Discussion Board-Study Critique Sample Paper Sample 2

Discussion Board-Study Critique Sample Paper Sample 2

Evidence-based practice (EBP) entails the use of available evidence to guide clinical decisions regarding a specific patient case. EBP ensures that caregivers provide quality care at reasonable cost. A systematic and holistic approach is used in executing EBP (Backhouse & Ogunlayi, 2020). Nurses, like other healthcare providers, use proven evidence to guide clinical decisions and offer quality care. The three major building blocks of EBP are internal evidence, external evidence, and practitioner`s clinical expertise.

Internal evidence refers to information gathered directly from the patient regarding the services they receive (Backhouse & Ogunlayi, 2020). It includes both the objective and subjective data gathered through observation. Clinical expertise is required in determining the relevance of the information and now it will be used to improve the quality of services.

External evidence, on the other hand, refers to evidence from the scientific research literature. The literature includes systematic reviews, meta-analyses, clinical guidelines, data, and conclusions from studies. The scientific works of literature are reviewed and provide relevant information that best suits the interests of the patients. The population, intervention, comparison, and outcome (PICO) question are useful in helping to collect relevant and systematic external evidence.

Both external and internal evidence are useful in quality improvement in several ways. The information gathered from internal evidence is useful in understanding the clients and their expectations. This helps in formulating better ways of addressing the clients` concerns and aim at client satisfaction through improved quality of care (Li, Cao & Zhu, 2019). Clinical expertise serves a major benefit in internal evidence determination. On the other hand, external evidence is useful in determining how effective the model being used is, and helps in coming up with better ways of improving it based on information gathered from scientific research.

EBP guides best clinical practice and enhances decision-making. Evidence from both internal and external sources is useful in improving the quality of care. Improved care leads to increased client satisfaction, reduced readmission rates, effective control of diseases, and improved quality of life at a lower cost.


Change Project Objectives

Nurse-driven Protocol to reduce Catheter-Associated Urinary Tract Infections (CAUTIs)


  • To understand early signs and symptoms of CAUTIs
  • To explain the safe techniques of inserting a catheter
  • To reduce patient exposure to antibiotics
  • To explain the guidelines for early removal of the catheter
  • To come up with catheter need forms.
  • The rationale of findings to Reducing CAUTIs

Understanding the signs and symptoms early enough allows for early administration of medication to reduce the severe effects of the disease. Inserting a catheter under an aseptic environment reduces the entry of micro-organisms with the catheter, this reduces the likelihood of infection. Prolonged antibiotic exposure can lead to resistance and this can be challenging when one acquires an infection that requires those particular antibiotics (Mitchell et al., 2017). In such cases, treatment will be hard to achieve leading to severe forms of the disease. Additionally, prolonged stay with catheters increases the rate of CAUTIs. It is therefore advisable that the catheters are placed at a specified time then removed to reduce infection. Finally, the catheter should only be placed on those patients that need it dearly (Rozario, 2018). In case there is no strong indication for the need for a catheter, then it should not be inserted. Also reviewing patients with the catheter is important as it helps identify those who no longer need it. Timely removal of the catheter reduces the patient’s exposure to CAUTIs.

The rationale for Advocating for Autonomy and Social Justice.

This project ensures that patients are involved in decision-making. Consent should be acquired from the patient before inserting the catheter. Ideally, the nurse must inform the patient of all the risks and benefits associated with catheter use. This, according to Saitone, Sexton and Ward (2018), is because the effects brought about by CAUTIs, such as pain, urgency, increased frequency, and dribbling of urine are devastating. Reducing the rates of infection ensures that a patient lives without disturbances and enhances the likelihood of improved quality of life.


  • Mitchell, B. G., Fasugba, O., Gardner, A., Koerner, J., Collignon, P., Cheng, A. C., Graves, N., Morey, P., & Gregory, V. (2017). Reducing catheter-associated urinary tract infections in hospitals: study protocol for a multi-site randomized controlled study. BMJ Open7(11), e018871. https://doi.org/10.1136/bmjopen-2017-018871
  • Rozario, D. (2018). Reducing catheter-associated urinary tract infections using a multimodal approach – the NSQIP experience of Oakville Trafalgar Memorial Hospital. Canadian Journal of Surgery61(4), E7–E9. https://doi.org/10.1503/cjs.017217
  • Saitone, T. L., Sexton, R. J., & Ward, S. A. (2018). The Hospital-Acquired Conditions (HAC) reduction program: using cranberry treatment to reduce catheter-associated urinary tract infections and avoid Medicare payment reduction penalties. Journal of Medical Economics21(1), 97–106. https://doi.org/10.1080/13696998.2017.1396993