Indwelling Catheter

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.

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

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 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.

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 nature of the information that was derived from the qualitative study was on the perceptions of a previous study done in the Michigan Health & Hospital Association Keystone Center shows a significant Catheter associated Urinary Tract Infection (CAUTI ) rate due to decrease urinary catheter use. The study was conducted on the understanding that, in CAUTI prevention why some hospitals are more successful than others and also identify the key elements to promote CAUTI prevention activities. (Saint, Gaies, Fowler, Harrod, & Krein, 2014). The researchers conducted a qualitative study using site visits, interviews and created a CAUTI -specific guide to prevent safety(GPS) to conduct their own evaluation for each hospital. The data were collected and analyzed perceptions from each hospitals and identify the potential challenges and strategies for improvement which was collected from the feedback from

Catheter-associated urinary tract infection (CAUTI) is a fairly common complication in hospitalized patients. Nosocomial infection prevention and patient safety promotion has been issued and many researches have been conducted to improve patient’s quality of life. In this article, Saint et al. (2005) hypothesize that using a paper-based urinary catheter reminder can reduce the incidence of urinary catheterization, and consequently this will enhance the patients’ safety.

Catheter-associated urinary tract infections are the most common infections that occur in the healthcare inpatient setting. Knowledge is sparse with CAUTI prevention in the emergency department. Existing studies have shown the decreased use of catheters in the ED, however a majority of them placed still do not qualify the medical need for such an intervention. This authors goal is to understand CAUTI prevention better and to determine the most prevalent programs or strategies for prevention that could decrease infections rates. This article written by these authors had an exceptional abstract and the article was well written and thorough. This study was easy to follow and the structure was well thought out with the appropriate subtitles for a primary research

The purpose of this paper is to implement a policy that will aid in reducing foley catheter induced infection by providing a guideline for the health care providers on how to care for patients with foley catheters. Catheter Associated Urinary Tract Infection (CAUTI) are the most commonly reported hospital acquired condition, and the rates continues to rise. According to American Nurses Association, greater than 560,000 patients developed CAUTI each year. Registered nurses can play a vital role in reducing CAUTI rates (ANA, 2015). Hospital acquired conditions are major threat to patient safety with estimated cost of 33 million annually (ANA, 2015).

The multifaceted intervention was implemented in the medical wards over a 1 week period following the initial 8 weeks of surveillance. Following the week-long implementation of the intervention, acute surveillance of CAUTIs was again carried out as a part of quality-improvement activity. Surveillance was performed for 7 additional weeks from May 2012 to July 2012. The primary outcome was the rate of CAUTIs per 1,000 catheter-days. Secondary outcomes included the rate of CAUTIs per 1,000 patient-days and catheter utilization rates (days of catheter us divided by total days of inpatient care). These secondary outcomes were measured to detect a decrease in CAUTIs due to a reduction in urinary catheter usage, which may not be apparent form the primary outcome alone. Bivariable analyses were carried out using the t test for continuous variables and the x² test or Fisher exact test for categorical variables. The primary analysis measured whether the intervention was significantly associated with a decrease in CA-UTIs (Tillekerante et al., 2015). A total of 125 patients received urinary catheters as part of routine clinical care during the study period, with 82 in the pre-intervention phase and 43 in the post-intervention phase

The leadership team in my organization took a conventional approach in assisting the frontline nurse with CAUTI. Indeed, the infection control department and the educational committee collaborated; an effort to curtail CAUTI, had an audit done amongst the five Emory Healthcare Hospitals, to understand the main reason behind the upsurge CAUTI. The results indicated staffing shortage, increase agency staff usage, nursing misunderstanding related to essential reasons why patients have an indwelling urinary catheter, and nurses’ lack of knowledge related to the indwelling removal protocol. Because of all the aforementioned, the committee established a nurse-focused indwelling catheter removal protocol that is essentially based

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.

Apart from his urinary retention and likely prostate problems, John was ready to go home. However, he was unable to get an appointment with urology before his date of discharge. Therefore had to go home with his IDC in situ. For this to occur John had to be able to manage it at home. It was important for John to be competent with managing his catheter in order to prevent a urinary tract infection (UTI) or other complications. Urinary tract infections are a predominant cause of infection in older adults. They also are a leading cause of morbidity and healthcare expenditures in patients of all ages. Around half of people with an

The overuse or misuse of indwelling urinary catheters (IUC) is a concern in the emergency department (ED) despite the well-known risks and complications. Although the medically indicated guidelines for use are specific, professionals often ignore the guidelines and insert an IUC without applying evidence-based practice strategies to manage urinary output.