NURSE 590 TOPIC 1 DISCUSSION 1 ESSAY
NURSE 590 TOPIC 1 DISCUSSION 1 ESSAY
NURSE 590 TOPIC 1 DISCUSSION 1 ESSAY
Topic 1 DQ 1
Catheter-associated urinary tract infections (CAUTIs) are a leading cause of increased costs and poor patient outcomes for millions of patients in healthcare facilities. The Centers for Disease Control and Prevention (CDC) (2019) is categorical that urinary tract infections among hospitalized patients account for over 75% of infections associated with the use of catheters. Nurses as healthcare providers require sufficient knowledge and understanding of the different aspects on CAUTIs to reduce their prevalence by using evidence-based practice interventions through a care bundle approach, use of aseptic techniques, and engaging in continuous professional development through education (Abdelmoaty et al., 2020). As such, the proposed intervention in this quality improvement project to tackle CAUTIs in the facility is training of nurses on best practices on catheter insertion and care to reduce the prevalence by 50%. Training nurses to understand different aspects of catheterization like use and removal of Foley catheters, replacing the Foley catheters and daily CHG bathing as well as keeping tubing free of kinks and loops will offer sufficient knowledge for the providers to improve overall management of CAUTIs and reduce their prevalence.
ORDER A CUSTOM PAPER NOW
The intervention supports the population of focus, the setting, and nurse’s role in many ways. Firstly, it improves patient safety and reduce the increased cost burden associated with longer stays in the facility. Secondly, the intervention ensures that the facility provides quality and patient-centric care for the targeted patients (Kaur, 2021). Again, the intervention is essential for nurses as it demonstrates their heightened and critical role in improving quality of care, patient safety and overall satisfaction with their duties and responsibilities.
The selected issue of investigation, CAUTIs and the need to offer training to nurses, is amenable to a research-based intervention as it can be altered to align with the PICOT approach. For instance, the use of nurse training can be replaced with other interventions like implementing care bundles to improve patient safety that include CAUTIs and other aspects of quality improvement (Lem et al., 2022). The increased prevalence of CAUTIs in the facility reduces the quality of care and having this intervention is critical to addressing quality improvement aspects.
PICOT Statement
Among hospitalized patients with indwelling Foley catheters (P), does training nurses on the best practices on catheter insertion and care (I) compared to standards Foley care (C) reduce the rates of CAUTIs by 50% and length of hospital stay (O) within four months (T)?
References
Abdelmoaty, A., A. Sabry, H., M. Kenawy, A., & H. ElSebaie, E. (2020). Indwelling Urinary
Catheter: Effect of Training on Nurses Knowledge and Skills. The Egyptian Family Medicine Journal, 4(1), 144–157. https://doi.org/10.21608/efmj.2020.90206
CDC. (2019, October 1). Catheter-associated Urinary Tract Infections (CAUTI) | HAI | CDC.
https://www.cdc.gov/hai/ca_uti/uti.html
Kaur, D. (2021). The Impact of Nurse-Led Initiative Interventions on CAUTI. Master’s Projects
and Capstones. https://repository.usfca.edu/capstone/1235
Lem, M., Jasperse, N., Grigorian, A., Kuza, C. M., Deyell, J. S., Prasad, J. P., … & Nahmias, J.
(2022). Effect of external urinary collection device implementation on female surgical patients. Infection, Disease & Health, 27(4), 227-234. https://doi.org/10.1016/j.idh.2022.05.005
ORDER A PLAGIARISM-FREE PAPER HERE
Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing. How does this support the population of focus, your setting, and role? Justify how the problem you selected to investigate is amenable to a research-based intervention using the PICOT format. Include your PICOT statement with your response.
THE POPULATION IS 60 BEDS IN THE MEDICAL UNIT
7O RNS TO EDUCATE
ITS MOSES WHO DID MY PICOT
ORDER A PLAGIARISM-FREE PAPER HERE
Education Tip Sheet: CAUTI Prevention Standards of Care
Professional Development Council and HAI Prevention Education Workgroup
Responsibilities | RN | RNs and Clinical Partners |
Assessment |
Ø Assess for alternatives to indwelling urinary catheter use to
avoid unnecessary catheter use Ø Assess that an indwelling urinary catheter is indicated Ø Review any contraindications to the procedure and notify MD |
|
Implementation of indwelling urinary catheter |
Ø Verify the MD’s order
Ø Choose appropriate catheter Ø If there are any problems encountered with catheter insertion, notify MD immediately Ø Observe sterile technique when inserting, manipulating, and maintaining an indwelling urinary catheter Ø Document date and time of insertion |
|
Maintenance and management of indwelling urinary catheter |
Ø Document assessment findings and indications for catheter use q shift
Ø Inspect periurethral area for signs of inflammation and infection Ø Provide pt and family education on proper handling of catheter Ø Provide other health care workers education on proper handling of catheter |
Ø CHG baths are required daily
Ø Document and provide peri care and foley care q shift and PRN after each loose bowel movement Ø Clean foley during CHG baths, and can also clean foley with peri wash, peri wipes, soap and water Ø Keep catheter and tubing free of kinks and avoid dependent loops Ø Keep the drainage bag below the pt’s bladder Ø Empty drainage bag regularly when it becomes ½ to 2/3 full Ø Inspect catheter for any leakages or break in system Ø Secure catheter properly and assess securement device every shift Ø Keep drainage bag off the floor Ø Maintain safety of catheter when turning, repositioning or transporting pt Ø Monitor and document urine output q shift
Clinical Partners: Ø Notify RN if there are any leaks in the system Ø Notify RN if pt is refusing CHG bath or foley care |
Indications for replacement |
Ø Replace catheter when leakages occur or break in sterile
system Ø Consider alternative devices prior to replacement Ø Notify MD if there are any problems with the catheter (e.g. obstruction, pain, discomfot) Ø Notify MD before replacing catheter |
|
Indications for removal of catheter | Ø Assess daily for indication for removal
Ø No appropriate indication Ø No order for catheter Ø Meets critereia for Indwelling Urinary Catheter Removal Standardized Protocol Ø Meets criteria for Active Voiding Trial |
|
Urine specimen collection from
inwelling urinary catheter |
Ø It is highly recommended to collect urine culture
specimen from a newly inserted catheter (if the catheter has been in placed >14 days) Ø Use the complete vacutainer foley collection kit to obtain urine from the disinfected sampling port Ø Send urine specimen w/in 1 hour of collection |
Reference: Lippincott Procedures Manual
For more information, contact the SME, Eunice Santos, MSN, RN, NPD Practitioner, at: Phone: (310) 967-8350 Email: Eunice.Santos@cshs.org
For any feedback, please contact the PDC chair at Charisse.Murakami@cshs.org