Evidence Based Practice Change to Incorporate a Standardized Process Checklist for Fecal Microbiota Therapy (FMT) to Increase Staff Adherence

Author

Alicia Gomez, University of St. Augustine for Health SciencesFollow

Date of Award

Spring 4-4-2024

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sheri Jacobson

Second Advisor

Anjal Pong

Abstract

Practice Problem: Staff adherence to new procedures is crucial for ensuring patient safety, maintaining quality care, reducing risks and liabilities, and fostering a positive organizational culture that supports continuous improvement. Having a procedure done safely for patients infected with C.diff provides an overall benefit to the healthcare system.

PICOT: In an endoscopy lab staffed with nurses and surgical technicians (P), does the implementation of a new standardized process of administering FDA approved Fecal Microbiota Transplant Therapy (I) compared to the current process (C), increase staff adherence to the process (O) over 12 weeks(T)?

Evidence: Leadership, supervision, and organizational culture are crucial for promoting adherence to guidelines, while factors such as lack of knowledge, lack of confidence, organizational climate, and forgetfulness contribute to non-adherence. Direct observation proved invaluable in bridging the gap between perceived and actual actions, while workplace culture holds sway over compliance with procedures.

Intervention: Fecal microbiota therapy is recommended for preventing Clostridioides difficile infection recurrence, administered as an enema without sedation or bowel prep, unlike traditional options. A stepwise process was established to ensure proper execution, including creating a checklist to aid endoscopy unit staff who will assist in the procedures.

Outcome: Nurses generally adhered closely to the checklist, with one nurse at 75% adherence. Feedback was provided to improve infusion pace for optimal results, and overall staff adherence exceeded the 70% threshold, with 74% adherence. Even though no statistical significance was calculated, clinically, the checklist was an important tool to utilize when training nurses for the first time or when refreshing someone who hasn’t done a procedure in some time.

Conclusion: This DNP project aimed to establish a standardized process with a checklist for treating CDI, emphasizing the crucial role of nursing staff adherence in delivering safe, effective, and high-quality patient care.

Comments

Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

Recommended Citation

Gomez, A. (2024). Evidence Based Practice Change to Incorporate a Standardized Process Checklist for Fecal Microbiota Therapy (FMT) to Increase Staff Adherence. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.UIDQ7261

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