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NR 505 Week 7 and Week 8 Graded Latest Discussions.NR 505 Week 7 TD Week 7: Exploring Research Results Using the following steps found within the translation phase of the Practice Evidence Translation (PET) model developed by Johns Hopkins, select a research result reported in a journal article t...

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  • July 20, 2022
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  • 2021/2022
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NR 505 Week 7 TD
Week 7: Exploring Research Results
Using the following steps found within the translation phase of the Practice Evidence
Translation (PET) model developed by Johns Hopkins, select a research result reported in a
journal article that supports your PICOT/PICo question. Please respond to the following
steps. Please note that wording of the steps may have been modified slightly from the PET so
that they help with this posting. Include the permalink at the end of your posting.
● Using references, identity the research result that you could use in your practice
setting.
● Determine fit, feasibility, and appropriateness of the result for your practice setting.
● Using Plan-Do-Study-Act (PDSA), outline an action plan.
● Identify the resources (physical, personal, technology) needed to implement your
action plan.
● Determine the criteria that you would use to determine whether the implementation
of your project was successful.
● Identify one future research study that would be useful in extending knowledge of
your selected project result.

, Dr. Pat and Class,

Denny and Munro (2017) conducted literature reviews for evidence on the impact of CHG bathing on HAIs. The
premises for their review is that CHG-impregnated wipes (no alcohol) are single use and disposable and require no
rinsing, eliminating the need for a reusable water basin. A recent study, moreover, indicated that when CHG liquid soap
was added to the bath basin, the bacterial growth in the basin was significantly decreased (Denny et al, 2017). Their
search included peer-reviewed studies and meta-analyses that examined the impact of CHG bathing on HAIs using
PubMed and CINAHL. They identified 23 articles for review, with additional studies identified by searching references
used in original studies or review articles on this topic. Their principle findings are there is good evidence to support
incorporating a CHG bathing regimen to reduce the incidence of CLABSIs, SSIs, vancomycin-resistant enterococci
(VRE), and methicillin- resistant Staphylococcus aureus (MRSA) HAIs (Denny et al, 2017).

In the inpatient transplant units of HMH hospital, all post-organ transplant patients are immuno-suppressed, from low
to high level of suppression. When bathing them, avoiding the use of water or a basin bath is considered better
practice for patients who are immunocompromised, have fresh surgical wounds, or are otherwise at high risk for
infection (Denny et al, 2017). Although the pre-packaging is costlier than that of the CHG bottle, its benefits
outweighed any financial considerations.

Defined project quality improvement objectives were the following:

Plan: 1. utilize the collaboration of multidisciplinary committee to review current practice guidelines

2. Utilization of multidisciplinary systemic and evidence-based approaches to decrease the rate of HAIs in the
post organ transplant patients through the change in practice for the pre-operative antiseptic cleansing of the
skin surface with 2% CHG.

Do: 1. the committee created a flowchart of the current process, from when the patient is identified for surgery
until discharge, to provide a baseline to analyze all processes for inconsistencies and variations.

2. Flowchart was posted in the transplant units and the operating room, where frontline personnel were
actively engaged in the improvement process by reviewing and contributing ideas and placing notes on the
flowchart.

Study: 1. direct observations were conducted in various areas throughout the patient care experience to ensure
accuracy of documentation.

2. Charts of patients with SSIs were reviewed for the common denominators, such as pre-transplant infections in
the donor or recipients, of which none were found.

3. The committee reviewed the recently in-house conducted study outcomes and current evidence-based
literature review to verify that the process mirrored best practice.

Act: 1. new protocol was developed and approved by all governing committees.

2. Working with all levels of the organization, the committee implemented cultural changes between
departments and worked together to make improvements.

3. For 6 months, changes implemented included pre-operative CHG bathing per new protocol, as well as
standardization of all processes.

Evaluation/Outcomes: 1. HAIs’ rate from March 2018-March 2019 decreased to 45%, surpassing the targeted goal. 2.
With the implementation of new practices and the standardization of processes, the incidence of HAI was reduced with a
resulting cost avoidance of $212355 and a decrease in excess hospital days to 27.

Future research: Studies on CHG bathing have often been limited by their before-and-after. Better designed RCTs with
specific durations and frequencies of exposure to CHG are needed to determine whether CHG bathing reduces HAIs.

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