Catheter-Associated Urinary Tract Infections Summary

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

Urinary tract infections are one of the most hospital-acquired infections in the country. With so much technology and evidence based practice, why is this still an ongoing problem worldwide? Could it simply be the basics of hygiene or just patient negligence? The purpose of this paper is to identify multiple studies that have been done to reduce or prevent hospital associated urinary tract infections. In these articles you will find the use of different interventions that will aid in lowering the risk of these hospital acquired infections.

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

Preventing Catheter-Associated Urinary Tract Infections in Older Adults: Improving Health Outcomes through Assessment, Intervention, and Prevention

Urinary tract infections are the most common type of healthcare infection, and CAUTI is the 2nd most common cause of nosocomial bloodstream infection in the healthcare setting. ("Catheter Associated Urinary Tract," 2011). The goal of our facility is to reduce CAUTIs by 50% by the end of the year, measured by the quality department on a monthly basis, and implemented through performance improvement factors including the interdisciplinary team through a strong focus on the nursing leadership team.

The PICO question is as follows: In hospitalized patients who are susceptible to catheter associated Urinary Tract infection (CAUTI), if nurses and other assistive personnel develop an action plan with a systematic team approach of evidence-based infection control practices, compared to current practices, could it reduce or eliminate incidences of CAUTI?

The three questions addressed were: Who should receive urinary catheters, what are the best practices for those who require urinary catheters and for preventing CAUTI’s acquired from urinary obstruction. This updated guideline offers recommendations for the appropriate use of indwelling catheters utilizing appropriate indications for usage, proper techniques for insertion of indwelling catheters, proper techniques for indwelling catheter maintenance, quality improvement programs, administrative infrastructure and surveillance including identifying those at risk for CAUTI (Gould et al, 2009). The strengths of this guideline are that many questions and scenarios are examined in this document and answered in explicit detail. Any healthcare professional can refer to the document to answer most practice based questions that are posed to them regarding indwelling urinary catheters. One weakness identified is the lack of an alternative explored for the external catheterization for female patients, for example the Purewick solution. However, the Purewick was not released until January 2016 and this guideline was last updated in 2009. Integrative Review

Hooton, T., Bradley, S., Cardenas, D., Colgan, R., Geerlings, S., Rice, J., Nicolle, L. (2010).

The patient and their families must be aware of the infection, the source of infection, signs and symptoms, treatments, and measures to apply at home to decrease their risk of receiving an infection. Because geriatric patients are incontinent they may need a catheter in place to help remove their urine. Nurses must perform aseptic technique, wearing proper gloves when inserting or removing device. Another way to help reduce the risk of elderly urinary tract infections would be to avoid or remove catheter soon as possible. Once patients are cleared for discharge they must be aware of the steps to take to insure proper bladder

This article does not provide the search strategy including a number of databases and other resources which identify key published and unpublished research. In this article, both the primary sources and the theoretical literatures are collected and appraised in order to generate the research question and to conduct knowledge-based research. In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. “Catheter-associated urinary tract infections in surgical patients: A controlled study on the excess morbidity and costs” is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, “Clinical and economic consequences of nosocomial catheter-related bacteriuria” is a review of a literature article which is the secondary source. Although many studies state that patient safety is a top priority and CAUTI can be controlled by the caution of health care providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care

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.

Health care-associated infection (HAI), are infections an individual may acquire while they are receiving treatment for another condition within a health care facility. Catheter-associated urinary tract infections (CAUTI) remain the most commonly reported hospital-acquired condition, and the rates continue to rise. Approximately 600,000 patients develop CAUTI each year, leading to increased health care cost, longer hospital stays, and increased morbidity and mortality rates. Furthermore, multiple studies have shown that urinary catheters are placed in patients who do not have an appropriate indication for catheter placement. In order to improve the quality of care and patient safety in our hospitals, CAUTI has become one of the CMS quality

The scope, history, and duration of catheter associated urinary tract infections is reviewed. The scope of catheter associated urinary tract infections is when an individual acquires an infection that has been caused by the insertion of a catheter. The individual may have had the catheter in place for a short period of time and acquired it upon insertion related to the lack of sterile technique. However, the individual also may have had the catheter in place over a long period of time and acquired an infection. Roger, Feneley, Hopley, and Wells (2015) explain that the body’s natural flora is disrupted from ascending in the urinary tract and colonizing a bacterial infection during normal bladder emptying. However, if a catheter is in place this allows for easy ascending bacteria to colonize and form an infection, and

The Quality Improvement nursing process that I have chosen to research is patient safety. I have chosen to focus specifically on the topic of catheter associated urinary tract infections (CAUTI’s) during hospitalization and their preventions. It is estimated that 15-25% of hospitalized patients receive a urinary catheter throughout their stay, whether or not they need it. A large 80% of all patients diagnosed with a urinary tract infection (UTI) can be attributed to a catheter (Bernard, Hunter, and Moore, 2012). The bacteria may gain entry into the bladder during insertion of the catheter, during manipulation of the catheter or drainage system, around the catheter, and after removal.