifications of the clinician
carrying out the surgery to enhance patient safety.
Directions: Please type your answers directly into the worksheet.
Describe the practice problem in your own words with reference to the identified population,
setting and magnitude of the problem in measurable terms:
Hip and knee replacement procedures are common among women. Despite the fact that most of the
processes are successful, a significant number of them take time before healing. Lack of proper
hygiene during surgery is one of the reasons that cause delayed recovery. Approximately 5% of the
surgical patients develop surgical site infections which increase readmission rates and even death in
extreme cases.
Type the complete APA reference for the systematic review article you chose from the list
provided. It must be relevant to the practice issue you described above. Include the APA
reference for any additional optional supplemental scholarly source related to the review you
wish to use.
Tanner, J., Dumville, J. C., Norman, G., & Fortnam, M. (2016). Surgical hand antisepsis to reduce surgical
site infection. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD004288. DOI:
Reichman, D. E., & Greenberg, J. A. (2009). Reducing surgical site infections: a review.
Reviews in Obstetrics and Gynecology, 2(4), 212.
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
Chamberlain College of Nursing
NR451 RN Capstone Course
Identify the objectives of the article:
To identify the impact of using surgical hand antisepsis in reducing surgical site infections for patients
with hip or knee replacement.
To determine the effects of using hand antisepsis on colony forming units bacteria on the hands of the
surgical team.
Provide a statement of the questions being addressed in the work and how these relate to your
practice issue:
What are surgical site infections and who is at risk?
What is the importance of using antisepsis before surgery?
The practice issue is patient safety using hand antisepsis to reduce infections after a hip or knee
surgery. By answering these questions, the researcher can find out who is at risk of getting surgical site
infections and ways in which clinicians can prevent these infections using specific types of hand
Summarize (in your own words) the interventions the author(s) suggest to improve patient
Lack of hygiene during operation procedures increases the possibility of surgical site infections. As a
result, the author suggests that clinicians should first wash their hands with soap and running water.
They then scrub their nails using a brush and clean running water. Later, they use a hand antisepsis
scrub which ensures that their hands are free of germs before putting on gloves. The operation surface
is then cleaned with alcohol or aqueous scrub before and after the procedure. This way, even if the
gloves wear out during the process, there is no possibility of germ transfer.
Summarize the main findings by the authors of your systematic review including the strength of
evidence for each main outcome. Consider the relevance to your project proposal for the
Milestone 2 project paper. (If an optional supplemental source is also used, include a statement
of relevance to it as well.)
â?¢ The author suggests that the use of Chlorhexidine gluconate could reduce the CFU on hands as
compared to other scrubs like povidone iodine. Nevertheless, there is no evidence to prove that one
hand antisepsis is more effective than the other.
â?¢ The duration of using the scrub matters to the point that a 3 minute scrub reduced CFU on hands
compared with a 2 minute scrub with hand antisepsis. However, the quality of this evidence is shallow
given that durations are not consistent.
â?¢ Additionally, there is weak evidence to explain that alcohol rubs that have additional antiseptic
ingredients may be more effective in reducing CFUs on hands compared to aqueous scrubs.
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018
Chamberlain College of Nursing
NR451 RN Capstone Course
Outline evidence-based solutions that you will consider for your project.
Using a simple hand wash before using hand antisepsis.
Administration of preoperative antibiotics to reduce the possibility of infections after surgery.
Discuss any limitations to the studies that you believe impacts your ability to utilize the
research in your project.
The studies were small in size and had a high risk of bias.
â?¢ Uncertainty about the optimal method of determining how hand antisepsis influences surgical site
Shallow quality of evidence may impact on the credibility of data.
NR451 W3 MS1 Practice Issue and Evidence Summary Worksheets 5/2018

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