We also incorporated Evidence-based practice into our home health agency in many different ways. One example of how evidence-based practice is incorporated into our practice on a daily basis is interventions utilized to prevent catheter-related urinary tract infections (CAUTI). Many of the patients we provide care for have indwelling urinary catheters, complete intermittent catheterization on a scheduled basis or have suprapubic catheters. As healthcare providers, we are aware of the possible negative outcomes of inadequate catheter care. This is why we incorporate interventions to promote proper catheter care in our home health agency utilizing evidence-based practice. Based off of evidence, “ Because the incidence of complications rises …show more content…
The education department at our organization assigns courses and providing resources to staff members to ensure we can identify vulnerable populations and how to ensure safety is maintained in every healthcare setting of our organization. In home health, we work as patient advocates ensuring patient safety is maintained. If we discover unsafe living conditions such as possible abuse or inadequate resources available while in the home, the nurse and health professionals are aware that we must report these situations to case managers, social worker, and our nurse managers. Weekly meetings are held in our facility, and we discuss concerns and patients situations with case managers, social worker, and nurse managers to ensure everything is being done to ensure a culture of safety is maintained for staff members and for the patients we provide care to. Our organization was evaluated by Joint Commission last month; this is also an excellent way to ensure a culture of safety is maintained in our healthcare organization. Receiving feedback from the surveyors and incorporating their suggestions for change into our organization is an excellent way to ensure a culture of safety as well. Ever since the results were received from our evaluation from Joint Commission, the education department and nurse managers have conducted two meetings and provided education on where improvements can be …show more content…
Fortunately, we do utilize computerized charting as well as the physician order entry system, but there is room for improvement in our home health organization. Epic home health is the system that we utilize, unfortunately, internet service is required to sync/update patient information. In order to review previous nurse, physician notes, and lab/test results internet service is needed. Many of our patients live in rural areas where cell phone service and internet service is not available. Therefore, we must often wait until we return to the home health office to find the patient information we need and to submit our charting. I am grateful our organization utilizes computerized charting, but often it is difficult to communicate with other healthcare providers or pull up pertinent patient information while in the field. Certified nursing assistants, nurses, physical therapists, social workers, and case managers are all required to use the same charting system, using the same system does improve communication within the organization. Nurse Managers review our charting on a regular basis and provide staff members with feedback and updates if changes are made in the computerized system. Also, technical service representatives are available 24-7 for employees to assist with questions and to address technical issues regarding
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.
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
Presented by BMJ Quality and Safety, Meddings et al (2013) sought to review interventions to reduce unnecessary catheter usage and prevent catheter-associated urinary tract infections. The review panel consisted of six individuals all listed as authors on this integrative review who utilized two
Health information technology is a familiar entity for most working nurses in the year of 2017. Many nurses, have lived through the transition from paper charting to online charting. This transition has not always been a progression of ease. Change is never easy. The process of paper charting with pen and paper and the use of paper medication administration records have been the routine process for many years. With the new onset of the electronic health record (EHR) many processes have become easier, safer, and more efficient while some tasks have become more complicated, confusing, and more time consuming. The goal of this paper is to describe the electronic health record system, expand on the essence
Progress. Over the last decade, the hospital has made a lot of progress regarding the use of HER’s. After the CPSI system was initiated, the transition from paper charts to computer charts began. Today, all charting is done electronically by all members of the healthcare team. From the dieticians to the physicians, everyone is trained and
Urinary tract infections are not generally considered as a sexually transmitted infection, however is it possible to contract the infection from unprotected sex? It is safe to assume that any bacteria present in the genital tract or area during unprotected sex could be transmitted to another person who comes in contact with that area during sexual intercourse. The question is does that bacteria spread and cause infection in the other person? It is always a smart idea for a person to protect his or herself by using a condom every time he or she has sex to eliminate or reduce the chance of contracting any sexually transmitted infection.
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
You gave a great example of how you incorporated Ohio’s scope of practice into your post. As a home health nurse, I find that I am the first person to notice a change in the patient’s normal status. I received a patient that had been wearing Foley catheters for around 5 years. After several months of visiting with this patient, my assessment showed a change in her behavior, along with becoming disoriented and she had also fallen a few times that week. My analysis was that I suspected a urinary tract infection and I implemented a plan by calling the squad to have her taken to the emergency room for evaluation. Once the squad came, the emergency medical team evaluated her and took her vitals (which were normal) and said there was no need to go
A review of his medical record indicates that he suffers chronic urinary tract infection with retention. He has a suprapubic catheter in place. On 1/8/17 he was ordered UA, C&S due to hematuria. He has new onset depression and was started on Cymbalta by his PCP in December. He suffers from chronic pain due to his arthritis and osteoporosis. He also suffers from co-morbidities of HTN-chronic and stable, anemia-chronic, Rheumatoid arthritis which is chronic and CHF-chronic.
This type of infection is common among older women than men. UTIs can cause sudden confusion such as delirium in elderly people as well in individuals with dementia. According to Beveridge, Davey, Phillips, &McMurdo, if a person with a memory impairment or dementia has a urinary tract infection, this can cause sudden and severe confusion known as delirium (2011). The cause of UTI includes an “enlarged prostate in men or a prolapse in women, where the uterus, bladder or bowel descends from the normal position due to a weakness of the supporting structures” (Beveridge et al., 2011, p. 173). As dementia progresses gradually, difficulty in maintaining a personal hygiene becomes a challenge. Abnormal changes in the structure of the urinary tract
When I started working at my current facility, we were just transitioning to electronic medical records. I was eager to learn about the new change that will occur with patient charting. Some of the nurses who had been practicing for years had trouble with the new changes that will be implemented into the patient charting system and did not understand how this new change will improve patient
The purpose of this paper is to discuss of how effective is the prophylactic intake of cranberry products (capsules, pills, juice) compared to the prophylactic use of Trimethoprim/Sulfamethoxazole in the prevention of any urinary tract infection within a six to twelve-month period in healthy premenopausal women (18-55 years old) with a history of recurrent urinary tract infections. Also to determine the resolutions that will help the advanced practice registered nurse to decide on the appropriate therapy for healthy premenopausal female population who suffer from recurrent urinary tract infections in order to decrease antibiotic overuse and antibiotic resistance.
Urinary tract infection (UTI) is one of the most common bacterial human infections encountered in medical practice in developing countries. More than ۱۰۵ colonies of an organism per milliliter of urine samples shows the symptom of UTI. The major UTIs caused by strains of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Proteus. Antibiotics play an important role in treating infections. Area-specific studies aimed to gain knowledge about the type of pathogens responsible for UTIs and their resistance patterns may help the physician to choose the correct empirical treatment.Therefore, the aim of this study was to determine the distribution and antibiotic resistance patterns of bacterial strains isolated from hospitalized patients of ****from ۲۰۱۱ to ۲۰۱۶
In addition to St. Andrew’s commitment to provide high quality and cost-effective health care this advanced practice registered nurse will offer patient-centered care based upon the individual’s physical, psychological, spiritual, and social entities. This APRN with a urology subspecialty would like to dedicate a part of practice to the premenopausal female population who suffers from recurrent urinary tract infections (UTIs) and help to prevent UTIs with natural remedies in order to decrease antibiotic overuse and antibiotic resistance. The APRN’s goals are to be an active member of the healthcare community and help patients manage acute and chronic illnesses. In addition, this APRN would educate and encourage patients to participate in their
Infections of the urinary tract can involve any structure from the kidney to the urethra and can be classified into either uncomplicated or complicated. UTIs occur more commonly in women, primarily due to having a shorter urethra and presence of male prostatic fluid. This experiment analysed a urine sample in the aims to determine whether Edna Watkins has a UTI, by utilising gram staining, spot tests and various biochemical assaying (Microbact GNB 12A System). Results obtained from spot and biochemical testing validated the presence of Escherichia Coli in the urine sample, therefore the patient was positive for a UTI. Amoxicillin was initially prescribed prior to laboratory testings, however antibiotic sensitivity plating showed that this particular strain of E.coli was mutated and resistant to many drugs including Penicillin (ZOI = 0mm), Augmentin (ZOI =5mm), Ciprofloxacin (ZOI = 3mm), Gentamicin (ZOI = 5mm), and Nitrofurantoin (ZOI=1mm). The greatest sensitivity was found when testing the E.coli strain against Trimethoprim (ZOI was 14mm), a common antibiotic treated for uncomplicated UTIs. With this information, it is recommended the patient immediately discontinue the dosage of Amoxicillin and switch to a recommended