Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection
PICO Question The PICO question proposed for this study is: Does the implementation of a care bundle compared to a no care bundle decrease the incidence of CAUTIs, in patients with indwelling urinary catheters? Conceptional Framework The Iowa Model (IM) of evidenced based practice (EBP) is the conceptual framework used for this
Identify the need or problem you intend to solve through your capstone project 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
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.
Urinary Catheter Reduction Reminders Usage of indwelling urinary catheters in critically ill patients can seem to be a permanent fixture in intensive care units. Most critical care nurse expect their patients to have an indwelling urinary catheter (IUC) in place without much regard to the risk of catheter associated urinary tract
Urologic Nursing, 32 (1): 29-37. Carter, Nina M, Reitmeier, Laura, Goodloe, Lauren R. (2014). An Evidence-Based Approach To the Prevention of Catheter-Associated Urinary Tract Infection. Urologic Nursing, 34 (5): 238-45. Hooton, T., Bradley, S., Cardenas, D., Colgan, R., Geerlings, S., Rice, J., Nicolle, L. (2010).
Background of the study Focus on enhancing quality of care has exaggerated on a nationwide scale. Decreasing preventable damages within the health care settings is being on focus furthermore. From this there has been an immediate connection between repayment to quality through pay-for-reporting and pay-for-execution programs. Around 25% of the hospitalized patients have an indwelling catheter in place (Saint, Kowalski, Forman et al., 2008) and there is a 3% to 7% has the probability to get urinary tract infections in such cases. The infection could cause the signs of bladder distress, trouble in urination, and high temperature in such patients. Analysis shows that 48% of patient who has indwelling catheter complains of pain from the catheter, 42 % experience inconvenience from the catheter and 61% found that their daily activities are exceptionally constrained by these catheters (Saint, Lipsky, Baker, McDonald, & Ossenkop, 1999). Urinary tract infections may prompt bacteremia (infection
Staff nurses on the unit expressed their frustration with the current practice regarding the frequency of PIV catheter replacements, stating that it was “time-consuming” and contributed to “patient dissatisfaction.” The process of replacing a PIV can often be time consuming and may take multiple attempts in order to successfully insert a new PIV. Research supports a change in practice that address these concerns. A pilot study performed in 2012, by Rickard, Webster, Wallis, Marsh, McGrail, French and Whitby indicated that replacing PIV catheters only when clinically indicated did not lead to catheter-related complications, as previously
. The organization’s culture patients are found using indwelling catheterization for long periods of time, and no protocol for removal of the catheter post-operative patient’s, and also unnecessary Foley insertion on elderly inpatients for incontinence. Simultaneously, it is important to note that by avoiding indwelling cauterization and prolonged stay of catheter in patients may increase the infection and (CAUTIs (Bernard, Hunter, & Moore, (2012). The author made a survey and then analyzed it as a whole. However, the survey documented low and high score related to the case.
As a nurse in an intensive care unit it was noticed there was increase in CAUTIs on the unit, which the unit did also have a large amount of new hires during that time. Therefore, an investigation took place as to why there was in increase into CAUTIs. Thus, data was gathered from the last three months, which the charts of all patients who had a urinary catheter were reviewed. In addition, a research on CAUTIs was completed using the latest information from professional journal articles, government based data, and current unit based CAUTI information from the nursing manager.
As of October 1st, 2008, the Centers for Medicare and Medicaid Services (CMS) began withholding reimbursement to hospitals for treatment of HAIs including the CAUTIs. The duration of the catheter use has been identified as a major risk factor for
W., Donahue, M., Brentlinger L., Dion K., & Polito S. C., (2014). A quasi-experimental study to test a prevention bundle for catheter-associated urinary tract infections. Journal of Hospital Administration, 3(4), 101-108. doi:10.5430/jha.v3n4p101
4) Significance: This research shows that there is a gap in the evidence, but that the primary concern for nursing staff is to ensure that catheters are removed as soon as it is possible to do so.