The Fight Against Catheter Associated Urinary Tract Infections ( Cautis )

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

One of the main roles of the nurse is to ensure the best patient-centered care for each individual to achieve an optimal outcome. However, it is difficult to do this when nosocomial infections are an endless problem to this day all over the world. One problem that seems to have a significant impact in the health field is the reoccurring incidences of catheter associated urinary tract infections. Studies show that catheter urinary tract infections are recognized as the most frequent adverse event in the health care system, thus resulting in increased economic costs, mortality, and morbidity rates (Tillekeratne, 2014.) Although the incidences of nosocomial infections are slowly decreasing with time, there are still prevalent problems occurring

Patient safety and hospital acquired infections (HAI) are deemed highly important in the health care setting. My organization uses quality indicators pulled from EPIC, which is our health information system, to ensure we are meeting regulations for catheter associated urinary tract infections (CAUTI). Data includes rates of infections, length of foley catheter placement, reasons for foley placement, as well as facility specific documentation that is used to aide in the prevention of CAUTI. By pulling this data, one could identify trends affecting rate of infections. This may lead to a change in policy or procedure that can improve the rate of infections for those patients with foley catheters. Thus decreasing the percentage of HAI’s 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.

In the first article, the author’s goal is too reduce urinary tract infections by implementing an evidence-based approach. By doing so it focuses on the importance of the nurses, physicians and staff working together as a team to reduce the urinary tract infections. The nurse driven protocol is what was tested, observing how the nursing staff communicated and how they followed evidence based practice approach. Also, focusing on an academic practice partnership to enhance patient outcomes (Johnson, Gilman, Linter, & Buckner, 2016).

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?

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

Nursing research offers the scientific foundation for the practice of the profession. “In order for nursing to be at the forefront of knowledge generation and address societal issues and health care, nursing research must be relevant to health and illness situations, scientifically rigorous, and readily translatable into practice and health policy”(Potempa & Tilden, 2004). Catheter associated urinary tract infections (CA-UTIs), accounts for almost 40% of all nosocomial infections, which result in increased morbidity, mortality, and costs and, it is one of the most common health care- associated infections in acute care area. The study existed in this paper discourses the influence of the 2008 nonpayment policy of the Centers for Medicare and Medicaid Services (CMS) on catheter-associated urinary tract infections (CAUTIs) from the viewpoint of infection preventionists.

Healthcare-associated infections account for nearly $45 billion yearly in the United States, because CAUTI is one of the most common, CMS stopped reimbursing hospitals for additional costs associated with CAUTIs in 2008 (Kennedy, Greene, & Saint, 2013). Costs incurred with CAUTIs when symptomatic urinary tract infections are involved can average up to $911 per patient, and up to $3824 per patient when bloodstream infections are involved (Kennedy et al., 2013). This includes costs associated with oral medications, intravenous medications, and laboratory testing.

This literature review essay will demonstrate a review of four different research articles and research related methodology The articles and review are based on the prevention of Catheter-associated Urinary Tract Infection (UTI). The aim of this literature review is to review publications concerning the management of Catheter-related to UTI 's including the prevention. Articles reviewed include the various precaution and preventions concerning Catheter-associated urinary tract infection (CAUTI) The article evidence summarized bellow was generated using a literature search conducted for Randomised Controlled Trials, Systemic Review or quantitative and qualitative research.

Critically evaluate the influences on infection control and prevention practices relating to the care of invasive devices (choose either Intra-venous or Urinary Catheters). You need to consider:

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.

The teaching initiatives describe proper insertion, catheter care and prompt removal of a urinary catheter to reduce patients’ risk of catheter-associated urinary tract infection. All in all, the project went well, and the students learning objectives were met. Hence, the students were receptive to the teaching and voice their appreciation and their passion for catheter care and will implement the evidence-based practice in their clinical practice. This project was essential for nursing students to have strong fundamental knowledge in catheter care and CAUTI prevention so when they graduate from the program, they will be able to utilize their knowledge and skills in the clinical area and to share their experience with other nurses to reduce catheter-associated urinary tract infection. The student learning outcomes were attained and evidence in their demonstration of the skills in the clinical lab area. My professional expectations were met to the maximum and achieved evidenced by my teaching and implementation phase. Recommendations for future projects related to CAUTI is to conduct systemic and analytic reviews and to evaluate clinically relevant outcomes. Furthermore, more research is needed for antiseptic-impregnated catheters in reducing CAUTI and the role of bacterial biofilms in the pathogenesis of catheter-associated urinary tract infections. Thinking critical collaborating with others and providing safe, quality care is vital. Educational gaming has been identified as a way to assist students in improving critical thinking, building problem-solving skills and facilitates higher order of thinking. After conducting the literature review on gaming and role-playing, I have a greater understanding of the benefits in the classroom, and the articles provided excellent