Using the 3 paragraph structure described below, please research and explain What does this TIP from Fast Company Mean: "The job of the CIO is to Provide organization and strategic Flexibility"? You are also required to post a response to a minimum of two other student in the class. You must use at least one scholarly resource. Every discussion posting must be properly APA formatted. Paragraph Structure: Your discussion response will take the form of a 3 paragraph, (no more than 1 page) response that can stand on its own right, so you need to write in academic style, aiming at an anonymous reader who may exist in a different time or space.  EG, you need to write for someone who will read your post 50 years from now, or 5000 miles from here, or both. Be formal and precise, because your goal is to educate that reader. While you are writing, try to avoid obvious phrases such as “This article is about…”.  It’s an annotated bibliography.  The entire purpose is to describe what the article is about.  So don’t waste space stating the obvious.  Just jump right into the good stuff: the stuff that the reader needs to know. For example, if you are given the task to research CLOUD COMPUTING, then a summary of an article on cloud computing might start with something along the lines of: Summary: CIOs under the mandate of the US Government’s “Cloud First” policy report that there are critically important challenges to moving to the cloud in a way that minimizes security concerns and maintains usefulness of the information resource.  Two main concerns are the contract structure and the information architecture, both of which must be well thought through prior to migration to the cloud.  Recommended actions to assist in this engineering effort are to have a cloud advisory board and participating in the FedRMP program. You should write only as many words as are needed to capture the summary of the article.  You’re not replicating the content but simply pointing out the important bits.  In fact, your goal should be to capture the spirit of the article in as few words as possible.  You don't need to quote or paraphrase: simple summarize the point of the article.  This is easier, by the way, with articles that are actually dense with facts and research.  News reports are notoriously difficult to summarize, simply because they tend to be summaries themselves.  They are also not particularly useful as sources for a research report.  The second paragraph, the Assessment, is where you tear apart the article and point out any flaws in logic or applicability.  Tell your reader what the article is good for AND what it is not good for. Your reader needs to know strengths and limitations, so tell her.  And be precise. For more information on how to be a critical evaluator of an article, see https://owl.english.purdue.edu/owl/resource/553/03/. Finally, the reflection paragraph is where you discuss how the article contributed to your learning.  I mean on a person ...

1. Using the 3 paragraph structure described below, please
research and explain What does this TIP from Fast Company
Mean: "The job of the CIO is to Provide organization and
strategic Flexibility"? You are also required to post a response
to a minimum of two other student in the class. You must use at
least one scholarly resource. Every discussion posting must be
properly APA formatted.
Paragraph Structure:
Your discussion response will take the form of a 3
paragraph, (no more than 1 page) response that can stand on its
own right,
so you need to write in academic style, aiming at
an anonymous reader who may exist in a different time or
space. EG, you need to write for someone who will read your
post 50 years from now, or 5000 miles from here, or both.
Be formal and precise, because your goal is to educate that
reader.
While you are writing, try to avoid obvious phrases such as
“This article is about…”. It’s an annotated bibliography. The
entire purpose is to describe what the article is about. So don’t
waste space stating the obvious. Just jump right into the good
stuff: the stuff that the reader needs to know.
For example, if you are given the task to research CLOUD
COMPUTING, then a summary of an article on cloud computing
might start with something along the lines of:
Summary: CIOs under the mandate of the US Government’s
“Cloud First” policy report that there are critically important

2. challenges to moving to the cloud in a way that minimizes
security concerns and maintains usefulness of the information
resource. Two main concerns are the contract structure and the
information architecture, both of which must be well thought
through prior to migration to the cloud. Recommended actions
to assist in this engineering effort are to have a cloud advisory
board and participating in the FedRMP program.
You should write only as many words as are needed to capture
the summary of the article. You’re not replicating the content
but simply pointing out the important bits. In fact, your goal
should be to capture the spirit of the article in as few words as
possible. You don't need to quote or paraphrase: simple
summarize the point of the article. This is easier, by the way,
with articles that are actually dense with facts and research.
News reports are notoriously difficult to summarize, simply
because they tend to be summaries themselves. They are also
not particularly useful as sources for a research report.
The second paragraph, the Assessment, is where you tear apart
the article and point out any flaws in logic or applicability.
Tell your reader what the article is good for AND what it is not
good for. Your reader needs to know strengths and limitations,
so tell her. And be precise.
For more information on how to be a critical evaluator of an
article, see https://owl.english.purdue.edu/owl/resource/553/03/.
Finally, the reflection paragraph is where you discuss how the
article contributed to your learning. I mean on a personal level,
what did you learn, and what could your classmates learn.
Finally,
on a separate line and in PERFECT APA format, you will
include your references. Using just one reference will get you a
minimum grade. I do not want a book report, so use more than
one reference.

3. Literature Evaluation Table
Student Name: Student Example
Summary of Clinical Issue (200-250 words): Central line
associated infections can happen in the ICU setting and can lead
to poor patient outcomes, longer complicated hospital stays, and
increased cost in hospital stays. Education is a crucial way to
inform frontline staff about how to prevent these infections. The
creation of a bundle of ways for nurses to care for central lines
and incorporating it into their protocols and daily routine can
decrease the rate of infections. As a nurse in the ICU, it is
helpful for staff to have direct and clear instructions to make
sure their responsibilities and skills are being performed
according to best practice and per protocol per facility. Nurses
are at the bedside and are frequently interacting with central
lines on a daily basis in the ICU. Making simple changes such
as proper hand hygiene before and after use of a central line can
have a very positive result on the rate of the infection. The Joint
Commission has included central line-associated bloodstream
infections (CLABSIs) in their National Patient Safety Goals. It
is a problem that can cause critical issues for patients and event
result in death. Nurses can have an impact on reducing
CLABSIs by implementing evidence-based interventions, such
as hand hygiene, proper education on central line care, visual
reminders for staff in unit with key points, proper catheter
access protocol, disinfecting caps, dressing changes, and
frequent assessment of the continued need for the central line.
As a nurse in the ICU, I want to establish a central line care
bundle using evidence-based research that can reduce CLABSIs
and improve patient outcomes.
PICOT Question: Does the implementation and use of a central

4. line care bundle compared to a non-standardized routine reduce
the rate of central line blood stream infections (CLABSIs) in
adult ICU patients during their hospital stay?
In _______(P), what is the effect of _______(I) on ______(O)
compared with _______(C) within ________ (T)?
In Adult Intensive Care Unit patients, what is the effect of
central line care bundle on central line blood stream infections
(CLABSIs) compared with non-standardized routine care during
the hospital stay.
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Scheck McAlearney, A., & Hefner, J. L. (2014). Facilitating
central line-associated bloodstream infection prevention: A
qualitative study comparing perspectives of infection control
professionals and frontline staff. American Journal of Infection
Control, 42(10), S216–S222. doi:
https://doi.org/10.1016/j.ajic.2014.04.006
Scheck, M. A. A., Hefner, J. L., Robbins, J., Harrison, M. I., &
Garman, A. (2015). Preventing central line-associated
bloodstream infections: a qualitative study of management
practices. Infection Control Hospital Epidemiology, 36(5), 557–
563. doi: 10.1017/ice.2015.27
Damschroder, L. J., Banaszak-Holl, J., Kowalski, C. P., Forman,
J., Saint, S., & Krein, S. L. (2009). The role of the "champion"
in infection prevention: results from a multisite qualitative
study. BMJ Quality and Safety, 18(6). doi:
http://dx.doi.org/10.1136/qshc.2009.034199

5. How Does the Article Relate to the PICOT Question?
Reiterates how frontline staff are responsible for delivering
direct and ongoing care for central lines. It helps discuss the
different perspectives about challenges of central-line
associated bloodstream infection prevention program successes.
It discusses how management and hospital-level differences can
affect the outcome of patients who have central line-associated
bloodstream infections. It gives me more of an idea of how my
hospital performs due to their level of performing. I can
recognize these barriers to help implement change to reduce
infection rates.
It explores types and numbers of champions who lead efforts to
implement best practices to prevent infections. It gives me ideas
on how to implement practices to prevent CLABSIs and the
characteristics is takes to promote change and improve patient
outcomes.
Quantitative, Qualitative (How do you know?)
Correct Qualitative- it describes quality and characteristics of
frontline staff through observation and interviews
Correct Qualitative- it interviews people and receives their
nonnumeric data through descriptive characteristics.
Correct Qualitative- it gathers data about characteristics of
people and observes behaviors not numeric type of data.
Purpose Statement
Infection control professionals play a critical role in
implementing and managing healthcare-associated infection
reduction interventions, whereas frontline staff are responsible
for delivering direct and ongoing patient care.
To identify factors that may explain hospital-level differences
in outcomes of programs to prevent central line-associated
bloodstream infections.
Although 20% or more of healthcare-associated infections can
be prevented, many hospitals have not implemented practices
known to reduce infections. We explored the types and numbers
of champions who lead efforts to implement best practices to

6. prevent hospital-acquired infection in US hospitals.
Research Question
To determine if ICPs and frontline staff have different
perspectives about the facilitators and challenges of central-line
associated bloodstream infection prevention program success.
How can management practices reflect CLABSI rates and what
can be implemented to streamline the reduction rate of
CLABSIs with appropriate and effective central line care.
Observing how champions can promote and create change
regarding CLABSIs or other hospital acquired infections/
Outcome
Study shows the need to include nurses in the implementation of
infection control initiatives. Frontline staff contribute a critical
real-world perspective that may facilitate the success of patient
safety interventions.
A main theme that differentiated higher from lower performing
hospitals was as distinctive framing of the goal of “getting to
zero” infections. Although all sites reported this goal, at the
higher performing sites the goal was explicitly stated, widely
embraced, and aggressively pursued; in contrast, at the lower-
performing hospitals the goal was more of an aspiration and not
embraced as part of the strategy to prevent infections.
The types and numbers of champions varied with the type of
practice implemented and effectiveness of champions was
affected by the quality of organizational networks. For practices
that require significant behavioral changes, however, a coalition
of champions may be needed.
Setting
(Where did the study take place?)
8 various sites in Ohio with approval of the Institutional Review
board of Ohio State University
Eight US hospitals that had participated in the federally funded
On the CUSP-Stop BSI initiatives.
14 hospitals from all over the US were sent surveys, telephone
interviews, sit down interviews, and some on-site visits.
Sample

7. Across the 8 sites in the study, they interviewed 194 key
informants with different jobs and roles in the hospitals. Among
these informants were 50 frontline nurses, and 26 ICPs. They
focused on the comments from these 76 informants because
their roles in the organizations are relevant to their research
question focusing on the perspectives of ICPS and frontline
staff.
194 interviewees including administrative leaders, clinical
leaders, professional staff, and frontline physicians and nurses.
Survey responses were used to select a stratified purposive
sample of 14 hospitals for in-depth semistructured telephone
interviews. These hospitals were selected for their potential to
further our understanding of organizational barriers and
facilitators in implementing infection prevention practices.
Method
They conducted interviews at 8 hospitals that participated in the
Agency for Healthcare Research and Quality CLABSI
prevention initiative called {On the CUSP: Stop BSI.” They
analyzed interview data from 50 frontline nurses and 26 ICPs to
identify common themes related to program facilitators and
challenges. Interviews lasted 30-60 minutes, and the majority
were conducted with at least 2 interviewers.
Extensive qualitative case study comparing higher and lower
performing hospitals on the basis of reduction in the rate of
central line-associated bloodstream infections. In-depth
interviews were transcribed verbatim and analyzed to determine
whether emergent themes differentiated higher from lower
performing hospitals.
Qualitative analyses were conducted within a multisite,
sequential mixed methods study of infection prevention
practices in Veteran Affairs and no-Veteran Affairs hospitals in
the USA. The first phase included telephone interviews
conducted in 2005-2006 with 38 individuals at 14 purposively
selected hospitals. The second phase used findings from phase 1
to select six hospitals for site visits and interviews with another
48 individuals in 2006-2007.

8. Key Findings of the Study
Identified 4 facilitators of the CLABSI program success:
education, leadership, data, and consistency. We also identified
3 common challenges: lack of resources, competing priorities,
and physician resistance. However, the perspectives of ICPs and
frontline nurses differed. Whereas ICPs tended to focus on
general descriptions, frontline staff noted program specifics and
often discussed concrete examples.
Five additional management practices were nearly exclusively
present in the higher-performing hospitals: 1) top-level
commitment, 2) physician-nurse alignment, 3) systematic
education, 4) meaningful use of data, and 5) rewards and
recognition. They present these strategies for prevention of
healthcare-associated infection as a management “bundle” with
corresponding suggestion for implementation.
It was possible for a single well-placed champion to implement
a new technology, but more than one champion was needed
when an improvement required people to change behaviors.
Although the behavioral change itself was often more
complicated than changing technology because behavioral
changes required interprofessional coalitions working together.
Recommendations of the Researcher
Their results suggest ICPs need to take into account the
perspectives of staff nurses when implementing infection
control and broader quality improvement initiatives. Further,
the deliberate inclusion of frontline staff in the implementation
of these programs may be critical to program success.
Adding a management practice bundle may provide critical
guidance to physicians, clinical managers, and hospital leaders
as they work to prevent CLABSIs.
Merely appointing champions is ineffective; rather, successful
champions tended to be intrinsically motivated and enthusiastic
about the practices they promoted. Create enthusiasm about the
topic because champions can implement change within their
own sphere of influence.

9. Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
Atilla, A., Doganay, Z., Kefeli Celik, H., Tomak, L., Gunal, O.,
& Kilic, S. S. (2016). Central line-associated bloodstream
infections in the intensive care unit: importance of the care
bundle. Korean Journal of Anesthesiology, 69(6), 599–603. doi:
10.4097/kjae.2016.69.6.599
Berenholtz, S. M., Lubomski, L. H., Weeks, K., & Goeschel, C.
A. (2014). Eliminating Central-Line Associated Bloodstream
Infections: A National Patient Safety Imperative. Infection
Control and Hospital Epidemiology, 35(1), 55–62. doi:
https://doi.org/10.1086/674384
Guerin, K., Rains, K., & Bessesen, M. (2010). Reduction in
central-line associated bloodstream infections by
implementation of a postinsertion care bundle. American
Journal of Infection Control, 38(6), 430–433. Doi:
https://doi.org/10.1016/j.ajic.2010.03.007
How Does the Article Relate to the PICOT Question?
Explains the importance and efficacy of a care bundle for
preventing central line-associated blood stream infections in the
Intensive Care Unit. Also reinforces why central lines should be
assessed daily if they are essentially needed for care.
It shows how the implementation of the “On the CUSP: Stop
BSI” program with uniform and appropriate central line care
can reduce the rate of CLABSIs.
Studied how a post insertion bundle was effective in decreasing
rates of infection. It also gives ideas of what post insertion
interventions help prevent infections for nursing care.

10. Quantitative, Qualitative (How do you know?)
Correct Quantitative- it evaluates numbers that result in
measurable data
Correct Quantitative- it evaluates using numbers and concludes
with measurable data
Correct Quantitative- they did measurable methods to gather
data and evaluated using numbers.
Purpose Statement
The importance and efficacy of a care bundle for preventing
central line-associated bloodstream infections and infections
complications related to placing a central venous catheter in the
patients in the intensive care unit.
Several studies demonstrating that central line-associated
bloodstream infections are preventable prompted a national
initiative to reduce the incidence of these infections.
Central line-associated bloodstream infections cause substantial
morbidity and incur excess costs. The use of a central line
insertion and postinsertion bundle has been shown to reduce the
incidence of CLABSI.
Research Question
What is the effect of a central line care bundle in association
with central line-associated bloodstream infections in the ICU.
How can implementing a national program help decrease the
rates of CLABSIs.
Post insertion bundles need to be consistent and uniform to be
effective.
Outcome
The catherization duration was longer and femoral access was
more frequently observed in patients with CLABSIs. CLABSI
rates decreased with use of the care bundle.
The overall mean CLABSI rate significantly decreased from
1.96 cases per 1000 catheter-days at baseline to 1.15 at 16-18
months after implementation.
During the preintervention period, there were 4415 documented
catheter-days and 25 CLABSIs, for an incidence density of 5.7
CLABSIs per 1000 catheter-days. After implementation of the

11. interventions, there were 2825 catheter-days and 3 CLABSIs,
for an incidence density of 1.1 per 1000 catheter-days.
Setting
(Where did the study take place?)
In a medical ICU and a surgical ICU
Adult ICU patients in a total of 44 states, the District of
Columbia, and Puerto Rico. Collectively more than 1000
hospitals and 1800 hospital units participated
DVAMC-Denver is a university-affiliated acute care teaching
hospital which includes a 10-bed medical intensive care unit
and a 13-bed surgical intensive care unit.
Sample
In total, 114 patients who had CVCs placed in a 22-bed medical
ICU and a 12-bed surgical ICU from July 2013 to June 2014
were enrolled.
Adult ICU patients in a total of 44 states, the District of
Columbia, and Puerto Rico. Collectively more than 1000
hospitals and 1800 hospital units participated
All ICU patients in both the medical and surgical ICU from
October 1, 2006 to September 30, 2009 with a preintervention
and a postintervention study completed.
Method
A care bundle was implemented from July 2013 to June 2014 in
a medical and surgical ICU. Data were divided into three
periods and a post intervention period. A care bundle consisting
of optimal hand hygiene, skin antisepsis with chlorhexidine
(2%) allowing the skin to dry, maximal barrier precautions for
inserting a catheter, choice of optimal insertion site, prompt
catheter removal and daily evaluation of the need for the CVC
was introduced.
They conducted a collaborative cohort study to evaluate the
impact of the national “On the CUSP: Stop BSI” program on
CLABSI rates among participating adult intensive care units.
The program goal as to achieve a unit-level mean CLABSI rate
of less than 1 case per 1000 catheter days using standardized
definitions from the National Healthcare Safety Network.

12. Multilevel Poisson regression modeling compared infection
rates before, during, and up to 18 months after the intervention
was implemented.
Surveillance for CLABSI was conducted by trained infection
preventionists using National Health Safety Network case
definitions and device-day measurement methods. During the
intervention period, nursing staff used a postinsertion care
bundle consisting of daily inspection of the insertion site; site
care if the dressing was wet, soiled, or had not been changed for
7 days; documentation of ongoing need for the catheter; proper
application of a chlorohexidine gluconate-impregnated sponge
at the insertion site; performance of hand hygiene before
handling the intravenous system; and application of an alcohol
scrub to the infusion hub for 15 seconds before each entry.
Key Findings of the Study
Infection rate increased when catheters remained in place longer
than needed, when healthcare workers did not follow the care
bundle practices, and when the catheter was placed via a
femoral route. During first 6 months, there were difficulty
complying with care bundle practices improved with regular
coordination meetings.
Coincident with the implementation of the national “On the
CUSP: Stop BSI” program was a significant and sustained
decrease in CLABSIs among a large and diverse cohort of ICUs,
demonstrating an overall 43% decrease and suggesting the
majority of ICUs in the US can achieve additional reductions in
the CLABSI rates
Findings demonstrate that implementation of a CVC
postinsertion care bundle was associated with a significant
reduction in CLABSIs. This study demonstrates that
interventions developed by front-line nursing staff can be a
highly effective response to a problem.
Recommendations of the Researcher
Use of all barrier precautions and removal of catheters when
they are no longer needed are essential to decrease the CLABSI
rate.

13. Have well-defined, evidence-based interventions. Build a solid
implementation structure and project plan. Collect and use
timely, accurate, and actionable data to improve performance.
Tailor national program for local and unit audiences. Evolves
project strategies and emphases over time.
Staff education and reinforcement of proper CVC care after
insertion, along with careful cleaning of the hub before access,
might reduce the incidence of infection.
© 2019. Grand Canyon University. All Rights Reserved.
8
Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
PICOT Question:
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
How Does the Article Relate to the PICOT Question?
Quantitative, Qualitative (How do you know?)

14. Purpose Statement
Research Question
Outcome
Setting
(Where did the study take place?)
Sample
Method
Key Findings of the Study
Recommendations of the Researcher

15. Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
How Does the Article Relate to the PICOT Question?
Quantitative, Qualitative (How do you know?)
Purpose Statement
Research Question
Outcome
Setting
(Where did the study take place?)
Sample

16. Method
Key Findings of the Study
Recommendations of the Researcher
© 2019. Grand Canyon University. All Rights Reserved.
2