The Catheter Associated Urinary Tract Infections

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.

4) Significance: This research shows that there is a gap in the evidence, but that the primary concern for nursing staff is to ensure that catheters are removed as soon as it is possible to do so.

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

Urinary tract infections are the most common type of healthcare infection, and CAUTI is the 2nd most common cause of nosocomial bloodstream infection in the healthcare setting. ("Catheter Associated Urinary Tract," 2011). The goal of our facility is to reduce CAUTIs by 50% by the end of the year, measured by the quality department on a monthly basis, and implemented through performance improvement factors including the interdisciplinary team through a strong focus on the nursing leadership team.

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?

They are responsible for what seems like everyone and everything. However, nurses have all the tools they need to be effective and safe nurses early on. The standards of precautions are one of those tools nurses are taught that aids them in protecting every patient they care for, including him or herself. Regardless of the patient’s health status, the nurse should use their better judgment when implementing care. In order to prevent interruption in the chain of infection, nurses are to adhere to the standards of precautions by thinking critically when providing patient care. No matter how presumably capable or experience a colleague may be, evidence-based practice proves that standard precautions are greatly impacting the nursing field. Nurses need to stick to their guns and not compromise their beliefs for fear of being the odd man out. The more the nurse implements those practices in their everyday routine the more it will become second nature. By gaining knowledge of the importance of standard precautions, the nurse will in turn become more compliant and adherent, and be better suited to provide effective quality care to all

General strategies for the prevention of CAUTI include measures such as hand hygiene and adherence. Strategies used for the prevention of CAUTI include using an aseptic technique for catheter insertion, limiting the duration of urinary catheters, and following standard infection control precautions for catheter care. Successful achievement implementation of these measures will result in a decrease of CAUTI 's (Bennett, 2014).

Catheter associated bloodstream infection (CRBSI) occurring in the neonatal intensive care unit (NICU) are frequent, complication related to it are potentially fatal and costly (Kim & Sandra, 2009). According to the center of disease control, an approximate of two hundred and fifty thousand cases of CRBSIs have been estimated to occur annually which cause health care to cost approximately twenty five thousand dollars per case, and between 500 to 4,000 patient die due to blood stream infection (CDC, 2002). Approximately 90 percent of blood stream infection occurs from central venous insertion (CVC). Even though CRBSI occurs from different ways, the most common source is contamination of the catheter by skin flora on insertion, skin flora

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).

Nicolle, (2014), found that the Center for Disease Control in the United States shows that the Catheter Associated Urinary Tract Infection constitutes the most commonly acquired infections in US, (Saint, et al. 2016). An examination of an implemented CAUTI was conducted to establish a link between perceptions of risk by healthcare providers and the potential impact they have on patient care decisions, (Wahr, et at. 2013). The Michigan Health and Hospital Association Keystone Center of patient safety constituted the main patient schemes, (Pearson, Needleman, Beckman, & Han, 2016: Nicolle, et al. 2014). The study design comprised of 12 eligible hospitals was selected, of which 42 interviews were identified and the 3 hospitals

Hospital acquired infections (HAIs) have been a topic of concern. Urinary catheters place patients at risk for these infections. HAIs cost approximately 9.8 billion dollars annually; However, Catheter associated urinary tract infections (CAUTIs) are less than 1% of that total (Waknine, 2013). None the less, steps must be taken to prevent CAUTIs. Some of the advantages of preventing/reducing CAUTIs is improved patient outcomes and a reduction in the facility’s costs of treating HAIs. There is some complexity in implementation of your solution, for example, increase in nursing assessment, treatment, documentation, and patient education. When there is an increase in the complexity of a solution, nurses will be more resistance to change. Thank

Urinary tract infections are a major health concern to the general public. Many people do not need any treatment; others might only need antibiotic therapy, which others get admitted to the hospital. Urinary tract infection admission rates are a concern for the Agency for Healthcare Research and Quality. They have developed a quality indicator about the admissions of UTIs to “highlight potential quality concerns, identify areas that need further study and investigations, and track changes over time” (AHRQ). To ensure a change takes place in the number of admissions for these infections, education is the most valuable tool.

One of the applications of NRL is urethral foley catheter. A Foley catheter is a sterile tube that collects urine from the bladder through the urethra. It is the most common type of indwelling urinary catheter. It is known as the indwelling catheter because it can be left in the bladder for a long period of time. However, Foley catheter cannot be used for too long because of the risk of catheter associated urinary tract infection and other adverse effects is high. Foley catheter is usually made of silicone rubber or natural rubber.

Catheter associated urinary tract infections (CAUTIs) have been a major issue in health- care. The implementation of Foley catheterization further heightens the possibilities of patients gaining urinary tract infection. As a result, healthcare workers will have to be meticulous when attending to patients who are being treated with catheterization. The secondary infections associated with catheterization have triggered a plethora of complications leading to prolonged hospital stays, higher hospital costs, and even deaths. Similarly, the case studies explored, show that CAUTIs are responsible for the majority of hospital acquired infections (HAI) that occur yearly. Dumont and Wakeman (2010) have concluded that catheters have been known to be

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