Developing An Implementation Plan

Running head: DEVELOPING AN IMPLEMENTATION PLAN 1

Developing an Implementation Plan

Name of Student

Institutional Affiliation

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Developing an Implementation Plan

Method of obtaining necessary approval

The necessary approval will be obtained from the IRB. Details of the intended procedures

and interventions to be involved will be drafted and forwarded to the Institution Review Board

(IRB) for review and approval. The proposal will also outline the benefits of the Surveillance

Bundle and how it will enhance the management of CAUTI (Menikoff, 2010). It will also show

the importance and efficiency of using Chlorohexidine Gluconate (CHG) for bathing among

individuals suffering from Foley catheter. This will be done because of the sensitive nature of the

medical industry. It values the well-being of the population, and thus every plan or new

intervention must be critically evaluated before it is implemented. Institutions, too, have to get

accredited before they are permitted to offer healthcare services and medicine to patients.

The proposed intervention will be forwarded to the IRB so as to be assessed and a

research of the project will be conducted so as to ensure that the implementation of the plan is

beneficial to the audience. This will be done by conducting a pilot research study of the plan to

evaluate the extent to which the participants are protected (Menikoff, 2010). It will evaluate the

potential physical, mental, invasiveness, and emotional risks to which the implementation of the

plan exposes the recipients. This project will require IRB approval as it involves human beings

as participants in the implementation of the plan. The proposal of the plan will also be compiled

to show the measures that will be taken so that the IRB can use it for review and approval. As

noted earlier, the implementation of the plan will be entrusted with nurses and other medical

personnel dealing with helping people with CAUTIs or prevention and control methods to

minimize new infections and the incidence rate.

Description of current deficit requiring a change

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A previous review of literature on existing interventions shows that the available methods

of management of CAUTI are ineffective and inadequate. Despite some being effective, most of

them are reliable to a certain extent (Pellowe, 2016). This stimulates the need for a more

effective, cost-effective, and reliable mode of intervention for the management of CAUTI.

It is crucial to have this kind of intervention plan implemented as CAUTIs is regarded as

the most common and expensive healthcare-related infection that is responsible for prolonging

the length of stay and comorbidity. Additionally, most healthcare facilities no longer reimburse

the extra cost of treating patients who develop the condition during their hospitalization period

(Weiner, 2016). However, statistics in the United States of America show that despite such

efforts by the Department of Health and Human Services, the incidence rate of CAUTIs has

continued to increase by 9 percent between the year 2010 and 2013. It is also notable that Foley

catheter levels of infection have also increased significantly.

Detailed Explanation of Proposed Solution

The CAUTI Surveillance Bundle will be applied in the monitoring of results of the

application of barriers. The nursing staff in charge of implementing the plan will be trained on

ways of assessing the need for early discontinuation, Foley, as well as education policy and the

procedures for ensuring effective and reliable management of CAUTI (Rebmann & Greene,

2016). Additionally, a shift Nurse Algorithm will be developed and revised from time to time. Its

role in the implementation of the plan is to ensure that the policies and procedures are followed

to promote the efficiency of the plan. Educational flyers will also be developed to guide nurses

on how Chlorhexidine Gluconate (CHG) will be used for bathing on a daily basis and

instructions on perineum cleansing to be done using CHG wipes.

DEVELOPING AN IMPLEMENTATION PLAN 4

The team will also ensure that both post and pre-patient satisfaction are developed. The

efficiency of CHG bathing will also be evaluated to establish the effectiveness of the plan once it

has been implemented. The microsystem will be assessed and analyzed based on the unit metrics.

A daily Foley utilization spreadsheet will also be developed for use during the implementation of

the plan. This will be done according to the number of patients to which the plan will be

implemented as well as the number of individuals suffering from Foley catheter. However, the

number of Foley catheter patients will only be evaluated up to as late as 11 p.m.

The staff involved in the implementation of the staff will also be encouraged to focus on

the goal of the plan so as to overcome any huddles that may limit their performance and the

implementation of the plan. This sort of encouragement will be done during staff meetings as

well as the use of visual boards. Champions who are respected by the rest of the staff were

selected to help in the plan. This was done because they also understood the procedures required

for the implementation of the plan. They are also self-driven; hence, they have the desire to

ensure that the aims and objectives of the project are achieved. Some of the staff who will be

considered to lack understanding of where they are and their direction will not be included in the

project. Only those who have proven to be self-driven will be included and encouraged to ensure

that it is successfully implemented as per the requirements of the IRB standards. This will also

help in outlining the future goals for the prevention and management of CAUTIs, as well as

developing clear steps and action plans to be undertaken and implemented. In regard to this, a

graph will be created and pinned on the visual board so that the nurse staff involved in the

implementation of the plan can monitor the progress trend of the project. Signs of success

enhance enthusiasm among the staff and encourage more of them to continue with the

implementation efforts.

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Another crucial tool that will be used in boosting the stability and success of the

implementation of the plan is the shift checklist and algorithm. The algorithm and checklist will

be used to focus on the assessment of Foley care and necessity on a daily basis as carried out by

the nurses. Additionally, the concerned CAUTI shift will be mandated to audit the effectiveness

and reliability of the CAUTI bundle on a frequent basis. The champions of the implementation of

the plan will also be tasked with reminding the project managers to consider discontinuing the

catheter if it proves unnecessary. The CAUTI management plan implementation team will hold

meetings once in every week.

Rationale for selecting proposed solution

The plan was selected for implementation because of its potentiality to enhance the

management of CAUTIs among patients. There are several positive outcomes that will result

from the implementation of the plan. One of such is that new infections of catheter-associated

UTIs will be reduced and some possible cases of infection prevented. This will aid in reducing

the number of patients with CAUTIs, reducing the burden of care imposed on the nurses. The

plan will also help in reducing indwelling catheter days for patients. The duration that CAUTI

patients spend in hospitals will be significantly reduced. The space can then be used for other

patients.

Another reason for selecting the implementation of CAUTI Bundle is its ability to

improve the quality of care, patients’ outcome, and patient satisfaction. The high level of

efficiency of the plan will enable nurses to provide satisfactory services to patients, as well as

reducing the length of stay in the hospital. This will go a long way in reducing the cost incurred

and the need for readmission of patients. The care provided will help the patients in acquiring

full recovery within the shortest time possible.

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Evidence from Review of Literature

The incidence rate of CAUTIs in the society has increased significantly. Consequently,

researchers have engaged in studies that aim at establishing interventions that could be

implemented to help in the control, prevention, and management of CAUTIs. Unfortunately,

most of the interventions established have failed to meet the expectations of nursing regarding

the management of CAUTIs. According to the existing literature reviewed earlier, it was shown

that the current management plans are expensive, unreliable, ineffective, inaccessible,

complicated to implement, or require too much time to implement. Studies have also shown that

some of the existing CAUTI management plans have failed to treat Foley catheter. As such, this

plan has been developed so as to cover this deficit and improve the management of CAUTIs. Its

implementation covers the gap identified in the implementation of the already existing

interventions.

Description of Implementation Logistics

The plan will be integrated into the current organizational structure once it has been

approved by the IRB; this is expected to take an approximate of 6 months. The plan and details

of what it entails will be introduced to the nurses within the organization to seek their support.

The daily duties of the nurses as shown in the routine will be adjusted so as to accommodate the

new plan. This means that the workflow will increase. As such, more nurses could be required to

assist in the extra duties resulting from the need to get the plan implemented within a short time.

The project manager assigned for overseeing the plan will be responsible for initiating the

change. They will also ensure that the staff is educated on the details and procedures of the plan,

as well as overseeing the implementation of the plan. In this case, the project manager will also

liaise with the administration to ensure that funding is provided when required.

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Resources Required for Implementation

There are various resources that must be obtained to ensure that the implementation of

the plan is possible. One of such is an experienced, self-driven, and able staff of nurses. They

will be required to provide the required labor during the process. Educational materials such as

pamphlets, handouts, posters, and PowerPoint presentations will also be required during training

of nurses. During the assessment and evaluation of the plan, assessment tools that will be

required include questionnaires, surveys, pre- and post-tests to assess knowledge of participants

at baseline and after intervention. This will determine whether or not the aims of the plan have

been achieved and whether or not it has improved the management of CAUTIs among patients

and solved the currently existing deficit in the field. Technology will also be required to cater for

technology or software needs. Another crucial resource is funds. Funds will be required to meet

cost of educating staff, printing or producing educational materials, gathering and analyzing data

before, during, and following implementation. These funds could be raised by the organization.

Provision of such resources and proper implementation of the plan will enhance management of

CAUTIs.

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References

Dixon, J. M., & Carver, R. L. (2010). Daily chlorohexidine gluconate bathing with impregnated

cloths results in statistically significant reduction in central line-associated bloodstream

infections. American journal of infection control, 38(10), 817-821.

Menikoff, J. (2010). The paradoxical problem with multiple-IRB review. New England Journal

of Medicine, 363(17), 1591-1593.

Pellowe, C. (2016). Reducing the risk of infection with indwelling urethral

catheters. nursing, 10, 32.

Rebmann, T., & Greene, L. R. (2010). Preventing catheter-associated urinary tract infections: An

executive summary of the Association for Professionals in Infection Control and

Epidemiology, Inc, Elimination Guide. American journal of infection control, 38(8), 644-

646.

Weiner, L. M. (2016). Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals—

United States, 2014. MMWR. Morbidity and mortality weekly report, 65.

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