WEEK 1 RUA Capstone Evidence-Based Project on Catheter associated urinary infection

Week 1 Catheter-Associated Urinary Tract Infections

Hospital-acquired infections cost healthcare organizations billions of dollars every year. They are the leading courses of the extended length of stay in a hospital, increased use of resources and a decreased patient outcome. After speaking with nursing management and infectious control department, it is clear that Catheter-Associated Urinary Tract Infections has become a menace in our healthcare facility with a higher acute rehabilitation unit incidence (Saini et al., 2017). I also noted that low hygiene and poor catheter insertion and removal techniques are the leading causes of organism inoculation inside the bladder promoting bacterial colonization through providing adhesion surfaces and resulting in irritation of the mucosal membrane in the perineal area.

Unnecessary and prolonged use of the indwelling urinary catheters is the major predisposing factor leading to (CAUTI) Catheter-Associated Urinary Tract Infections ((Felix, et al., 2016), and more so failure to adequately clean the perineal area and on daily basis. Alone, CAUTI causes approximately 13000 deaths annually, causing increased mortality and morbidity arête and increased healthcare costs. Yet hospital-acquired infections such as CAUTI can be easily prevented (Healthcare-associated infection, 2018). Indwelling urinary catheters are external catheters used by in cooperative urinary tract male patients with a dysfunction of bladder emptying or such conditions as a spinal injury. Therefore the urinary tract catheter device is inserted by a physician to help in managing the flow of urine in cases where there is no bladder obstruction or urinary retention.

Indwelling urinary catheter insertions (IDC) is done mostly in the admission room which is where I work in a community hospital. CAUTI has become a serious infection concern which occurs when urinary catheter insertion or removal is inappropriate or unjustified and lack of frequent cleaning of the perineal area (CDC, 2016). Working in an environment where most patients get urinary tract catheter insertions makes those patients more prone to acquiring infections while in the hospital.  CAUTI can be devastating complications for patients that are already critically ill in the intensive care unit. According to (Curiej, 2019), hospital-acquired infections affect 1.7 million patients annually and result in 9,000 deaths each year. Research has shown the risk of developing bacteriuria on catheterized patients as high as 3% to 10% per day and close to 100% after the catheter has been in place for 30 days (McNeill, 2017). In the United States, the statistics are alarming, approximately five million catheters are placed annually, and 50% of the patients do not meet appropriate criteria, and 40% of physicians are unaware of their patients have a urinary catheter in place (Mori, 2014).

After discussing with the critical care manager and infectious control team, it was agreed that perineal area damage during insertion and removal of the urinary catheter in the urethra and lack of frequent cleaning is detrimental to patient outcomes which include the entry of gram-negative bacteremia, sepsis, and high mortality (Skanlon, 2017). We discussed many ways to prevent CAUTI which include use of the long-term acute care hospital (LTACH), that involve frequent and regular cleaning of the perineal area. extra catheter care supplies, such as Foley catheter bags, tubing, stat locks, perineal soap, etc. and providing educational resources for staff and patients on recognizing CAUTI, ways of preventing CAUTI and general care for an indwelling catheter. It is very important to prevent any complications when it comes and the quality of care that is provided is the main contribution to whether an infection is either obtained or prevented. Capstone Paper Discussion Project

References

European Society of Radiology (ESR. (2019). Patient safety in medical imaging: A joint paper of the European Society of Radiology (ESR) and the European Federation of Radiographer Societies (EFRS). Insights into imaging, 10(1), 45.

Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G., Pegues, D. A., & Healthcare Infection Control Practices Advisory Committee. (2010). Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control & Hospital Epidemiology, 31(4), 319-326.

McNeill, L. (2017). Back to basics: How evidence-based nursing practice can prevent catheter-associated urinary tract infections. Urologic Nursing, 37(4), 204-207.

Oliveira, P. R., Carvalho, V. C., Felix, C. D. S., Paula, A. P. D., Santos-Silva, J., & Lima, A. L. L. M. (2016). The incidence and microbiological profile of surgical site infections following internal fixation of closed and open fractures. Revista brasileira de ortopedia, 51(4), 396-399.

Saini, H., Vadekeetil, A., Chhibber, S., & Harjai, K. (2017). Azithromycin-ciprofloxacin-impregnated urinary catheters avert bacterial colonization, biofilm formation, and inflammation in a murine model of foreign-body-associated urinary tract infections caused by Pseudomonas aeruginosa. Antimicrobial agents and chemotherapy, 61(3), e01906-16.

Scanlon, K. A., Wells, C. M., Woolforde, L., Khameraj, A., & Baumgarten, J. (2017). Saving lives and reducing harm: A CAUTI reduction program. Nursing Economics, 35(3), 134-141.

ADDITIONAL INSTRUCTIONS FOR THE CLASS – WEEK 1 RUA Capstone Evidence-Based Project on Catheter associated urinary infection

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Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

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Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. WEEK 1 RUA Capstone Evidence-Based Project on Catheter associated urinary infection

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Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

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I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

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The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

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