NU560-WEEK5-DISCUSSION1-REPLY2: Change Agent: To purpose and use evidence-based practice in promoting positive outcomes, change is inevitable.


Change Agent

To purpose and use evidence-based practice in promoting positive outcomes, change is inevitable. As much as “change is vital to progress in evidence-based nursing practice, there are many complexities associated with transforming plans into action, and attempts at change often fail because change agents take an unstructured approach to implementation” (Mitchell, 2013). I believe I can be a change agent by “carrying out a calculated, purposeful and collaborative effort to guide others to move from a process focus to an outcome focus” (Mitchell, 2013).

Relationship to the area of practice

I work in an acute care setting where most of the patients have a therapeutic indication for indwelling urinary catheters (IUC). We have a CQI team which I am part of, as a change agent and member of the CQI, it is my responsibility to see that to the pre-assessment and monitoring of patient on IUC. IUC must have a physician’s order, then a urinary catheter assessment bundle must be filled and signed by two registered nurses after assessing the patient and reviewing his or her chart for allergies to latex or silicone and a therapeutic/appropriate indication for the IUC. 

Afterward, placement must be done by two nurses with an utmost degree of hand hygiene and sterility. After the catheter placement, a daily assessment is done by the CQI team to identify indications for continued use or discontinuation of the IUC. The CQI team always make sure CDC guideline for CAUTI prevention is followed at all time. Although this process of IUC use was resisted by many, the change was implemented and still in place.


The rationale behind the change from a process focus to an outcomes focus.

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Shifting from process to outcome focus especially on the nursing and care of patients is imperative. While a process focus will only explain whether the “procedures, activities or services have been performed rightly and implemented as intended, an outcome focus will explain the results and determines whether the intended outcomes are achieved” (Center for Disease Control and Prevention, n.d). Outcomes focus thus helps to determine the degree to which the nursing care rendered helps to meet the goal and provide evidence-based practice for use thus improves patient care, safety, and recovery.

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