Foley Rounding Case Study

However, there are additional guidelines in terms of assessing the patient for prolonged catheter use. There should be frequent assessment and evaluation of the patient’s need for continued use. It is important to note that in addition to determining the patient’s need for catheterization, prior to insertion the nurse should also complete the following:

For nurses, (P) on 2 South caring for patients with urinary catheters, will education, on the importance and proper use of a nurse -driven indwelling catheter removal protocol (I), change knowledge on the use of the nurse driven protocol, as compared to knowledge before receiving an education, (C), as evidenced by (O), change in knowledge in the use of the nurse -driven indwelling catheter removal protocol, and CAUTI rates as evidenced by, pre and posttest scores and CAUTI audits after three months? The project will utilize a

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

A nurse-driven protocol is the recommended tool to be used by the nurse to remove catheters without orders following set CDC guidelines and prevent CAUTI

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.

The nurse driven protocol was tested in 4 intensive care units. It included evidence-based orders for discontinuing, handling, and properly managing the catheters. One of the most important factors was the removal of the catheters in a timely manner. The data pre

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

Educate healthcare personnel involved in the insertion, care and maintenance of urinary catheters about CAUTI prevention, including alternatives to indwelling catheters and procedures for catheter insertion, management, and removal.

National Patient Safety Goals (NPSGs) were established in 2002 by the Joint Commission 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 our 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.

Emergency department (ED) nurses save lives every day by utilizing their skills and knowledge to assist the physician in providing emergent care to patients who arrive via ambulance or by private auto. Nurses are aware of their responsibilities to respond to the patient's needs quickly and efficiently to provide life-saving interventions and care. However, are ED nurses aware that they contribute directly and indirectly to a large percentage of patient's demise through the insertion of foley catheters, peripheral

One object of the NIH is improving the health of Americans by building a scientific foundation for clinical practice through reach and training (NIH, n.d.). The NIH’s mission is to promote and improve the health of individuals, families and the community (NIH, n.d.). Gaining the support of the NIH is important because the organization promotes the use of evidence-based practice. NIH uses research to validate its findings through continuous research in the areas of acute and chronic diseases and ways to manage the disease. NIH would be able to provide numerous confirmations as to why early Foley catheter discontinuation is vital to patient care outcomes.

The accomplishment was made possible by maintaining the QC and constantly enforcing STARS, peer review, and quarterly evaluation in the unit. The nurses in MTU took action immediately to address CAUTI incidences. Staff huddles were given on every shift to reflect on CAUTI and hospital policy and protocols for urinary catheter care was reviewed (Patzer, 2017). In addition to huddle, every incidence was investigated by performing a root cause analysis from the safety team (Patzer, pc, 2017). The STARS posters were in every room to remind nurses of proper maintenance of tube, and it also served as an education tool to teach patients and family members (Patzer, pc, 2017). The result of the STARS program was evaluated by comparing with the SNI. Although the unit has reached the goal with no incident of CAUTI after the implementation of the STARS program, the unit will continue to work towards improving the quality of patient care (Patzer, 2017).

This paper, will discuss the National Patient Safety Goal NPSG 0.7.06.01 entitled “ Use proven guidelines to prevent infection of the urinary tract that are caused by catheter” (The Joint Commission, 2015). It will identify reasons why this National Patient Safety Goal was chosen as well as the type of organizations that utilize urinary catheters. It will look into financial implications of implementing educational process versus the hospital cost of Catheter-Associated Urinary Infections (CAUTI). The Advanced Practice Nurse (APN) will demonstrate method on how to gather data, design educational tool, implement standard practice and create a committee by collaborating with other health care discipline. Effectiveness of the educational process will be evaluated through data collection. Finally, future health care delivery implications will be explored.

The participants included all direct healthcare providers that were involved in the care of the patients. This included: the patients, loved ones, physicians, uscs, ancillary staffs, transporters, physical therapists(PT), occupational therapists (OT), and as well as, the nurse educator. PT and OT were included in this because they have to get many of these patients up who have a foley inserted, and a lots of times the foley bags are placed in the laps of these patients. This allows for the backflow of urine to occur that can increase one’s risk of an infection. Utilizing the team approach has aided in the preventions and spread of CAUTIs as being implemented by this model.

I was slightly familiar with the foley catheter, however, I need some slight guidance. I knew that I needed to drain the foley bag because it was slightly full, but I did not know where to unclamp to drain it. The nurse’s aid taught me how to unclamp the bag so I can drain the urine. I also learned that when moving the patient who has a foley bag, it was important to make sure that the patient is not going to get a UTI. UTI can be caused by holding the foley bag at a higher positon causing the urine to backtrack. It is important to keep that in mind as a healthcare worker. I have not been skill checked on foley catheters, however, I need to practice working around foley catheters to protect the patient. I could always go on youtube and search videos on foley catheters or I can use the perry and potter book to learn