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.
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
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not provide the search strategy including a number of databases and other resources which identify key published and unpublished research.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
Urinary tract infections (UTI’s) are much too common in the elderly population (Lim, Whitehurst, Usoro, & Ming Ng, 2014). Some residents who develop these nosocomial infections will become septic, leading to 10% mortality within 7 days (Saint, S., Kaufman, S.R., Rogers, M.A., Baker, P.D., Boyko, E.J., Lipsky, B.A., 2006). UTI’s can cost between $749 and $1,007 per infection (Meddings, J., Rogers, M.A.M, Krein, S.L., Fakih, M.G., Olmsted, R.N., & Saint, S., 2013) and according to Spector, Limcango, Williams, Rhodes, & Hurd, (2013), UTI’s are 23% of the total avoidable hospitalizations. The Centers for Medicare and Medicaid Services (CMS), consider
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.
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
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
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.
According to the Centers for Disease Control and Prevention [CDC] (2017), “Urinary tract infections (UTIs) are the fourth most common type of healthcare-associated infection, with an estimated 93,300 UTIs in acute care hospitals in 2011. UTIs additionally account for more than 12% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract” (p. 7-1).
Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection
For patients that have indwelling catheters, with the evidence-based practice and standards of care, UTI’s does still continue to be an ongoing problem today. In one of the large hospitals in my area had recently developed a poster and video approach with special focus on alternatives to urinary catheterization, removing catheters early, and the reinforcement of sterile technique prior insertion and foley catheter care were used to educate nursing staff and improve outcomes. The purpose of this paper is to educate nursing on
National Patient Safety Goals (NPSGs) were established in 2002 by the Joint Commission 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 our 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 (UTIs) are the most common nosocomial infection; accounting for up to 40% of infections reported by acute care hospitals. Up to 80% of UTIs are associated with the presence of an indwelling urinary catheter. Catheter associated urinary tract infections (CAUTIs) represent the largest proportion of healthcare associated infections (HAI). Catheter-associated urinary tract infection (CAUTI) increases hospital cost and is associated with increased morbidity and mortality .CAUTIs are considered by the Centers for Medicare and Medicaid Services to represent a reasonably preventable complication of hospitalization. As such, no additional payment is provided to hospitals for CAUTI treatment-related costs.CAUTIs can lead to
(2014) article “Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: An integrative review,” was published in the British Medical Journal Quality Safety. Meddings et al. (2014) conducted a systemic review and a meta-analysis in a hospital setting. Also, Meddings et al. (2014) report CAUTIs was reduced by 53%. The authors conclude UC reminders and stop orders appear to reduce UC use and CAUTIs.
A Catheter-Associated Urinary Tract Infection (CAUTI) prevention team was developed at a hospital in response to the Centers for Medicare & Medicaid Services’ policy and to improve patient safety. This policy significantly