Data Table of Current and Desired Clinical Outcomes  NURS FPX 6021 Assessment 2 Change Strategy and Implementation NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1 Change Strategy and Implementation

The data table in the appendix depicts the current and desired states of various clinical outcomes in AKI-infected patients at MedStar Washington Hospital Center. The data is collected through the organization’s dashboard and patient surveys. Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is prioritized to maintain patients’ privacy and confidentially and ensure robust security measures are applied to extract the data from the organization’s information management systems (Rosenbloom et al., 2019).

However, some areas of ambiguity in the data collection process required further information to improve the analysis. These include a lack of detailed data on specific infection types and sources, unanswered questions about the factors leading to mortality, knowledge gaps on antibiotic usage and patterns of resistance, lack of information on secondary factors increasing hospital stays, and minimal information on factors contributing to patient dissatisfaction. Further information on these areas will improve the analysis and direct the change implementation process, targeting particular concerns. 

Change Strategies to Achieve Desired States

Secondary infections are commonly found in AKI patients due to the disease’s impact on individuals’ immune systems. Patients with acute kidney injury admitted to intensive care settings are 40-50% prone to developing infectious states (Peerapornratana et al., 2019). Antibiotic resistance and patient dissatisfaction are primary clinical outcomes that require prompt action through various change strategies. The strategies include the Antimicrobial Stewardship Program (ASP) and infection control practices (hand hygiene and environmental hygiene). 

The proposed change strategy is implementing an antimicrobial stewardship program to address antibiotic resistance. This initiative involves optimizing antibiotic use through appropriate drug selection, precise dose setting, and monitoring the duration of antibiotic treatment to ensure the best possible clinical outcomes are achieved to treat and prevent infection without encountering toxicity or resistance (Alawi et al., 2022). In my current workplace, the implementation of ASP includes developing guidelines for appropriate antibiotic use, conducting interprofessional training sessions, and seamlessly integrating existing workflows. Moreover, we aim to implement surveillance systems to monitor resistance patterns and foster a culture of answerable antibiotic prescribing.  

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Similarly, we propose Infection Control Practices (ICPs) as an environmental change strategy to improve patient satisfaction with healthcare practices. These robust ICPs include hand hygiene protocols and ensuring a transparent and sanitary environment to minimize the risk of secondary infections in all hospitalized patients (Braun et al., 2020), especially AKI patients. The implementation plan for the current workplace includes creating standardized protocols for infection prevention, conducting frequent training sessions, and integrating infection control into daily routines. Moreover, educating patients and their family members through educational materials and awareness campaigns is imperative to foster a shared responsibility for infection prevention.

However, several challenges might be associated with implementing these strategies, including staff readiness to change and compliance with the plan, resource constraints, availability of technology, and adapting practices to diverse patient populations. These challenges can be mitigated using transparent and open communication channels, ongoing education and leadership support, effective resource optimization and budgeting, upgrading existing technological infrastructure, and tailoring change strategies according to patients’ preferences.

Moreover, monitoring Key Performance Indicators (KPIs) is essential to evaluate the proposal’s effectiveness. These include reduced inappropriate antibiotic prescriptions, decreased antibiotic resistance rates, reduced hospital-acquired secondary infections in AKI patients, improved patient satisfaction scores, and improved patient outcomes. Regular audits, feedback mechanisms, and continuous data analysis ensure ongoing refinement to maximize effectiveness.

Justification of the Change Strategies

The antimicrobial stewardship program is relevant for reducing antibiotic resistance by promoting judicious and evidence-based use of antibiotics. This change strategy is justified by a study that mentions that in the evolving state of AKI-infection patients, the significant challenge is balancing the safety and efficiency of antibiotic dosage and utilization. Such a situation requ