Analysis Of Urinary Tract Infections

Nurses lacked knowledge in the use and was unaware of the importance of the underlying evidence- base recommended criteria’s indicated on the nurse driven protocol to remove inappropriate UC’s. A nurse driven indwelling catheter removal protocol is an evidence base tool recommended by infection control organization and experts for the early removal of unnecessary or inappropriately placed urinary catheters (UC). Evidence shows that urinary catheters are the source of catheter associated urinary tract infection (CAUTI). CAUTI, is the leading cause of hospital acquired infections in the United States. The purpose of this evidence-based quality project is to evaluate the effectiveness of an educational intervention on the importance and use of the nurse driven protocol on nurses ' knowledge and CAUTI rates.

1) Summary of Article: Indwelling catheter use is common, but so are infections associated with them. About 80 percent of all urinary tract infections in hospitals are caused by catheters, and about 20 percent of all hospital infections total are UTIs. Evidence-based practice should be used for insertion, maintenance, and removal. Catheters should not be left in longer than they need to be. Unfortunately, this research shows poor administrative efforts are to blame for

In 2013, a magnet recognized hospital, Baptist Health Lexington, reduced CAUTI rates in ICU patients by 60% (Roser, Piercy & Altpeter, 2014). The study included six interventions that were followed by the staff in the effort to reduce CAUTI. The six interventions included: “communication of CAUTI data to interdisciplinary teams, a nurse-driven, physician approved protocol, problem analysis using Lean principles, daily unit-based surveillance rounds, silver alloy urinary catheters, and an antimicrobial bundle comprised of two cleansing products for patients with an indwelling urinary catheter” (Roser, Piercy & Altpeter, 2014). The nurse-physician protocol allowed for nurses to assess whether the catheter was still necessary and if found not to be, the nurse could discontinue it. This resulted in a 58% decrease in the number of catheters used (Roser, Piercy & Altpeter, 2014). An education session was implemented by nurses using principles from the Lean system that checked the capability of nurses to understand just how dangerous CAUTI can be. It was found that no single intervention alone could reduce the occurrence of CAUTI development. Nurses must integrate several interventions to have an effective result at lowering the rates. However, this particular study found that after the use of the antimicrobial bundle, rates of CAUTI did decline. Roser et al. (2014) emphasized that education and awareness of

National Patient Safety Goals (NPSGs), established in 2002 by the Joint Commission, is to help accredited organizations address specific areas of concern in regard to patient safety ("Catheter-Associated," 2015). NPSG.07.06.01 Implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission," 2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing CAUTIs can be achieved with a strict goal, addressing the financial implications, interdisciplinary collaboration, nursing leadership, a measurement tool, and discussing the future healthcare delivery methods.

For patients that have indwelling catheters, with the evidence-based practice and standards of care, UTI’s does still continue to be an ongoing problem today. In one of the large hospitals in my area had recently developed a poster and video approach with special focus on alternatives to urinary catheterization, removing catheters early, and the reinforcement of sterile technique prior insertion and foley catheter care were used to educate nursing staff and improve outcomes. The purpose of this paper is to educate nursing on

A Urinary Tract Infection (UTI) is a serious problem in the clinical setting. “UTIs are mostly associated with catheterization” (Hooton, 2010, p. 629). The infection can be described as bacteria invading the urinary tract. More so, the bacteria accounts for nosocomial bacteremia since the patient obtains the infection in the hospital (Hooton et al., 2010). A Catheter Associated Urinary Tract Infection (CAUTI) is common because nurses do not find this problem at the top of their to-do list during their shift. It can be easy for the nurse to become accustomed to a slight deviation from the correct method. Any break in the chain of infection has opened the opportunity for microorganisms to reproduce in a susceptible host. Research has proven that when hospitals, long-term care facilities, and other healthcare settings intervene with making positives changes, less of the patients developed a UTI with catheterization. Infection control with catheterized patients can be implemented and resolved with collaboration and education among healthcare staff.

A nurse driven indwelling catheter removal protocol is an evidence base tool recommended by infection control organization and experts for the early removal of unnecessary or inappropriately placed urinary catheters (UC). Evidence shows that urinary catheters are the source of CAUTI’s. CAUTI, is the leading cause of hospital acquired infections in the United States. Seventy- five percent of urinary tract infections in hospitalized patients are associated with urinary catheters and more than 50% of these infections are preventable (Center for Disease Control and Prevention (CDC), 2015). A urinary catheter is a device inserted into the bladder for emptying. Roughly, 25 percent of hospitalized patients receive urinary catheters in the United States

exposed catheter is cleaned in a downward motion away from the insertion site without touching the mucus membranes, to reduce the risk of infection. These CHG Wipes were also utilized when a patient has a bowel movement. The outcomes reported by the article showed significant decrease in the amount of catheter associated UTI occurring on the unit. It is reported that in the first quarter of the trial, only four CAUTI incidents occurred on the unit, in the second quarter, only three CAUTI incidents were reported on the unit, and these were identified in patients who were transferred from another facility with Foley insertions. A revision was done to remove catheters past three weeks. By the 4th and last quarter, there were no CAUTI attributed to the unit (Carter et al, 2014).

Catheter-associated urinary tract infections (CAUTI) are the most common type of hospital acquired infections (HAI) and account for more than 30% of those reported in acute care hospitals (National Healthcare Safety Network, n.d.). The National Healthcare Safety Network (n.d.) announced there are an estimated 449,334 cases of CAUTI each year which costs the United States annually over $340 million and unfortunately results in 13,000 deaths each year. The aim of this performance improvement is to seek out and present implementation of best practices and ways to prevent CAUTI. This paper identifies one of The Joint Commission safety goals, a situation in need of change, data related to the problem, develops a plan for change and data analysis, and identifies potential supporters and opposers, as well as, strategies to build a coalition of supporters. Lewin’s force-field model of change will be used to prepare and implement the change process with discussion of anticipated resistance, strategies to manage the resistance, feedback mechanisms, measurable outcomes, and a plan for stabilizing the change.

One of the issues that has been addressed since the initial release of the report is the need to eliminate the occurrence of hospital-acquired infections (HIAs). As noted by Knudson (2014), current efforts to improve healthcare practices encompass new regulations and prevention efforts to eliminate, or at least reduce, HAS, including catheter-associated urinary tract infections (CAUTI). The following paper discusses current efforts in CAUTI prevention, contemporary regulations and mandates, and a quality improvement plan that can be initiated at the focus clinical site.

As a conclusion, our nursing care will continue to evolve as we continue to identify the best approach to providing care. Throughout nursing school, our class has been educated about the importance of preventing catheter acquired urinary tract infections. If a hospital-acquired infection is obtained, that will place the patient at risk for other infections, increase the hospitalization period, and the hospital is responsible for healthcare expenses. Not to mention, a majority of these infections could be avoided through proper nursing care.

Carter, Pallin, Mandel, Sinnette and Schurr (2016) conducted a qualitative study to investigate the catheter-associated urinary tract infections (CAUTIs) reduction practices in the emergency department (ED). These researchers clearly identified that little is understood about ED workflow and ED-specific CAUTI prevention strategies. In an effort to better understand the flow, they enrolled EDs with CAUTI prevention strategies, so they can observe the motivations, risk factors and strategies to address those risks. This topic is very relevant to nursing, as today’s healthcare is in the midst of a paradigm shift and care has redirected its attention from quantity towards quality. Healthcare facilities, driven by better reimbursement from

A urinary tract infection (UTI) can develop into a very uncomfortable and very bothersome condition. The urinary system consists of the kidneys, ureters, bladder, and/or urethra. These organs play an important role in filtering blood and eliminating waste from the body. The kidneys are a pair of small bean shaped organs located on both sides of the spine at waist level. They have several important functions in the body, including removing waste and excess water from the blood and eliminating them as urine. The ureters are responsible for carrying urine from the kidneys to the bladder. Lastly, the bladder. The bladder's walls relax and grow to store urine, and contract and compress to empty urine through the urethra. The urethra allows urine to pass outside the body.

A few weeks ago nursing staff in my facility had a meeting with Nursing Director who was discussing upcoming changes in the nursing practice and interestingly enough one of the topics was related to the subject you mentioned in your thread discussion: Catheter-associated urinary tract infections. Conversely, VA Hospital nurses have been diligently working on eliminating catheter-associated urinary tract infections by creating a protocol which would empower them as professionals to make an executive decision when to place or remove Foley catheter. As of now, a nurse depends on physician's order to initiate the catheter-related intervention while taking entirely under consideration patient's condition. At the same time, we must remember that

Bacterial urinary tract infections represent the most common type of nosocomial infections. Often, the ability of bacteria to both establish and maintain these infections are directly related to biofilm formation on indwelling devices or within the urinary tract itself (30). Enterococci (especially E. faecalis) are one of the main causative agents of urinary tract infection and Catheter-associated urinary tract infections (CAUTIs) besides gram-negative pathogens (31, 32). In these infections Biofilm provides a favorable milieu for microbial survival within the host as the organisms are shielded from the host immune response, as well as antibiotics and antimicrobial agents (33, 34). Several studies conducted to introduce main virulence genes of enterococci that are associated with biofilm formation in these bacteria (11, 13,-17), but virulence mechanism and related genes for biofilm formation are not well understood (35). In this study we investigated biofilm formation of clinical enterococci isolates isolated from Urinary tract infections. These strains were characterized for presence of adhesions and secretory virulence factors. Isolates had diverse presence of virulence from lack to highest amount of virulence genes. Several previous studies investigated relation of virulence genes and biofilm formation, especially presence of esp and gel. Enterococci esp has been implicated as a contributing factor in colonization and persistence of infection within the urinary tract