Evidence-Based Practice Project: Addressing a Clinical Challenge
Summative:
Evidence-Based Practice Project: Addressing a Clinical Challenge
This assignment requires you to develop a PICOT question addressing a significant clinical challenge in your area of practice. The project should reflect the application of EBP principles throughout the process. You will identify a clinical problem, develop a PICOT question and conduct a literature review.
Instructions:
Problem Identification and Literature Review: Clearly identify a significant clinical problem within your area of expertise, justifying its selection based on evidence of a practice gap and its potential for improvement through EBP. Conduct a thorough literature review to support your choice and inform the development of your intervention. (Minimum of 5 peer-reviewed sources).
PICOT: Based on the literature review, design a PICOT question to address the chosen problem. Provide rationales for each part of your PICOT question.
Barriers and Theory Application: Identify 2-3 barriers that may exist for implementing your intervention. Using nursing theory, describe how you would overcome those barriers.
Document Type/Template:
Word Document
Evidence-Based Practice (EBP) Project: Addressing a Clinical Challenge
EBP projects are adopted by medical facilities to resolve current clinical challenges. This goal is achieved through a multifaceted approach involving integrating the best scientific research evidence with patient values and clinical expertise. EBP further aims at resolving inefficiencies in clinical operations to reduce medical errors and enhance quality of care. Moreover, EB projects improve patient’s treatment outcomes, thereby reducing healthcare costs (Connor et al., 2023). This paper presents an EBP that would be implemented within the hospital’s post-operative medical ward to address a clinical problem of concern.
Clinical Problem Identification
Medical-surgical units report various clinical problems that are usually resolved by implementing EB projects. A significant clinical issue reported in the hospital’s medical-surgical units is the high prevalence of postoperative infections among adult diabetic patients undergoing elective surgery. Adults diagnosed with diabetes mellitus (DM) are at a relatively high risk of developing surgical site infections (SSIs) (Mansour et al., 2025). This hospital acquired infection is common among DM patients since hyperglycemia impairs functioning of the immune system. DM diagnosis further delays wound healing, making this patient population more prone to SSIs risk. DM diagnosis also makes individuals more susceptibility to bacterial growth. Additionally, increasing prevalence of postoperative infections raises healthcare costs due to extra treatment procedures and prolonged hospital stay. This upward trend in postoperative infections has further led to higher morbidity and mortality rates.
Based on data retrieved from the hospital’s data regarding the high prevalence of postoperative infections among adult diabetic patients undergoing elective surgery represents a significant gap in the clinical practice that must be resolved. This quality metrics indicates a 50% increase in the rate of postoperative infections involving this patient population over the last 12 months. This rate has been on the rise despite adherence to current standard infection prevention protocols. This trend depicts inefficacy of current standard infection control measures, including sterile technique, prophylactic antibiotics, and hand hygiene in preventing infections among post-operative diabetes patients. However, these measures have demonstrated efficacy in controlling infections in other patient populations or clinical settings (Simmons et al., 2022).
An EBP project should be adopted within the hospital’s medical unit to resolve the current clinical problem. Integrating the best available research evidence, patient preferences, and clinical expertise will lower postoperative infections among adult diabetic patients undergoing elective surgery. Integrating EB glucose management protocols into clinical practice will lower the prevalence postoperative infections among diabetic patients, thereby boosting their surgical recovery. Therefore, current literature should be explored to determine efficacy of perioperative glucose control protocols in reducing postoperative infection rates among diabetes patients.
Literature Review
Recent studies have explored efficacy of structured glucose management protocols in lowering infection scores in surgical diabetes patients. Hara et al. (2024) examined the impact of pre-operative blood glucose control and pre-operative hemoglobin A1c (HbA1c) on SSI rates following posterior lumbar instrumentation surgery in DM patients. High SSI rate after posterior lumbar instrumentation surgery was reported among DM patients with elevated HbA1c. Secondly, Hu et al. (2025) established an updated clinical practice guideline protocol for mitigating postoperative health complications, including infections in surgical patients. Findings indicated efficacy of perioperative glucose control in reducing postoperative complications and boosting recovery outcomes. The study highlighted the importance of standardized glucose monitoring and insulin management protocols in surgical settings. Similarly, the Centre for Perioperative Care documented a guidance targeting perioperative management of glucose level in diabetic patients undergoing surgical procedures (Grant & Chowdhury, 2022). Early identification of diabetic patients and glucose optimization in pre-operative phase plays a significant role in the formulation of a patient-centered plan to ensure effective diabetes care pre-operatively, during surgery, and postoperatively. Diabetes medication dose adjustments has also been recommended in the diabetes care plan.
In another study, Mattina et al. (2024), examined the effect of systematic diabetes screening on peri-operative infections among individuals diagnosed with DM undergoing cardiac surgery. Findings indicated efficacy of systematic A1c assessment at admission combined with regular professional DM management in lowering perioperative infectious complications in diabetes patients undergoing cardiac surgery. Lastly, Albalawi et al. (2024) explored enhanced recovery measures in diabetes patients undergoing colorectal surgery. Glycemic control was further identified as a significant component in minimizing postoperative complications, such as infections. Study results depicted efficacy of multimodal perioperative management strategies in boosting patient outcomes and reducing hospitalization duration.
Evidence collected from reviewed literature depicts practice gap between recommended perioperative glucose management protocol and standardized infection control measures currently implemented within medical-surgical units. Thus, the hospital’s medical unit should adopt preoperative glucose management protocol as an EB protocol for stabilizing blood glucose to lower post-operative infection rates among diabetic patients, thereby optimizing their treatment outcomes.
PICOT Question
Proposed PICOT question, “In adult diabetic patients who have undergone elective surgeries (P), how does adopting a pre-operative glucose management guideline (I), compared to standardized infection control measures (C), influence post-operative infection rates (O) within the first 30 days of post-operative period (T)?”
Barriers and Theory Application
Barriers might compromise implementation of pre-operative glucose management guideline in the hospital’s medical ward. The first barrier is inadequate knowledge among staff members. Understanding of perioperative glucose management protocol and its components, including insulin administration might be insufficient in some nurses. Consequently, medical ward nursing staff might fail to comply with the newly implemented perioperative glucose management protocol, resulting in medication errors and high infection rates. This barrier can be resolved through staff education programs aiming at enhancing nurses’ knowledge regarding perioperative glucose management protocol. This solution is supported by Patricia Benner’s Novice to Expert Theory, which recommends for staff’s continuous skill development via multiple strategies, including mentorship, education and training programs, and clinical experience (Lamichhane, 2025).
The second barrier is staff resistance to adopt the new perioperative glucose management protocol. Nurse might prefer current standardized infection control measures since the new protocol involves established routines, which are time-consuming. This challenge can be resolved through the three phases of Kurt Lewin’s Change Theory (Makhanya, 2025). Credible evidence will be used to indicate benefits of the new glucose management protocol during the unfreezing stage, thereby convincing nurses to adopt the new EB guideline. Additionally, staff training during this phase will enhance knowledge about the new glucose management protocol, thereby minimizing staff resistance.
Conclusion
In the medical ward, postoperative infection rate in diabetic patients undergoing surgeries is on the rise. This trend is attributes to prolonged hospital stay and high mortality rates, thereby increasing treatment cost. Additionally, this patient safety issue predisposes diabetic surgical patients to significantly high mortality rates. This trend has persisted despite nurses’ compliance with current standardized infection control measures. Thus, pre-operative glucose management guideline, which is an EB intervention should be implemented within the medical unit to lower high rates of infections among diabetes patients through blood glucose stabilization.
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Evidence-Based Practice Project: Addressing a Clinical Challenge
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