Urinary Catheter-Associated Infection

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

Focus on enhancing quality of care has exaggerated on a nationwide scale. Decreasing preventable damages within the health care settings is being on focus furthermore. From this there has been an immediate connection between repayment to quality through pay-for-reporting and pay-for-execution programs. Around 25% of the hospitalized patients have an indwelling catheter in place (Saint, Kowalski, Forman et al., 2008) and there is a 3% to 7% has the probability to get urinary tract infections in such cases. The infection could cause the signs of bladder distress, trouble in urination, and high temperature in such patients. Analysis shows that 48% of patient who has indwelling catheter complains of pain from the catheter, 42 % experience inconvenience from the catheter and 61% found that their daily activities are exceptionally constrained by these catheters (Saint, Lipsky, Baker, McDonald, & Ossenkop, 1999). Urinary tract infections may prompt bacteremia (infection

The first step nurses can take to decrease the incidents of CAUTIs in older adults is avoiding unnecessary use of catheters altogether. Initially, this begins with nurses knowing both appropriate and inappropriate situations in which a catheter should be utilized. According to (Gould et al., 2017), an appropriate situation is one where a patient has acute urinary retention or bladder obstruction, whereas an inappropriate situation is one where a catheter is being used a means of obtaining urine for culture when the patient can voluntarily void. Nurses can also use basic techniques like palpation, percussion, and inspection to effectively assess urinary retention, which is the main reason for catheterization as mentioned earlier. When techniques like this do not achieve desired results,

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.

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.

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

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

The most common health care associated infection (HAI) is CAUTI. Forty percent of all hospital-acquired infections are UTIs and 80% of these are directly linked to having an indwelling urinary catheter in place (Underwood, 2015). Urinary catheters are required in up to 25% of hospitalized patients and bacteriuria results in about 25% of patients with a catheter for greater than 5 days and this number increases by 1 to 5% for each day the catheter is in place after that. The harmful consequences of CAUTI include increased length of stay, higher health care cost, and increased mortality. CAUTI is known to cost health care in the U.S. $400-$500 million annually (Leuck et al., 2015).

Lo et al. (2014) discusses a strategy of education and training for CAUTI prevention. This educational strategy will entail proper insertion techniques, appropriate care of urinary catheters, discontinuation protocols, and alternatives to urinary catheters (Lo et al., 2014). This plan for change will be presented to staff with ongoing education and evaluation over a period of six months. Resources will involve the unit’s leadership team (unit coordinators, clinical nurse specialist, manager). The unit’s leadership will be involved and supportive to staff during all phases of the change

Joint Commission released national patient safety goals for hospitals in January of 2016. These patient safety goals were “established to help accredited organizations address specific areas of concern in regards to patient safety” (Facts about the National Patient Safety Goals, 2015). National patient safety goal 07.06.01 focuses on the prevention of catheter associated urinary tract infections (CAUTI) in hospitalized patients. Evidence based practice should be implemented to stop these common infections occurring in patients nationwide. Indwelling urinary catheters are only recommended in certain patients, for example to prevent further breakdown of sacral wounds or pressure ulcers in incontinent patients, for comfort in end of life care

Urinary tract infections are one of the most hospital-acquired infections in the country. With so much technology and evidence based practice, why is this still an ongoing problem worldwide? Could it simply be the basics of hygiene or just patient negligence? The purpose of this paper is to identify multiple studies that have been done to reduce or prevent hospital associated urinary tract infections. In these articles you will find the use of different interventions that will aid in lowering the risk of these hospital acquired infections.

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?

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

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.

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