Evidence-Based Practice (EBP)

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.

One of the main roles of the nurse is to ensure the best patient-centered care for each individual to achieve an optimal outcome. However, it is difficult to do this when nosocomial infections are an endless problem to this day all over the world. One problem that seems to have a significant impact in the health field is the reoccurring incidences of catheter associated urinary tract infections. Studies show that catheter urinary tract infections are recognized as the most frequent adverse event in the health care system, thus resulting in increased economic costs, mortality, and morbidity rates (Tillekeratne, 2014.) Although the incidences of nosocomial infections are slowly decreasing with time, there are still prevalent problems occurring

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.

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

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

A Catheter-Associated Urinary Tract Infection (CAUTI) prevention team was developed at a hospital in response to the Centers for Medicare & Medicaid Services’ policy and to improve patient safety. This policy significantly

According to Hamer and Collinson (2005), evidence based practice (EBP) is about “finding, appraising and applying scientific evidence to the treatment and management of health care.” (p.6) Therefore, in nursing, EBP is relevant because it supports nurses’ performances of delivering suitable, safe and efficient care towards the patients and their families. Research is based upon clinical experiences and patient’s preferences. (Grove, Gray, and Burns, 2014) Through this nurses will have a better understanding of patient views and be able to make clinical decisions that can results of better outcomes towards their health.

One of the most common hospital-acquired infections being reported today by hospitals is urinary tract infections (UTIs), UTIs account for up to 40% of the infections reported by hospitals (Elpern, 2016). One of the most common reasons for hospital-acquired UTIs has been associated with the use of indwelling urinary catheters, these infections are known as catheter-associated urinary tract infections (CAUTIs). CUATIs have been shown to increase healthcare cost, increase in morbidity and mortality and are one of the most preventable complications that can arise from hospitalization (Elpern, 2016). The purpose of this paper is to explore hospital acquired infections and common problems and complications

Data sources: The search engine that was used to find three randomized controlled trial articles and support my PICOT question was PubMed. Key terms that were used to search for them included intensive care unit infections, chlorhexidine dressings, antiseptic solutions, and prevention methods for catheter-related infections. A clinical guideline for the prevention of intravascular catheter-related infection was retrieved from the Agency for Healthcare Research and Quality (AHRQ).

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

Galiczewski’s article was aimed at medical professionals and the role they play in preventing catheter associated urinary tract infections (CAUTIs). The author provided significant statistical information on CAUTIs and the impact they have on patients in the intensive care unit (ICU) of hospitals. Using information from various research articles and their associated electronic data bases, Galiczewski effectively summarized interventions that have the maximum effect in preventing CAUTIs. For example, removing catheters when they are no longer deemed necessary was shown to significantly decrease the risk of CAUTIs in adult ICU patients. The author used a plethora of empirical evidence to successfully support her findings that health care

Oman, K. S., Makic, M. B. F., Fink, R., Schraeder, N., Hulett, T., Keech, T., & Wald, H. (2012). Nurse-directed interventions to reduce catheter-associated urinary tract infections. AJIC: American Journal of Infection Control, 40(6), 548-553. doi:10.1016/j.ajic.2011.07.018

Catheter associate urinary tract infections are detrimental to every hospital. Examining how catheters are cleaned is vital in preventing infections. Comparing cleaners to eliminate bacteria during cleaning is one example of how inquisitive minds backed by evidence can create a positive change. Nurses are in a great position to promote patient awareness and help make improvements in patient care (LoBiondo-Wood & Haber, 2014). Anytime you changing a procedure within your organization ensuring that staff members are educated and are capable to correctly perform the procedure is crucial. Even policies or procedures that are proven and backed with countless hours of evidence to improve patient outcomes can become faulty if the staff members are

Stenzelius, K., Laszlo, L., Madeja, M., Pessah-Rasmusson, H., & Grabe, M. (2016). Catheter-associated urinary tract infections and other

The last article evaluates an intervention program to prevent hospital acquired catheter associated UTIs. The study was analyzed by the pre-phase and the post-phase and compliance of the staff (Amine, 2014). The compliance rate of ICU nurses was raised 100% in the last 2 months of the post-phase. This is a prevention technique that can support my PICOT and change