The Threat of Catheter-Related Infections

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

Getting an infection from improper care during or after insertion of a central line is the last thing you want to get while in the hospital. This paper will discuss Kaiser Permanente’s policy on central venous catheter, also known as a central line, care and dressing change, and whether it follows the current evidence-based practice on preventing bloodstream infection in patients who have them inserted. I will explain about what a central line is, why evidence-based practice is important in the clinical setting, what Kaiser Permanente’s policy about central line care and dressing change is, if Kaiser is currently following evidence-based practice based on current articles about preventing central line associated bloodstream infections (CLABSIs), and what my role in using evidence-based practice is as a future registered nurse.

Usage of indwelling urinary catheters in critically ill patients can seem to be a permanent fixture in intensive care units. Most critical care nurse expect their patients to have an indwelling urinary catheter (IUC) in place without much regard to the risk of catheter associated urinary tract infections (CAUTI) or the ability to implement IUC alternatives. Critical care patients may require IUC usage due to diagnosis, need for accurate hourly intake and output measurements, or other specified documented reasons. The risk of acquiring a catheter associated urinary tract infections is a result of IUC usage. The Centers for Disease Control and Prevention’s Guideline for Prevention of Catheter-associated

Healthcare-associated infections from invasive medical devices are linked to high morbidity, mortality, and costs worldwide. Especially in central line–associated bloodstream infection (CLABSI) or catheter-related bloodstream infection (CRBSI) and

The purpose of this author for this project is to analyze current literature reviews to establish a firm basis to implement evidence based central line bundle intervention to decrease catheter related blood stream infection in neonatal intensive care unit.

Another research article about the use of 2% chlorhexidine for daily skin cleansing was established by Munoz-Price and implemented by the task force. Munoz-Price demonstrated that this intervention reduces the rate of CLABSI from 9.5 to 3.8 per 1000 catheter days. The task force also replaced the administration sets and add-on devices no more frequently than every 72 hours unless contamination occurred. Replacing tubing used to administer blood, blood products, or lipids within 24 hours of start of infusion was also monitored, along with changing IV port protectors no more often than 72

This article does not provide the search strategy including a number of databases and other resources which identify key published and unpublished research. In this article, both the primary sources and the theoretical literatures are collected and appraised in order to generate the research question and to conduct knowledge-based research. In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. “Catheter-associated urinary tract infections in surgical patients: A controlled study on the excess morbidity and costs” is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, “Clinical and economic consequences of nosocomial catheter-related bacteriuria” is a review of a literature article which is the secondary source. Although many studies state that patient safety is a top priority and CAUTI can be controlled by the caution of health care providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care

Central venous catheters, usually called CVCs, are extremely important for patients in any type of intensive care unit. It is because of their crucial role in the care of these patients that their troublesome risk of catheter-related bloodstream infections, sometimes referred to as CR-BSIs, has developed into such a problem. There are approximately 80,000 CR-BSIs diagnosed each year in the United States alone. These infections lead to nearly 28,000 patient deaths in intensive care units. Not only is this a dreadful loss of life; it is also incredibly expensive. Extra care and treatment for a patient suffering from a CR-BSI can cost an average of $45,000. In fact, these infections can cost as much as $2.3 billion for the United States each

It is very important for the researcher to control the extraneous variable that could affect the study results. The extraneous variables that would affect the results in this study include, the catheter material, the catheter care, and the method of obtaining the urine sample. To control the catheter material, this study will be using the antimicrobial and antiseptic-impregnated catheters instead of the standard catheters as recommended by the Centers for Disease Control and Prevention (CDC) 2009 guidelines because they are effective in reducing the risk of CAUTIs. To control the catheter care, the study will follow the CDC guidelines for routine catheter care by ensuring that all the indwelling urinary catheters (IUC) maintain a sealed drainage system, and an unobstructed urine flow. In addition, the nursing staff will be cleansing the meatal area daily with warm soapy water instead of antiseptics, while maintaining the standard precautions including hand hygiene and wearing of gloves while performing peri-urethral care. To control the procedure for obtaining urine sample, the study will use the CDC recommendation for collecting the urine sample aseptically, by aspirating the urine from the sampling port with a sterile syringe after thoroughly cleansing the port with an antiseptic wipe (Gould et al., n.d.).

Morrison and Holt (2015) found numerous studies with similar research and came up with the same outcome; there was no increase of infection between routine and clinically indicated IV changes. The meta-analysis of seven studies cited in this article were all randomized controlled studies. Thousands of hospitalized patients over the age of 18 were involved when intravenous catheters were medically necessary. All patients were mentally stable with no bacteremia, or immunosuppression. The studies divided their groups randomly; one group had routine IV replacements following the present CDC guidelines, and the other half of the group only had their IV’s changed when clinically necessary. Based on these findings, these studies will change how often nurses are placing IV

Catheters may be inserted when a patient is having a specific type of surgery, such as repair of hip fracture (Johansson et al, 2002). The EPIC Project guidelines, recommend four interventions related to reducing urinary catheter-associated infection (Pratt et al, 2001): Assessing the need for catheterization, selecting the catheter type, Aseptic catheter insertion, Catheter maintenance. Tsuchida and colleagues (2008) found that the use of a ‘pre-connected closed system’ and ‘daily cleansing of the perineal area’ could reduce the incidence of CAUTIs by nearly 50%. Also following guidelines is essential for preventing urinary tract infections some guidelines are; Perform hand hygiene before and after all handling of the catheter, tubing, and drainage bag. Empty the drainage bag when it becomes full or at least once every 8 hours to prevent migration of bacteria. Lastly, keep the drainage bag lower than the level of the patient’s bladder to prevent backflow of urine in the bladder; verify that the bag does not rest on the floor (Caple,

According to the United States Centers for Disease Control and Prevention (2015), urinary tract infections (UTIs) are among the most prevalent healthcare associated infections with 93,300 healthcare related UTIs diagnosed in 2011. Seventy five percent of healthcare acquired UTIs are catheter associated urinary tract infections (CAUTI). Because of this, major efforts, including the creation of preventive guidelines, have been made worldwide to reduce the numbers of these infections. These guidelines center on using catheters only when they are needed and only for as long as they are needed. They include specific situations in which catheters should be used which mostly include operative procedures or medical situations that would require

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).

Health care-associated infection (HAI), are infections an individual may acquire while they are receiving treatment for another condition within a health care facility. Catheter-associated urinary tract infections (CAUTI) remain the most commonly reported hospital-acquired condition, and the rates continue to rise. Approximately 600,000 patients develop CAUTI each year, leading to increased health care cost, longer hospital stays, and increased morbidity and mortality rates. Furthermore, multiple studies have shown that urinary catheters are placed in patients who do not have an appropriate indication for catheter placement. In order to improve the quality of care and patient safety in our hospitals, CAUTI has become one of the CMS quality

The need for intravascular catheters are evidently clear in modern day medical practices especially in the intensive care setting (ICU). Despite the necessity of such catheters, their use places patients at risk of developing complications such as infections, thrombophlebitis, endocarditis and a variety of other metastatic infections. In the hospital setting an estimated 250,000 bloodstream infections (BSI) associated to CVC occur annually, thus the need for proper aseptic skin care. The widely used antiseptic for cleansing CVC sites in the United States was iodine. However several studies have shown that cleansing CVC sites with 2% aqueous chlorhexidine gluconate lowered BSI when compared to iodine. (O’Grady et. al., 2011)