Patient Dissatisfaction Of Piv Catheter Replacements

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.

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

The next step will focus on educating the unit’s staff. Employees that place an indwelling catheter will be required to go through a refresher course on proper insertion technique, indications for catheterization, and catheter care. Additionally, there will be a class on the new flow sheet created to track indwelling catheters (Andreessen et al., 2012). Posters with information pertaining to catheter care, CAUTI prevention, the new charting system, and alternative bladder management systems will be placed in highly visible areas such as break

These patients were chosen from respiratory intevensive care units for this randomized controlled trial. They were patients that were had respiratory infection and were on mechanical ventilators. The criteria was that they had to have indwelling catheters in place at admission or during their stay in the RICU for more than 2 days. There were two groups, the intervention group (147) and the control group (131). The intervention group recived the reminder and indications for removal and the control group received no reminder. Both groups had routine urine alayses that were conducted when the cathether was inserted, every seven days after the insertion, the day of the removal, and the seventh day after the removal. The research hypothesis was proved accurate because use of the reminder intervetin reduced the incidence of Cathether Associated Urinary Tract Ifnections by 48% (P=.009). There were no complications in this study. This study, along with the Healthcare Infection Control Practices Advisory Committee, that there needs to be a system of reminders to identify ptients who have catheters set and for those will need continued use of

Because the US uses an estimated 150 million PIVCs annually, and catheter-related complications (CRC) are presumed to be directly related to the indwell time (Lopez et al., 2014), this study

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 CAUTI’s. CAUTI, is the leading cause of hospital acquired infections in the United States. Seventy- five percent of urinary tract infections in hospitalized patients are associated with urinary catheters and more than 50% of these infections are preventable (Center for Disease Control and Prevention (CDC), 2015). A urinary catheter is a device inserted into the bladder for emptying. Roughly, 25 percent of hospitalized patients receive urinary catheters in the United States

exposed catheter is cleaned in a downward motion away from the insertion site without touching the mucus membranes, to reduce the risk of infection. These CHG Wipes were also utilized when a patient has a bowel movement. The outcomes reported by the article showed significant decrease in the amount of catheter associated UTI occurring on the unit. It is reported that in the first quarter of the trial, only four CAUTI incidents occurred on the unit, in the second quarter, only three CAUTI incidents were reported on the unit, and these were identified in patients who were transferred from another facility with Foley insertions. A revision was done to remove catheters past three weeks. By the 4th and last quarter, there were no CAUTI attributed to the unit (Carter et al, 2014).

In the course of daily practice, nurses soon realize that many patients will acquire urinary tract infection (UTI) during their stay in hospital. Research and practice have both shown that the main cause of frequent UTI in hospital has been urethral catheter for the patients. Meddings, Reichert, Robers, Saint, Stephansky & McMahon (2012) find that most (59% to 86%) hospital-acquired urinary tract infections (UTIs) are catheter-associated urinary tract infections (CAUTIs) (p. 305). According to Dailly (2011), "approximately 20 per cent of all healthcare-associated infections are urinary tract infections (UTIs), with an estimated 80 per cent of those linked to urethral catheters," (p. 14). "It is estimated that 2 6% of people with catheters will develop a UTI," (Slater, n.d., p. 168).

Greene (2015) conducted a surveillance study on a 30-bed medical/surgical/neurological intensive care unit at Northwestern Hospital in Minneapolis, MN. A comprehensive approach to decrease catheter associated urinary tract infections (CA-UTIs) and to sustain CA-UTI rates below the National Healthcare Safety Network (NHSN) benchmark was implemented. 29 CA-UTI cases from April 2013 to March 2014 were reviewed in depth to define trends (Greene, 2015). The attitudes of nurses and doctors towards indwelling urinary catheters were assessed per surveys and aseptic technique for foley catheterization was assessed to define gaps. The CA-UTI cases reviewed indicated that 66% were from indwelling urethral catheters placed on the units, 39% occurred

The hospital’s current practice for CAUTI prevention includes the use of the HOUDINI protocol. This protocol features the acronym for the strict indications required for the insertion and the continued use of the urinary catheter (hematuria, obstruction, urologic surgery, decubitus ulcer, intake and output, no code/comfort care, and immobilization). The physician places the original order for the catheter with HOUDINI protocol and chooses the indication that applies. The order empowers the nurse to assess the patient daily for the continued indications and to remove any urinary catheter that no longer meets the indications. Hospital wide the protocol has been successful at decreasing CAUTI rates, however the target for CAUTI rates is 0 and our current rate is 1.37 per 1000 catheter days. Intensive care units have higher urinary catheter usage than in medical surgical or telemetry units (Halm, O’Conner, 2014). In MICU the most common indication for a urinary catheter is the need for accurate intake and output on patients with hemodynamic instability. Staff nurses are required to assess the patient daily and readdress the continued indications. In the past month no urinary catheters were removed

The authors studied multiple articles and used a total of 20 articles to validate their results concerning CAUTIs. The author studied how urinary catheter placement was one of the biggest reasons of hospital-acquired infections today. The authors also studied current percentages of catheters placed where no need of one is indicated. They also studies education regarding compliance, appropriate uses, nurse derived initiatives and overall prevention of infections. The citing of references were properly placed and had a sufficient reference page. Majority of the articles were up to date. Fifteen of the twenty articles were written since 2010 and nine in the past three

The diminished use of indwelling urinary catheters is accompanied by a decreased incidence of UTIs and other catheter-associated complications such as urethral stricture (Saint et al., 2015). This, in turn, reduces the risk of permanent kidney damage to the patient in the long run (Saint et al., 2015). Furthermore, if nurses were to conform to the guidelines set forth by the ANA and utilize the CAUTI Prevention checklist, patient safety and satisfaction level would improve, thereby improving and advancing nursing practice (Gelinas, 2015). Regarding the financial aspect, hospitals would benefit immensely if the rate of CAUTIs declined since Centers for Medicare and Medicaid Services no longer recompenses hospitals for CAUTIs which were not present upon the patient’s admission (Bernard, Hunter, & Moore,

Morrison, K., & Holt, K. E. (2015). The Effectiveness of Clinically Indicated Replacement of Peripheral Intravenous Catheters: An Evidence Review With Implications for Clinical Practice. Worldviews On Evidence-Based Nursing, 12(4), 187-198.

On the cardiac and vascular outpatient unit(CAV) patients are seen for a variety of procedures including cardiac catheterizations, arterial angiograms, thrombosis of arteriovenous grafts(AV grafts), placement of new lines and pacemakers. While this area is a predominantly outpatient area, some of the procedures require an overnight stay. Procedures such as new pacemaker insertions or, infusion of clots are usually scheduled and will automatically require an inpatient unit. The nature of the procedures performed on this unit may also warrant an admission. For instance a routine catheterization may require stenting which would lead to an admission. An emergent fistulagram (invasive checking of the AV graft) could also lead to patient status changes. The unit is considered an outpatient unit and is not staffed around the clock. The problem arises when the hospital has a waiting list from the emergency room and our patients are excluded from the list or added to the list after the emergency room patients. The results delays patient admissions from our

The policy was initiated July 2015. Hospital across the world are struggling with catheter-associated urinary tract infection which is an easily preventable hospital acquired infection. In nursing school, of the first skills check-off in the use of aseptic technique. During my maternity and pediatric clinical rotation in nursing school the proper insertion of an indwelling urinary catheter using aseptic technique was a required skill check off. As a new nurse on the medical surgical unit during my eight-week orientation proper insertion of indwelling urinary catheter was required competency check off. As a floor nurse and ICU nurse, I have put in many urinary catheters and have used my nursing judegement to discontinue those catheters that