Urinary Catheters

Bernard, M.S., Hunter, K.F., & Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urologic Nursing 32(1)

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?

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.

A catheter is used in an event of an individual that has either had trauma or surgery and as a result has temporary urinary retention (Patton & Thibodeau, 2013)

A Foley catheter is a thin, sterile tube inserted into the bladder to drain urine ( ). There are many types of catheters such as a straight, indwelling, and condom catheters. A straight catheter is one that does not stay inside the person. It is removed immediately after urine is drained. An indwelling catheter is one that stays inside of the bladder for a period of time. And last, a condom catheter is one that has an attachment that fits onto the penis. This catheter is changed daily or as needed. For the purpose of this document, the care that is going to be performed will need to be performed on a patient/resident with an indwelling catheter.

This study focuses on whether the use of reminders assists in decreasing the use of urinary cathethers and the occuruence of catheter associated urinary infections. UTI risk increases by 5 percent with the use of indwelling catheters. The Center for Disease Control and Prevention (CDC) has recommended that patients receive catheters if indicated but over 41% of physicians have ignored this and nursing staff have ignored evaluating when the catheter should be removed. Besides noncompliance with the CDC, this study shows for patients who have catheters, the reminder system will help to decrease the length of indwelling cathethers are potential UTI infection associated with it. In previous studies, their has been different views as to whether

Clean intermittent catheterization (CIC) is a procedure to remove urine from the bladder by placing a small, flexible tube (catheter) into the bladder though the urethra. The urethra is a tube in the body that carries urine from the bladder out of the body.

Catheter Associated Urinary Tract Infection (CAUTI) is defined as the occurrence of a urinary tract infection (UTI) in patients with a urinary catheter in the past 48 hours. Published guidelines by the Infectious Diseases Society of America (IDSA) further defines CAUTI by the presence of significant bacteriuria of ≥ 103 CFU/ml found in the urinalysis and signs and symptoms of a UTI without the presence of another cause for these findings. Signs and symptoms of CAUTI could include: altered mental status, fever, chills, flank pain, costovertebral angle tenderness, and hematuria. If the catheter has been removed in the past 48 hours the symptoms could also include urgency and frequency (Fakih et al., 2016).

Peripheral IV catheterization is a painful and potentially anxiety-provoking procedure for the patients. The interventions to reduce the pain caused by venipuncture were explored in the past decades (Oman, 2014). The majority of the studies reviewed in this summary included one level 1 evidence of meta-analyses (Oman, 2014), three level 2 evidences of randomized controlled trials (Beck, 2011; Deguzman, 2012; Kahre, 2011) and one level 3 evidence of controlled trials without randomization (Levitt , 2013). Many studies have demonstrated that 1% lidocaine intradermal injection before IV insertion can reduce the pain significantly (Oman, 2014). Kahre and his colleagues’ study indicated bacteriostatic normal saline (BNS) group had lower pain score

When changing a suprapubic catheter, you need to follow precise steps to keep the procedure sanitary as well as correct. Firsts, you need to have a clean and sanitize table that you can place all the supplies needed for it. Once, the table is clean go ahead and lay out all the following supplies; the catheter, insertion kit, iodine, personal lubricant, saline syringe, and collection bag. After you have everything you need laid out go ahead and put on both sets of surgical gloves. Next, clean the area in which the suprapubic catheter will go in with the iodine, making sure that you cover a 1-inch circumference around the surgical site. Afterward, you will need to open the insertion kit and get out the empty syringe and connect it to the used

Cardiovascular disease has long been the leading cause of death in the United States and is predicted to affect forty percent of the population by 2030 (Narang et al., 2016). Moreover, research states the cardiovascular workforce is inadequate to meet the rising demands of our aging population (Narang et al., 2016). Nurses caring for patients in the cardiac catheterization laboratory are key members of the cardiovascular workforce. While there is research to support the development of nurses working in the pre- and post-cardiac catheterization laboratory settings; current literature reveals little information about the development of nurses working in the cardiac catheterization laboratory (Currey, White, Rolley, Oldland, & Driscoll, 2015).

I do agree with you that utilization of Health Information Technology (HIT) and Electronic Health Records (EHRs) will enable adequate data collection and research analysis for evidence-based practice and patients’ quality improvement.

Contributing factors to the problem could be lack of education and training in caring for patients with urinary catheters, poor time management to properly care for patients with urinary catheters, and a lack of evidence-based bundled intervention. An example of an inappropriate reason would be keeping a urinary catheter device for convenience due to the incontinence of the patient.

The policy was initiated July 2015. Hospital across the world are struggling with catheter-associated urinary tract infection which is an easily preventable hospital acquired infection. In nursing school, of the first skills check-off in the use of aseptic technique. During my maternity and pediatric clinical rotation in nursing school the proper insertion of an indwelling urinary catheter using aseptic technique was a required skill check off. As a new nurse on the medical surgical unit during my eight-week orientation proper insertion of indwelling urinary catheter was required competency check off. As a floor nurse and ICU nurse, I have put in many urinary catheters and have used my nursing judegement to discontinue those catheters that

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