The topic that I chose is interventions used to reduce catheter associated urinary tract infections(CAUTI). This type of infection is acquired from the use of urinary catheter while in the hospital. According to the Institute for Healthcare Improvement, urinary tract infections are responsible for 40 percent of all hospital-acquired infections annually, with 80% of these hospital acquired infection caused by use of indwelling urinary catheters. When any type of tubes or catheters are introduced in the body it serves as a medium for infection. Urinary catheters are used during surgery to prevent injury to the bladder. It is also used for urinary retention or bladder obstruction. The implementation of evidenced based practice when providing care
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
BioPatch, and alternatives like Tegaderm CHG, are an important first step in helping prevent catheter-related bloodstream infections (CBIs). As CBIs rank among the most frequent and potentially lethal nosocomial infections, the need for a device to cut down infections at the insertion site has increased. The growing numbers of infections has driven companies to consider a three-tiered approach: a maximal aseptic barrier at insertion, proper site maintenance, and hub protection. With BioPatch and alternative products catheter sites receive that maximal aseptic barrier to prevent bacteria growth.
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
• Always keep the bag below the level of the catheter. This keeps urine from flowing backwards into the catheter.
In the article “Using Evidence-Based Practice to Reduce Catheter-Associated Urinary Tract Infections”, by AJN, the author states how catheters are causing urinary tract infections among adult patients in healthcare facilities. The purpose of healthcare workers reading the article, “Using Evidence-Based Practice to Reduce Catheter-Associated Urinary Tract Infections”, is to provide better care to their patients with a Foley catheter and to try and prevent a urinary tract infection associated with a Foley catheter. This article affects the nursing process by presenting it with further education, and affects the patients by giving them a better catheter experience.
The goal was chosen, background obtained, literature review done, methods established, and implications for nursing practice reviewed. They wanted to implement one-on-one discussions with bedside nurses related to behavioral justification for restraint use, use of least restrictive restraint, and prompt removal when clinically justified, along with coordination of information-sharing with nursing leadership to promote a data driven approach to reduction in restraint usage. Outcomes were that as a result of monthly discussions, there was a sustainability of reduction in usage of restraints in the adult ICU’s. Another initiative was the nurse driven urinary catheter removal protocol. The goals were to reduce catheter associated urinary tract infections through early removal of indwelling urinary catheters and increase compliance to the Surgical Care Improvement Measure Urinary Catheter Removal through a nurse driven protocol that standardizes care and sanctions catheter removal based on approved criteria. A pilot was conducted at two hospitals to assess efficacy of implementing the plan system wide. A plan was developed with interventions, a urinary catheter removal algorithm, and documentation compliance parameters. Outcomes were lower catheter days and reinsertion rates, decreased catheter utilization ratio, and infection rates
The key to conducting successful clinical research involves five steps. These steps are: “asking answerable clinical questions, searching for the evidence, critically appraising the evidence for its validity and relevance, making a decision by integrating the evidence with your clinical expertise and the patient’s values, and evaluating your performance” (Heneghan, & Badenoch, 2006, p.2). To develop my research question I used the evidence- based model PICO. PICO stands for: P ( Problem: high infection rate by the spread of bacteria in ICU), I (Intervention: hand washing with soap and water or the use of hand sanitizer), C (Comparison: the use of gloves, gown, mask), O (Outcome: reduction of infection due to the spread of bacteria). With these elements as refrence I formulated the question: Is the use of soap and water or alcohol-based rubs more effective than the use of protective gear (gloves, mask, ...
In this section the researchers explain the complications that can occur based on non-adherence to a proper self-catheterization regimen. A spinal cord injury can cause an interruption in neural pathways which affect the function of the bladder causing urinary incontinence, urinary retention, urinary reflux, and recurrent urinary tract infections. These problems can ultimately lead to an increase in renal morbidity and mortality (Shaw & Logan, 2013) Later, in the discussion section of the article, the authors focus on the importance of nursing education to teach patients proper methods to perform and cope with ISC in order to eliminate these common occurrences in patients suffering from SCIs (Shaw & Logan, 2013). The perception of performing this task may vary from patient to patient. This research helps identify various educational approaches that could be taken to accommodate all patients. Therefore, the research is significant to nursing due to the fact that nurses are considered the primary educators and are expected to address practical issues with patients performing ISC and help them manage the psychological issues that are faced with this
The QI project that will be described in this analysis pertains to catheter related blood stream infections (CR-BSI). CR-BSI and the ability in which they can be prevented is a common focus in the healthcare industry. The Center for Disease Control (CDC) has reported that 5 CR-BSI per 1000 catheter days is the current rate of infection. This translates into 80,000 patients every year will acquire a CR-BSI. This infection can be introduced at the time of insertion, or by the way in which it is used and cared for. This report of 80,000 patients is only limited to studies based on patients in various Intensive Care Units. Current infection rates for medical surgical units, skilled nursing centers, home health, and ambulatory care patients does not exist. An estimate by many researchers would place the annual number of CR-BSI at 250,000 cases. The estimated deaths caused by CR-BSI at around 12-25% of the total infections. In addition to increased mortality the approximate cost per infection is $ 25, 000. (Posa, Harrison, & Vollman, 2006, p. 446) These numbers leave large room for impro...
There are approximately 4.5 HAIs for every 100 hospital admissions; the annual direct costs on the healthcare system were estimated to be $4.5 billion dollars. Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter; between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter. Central line-associated bloodstream infections (CLABSIs) result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable. According to the CDC, CLABSIs cost hospitals thirty to fifty thousand dollars per infection and CAUTIs cost eight to ten thousand per infection. My project will help reduce the cost of CAUTIs and CLABSIs, by training nurses how to properly document the insertion and discontinuation of central lines and urinary catheters thus providing accurate data that can be reported to the appropriate agencies (see Appendix A). Inaccurate data causes the numbers reported to CMS to be skewed resulting in a high numbers of infections reported due to the calculations being inaccurate from improper
Therefore, implementing evidence-based knowledge focused on arriving at positive goals for better patient outcomes should be a priority. Additionally, if nurses are to decrease the incidences of central-line infections, then hospitals need to be focused on prevention through clinical reasoning and preventive action. It is the responsibility of nursing care to provide the best care possible and to follow infection control standards.
The annual cost of catheter-associated urinary tract infection (CAUT) is about three hundred and fifty million, in the United States (Saint et al., 2014). This cost affects the hospital, due to the fact that CAUTIs are preventable through nursing implementation and evidence- based practice. Catheter use is associated with physiologic complications, such as bladder calculi, bladder inflammation, and catheter-associated urinary tract infections. They can contribute to further complications, especially in older adults, leading to falls and delirium (Carter et al., 2014). The Centers for Disease Control and Prevention has specific guidelines that detail high priority recommendations for controlling catheter-associated infection prevention. Inserting catheters for only appropriate indications and leaving them in place for as long as medically necessary is their main concern and priority (Carter et al., 2014). The safety and comfort of the patient should be most important in the practice for all nurses when inserting and taking care of catheters. Unfortunately, this is not always the case, and the consequences of nursing implementation are left with the
Hospitals take various precautions to ensure that their patients do not develop a UTI. Hospitals have an infection control program that is put into effect by the Centers of Disease Control (CDC). This program puts into consideration the causes that lead to patients to develop infections and the CDC also keeps track of the changes in rates of infections within the hospital. For every 200 hospital beds, hospitals have employed an infection control practitioner who makes note of procedures and identifies other sources that may have the potential of causing an infection. The practitioner also enforces the importance of hand washing by employees and visitors. By practicing hand washing one can reduce the risk of spreading microorganisms to patients and everyone else in the health care facility. Aseptic or sterile technique should be practiced correctly as well. The use of sterile gowns, gloves, masks, and other protective barriers is encouraged. Other methods of prevention include the sterilization of ventilators, humidifiers, and any other instruments that may come into contact with the respiratory tract. To prevent infection in surgical wounds, dressing should be changed often and antibacterial ointments should be applied. Antibiotics should also be limited as this helps the immune system to properly function which reduces the growth of resistant bacteria.
The author of the research study used a standardized test to determine the knowledge of ICU nurses on surgical site infections. The introduction allowed the readers to realize there is a country wide issue with surgical site infections (SSI). During the research, the quantitative approach was attempted by having a group of nurses take a multiple choice knowledge test consisting of three possible answers and the fourth choice of being I do not know. The test consisted of questions based on prevention guidelines. The group of 809 nurses attending the Flemish Society for critical care nurses were included in the study. Although, the test was timed the questions were reviewed by seven experts to determine the clearness of the questions. Statistics
Urinary incontinence is a major problem for many people and some treatments are time-consuming and come with many risks, such as the insertion of a catheter. Furthermore, it is a problem for many older people because they are less mobile and may not be able to care for themselves; it may lead to more complications such as urinary tract infection. This study may not be conclusive but it is a step towards finding a more noninvasive and conservative way in managing urinary incontinence.
For this discussion post, I decided to research urinary tract infections. I chose this topic because at the assistant living I work at, there is quite a few residents that suffer from this. And I believe its always good to have more knowledge with something that is more common to us. The medication that is most common used to UTIs is amoxicillin. Amoxicillin is a medication that is used to treat most infections caused by bacteria. Amoxicillin acts through the cell wall then leads to the death of the bacteria. However if the patient is allergic to any penicillin, this medication is a no. Some side effects to this medication would be headache, stomach pain, vomiting and/or vaginal pain.