Star Change Model

Preventing surgical site infections are a major concern for surgeons. Many surgeons require patients to wash with a skin antiseptic prior to surgery. A chlorhexidine wash is the antiseptic of choice for many surgeons. The patient is to wash with the chlorhexidine wash daily for three days. Chlorhexidine has been proven to prevent surgical site infections when used as directed but many patients do not complete the three-day regimen. Patients complain of skin irritation that range from mild to severe.

Change Model Overview The Star Model of Knowledge Transformation formally known as the ACE Star Model, is a model used in evidence-based practice (EBP) processes and approaches. This model is used for discerning the cycles, nature, and characteristics

This step is where the rubber meets the road. Information and research has been collected and this is where the recommendations in the form of Clinical Practice Guidelines are produced. CPGs are presented to the community and stakeholders. The best CPGs state benefits, harms and cost of various options, while the strongest options will use a process that is explicit and reproducible. This stage is comprised of two other stages, translation of evidence into practice recommendations and integration into practice.

Stage number four is Practice Integration. This stage is considered the most familiar in healthcare because of the long standing societal expectation that healthcare is based on the most current knowledge. "This step involves changing both individual and organizational practices through formal and informal channels." (Stevens, 2012). While that sounds easy, this could be a culture change in some instances and that takes time to accomplish.

Stage number five is Process, Outcome Evaluation. This is probably the most important stage. It answers questions such as “Did the change have an impact?”. The answer to the questions is obtained by evaluation. It is one of the best ways to evaluate the impact of EBP on patient health outcomes, provider and patient satisfaction, efficacy, efficiency, and health status impact, to name a

Currently many patients state they do not use the 4% solution because it causes severe skin irritation. The stakeholders in this study would be the surgeons, pre-operative nurses, and the management team of the hospital who order products. This may also result in a cost reduction for the hospital. The team members include the surgeons and pre-op nurses would have to be divided into two areas. Those that use 4% solution and those who use a 2% solution. Each team would be responsible for using and tracking how well each solution worked. A limitation found in the study was the lack of follow up on the participants. Being that most of the surgeries we do in my department are outpatient surgeries. Many of the patients go home after surgery and I may no longer have the ability to see if they had developed a surgical site infection.

Conclusion

I have learned from the study that there needs to be further research conducted with proper follow ups on all patients to determine what percentage of chlorhexidine solution would be best to use in the pre-op routine of patients to best protect against surgical site infections. It was noted in the study that quite a few participants had some sort of reaction to the chlorhexidine solution. The study did say there was reductions in chlorhexidine regimens versus regular soap and water pre-operative