Constructing the Written Evidence-Based Proposal: Final
Combine all elements completed in previous weeks (Topics 1-4) into one cohesive evidence-based
proposal and share the proposal with a leader in your organization. (Appropriate individuals include unit
managers, department directors, clinical supervisors, charge nurses, and clinical educators.)�
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Obtain feedback from the leader you have selected and request verification using the Capstone Review
Form. Submit the signed Capstone Review Form to CONHCPfield@gcu.edu�
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For information on how to complete the assignment, refer to “Writing Guidelines” and the “Exemplar of
Evidence-Based Practice Capstone Paper.”�
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Include a title page, abstract, problem statement, conclusion, reference section, and appendices (if
tables, graphs, surveys, diagrams, etc. are created from tools required in Topic 4).�
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Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the
Student Success Center.�
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This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become
familiar with the expectations for successful completion.�
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CONSTRUCTING THE WRITTEN EVIDENCE-BASED PROPOSAL
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student
Success Center.�
Abstract
The frequency of people with MRSA infections has increased considerably in recent
years. In 2006, over 50% of all cases of skin infections because of MRSA happened in healthy
persons living in the community. The 3 types of MRSA include healthcare-associated MRSA,
hospital-associated MRSA, and community-associated MRSA. In the year 2008, MRSA resulted
in about 89,786 cases of invasive disease leading to nearly 15,300 deaths in America. In the year
2008, roughly 27 percent of hospital-acquired MRSA infections were because of USA300
strains. MRSA is a major threat to communities and to patients in healthcare facilities. An
MRSA infection can actually be more severe compared to other bacterial infections and can be
life threatening. In America, studies indicate that MRSA is actually responsible for about 60
percent of community acquired infections with S Aureus presenting to healthcare facilities. The
rates of MRSA is increasing rapidly in many regions and there is a dynamic spread of strains all
over the world. At present, healthcare associated/acquired MRSA (HA-MRSA) is endemic in
hospitals. The proposed solution for the prevention of MRSA is to provide education to
individuals and communities on the ways to prevent the spread as well as transmission of the
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CONSTRUCTING THE WRITTEN EVIDENCE-BASED PROPOSAL
difficult-to-treat MRSA. The main reason for providing education to communities and
individuals is essentially to promote health and prevent disease.
Problem Statement
MRSA is defined as an oxacillin minimal inhibitory concentration of at least 4 µg/mL
(Raygada & Levine, 2010). The rates of MRSA keep on increasing in many countries around the
world. Romano, Lu and Holtom (2011) stated that MRSA infections occur in 3 particular
groupings of people: (i) those with recent hospitalization or continuing contact with dialysis
units, medical clinics, or those who are going through intricate outpatient treatments, for instance
chemotherapy. They are exposed to healthcare-associated MRSA. (ii) Those who are presently
within the hospital setting, and these are exposed to hospital-associated MRSA. (iii) Those in the
community and these are exposed to community-associated MRSA (Green et al., 2012). A
person can become colonized, meaning to be infected with MRSA, by touching a surface which
is contaminated, for instance a phone, a door handle, or a counter top; and by touching the skin
of an individual colonized with MRSA (Raygada & Levine, 2009).
Mascitti et al. (2010) stated that Staphylococcus is a significant public health issue, and is
known to be associated with infections that are difficult to treat. It is also linked to high
incidences of mortality and morbidity, as well as increased costs of health care. Staphylococcus
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CONSTRUCTING THE WRITTEN EVIDENCE-BASED PROPOSAL
is essentially a bacterium which is carried on the nasal lining or skin of about 30% of healthy
people (Stefani et al., 2012). In such settings, the bacteria usually does not cause any symptoms,
and in such instances the individual is colonized with MRSA. Nonetheless, when the skin of that
person is damaged, for instance is cut or scratched, this bacterium can bring about various
problems ranging from severe illness to a mild pimple, particularly in elderly persons, children,
and persons whose immune system is weakened (Koydemir et al., 2011). Methicillin-resistant
staphylococcus aureus is a serious threat to the community and to patients in healthcare facilities.
It is particularly difficult and expensive to treat because of its resistance to common antibiotics.
In the year 2006 in America, there were roughly 94,350 invasive MRSA infections,
resulting in over 17,900 deaths annually (Green et al., 2012). In America, the proportion of
hospital-acquired MRSA infections is high. From 2009 to 2010, 58.7 percent of S.aureus
catheter-associated urinary tract infections, 54.6 percent of S. aureus central line associated
bloodstream infections, 43.7 percent of S. aureus surgical site infections, and 48.4 percent of S.
aureus ventilator-associated pneumonia episodes were caused by MRSA (Calfee et al., 2014). In
the year 2008, MRSA resulted in about 89,786 cases of invasive disease leading to nearly 15,300
deaths in America (Prosperi et al., 2013). In the year 2008, roughly 27 percent of hospital-
acquired MRSA infections were because of USA300 strains.
Community-associated MRSA was initially seen as a cause of infection in community-
based people without any health care contact. The emergence of Community Acquired-MRSA as
a cause of hospital acquired infections places many patients, health workers, as well as their
community contacts possibly at risk of getting an MRSA infection (Otter & French, 2011). The
emergence of community-associated MRSA also serves to expose its strains to the selective
pressure of antibiotic usage in hospitals possibly leading to increased anti-biotic resistance.
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CONSTRUCTING THE WRITTEN EVIDENCE-BASED PROPOSAL
Different strains of CA-MRSA have invaded healthcare settings. In the year 2008, roughly 27
percent of hospital-acquired MRSA infections were because of USA300 strains. Currently,
MRSA strains are resistant to the available β-lactam antibiotics, such as cephalosporins and
penicillins. Gray (2014) pointed out that Methicillin-Resistant Staphylococcus Aureus are
commonly not just resistant to methicillin and other β-lactam antibiotics, but they are also
resistant to other classes of antibiotics.
MRSA is a major threat to communities and to patients in healthcare facilities. An MRSA
infection can actually be more severe compared to other bacterial infections and can be life
threatening. There is a growing occurrence of health care associated infections with MRSA in
youngsters with underlying conditions predisposing to infection with S aureus. In America,
studies indicate that MRSA is actually responsible for about 60 percent of community acquired
infections with S. Aureus presenting to healthcare facilities (Gray, 2014). According to Stefani et
al. (2012), the rates of MRSA is increasing rapidly in many regions and there is a dynamic
spread of strains all over the world. At present, healthcare associated/acquired MRSA (HA-
MRSA) is endemic in hospitals. The proposed solution for the prevention of MRSA is to provide
education to individuals and communities on the ways to prevent the spread as well as
transmission of the difficult-to-treat MRSA. The main reason for providing education to
communities and individuals is essentially to promote health and prevent disease. The education
activities would be targeted at healthcare workers and the community members in order to
prevent community-associated MRSA, healthcare-associated MRSA, and hospital-associated
MRSA. One of the most important ways of protecting community members, healthcare workers,
and patients is by providing education both to patients and community members.
Conclusion
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CONSTRUCTING THE WRITTEN EVIDENCE-BASED PROPOSAL
Methicillin-resistant staphylococcus aureus is a serious threat to the community and to
patients in healthcare facilities. It is particularly difficult and expensive to treat because of its
resistance to common antibiotics. In the year 2006 in America, there were roughly 94,350
invasive MRSA infections, resulting in over 17,900 deaths annually. There is a worldwide
epidemic of CA-MRSA and different strains of CA-MRSA are emerging as a cause of
healthcare-associated infections and hospital outbreaks have taken place all over the world. As
an emerging cause of hospital-acquired infections, CA-MRSA puts many healthcare workers and
patients potentially at risk of developing MRSA infection.
References
Calfee, D. P., Salgado, C.D., Milestone, A.M., Harris, A.D., Kuhar, D.T., Moody, J…Yokoe,
D.S. (2014). Strategies to prevent Methicillin-resistant staphylococcus aureus
transmission and infection in acute care hospitals: 2014 Update. Infection Control and
Hospital Epidemiology, 35(7), 52-9.
