The purpose of this paper is to describe CAUTIs, the methodologies used to find the guideline, and to explain how the guideline helps to prevent CAUTIs. CAUTIs are a pain for hospitals, health care providers, and the patient. These infections should never occur in a hospital setting,
Phenomenon of Interest
Catheter Associated Urinary Tract Infections (CAUTIs) is one of the most common health-care associated infections, with an estimated 1.7 million infections reported yearly, accounting for a total of 36% of all hospital associated infections (HAIs) in the U.S (citation). CAUTIs are the result of microorganisms entering the urinary tract. Urinary tract infections may be characterized by cloudy, foul smelling, or blood tinged urine (Ignatavicius
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Other symptoms for elderly people may include mental confusion that could further result in falls.
CAUTIs are sentinel events. The occurrence of a CAUTI may result in an extended hospital stay for the patient, high incidences of morbidity and mortality, and adds an average additional cost of $3,803 per occurrence. CAUTI could lead to further health complications such as reduced control of fluids, buildup of nitrogenous wastes, increased blood pressure, and even sepsis and metastatic osteomyelitis.
Following the Medicare Modernization Act of 2003 and the Deficit Reduction Act of 2005, the Medicare and Medicaid programs, two of the largest health insurance programs in the nation, deemed CAUTIs as a “never event.” On October 1, 2008, the Centers for Medicare and Medicaid Services ceased reimbursements for the treatment of CAUTIs that were not present upon admission of the patient. The CDC reports that the occurrence of CAUTIs added an extra charge of $589 per incident in 2008, costing the U.S. health care system an additional $400 million per
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APIC also recommends to secure catheters following insertion to prevent traction on the urethra and to minimize urethral injury. It is also essential maintain unobstructed flow, ensuring the tubing is free of kinks and dependent loops. It is of utmost importance to discontinue indwelling catheters when they are no longer needed and to consider other alternatives such as condom catheters for men or periodic
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
In over-all, 65 years and older suffer from many geriatric symptoms, due to psychotropic and anti-psychotropic medications, including Electroconvulsive therapy (ECT), mobility challenges, incontinence, poor balance, disorganization and confusion which all lead to high falls. According to a study in the International Journal of Geriatric Psychiatry, patients with the highest risk for falls presented with one or more of the following variables such as Parkinson’s syndrome, Dementia, female gender, mood stabilizers, cardiac arrhythmia, and ECT. Edmonson et. al established, “The Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT) specific to the psychiatric, geriatric population and found initial testing of EPFRAT to have higher sensitivity in assessing fall risk in the geri-psych inpatient population” (Edmonson, Robinson, & Hughes, 2011). This project purpose is to investigate and explore whether an Edmonson Fall risk assessment Toll decreases patient falls in inpatient geri-psych units. Stakeholders and Change
Falls in nursing homes residents are associated with morbidity, mortality, and healthcare costs. The centers for Medicare and Medicaid indicate falls as the quality indicator. (Leland, Gozalo, Teno, Mor, 2012). Factors such as new environment, medication, cognition, and non-compliance contribute to falls. A significant number of falls occur from wheelchairs. (Willy, 2013). Newly admitted residents to long-term care facilities are confused with the change. The new environment and the new unfamiliar faces increase the level of anxiety. Pain may also contribute to falls. In order to take tailor made preventative measures, fall risk factors for each resident should be evaluated periodically. Tools scoring risk factors can be utilized.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
A urinary tract infection (UTI) is an infection of the urinary tract. The urinary tract is the body's drainage system for removing wastes and extra water. Urinary tract infections can have different names, depending on what part of the urinary tract is infected. The infection can include the bladder, kidneys, ureters, or the urethra. If the infection is in the bladder it is called “cystitis” or a bladder infection. If the infection is in the kidneys is it called “pyelonephritis” or a kidney infection? If the infection is in the urethra it is called “urethritis”. Most urinary tract infections are bladder infections. Infections in the ureters are very rare. Everyone is at risk of getting a UTI allowing bacteria to grow in the urine that stays
The Foley Catheter has allowed for people to excrete their urine. Not being able to excrete your urine can cause higher chances of urinary retention, not being able to empty your bladder completely, Urinary tract infections, your bladder will fill up until it bursts open inside your body, and you won’t get rid of the waste and excess water
Direct legal issues that result in inadequate infection-control practices, medical costs of healthcare-associated infections and the amount of deaths that have occurred due to these preventable infections are the main targeted issues that will focus on this project. Reporting requirements of HAIs vary from state to state, provider, facility, frequency, and type of infection. Due to this, there is inconsistency in the methods of data collected, risk management, data validation, and the requirement or reporting HAIs. The legal requirements and statutes that mandate disclosure of errors need to be addressed in order to reduce and prevent HAIs. In addition, the discussion of legal duties and responsibilities of the care providers, facilities and patients are discussed.
The purpose of his article was to find a better way to prevent healthcare-associated infections (HCAI) and explain what could be done to make healthcare facilities safer. The main problem that Cole presented was a combination of crowded hospitals that are understaffed with bed management problems and inadequate isolation facilities, which should not be happening in this day and age (Cole, 2011). He explained the “safety culture properties” (Cole, 2011) that are associated with preventing infection in healthcare; these include justness, leadership, teamwork, evidence based practice, communication, patient centeredness, and learning. If a healthcare facility is not honest about their work and does not work together, the patient is much more likely to get injured or sick while in the
Nursing diagnosis Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). a. (book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa. Urinary tract infections occur when one or more microorganisms enter the urinary system and affect the bladder and/or the kidneys.
A urinary tract infection is a very common infection that can happen to anybody. A urinary tract infection usually occurs when bacteria enters the urethra and multiples in the urinary system. The Urinary tract includes the kidneys, the thin tubes that carry urine from the kidneys to the bladder (ureters), and the main tube that carries the urine from the bladder (urethra). Women, men, and children are all immune to this infection. Women have the highest chances of getting it. In the Urinary tract, the main links of the ureters help get rid of any bacteria that tries to enter the urine, and the bladder helps prevent urine from backing up into the kidneys.
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
Hospital-acquired bladder infections. These infections, occur in people in a medical care facility, such as a hospital or nursing home. Most often they happen in those who have had a urinary catheter placed through the urethra and into the bladder to collect urine, a common practice before surgical procedures, for some diagnostic test, or as a means of urinary drainage for older adults or people confined to bed.
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...