NUR 590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Sample Answer

Hospital-acquired infections or healthcare-associated infections (HAIs) are a major patient safety issue because they cause illnesses and even death. In their paper, Alamer et al. (2022) observe that healthcare-associated infections are contagious illnesses that manifest two days after hospital admission, within three days of discharge, and within 30 days after getting medical attention.

Patients can acquire infections in any healthcare setting, from long-term units to personal care, inpatient units, and outpatient clinics. The Centers for Disease Control and Prevention (CDC) (2024) observes that while significant progress has been made in reducing and preventing nosocomial infections, much work is still required to address the issue.

The CDC notes that one in 31 hospital patients gets at least one healthcare-associated infection on a given day. CDC estimates that HAIs comprise close to 1.7 million infections and close to 99,000 associated deaths every year. While all hospitalized patients are susceptible to getting nosocomial infections, certain patients are at increased risk.

These include the elderly, young children, and individuals with compromised immune systems. Other risk factors include long hospital stays, utilizing indwelling catheters, inappropriate or failure of healthcare workers to observe hand hygiene measures like hand washing with soap and water and hand sanitizers as well as the overuse of antibiotics.

The elderly have compromised immunity that makes them susceptible to healthcare-associated infections (HAIs). According to Cristina et al. (2021), the elderly also suffer from comorbid conditions that complicate infections and diminish their ability to get better outcomes when infected.

Respiratory tract infections are the most prevalent healthcare-associated infections, followed by urinary tract infections in this population. Healthcare-associated infections (HAIs) in geriatric patients lead to longer hospital stays, increased and extended antibiotic therapy or use, significant mortality, and higher costs of healthcare.

Again, geriatric patients get transferred from one facility like nursing homes, or skilled nursing facilities, to another or from one hospital ward to another leading to care fragmentation which negatively affects the effectiveness of treatment. The transition also allows pathogens to be transferred from one setting to another and from one individual to another.

Therefore, healthcare workers in such settings should develop and implement effective evidence-based practice (EBP) interventions like hand hygiene measures and protocols to reduce and prevent the transmission of healthcare-associated or hospital-associated infections.

Nurse practitioners and other healthcare professionals transmit infections to patients because of poor hand hygiene measures and protocols. Evidence-based practice interventions like hand hygiene measures and protocols enable healthcare providers and organizations to offer better services that enhance the quality of care and increase patient engagement, and their preferences, leading to better outcomes (Melnyk & Fineout-Overholt, 2022).

Hand hygiene measures like hand washing and the use of hand sanitizers are evidence-based practice interventions that can help reduce and prevent healthcare-acquired infections among hospitalized elderly patients in inpatient facilities. The purpose of this evidence-based practice project proposal final paper is to present a proposed EBP intervention to reduce and prevent healthcare-associated infections among hospitalized elderly patients.

The paper proposes hand hygiene measures and protocols among healthcare providers to reduce and prevent nosocomial infections among geriatric patients in hospitals. The proposed measures and protocols include hand washing using soap and water, and hand hygiene using hand sanitizers.

Problem Statement & Refined PICOT Question

Hospital-acquired infections or healthcare-associated infections are newly acquired infections that patients get due to their stay in hospital settings or facilities. As advanced by Alamer et al. (2022), these infections manifest at different times during an individual’s interaction with healthcare facilities and providers.

Over 1.7 million infections occur each year with 32% being urinary tract infections, 22% being surgical site infections, 15% being pneumonia or lung infections, and 14% bloodstream infections. Patients who get infections from surgical procedures spend an additional 6.5 days in hospitals, are five times more likely to be readmitted after discharge, and are twice as likely to die.

As such, healthcare-acquired infections place a significant healthcare burden on patients and the healthcare system because of their adverse effects on patients and health populations. In their paper, Cristina et al. (2021) note that multifactorial efforts like early recognition of infections, restricted use of invasive devices, and effective control measures that include hand hygiene measures like hand washing can contribute to a substantial reduction in HAIs among geriatric patients.

Healthcare workers like nurse practitioners transmit nosocomial infections when they fail to adhere to effective control measures like hand hygiene interventions that include hand washing with soap and water or using alcohol-based sanitizers and hand rubs when handling and interacting with patients in the care delivery process.

Driving the rate of HAIs is essential to improving patient safety and quality, and providers can achieve this goal when they integrate protocols and measures to reduce and prevent their occurrences, especially when dealing with patients who have a compromised immune system (Puro et al., 2024).

Patients need to clean their hands with soap and water or alcohol-based hand rubs before and after caring for every patient, especially elderly patients with compromised immune systems. While the effectiveness of simple hand washing in preventing infection transmission has been known for several decades, the rates of hand washing among clinicians and other healthcare providers have been low.

Strategies to enhance hand hygiene that depend on traditional educational approaches and enhanced monitoring, feedback on hand hygiene practice in these healthcare settings, and sociocultural approaches have led to improved hand hygiene protocols and measures at many hospitals and other healthcare facilities.

Evidence-based practice interventions follow an EBP process that entails systematic steps to generate a solution to an identified healthcare issue (Melnyk & Fineout-Overholt, 2022). The PICOT question framework is essential as it helps gather evidence based on the identified health issue or problem and solution. The framework ensures that providers develop and implement solutions that will lead to better outcomes for their identified health population.

PICOT components

• Population Healthcare workers in geriatric settings
• Intervention hand hygiene measures and protocols; hand washing and use of alcohol-based hand rubs
• Comparison No hand hygiene protocols
• Outcome Reduce and prevent hospital-acquired infections (HAIs) by 30%.
• Time Three months

Refined PICOT Question

Among nurses in the geriatric setting (P), how do hand hygiene protocols and measures (I) compared to no hand hygiene protocols and measures (C), reduce healthcare-acquired infections by 30% (O) within three months (T)?
Organizational Culture and Readiness for Change

An organization’s culture is instrumental in change implementation as it provides the vision, mission, values, and practices that influence employees and other stakeholders to embrace new ways of doing things.

An organizational culture that embraces and involves employees, values and integrates a learning approach, and possesses core values like empathy, integrity, dedication, and services is essential in implementing changes like the proposed EBP intervention.

Imperatively, the analysis of organizational culture and its readiness for change allows the project team to implement the proposed interventions with full support from all stakeholders, especially internal stakeholders like employees and the management who offer support and apportion appropriate resources to attain the set objective and goals of such changes.

The evaluation of the organizational culture in the facility shows that it values and supports change by encouraging nurses to implement best practices, integrate evidence, and empower patients to make better choices and decisions through purposeful engagement.

The leaders in the facility have an open-door policy and are keen on novel ideas to enhance patient care. The facility also boasts of a robust inter-professional collaboration with employees working in teams to attain better outcomes.

The organization’s culture based on its mission and vision, encourages lifelong learning since it is a learning entity where providers have access to continuing education opportunities to up skills competencies, and expertise in dealing with diverse patient situations.

The assessment of an organization’s readiness for change based on its culture is important in implementing evidence-based practice projects. Readiness shows the level at which organizational members are prepared to implement and accept change from a behavioral and psychological perspective.

Readiness is a psychological state of mind that illustrates one’s commitment to a certain course of action. The organizational readiness to change assessment (ORCA) is an appropriate tool used to evaluate the readiness of any facility to implement EBP interventions to reduce and prevent hospital-acquired or nosocomial infections (Kononowech et al., 2021).

The readiness tool entails three important levels that are evidence, context, and facilitation. These scales evaluate the evidence’s strength for the proposed change, the organizational capacity to support change, and its ability.

As such, this evaluation tool is a self-report framework and has structured survey questions that evaluate evidence and organizational-level perception aimed at implementing a certain EBP intervention. The evaluation of the organization to ascertain its readiness using this tool demonstrates that the facility and its providers are ready to implement the proposed EBP intervention.

The three levels advanced by the ORCA tool are evident in the healthcare setting since the management is willing to offer sufficient resources and support for the EBP team. The organization has an effective communication protocol, a collaborative approach to change implementation with a willingness to learn based on its culture.

As such, it is practical to implement the suggested intervention since the facility and its management are ready for change to reduce and prevent healthcare-associated infections (HAIs). The stakeholders, both external and internal, are ready and willing to support changes, including learning new skills in hand hygiene measures and protocols to improve patient safety and quality care outcomes.

Review of Literature

Prevalence of hospital-acquired infections among the elderly

A core part of the evidence-based practice process is to gather evidence by reviewing existing research findings from scholarly articles to support a proposed intervention to improve care quality and patient outcomes. A literature review in this case would focus on the identified problem and the proposed solution entailing hand hygiene measures to reduce and prevent healthcare-associated or hospital-acquired infections (HAIs) among geriatric inpatients.

Zhao et al. (2020) conducted a systematic review of the epidemiology and clinical characteristics of healthcare-associated infections among elderly patients in a tertiary Chinese hospital for three years. The results show that close to 2% of the over 134,000 inpatients contracted HAIs. The authors note that the HAI rates in elderly patients were higher compared to non-elderly patients.

The study observes that elderly patients are more likely to get respiratory tract infections, urinary tract infections, bloodstream infections, surgical site infections, and anti-biotic-related diarrhea. As such, the study demonstrates the increased susceptibility of elderly patients to infections because of their weak immunity and other related factors.

Again, Despotovic et al. (2020) focus on the epidemiology, antimicrobial resistance patterns, and risk factors associated with the acquisition of HAIs among adults in intensive care units. The authors observe that infections are a major concern among delicate patients and suggest an urgent review of infection control policies and their implementation.

The authors note that such policies must entail a behavioral change where providers emphasize hand hygiene measures and reduce the utilization of invasive devices. A study by Sands et al. (2023) compares HAIs among hospitalized patients with COVID-19 and those without.

The authors observe that having a pre-existing condition increases the risk for all common infections, from urinary tract-associated infections to bloodstream infections. As such, the authors recommend high hygiene measures, including the use of hand washing and alcohol-based hand rubs to reduce and prevent HAIs among patients, especially those with a compromised immune system.

The study by Gao et al. (2022) develops a predictive nomogram for postoperative HAIs to help healthcare providers reduce infection rates among elderly patients in cardiac care settings. The study demonstrates the increased risk for HAIs among patients and the development of relevant protocols to reduce and prevent their occurrence because of their adverse effects on patients and healthcare facilities.

Furthermore, in their expert opinion, Puro et al. (2022) explore pillars of prevention and control of healthcare-associated infections. The expert opinion statement observes that practical interventions based on the Infection Prevention and Control (IPC) framework are evidence-based practice approaches that can lower and stop infections among elderly patients.

The authors observe that using a practical bundle of organizational, structural, and professional requirements is necessary for promoting, through multimodal strategies, the improvement of quality and safe care to reduce the risk of infections and infections among patients and healthcare providers. The implication is that elderly patients are at an increased risk for all main types of HAIs compared to other patient populations in healthcare facilities.

As such, developing evidence-based practice (EBP) interventions is critical to prevent the prevalence of nosocomial infections among the elderly. Developing and executing hand hygiene measures like hand washing and the use of alcohol-based hand rubs will be critical to reducing and preventing HAIs.

Hand Hygiene Protocols to reduce and prevent Hospital-associated infections

Different studies support the implementation of hand hygiene measures to reduce and prevent infections across all healthcare settings and among patients, especially hospitalized patients. Ni et al. (2020) demonstrate that hand hygiene measures lead to reduced hospital-acquired infections transmitted by healthcare workers.

Through a qualitative design, the article discusses the outcomes of research in a large teaching hospital in China about the integration of hand hygiene measures to prevent infections and enhance patient safety. The authors demonstrate that hand washing has the potential to lower healthcare-associated infections (HAIs) in various care settings, including the geriatric population.

In their study, Liana (2020) explores the impact of hand hygiene practices aimed at lowering hospital-acquired infections. The article advances that hospitalized patients are at an increased risk for getting nosocomial infections with certain categories being at an elevated risk than others. According to the study, children, the elderly, and individuals with compromised immunity are at greater risk for HAIs.

Again, the study notes that longer stays in hospitals, use of indwelling catheters, overuse of antibiotics, and the inability of healthcare workers to frequently and routinely wash hands increase the risk of getting nosocomial infections.

The study by Mitra et al. (2021) focuses on the prevention of hospital-acquired infections during the Covid-19 pandemic. The authors measure the impact of the COVID-19 pandemic on the four main forms of hospital-acquired infections about hand hygiene compliance rates among healthcare workers.

Using hand hygiene measures reduced the rate of HAIs by 28% with the highest decline being in central-line-associated bloodstream infections (CLABSI) which declined by 37.6%. The article also notes that hand hygiene measures and protocols also improved during the pandemic, demonstrating the effectiveness of implementing the intervention to reduce and prevent healthcare-associated infections (HAIs).

The study concludes that compliance with hand hygiene and implementation of standard infection control practices as recommended by the CDC and the World Health Organization (WHO) can drastically lower the range of HAIs and their severity on patients.

In their study, Sandbekken et al. (2024) explore the effects of multimodal interventions targeted at behavioral change on hand hygiene adherence in nursing homes. The 18-month quasi-experimental study asserts that multimodal intervention increases hand hygiene adherence in intervention settings.

The authors note that facilities should motivate workers and continuously reinforce hand hygiene protocols to ensure increased patient safety and lower the rate of HAIs. The article recommends that interventions need to target proper hand hygiene before healthcare workers contact patients since they have low adherence rates.

The article concludes that a behavioral change approach and continuous reinforcement are essential in implementing hand hygiene measures to reduce and prevent hospital-acquired infections among the elderly.

Hand hygiene measures lower pathogen transmission in healthcare settings and healthcare providers need to implore patients, their families, and all stakeholders to regularly decontaminate their hands to lower infections.
Through their systematic review of the literature, Staniford et al. (2020) focus on hand hygiene and environmental disinfection strategies to enhance hygiene standards in healthcare settings.

According to the study, behavioral change among healthcare workers is essential in embracing hand hygiene protocols and measures. Through the behavioral model, nurses can embrace and implement best practices in hand washing like soap and water, and use alcohol-based hand rubs and sanitizers.

The authors emphasize the importance of a positive attitude, organizational support, and having a safety culture as well as sufficient information and procedures to improve hand hygiene adherence to reduce and mitigate all types of major infections that cause increased suffering and negatively affect the quality of care.

Hillier et al. (2020) discuss the correct procedures required for effective hand hygiene measures. The article emphasizes the importance of relevant nursing knowledge and understanding of evidence-based guidelines like the use of sanitizers alongside hand washing with soap and water. The article is categorical that healthcare workers should have knowledge, awareness, and sufficient information on the benefits of effective hand hygiene measures to reduce and prevent HAIs.

By using hand hygiene measures, healthcare workers can control and stop the spread of emerging and reemerging diseases, especially pandemics and epidemics, and guarantee patient safety. The authors demonstrate the importance of evidence-based practice interventions in care practice among providers to mitigate the transmission of infections.

As such, it is evidence that hand hygiene measures are a critical part of reducing and preventing healthcare-associated infections (HAIs) among elderly patients in different healthcare settings; from long-term care facilities to hospitals.

Change Model or Framework

Change implementation requires project teams to apply change models to attain expected outcomes or results from such initiatives. The evidence-based practice (EBP) process is a systematic approach that leads to the implementation of best practices based on collected evidence of its suitability or viability in healthcare settings (Spoon et al., 2020).

As such, attaining the required or envisioned change implores providers to use change models. Behavioral change patterns as evidenced in this EBP project are essential to reduce and prevent hospital-acquired infections (HAIs) among providers and onward transmission to patients. The selected change model for the proposed EBP project is the ADKAR change framework.

Developed by Jeff Hiat after studying change patterns in various situations or settings, the ADKAR model focuses on people driving change in organizations by guiding them through certain approaches or methods and addressing barriers to change along the way. The ADKAR model and its sequential stages are ideal for the proposed solutions as it focuses on education and information, creating awareness, and implementing hand hygiene measures among providers and even patients to reduce and prevent infections (Balluck et al., 2020).

These measures require a behavioral change and approach since they seek new ways of doing things and developing a culture based on practices that are practical to prevent HAIs among geriatric patients in healthcare settings.
The ADKAR model comprises five stages; awareness, desire, knowledge, ability, and reinforcement.

The awareness stage is about creating an understanding that change is important through effective communication and education since providers or internal stakeholders should know the urgency and need for change. The second stage is desire where stakeholders focus on change among themselves by creating a clear and inspiring vision, highlighting the significance of change (Wong et al., 2020).

The implication is that organizational members should know and implement change. The third stage entails ensuring that all stakeholders, especially the change management team, have sufficient information and knowledge on change and its effects on the organization. The fourth stage is to develop the capacity and competencies to implement the proposed change in the organization.

Organizational leaders assist members like nurses and other healthcare workers to improve their capacities to implement changes by supporting them, allocating sufficient resources, and celebrating small wins or successes at every level.

The fifth stage is reinforcement where the implemented changes become part of the organization’s practices and culture. Nurses and organization leaders help the project team to embed new practices through positive approaches, more engagement, and encouragement.

The proposed EBP project aims at improving and integrating hand hygiene measures among providers to prevent and reduce hospital-acquired infections. The project provides sufficient information, education, training, and setting up of hand washing points to enhance adherence and compliance within the facility.

It also entails having hand sanitizers and rubs for providers in designated places where they come into contact with patients. The integration of resources at the organizational and individual patient levels to enhance hand hygiene is also part of the proposed project.

Therefore, the ADKAR model is applicable since all stakeholders require awareness, have a desire, need knowledge, possess ability, and should be supported to integrate new practices to attain the required compliance.

Awareness will occur by nurses having sufficient training and information through effective communication from the project team. The project team will get sufficient evidence on the issue and benefits of implementing the proposed intervention (Jaaron et al., 2021).

After gathering evidence on the benefits of the proposed intervention, the project team will create a desire for change by engaging the internal stakeholders and emphasizing the urgency of the organization.

For instance, the implementation will enhance the quality of care the facility provides to patients and improve outcomes. The third stage will focus on nurses increasing the rationale for change by giving evidence and justification.

Knowledge of nosocomial infections, their effects on patients and organizations, and better ways to mitigate them will provide a foundation for the implementation. The team will then train nurses and other healthcare providers to possess sufficient competencies and strategies to implement the proposed change.

Organizational leaders will offer support, required resources, time, and expertise and collaborate in the implementation of the suggested practices. The team will have a trial phase in one unit before rolling out the initiative in the entire facility. Based on support and fulfillment of requirements, nurses will have the motivation to implement these new practices to reduce infections (Harrison et al., 2021).

The reinforcement stage will entail embedding these new practices as part of the organizational safety measures and culture aimed at improving care delivery and quality outcomes. The ADKAR model will focus on changing the attitudes of all stakeholders in the organization to embrace and comply with the proposed interventions to reduce hospital-acquired infections.

(Appendix 1 ADKAR model).

Implementation of the Proposed Intervention

Implementation entails the actualization of the developed intervention in the proposed EBP project to attain its goal (Melnyk & Fineout-Overholt, 2022). The goal of the proposed EBP is to reduce and prevent healthcare-acquired infections among hospitalized geriatric patients through hand hygiene measures and protocols among nurses.

The implementation stage has several steps that include the setting, timelines, resources, methods and instruments, delivery of the intervention, and data collection tool. It also considers critical components like barriers and facilitators to the project and its feasibility.

Setting of the project and subjects

The setting for the proposed EBP project will be an inpatient facility dealing with geriatric patients, especially an inpatient ward in various units like critical care or medical-surgical units. The implementation in this setting will focus on effective interventions to improve hand hygiene measures and protocols to reduce HAIs.

The proposed EBP project will target all healthcare workers in the facility with a preference for those working in critical units. The project team will get consent from participants and approval from organizational leadership. The nursing staff to participate in the project will have sufficient information before consenting to their involvement.

All willing nurses will participate in the pilot project but after its rollout, all providers will be expected to comply with the set provisions. The project team will seek approval from the Institutional Review Board (IRB) in the university and at the facility to commit to comply with required and expected ethical provisions and legal requirements. The consent and approvals are attached in the appendices section.

Timelines

The project team will implement the proposed intervention within three months with various activities happening based on the attached timeline in the appendices section. The timeline will comprise and execute activities based on the ADKAR change model.

The activities at each stage will align with the change model (ADKAR) to ensure the realization of set goals. For instance, the first month will entail setting up all requirements, engaging stakeholders, providing information, and seeking approval from various entities, including the institutional review board at the practicum site and from the nursing school.

In the last two months, the project team will execute all the proposed aspects of the intervention and review benefits before a large-scale rollout. The last week will entail analyzing the outcomes of the measures implemented to reduce infections. The timeline for the proposed EBP is attached in the appendix.

Resources

Successful implementation of the proposed EBP project requires resources; both human resources and materials or funds to access necessary tools. The proposed EBP will require human resources that include competent trainers to educate nurses and prepare them for the implementation stage.

The human resources component will include nurse practitioners, clinical nurse leaders, nurses, and project managers. It will also need physical resources like training manuals and guidelines, appropriate furniture, and audiovisual equipment like computers and screen projectors for presentation. It will also require the Internet.

The project will also require financial resources to procure equipment and supplies like setting had washing points, and having the soaps and sanitizers at appropriate positions in the facility.

The other resource will be information through booklets for patients and their families to read to enhance their understanding of the proposed interventions and what they can also do to prevent infections. Nurse leaders will champion changes and ensure that all nurses embrace the proposed intervention. All required resources and the proposed budget are attached in the appendix.

Data Collection Design and Effectiveness

Gathering relevant data is critical to ascertain the effectiveness of the proposed intervention. As such, the EBP initiative will use a qualitative design through an observational approach and semi-structured interviews to collect feedback from healthcare workers on implementing hand hygiene measures.

The project team will also use a pre-and-post-implementation model to analyze data. Data collection will begin in the first week of the second month to the third week of the third and final month. The collected data will assess the outcomes and effectiveness of the intervention in improving patient safety through reducing HAIs (Wei et al., 2020).

The collected data will demonstrate the effectiveness of the intervention by ascertaining that nurses comply with hand hygiene measures for better care delivery and reducing HAIs.

Methods and Instruments for Monitoring

Different methods will monitor the outcomes based on the effectiveness of the intervention. The project will use an audit tool and a satisfaction survey. The survey will evaluate the effectiveness of measures to reduce the cost of HAIs among patients. Using this tool, the team will complete the audit process and collect data on certain hand hygiene interventions and their outcomes.

The project will use semi-structured questionnaires to collect data and observational checklists for self-reported compliance measures among nurses. Using the collected information, the team will make necessary changes to identify any gaps in the implementation and improve such areas. The method (satisfaction survey) is attached in the appendix.

Delivery of the Intervention

The delivery process will involve the project members and nurses in the facility who will develop and execute the proposed interventions that include hand washing initiative, education and training of providers, setting up points for hand washing, getting supplies for sanitizers and rubs, and integrating these measures as part of the organizational culture. Participants will get training to possess the capacity based on the ADKAR model and implement the interventions as required.

Stakeholders

Stakeholders are essential in implementing any project, including the proposed EBP project. Stakeholders provide resources, support, and implement the suggested interventions. In this case, the internal stakeholders in the project will include organizational managers and leaders who will approve the initiative and allocate sufficient resources, nurse leaders, and managers who will coordinate with the team to implement the intervention.

The project manager will oversee the implementation and coordinate with all stakeholders. Nurses and healthcare workers will implement the proposed interventions. External stakeholders like expert trainers will prepare nurses through education while patients and their families will benefit from the project.

Components of the Implementation & Feasibility

The success of the project will rely on the management of various components of the implementation that include facilitators, barriers, and creating effective strategies to respond to any emerging issue. Facilitators will include sufficient resources, information, engagement of all stakeholders, and support.

Other facilitators will include effective communication, employee motivation to embrace change, and an organizational culture that encourages continuous quality improvement (Kerr et al., 2022). Conversely, barriers may include time and resource limitations, insufficient support and resources, and limited knowledge and skills among nurses and project teams (Alatawi et al., 2020).

Negative attitudes from employees may lead to resistance to the implementation of the suggested interventions. Therefore, the team can overcome these barriers by developing and implementing a collaborative approach, engaging stakeholders, and effectively communicating to reduce possible resistance and get support to achieve the expected outcomes.

The project is feasible based on the cost-benefit analysis as its benefits to patients and the organization will surpass the costs involved. For example, the project will improve patient safety and quality of care. As such, the organization and its stakeholders will implement the initiative to lower costs associated with healthcare-associated infections (HAIs).

Based on the budget, the cost of the intervention is a one-off investment expense with anticipated improvement in patient safety (DeNisco et al., 2023). Therefore, the facility will save on such costs and get excellence status with compensation due to the value-based healthcare model which rewards quality and not quantity of care offered.

Evaluation Plan

Evaluation is important in EBP projects as it shows successful execution what needs to be changed and if the proposed work is sufficient to prove funding and supported by its outcomes. The evaluation entails assessing expected outcomes, review of data collection tools, an appropriate statistical test, and methods to collect data and measure outcomes.

Expected Outcomes from the EBP Project Proposal

The expected outcomes from the project include a reduction in HAIs among patients by 40% within three months, improved understanding and knowledge of the effects of infections by nurses, and reduced cost of cases associated with comorbidities emanating from infections (Kerr et al., 2021).

Additionally, the project will improve nurses’ skills, experiences, and perspectives on hand hygiene and effective management (Heavey, 2022). It will also improve collaboration and advocacy for patients to improve safety and better care experiences.

Data Collection Tool

The proposed EBP will use a qualitative design and employ various approaches like observation and a pre-and-post-implementation model to evaluate the collected data. The project will use semi-structured interviews and self-reporting feedback to collect data about the implementation and effectiveness of the intervention (Melnyk et al., 2022). The data will be reliable, and accurate, and express original sentiments and opinions concerning the effectiveness of the proposed solution.

Statistical Test for the Proposes EBP Project

Statistical tests assess the hypothesis about the importance of the proposed EBP and interactions of different variables like predictors and outcomes. As such, the proposed project will use a Chi-square test to analyze categorical variables. The Chi-square test is effective in hypothesis testing and determining the link between variables (Heavey, 2022).

In this case, the Chi-square will help the project team to determine the interactions or relationship between hand hygiene measures and the prevalence of hospital-associated infections.

Measuring project Outcomes & Sustainability

The project team will measure outcomes from the interventions by evaluating the number of infections before and after the implementation of the suggested intervention. Data collected and feedback from the observational model will demonstrate the remaining gaps in reducing and preventing infections in the facility.

The satisfaction surveys will assess the effectiveness of the measures to reduce infections (Kerr et al., 2021). Positive outcomes will include a decline in HAIs as reported by providers, a rise in hand hygiene compliance rates among providers and even patients, and integration of the protocols and measures in the organization as part of its culture. If the outcomes do not produce the expected results, the team will analyze all components of the project that may have led to its failures.

The team will review the process to ensure that all aspects are correct and get feedback from subjects to determine the gaps and correct them (Melnyk et al., 2022). However, if all these strategies fail, the team will start the project afresh based on resources. The team may alter the approach but maintain the intervention.

The organization will sustain the project and its proposal through an effective plan. The team’s plan will also entail extending, reviewing, and discontinuing the proposed solution based on certain parameters. To maintain the project, the organization will integrate the proposed aspects like hand washing routine and points to improve compliance. The extension will entail roll out in other units based on available resources (DeNisco, 2023).

The management will disseminate knowledge on hand hygiene measures to enhance patient safety and quality care. The sustainability of the project will also entail continuous quality improvement and alignment of the organization’s best practices, policies, and programs to improve care delivery. The organization and project team will only discontinue the project if it does not achieve its set objectives and aims.

Conclusion

The proposed EBP project is critical in reducing and preventing healthcare-associated infections (HAIs) among geriatric patients through hand hygiene measures and protocols. Existing evidence from the literature shows that hand hygiene compliance can reduce the prevalence of nosocomial infections in geriatric settings since the elderly are among the population groups with increased risk for and susceptibility to HAIs.

The selected change model, ADKAR, will be effective in integrating the proposed intervention to improve patient safety by reducing and stopping healthcare-acquired infections. Therefore, nurses in geriatric settings should embrace and implement these recommendations to reduce the susceptibility of geriatric patients to contract infections. Healthcare providers should implement these initiatives to reduce infections because of their adverse effects on patients and healthcare facilities.

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