NURS 6052 Week 9 EBP Adoption Proposal Example

Course	NURS 6052 Essentials of Evidence-Based Practice
Week	Week 9
Paper type	EBP adoption proposal
Length	About 1,070 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NURS 6052 Week 9

Proposal to Adopt Daily Chlorhexidine Gluconate Cloth Bathing for Adult Patients With Central Lines in the Medical ICU

Student Name

College of Nursing, Walden University

NURS 6052: Essentials of Evidence-Based Practice

Instructor Name

Month Day, Year

What this page is doingThe title states the recommendation in full: frequency, product, population, and unit. A proposal is graded on the link between each element of the recommendation and the evidence behind it, and naming every element on the title page commits the paper to tracing each one.

Proposal to Adopt Daily Chlorhexidine Gluconate Cloth Bathing for Adult Patients With Central Lines in the Medical ICU

Recommendation and Strength

Recommendation: all adult patients with a central venous catheter in the medical ICU will receive a daily bath with 2 percent chlorhexidine gluconate (CHG) cloths in place of soap and water, unless they have a documented CHG allergy or skin condition that contraindicates it.

Strength: moderate. The recommendation rests on a meta-analysis, two cluster-randomized trials with inconsistent results, and a national prevention compendium; the benefit is most consistent in units with higher baseline infection rates, which describes this unit's recent trend.

Evidence Trace, Element by Element

Daily frequency. Supported by the multicenter cluster-randomized trial, in which units bathed patients every day with CHG cloths (Climo et al., 2013), and by the national compendium's recommendation for daily bathing of ICU patients (Buetti et al., 2022). Level II and Level I.

Cloth form, 2 percent. Supported by the same trial and by the before-and-after study, both of which used no-rinse 2 percent CHG cloths (Montecalvo et al., 2012), and by the meta-analysis, most of whose included studies used cloths (Frost et al., 2016). Level I to Level III.

Patient group, adults with central lines in an ICU. Supported by the meta-analysis, limited to adult ICU patients, and by the compendium's focus on CLABSI prevention. The pragmatic trial that found no benefit was also in adult ICUs, which is why the strength is moderate rather than strong (Noto et al., 2015).

Exception for allergy or skin contraindication. Supported by the product labeling and by the compendium's caution on skin reactions; not an effect claim, but a safety boundary.

What this page is doingEach element of the recommendation is linked to the appraised sources and their levels, which is where proposal rubrics put the most weight. No element appears that the evidence does not support, and the strength statement is matched to the inconsistency the appraisal found rather than inflated.

Stakeholder Map: Interest and Influence

High interest, high influence. Infection preventionist: wants lower CLABSI rates, controls surveillance and audit data; the change asks her to add a bathing element to monthly audits. Nurse manager: accountable for the unit's CLABSI rate and staffing; the change asks her to protect time for baths on nights.

High interest, lower influence. Registered nurses: will assess skin, document baths, and answer patient questions; the change asks them to treat the bath as a scheduled task rather than a flexible one. Nursing assistants: give most baths and will feel the workload change first; the change asks them to use a new product and technique, and to document each bath. Patients and families: gain lower infection risk and may notice cooler cloths or skin irritation; the change asks them to accept a new bathing routine.

Lower interest, high influence. Intensivists: can support or undermine the change through orders and comments on rounds; the change asks them to endorse bathing in the central line policy. Supply chain: controls whether cloths are stocked; the change asks for new par levels and a cloth warmer.

Lower interest, lower influence. Wound care nurse: will be consulted on skin reactions and CHG-compatible products; the change asks for an education session and a list of compatible lotions.

Barriers, Sources, and Responses

Night-shift bath time. Source: assistants on nights already report too little time, and interviews in another ICU identified workload and scheduling as the main barriers to sustaining daily CHG bathing (Musuuza et al., 2017). Response: CHG cloths need no basin or rinse, and the champions will pilot a schedule that spreads baths across two time blocks.

Skin reactions. Source: CHG can cause dryness or irritation, particularly with daily use. Response: the wound care nurse will teach skin assessment, and the policy will name when to stop and substitute.

Lotion and soap incompatibility. Source: CHG is inactivated by some anionic compounds found in common lotions and soaps, so using the unit's usual lotion after a bath can cancel the antimicrobial effect. Response: supply chain will stock a CHG-compatible lotion, and incompatible products will be removed from the unit.

Patient refusal. Source: some patients dislike the cool, slightly tacky feel of the cloths or decline daily baths. Response: nurses will explain the purpose, warm the cloths, and document refusal so that it can be addressed rather than hidden.

Memory of a faded initiative. Source: staff recall a previous practice that disappeared within months. Response: unit champions, visible audit feedback in the first months, and a documentation field that makes adherence measurable.

Resources Required

The change needs four resources, each modest. Supplies: CHG cloth packages sufficient for one bath per central line patient per day, a cloth warmer, and a CHG-compatible moisturizer, all available through existing contracts; the unit's central line census averages about twelve patients, which sets the daily par level. Staff time: a thirty-minute education session for every registered nurse and assistant, delivered at shift change on each shift over two weeks by the champions and the wound care nurse. Informatics: one documentation row in the flowsheet recording that a CHG bath was given, not given, or refused, with a reason, built by the unit's informatics liaison. Oversight: the infection preventionist adds two items, bathing documentation and skin assessment, to her existing monthly central line audit.

Against these costs sits the cost of the problem. Each CLABSI extends the ICU stay, requires additional antibiotics and cultures, and is a publicly reported event that affects the hospital's quality ratings. The proposal does not claim a specific dollar return, because savings depend on how many infections are actually prevented, but it notes that the resources above are small relative to the cost of even one additional infection.

Decision Requested

The practice council is asked to approve the recommendation, the resources above, and a start date six weeks after approval, which allows time for supplies, education, and the documentation row to be in place before the first bath. The champions will return to the council at three months with adherence, skin reaction, and CLABSI data and a recommendation to continue, adjust, or stop.

What This Proposal Does Not Recommend

The proposal does not recommend CHG bathing for patients without central lines, for pediatric patients, or outside the ICU, because the appraised evidence did not address those groups. It does not recommend nasal decolonization, which some trials combined with bathing, because that is a separate intervention with its own evidence. It does not change central line insertion or maintenance practice, which is governed by the existing bundle. Measures of success, such as CLABSI rate, bathing adherence, and skin reactions, are named here and will be defined in the implementation plan, rather than promised as results (Melnyk & Fineout-Overholt, 2023).

References

Buetti, N., Marschall, J., Drees, M., Fakih, M. G., Hadaway, L., Maragakis, L. L., Monsees, E., Novosad, S., O'Grady, N. P., Rupp, M. E., Wolf, J., Yokoe, D., & Mermel, L. A. (2022). Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infection Control & Hospital Epidemiology, 43(5), 553-569. https://doi.org/10.1017/ice.2022.87

Climo, M. W., Yokoe, D. S., Warren, D. K., Perl, T. M., Bolon, M., Herwaldt, L. A., Weinstein, R. A., Sepkowitz, K. A., Jernigan, J. A., Sanogo, K., & Wong, E. S. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. New England Journal of Medicine, 368(6), 533-542. https://doi.org/10.1056/NEJMoa1113849

Frost, S. A., Alogso, M.-C., Metcalfe, L., Lynch, J. M., Hunt, L., Sanghavi, R., Alexandrou, E., & Hillman, K. M. (2016). Chlorhexidine bathing and health care-associated infections among adult intensive care patients: A systematic review and meta-analysis. Critical Care, 20(1), 379. https://doi.org/10.1186/s13054-016-1553-5

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Montecalvo, M. A., McKenna, D., Yarrish, R., Mack, L., Maguire, G., Haas, J., DeLorenzo, L., Dellarocco, N., Savatteri, B., Rosenthal, A., Watson, A., Spicehandler, D., Shi, Q., Visintainer, P., & Wormser, G. P. (2012). Chlorhexidine bathing to reduce central venous catheter-associated bloodstream infection: Impact and sustainability. The American Journal of Medicine, 125(5), 505-511. https://doi.org/10.1016/j.amjmed.2011.10.032

Musuuza, J. S., Roberts, T. J., Carayon, P., & Safdar, N. (2017). Assessing the sustainability of daily chlorhexidine bathing in the intensive care unit of a Veteran's Hospital by examining nurses' perspectives and experiences. BMC Infectious Diseases, 17, 75. https://doi.org/10.1186/s12879-017-2180-8

Noto, M. J., Domenico, H. J., Byrne, D. W., Talbot, T., Rice, T. W., Bernard, G. R., & Wheeler, A. P. (2015). Chlorhexidine bathing and health care-associated infections: A randomized clinical trial. JAMA, 313(4), 369-378. https://doi.org/10.1001/jama.2014.18400

NURS 6052 Week 9 instructions, in plain terms

Week 9 of NURS 6052 commonly asks for a proposal to adopt an evidence-based practice. You state the recommendation and its strength, trace each element to evidence, map stakeholders, address barriers, list resources and request a decision. Faculty penalize recommendation elements with no supporting source. Cite appraised sources in APA 7. Six to eight stakeholders is typical. Evaluation measures may be included briefly or saved for later. The proposal is an academic recommendation, not clinical guidance for readers. NURS 6052 faculty want the recommendation stated in one sentence with its strength, each element traced to a source and the decision-maker named. Barriers need responses. Resources need costs or estimates.

How the NURS 6052 Week 9 example is put together

Six pages, headed by a one-sentence recommendation and a line naming its strength. An evidence trace follows as a short table linking each element of the recommendation, daily frequency, cloth form and patient group, to the appraised sources and levels behind it. The stakeholder map is a two-by-two grid of interest and influence holding bedside nurses, the nursing assistants who give most baths, the infection preventionist, intensivists, the wound care nurse watching skin integrity, supply chain, and patients with their families; each gets a sentence on what the change asks of them. The barrier table has three columns, barrier, source and response, with night-shift bath time, skin reactions, lotion incompatibility and patient refusal among its rows. A scope paragraph names what the proposal does not recommend. Measures are named but left for later planning.

Reading the NURS 6052 Week 9 rubric

Proposal rubrics usually weight the link between evidence and recommendation most, and a recommendation containing an element no appraised source supports is where points drain first. Stakeholder analysis follows; a list of job titles with no stated interest or influence gets partial credit at best, and omitting the staff who actually perform the baths is a telling gap. Barrier treatment is judged on pairing, since barriers named without responses read as a worry list, and responses unconnected to any barrier read as a wish list. Graders reward proposals whose strength statement matches the earlier appraisals. The scope paragraph tends to earn credit quietly, because proposals that extend a recommendation beyond the studied population invite a pointed comment. Currency of sources, APA formatting and a professional register make up the rest, with small losses for tables missing captions.

NURS 6052 Week 9 help: mistakes that cost marks

Proposals lose the most when the recommendation includes something no source supports, such as bathing every patient. Trace each element. Another common gap is no strength rating. State it. Writers also list barriers without responses. Pair them. Avoid a decision request with no decision-maker. Name the council. Cost the supplies. State what you are not recommending. Close with the decision requested. Writers also forget to say how adherence will be monitored, since skipped baths undo the effect. Mention it. Another frequent slip is ignoring contraindications. List them. Check the strength rating against the appraisal. Keep the stakeholder grid readable.

Get a NURS 6052 Week 9 example written to your instructions

Send the Week 9 prompt and rubric, your appraised sources or matrix, and last week's readiness work if you have it. Back comes a proposal with the recommendation traced element by element, stakeholders placed on an interest-and-influence grid and each barrier matched to a response. The first one is free, delivered in 24-48 hours.

More NURS 6052 papers and MSN samples

NURS 6052 Week 9 questions, answered

Is this proposal clinical guidance for chlorhexidine bathing?

No. The proposal is coursework set on an ICU invented for the page, drawing on studies identified by design, never by what they found. A real decision about bathing products would rest on a facility's own infection surveillance, its product committee and its clinicians. This page describes only how the finished proposal is organized and where it earns or loses marks.

How many stakeholders should the grid include?

Enough to cover everyone the change asks something of, often six to eight groups for a unit-level practice. The example includes the nursing assistants because they give most baths, a group many drafts forget. Patients and families belong too. A grid padded with departments the change never touches shows less judgment than a shorter, carefully placed one.

Should the proposal include evaluation measures?

Name them, usually, but save the detail. The example lists the outcome and one process measure in a sentence and leaves collection methods for later planning, since this week's rubric grades the recommendation and its support. If your section folds evaluation into Week 9, the sample adds a short measurement section tied to your PICOT outcome.

Where can I find a free NURS 6052 Week 9 sample paper?

The chlorhexidine adoption proposal is reproduced here with the recommendation and strength, the evidence trace, stakeholder map, barriers, resources and decision.

What does the NURS 6052 Week 9 proposal recommend?

A daily 2 percent chlorhexidine cloth bath for ICU patients with central lines unless contraindicated.