Catheter-associated urinary tract infections (CAUTIs) acquired in hospitals are a typical and exorbitant concern in the healthcare sector. Healthcare-associated infections account for over 30% of catheter-associated urinary tract infections in the world. Evidence-based practice rules obtained from legal, current research and other evidence sources can effectively improve patient outcomes and quality care. The essential objective of this paper is to outline how nurses can apply critical interventions for CAUTI reduction.
Nosocomial infections are equally dangerous, and the fact that they are mostly caused by negligence is more reason why they are preventable. There are a couple of risk factors for catheter-affiliated infections and provide the key areas that healthcare practitioners should be more vigilant in. They include, catheter hub or exit-site colonization, catheter insertion, hospital stay longer than seven days, among others.
Data to Support QI Problem
UTIs are infections that involve any part of the urinary system such as urethra, bladder, ureters, and kidneys. Statistics show that in nosocomial infections, catheter-associated urinary tract infections top the list. Data from the National Healthcare Safety Network (NHSN) indicate that around 75% of nosocomial UTIs are affiliated with urinary catheterization. Recent prevalence surveys show that 17.5% of patients in European hospitals and 23.6% of patients in American hospitals have an indwelling catheter. Approximately 45 79% of patients in adult critical care, 17% of patients on medical wards, 23% on surgical wards, and 9% on rehabilitation are subjected to catheterization. According to these statistics, it is evident that catheterization is almost unavoidable and the best that healthcare practitioners can do is improve their quality.
Literature to Support QI Problem
The primary purpose of a urinary catheter is to drain urine and is used on patients whose locomotion is compromised such as the young and the aged. Between 15-25% of all hospitalized patients receive the urinary catheters during their stay at the hospital and the longer the catheterization, the increased is the risk for catheter UTIs. Catheters are classified according to their duration of use. Catheters are considered short-term if they are in situ for less than one month and chronic for any period more than 30 days. Short-term catheters are preferred in acute care facilities whereas the chronic catheters are for patients in long-term care facilities. The duration that a patient is on catheterization is the most significant in determining bacteriuria.
Action Plan
To start with, hospitals must consider educating staff about management of indwelling catheter and providing assessments on a regular basis about any incidence of urinary tract infection related to catheter helps in reducing CAUTI (Spath, 2013). Review of every indwelling catheter should happen 3 to 4 days after insertion. Observing the patient should proceed until the patient is dispensed from the ward or his/her catheter detached ("Hospital-Acquired Infections: Practice Essentials, Background, Pathophysiology", 2017).
When introducing an indwelling catheter, health organization leaders should ensure that the staff practices utilization of refined sterile technique suggested by Centers for Disease Control and Prevention (Spath, 2013). Strict use of pure method along surgical outfits and full use of clean window drapes like the ones utilized in an operation room should be adopted (Nicolle, 2017).
Water, soap and incontinence cleanser should be used to cleanse the urethral meatus. Antibacterial solutions and treatment creams should be avoided when cleaning the meatus. Well maintenance of closed urinary system decreases the probability that patients will detach the urinary drainage system (Vincitorio D, 2017). This method minimizes the danger of bacterium and CAUTIs.
References
Hospital-Acquired Infections: Practice Essentials, Background, Pathophysiology. (2017). Emedicine.medscape.com. Retrieved 7 July 2017, from http://emedicine.medscape.com/article/967022-overview
Nicolle, L. (2017). Catheter associated urinary tract infections. Retrieved 7 July 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114799/
Spath, P. (2013). Introduction to healthcare quality management (2nd edition ed.). Chicago Health ADMINISTRATION PRESS.
Vincitorio D, e. (2017). Risk factors for catheter-associated urinary tract infection in Italian elderly. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 7 July 2017, from https://www.ncbi.nlm.nih.gov/pubmed/25087142
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