The implementation of the catheter associated urinary tract infection (CAUTI) prevention bundle is the proposed solution.

Description

Proposed Solution

The implementation of the catheter associated urinary tract infection (CAUTI) prevention bundle is the proposed solution. The problem states that the population is adult patients with an indwelling catheter. A near sterile system with a catheter and a ball retention device implanted either through the urethra for bladder draining is an occupied urinary catheter(Davies, et al., 2018). The urine storage catheter is associated with external collecting instruments (e.g., drainage pipe and bag). Urinary catheters for indwelling are only recommended for short-term use, defined less than 30 days. Throughout two specific bladder dysfunctions, Urinary Incontinence (UI), and urinary retention, the bladder emptying by the catheter(Dehghanrad, et al., 2019).

The definition of a CAUTI Prevention Package strategy is a collection of straight forward, evidence-based interventions that have an interconnected and preferably synergistic impact. Avoid unnecessary urinary catheters, attach urinary catheters using aseptic procedures, manage urinary catheters dependent on instructions, assess urinary catheters on a daily basis, and eliminate as quickly as possible. The package method includes the following(Davies, et al., 2018).

In particular, CAUTI prevention is primarily targeted at the use of urinary catheters with a particular focus on continuous catheter evaluation and elimination, especially for those patients for whom no clear indication is appropriate. The bladder kit, therefore, focuses primarily on the “method” of urinary catheter reduction(Sorour, et al., 2016). In CAUTI prevention, Bladder Bundle is the first defense line. This helps healthcare clinicians to have an effect on results by assessing the bladder role and then using the right alternatives. The bulk of patient care starts and ends with the bladder kit. The opportunity for contamination is one of the significant risks involved with urinary catheters. Reasonable care will mitigate this risk(Monina Hernandez, PGDipHSc, Stewart, & PGDipHSc, 2019).

Organization Culture

The bladder bundle approach also reflects the culture and resources of the community. In the corporation, it could quickly be enforced. For a number of essential factors, CAUTI avoidance has been difficult. Careful use of urinary catheter and CAUTI rates monitoring will help to maintain urinary catheter interventions. Most specifically, changing procedures of placing and removal of urinary catheters will also include steps to improve nurses, doctors, and patients ‘ needs for urinary catheters(Elkbuli, et al., 2018).To help organize and prioritize the many options for CAUTI prevention, the conceptual model of the “Urinary Catheter Lifecycle” highlights the fact that the best-performance interventions to prevent CAUTI will be directed at least one of the four “stages” of catheter “life.” Urinary catheter bags need to be emptied to a clean container daily at regular intervals to prevent pull on the catheter.It must be occur every 3to 4 hours or whenever the bag is about half to three-quarters full. Hand hygine is the effective method to prevent all the infections(Monina Hernandez, PGDipHSc, Stewart, & PGDipHSc, 2019).

Expected Outcomes

The expected result of the PICOT is that the CAUTI levels would be rising.  The solution of the bladder kit lowers the CAUTI output efficiently. Nevertheless, the correct urinary catheter placement procedure is also essential. Ensure that catheters are inserted using the right technique only by trained individuals. Using the aseptic technique and sterile tools, insert the catheter, and protect it correctly after injection to avoid friction and urethral movement. Velcro moves and also slipping in and out can lead to irritation as well as micro-organism transmission to urinary meatus(Elkbuli, et al., 2018). It is crucial to take the protection. There are various types of protections available for the skin care of the patient. It is also critical to resist the products which can hurt the skin of the patient (Elkbuli, et al., 2018).

Hand hygiene is the most important method to prevent transmission of infection. The maintenance of a correct protocol of hand hygiene is the only significant means to avoid infectious agents’ transmission. Make the use of antimicrobial / antiseptic impregnated catheters if the CAUTI threshold for your company is not lowered with the aid of a specific strategy (Davies, et al., 2018).

Method to Achieve Outcomes

The first phase in the development is participating and preparation. Involving and educating the bladder package program, encourageparticipating in presentations, through material conference calls. In turn, each location will be provided a packaging toolkit outlining prevention strategies, interventions, and helpful guides through face-to-face sessions(Davies, et al., 2018).

In order to lead the effort and to assemble a bladder package squad that usually often involves a surgeon, the facility will recognize and welcome at least one nurse champion (for example, case manager, child supervisor, professional nurse expert). Members are invited to participate in regular face-to-face workshops by the bladder bundle team. The conference calls include all material calls of experts concerned with a specific subject matter as well as coaching calls. These calls are recorded so that participants who do not participate can listen to the debate at any time(Dehghanrad, et al., 2019).

 

 

 

 

 

 

 

 

 

Evidence-Based Practice Proposal – Section B: Problem Description

AnittaJacob

Grand Canyon University: NUR 699 Evidence Based Practice Project

01/22/2020

Evidence-Based Practice Proposal _Section B: Problem Description

Background

CAUTI is one of the severe diseases contracted in the hospital. This leads to prolonged hospital stays and higher health care costs and mortality of patients at times. Extended use of the urinary catheter is the primary source of urinary tract infections (CAUTI) connected with the catheter. The most severe healthcare-related infection, urinary tract infections (UTI), accounts for as many as 36% of all medical-related infections. Up to 80% of the diseases represented by catheter associated urinary tract infection (CAUTI). Urinary catheter insertions can often be unnecessary or ineffective, causing possibly preventable and severe patient anxiety, humiliation, irritation, and reduced pain and workload, as well as substantial treatment pressures, costing and hospitalization, in many cases, insertions can trigger (Meddings, et al., 2014, pp. 280-281).

Stakeholders

Some stakeholders deal with CAUTI hospital prevention. The main parties involved are the hospital owners and staff with the CAUTI. They will benefit from the CAUTI Prevention Tool as it improves thefunction and reduces the CAUTI. New partners include an agency running CAUTI programs, for example, the Disease Control Center, Mayo Clinic, etc. The organization must be active as it will allow the workers on CAUTI to receive the information. Health centers and health professionals must also be trained on CAUTI because they deal every day with patients (Lo E., et al., 2008, pp. S43-S44).

   PICOT question

Among hospitalized adult patients with indwelling catheter (P) how does the implementation of CAUTI prevention bundle (I) when compared with no specific measures (C) reduces CAUTI (O) during the hospitalization period (T)?

Purpose and Project Objectives

The project’s goal is to reduce hospital CAUTI levels through the CAUTI reduction method.  Protracted use of the urinary catheter is the leading risk factor for catheter-associated catheter UTI (CAUTI).Consequently catheters should only be used per protocol and withdrawn once no more required. CAUTI treatment is essential promptly. An untreated UTI may cause a severe infection of the kidney. Furthermore, catheterizes can already be impaired by immune system disorders. Combating the CAUTI will lead to additional tension on the immune system. This enhances the risk of future infections (Lo E., et al., 2014, pp. 465-466).

Rationale

One of the most severe infections that patients can have in the hospital is the CAUTI. CAUTIs are generally more treatment-resistant than other UTIs. This is true for infections in hospitals. Since CAUTIs can lead to acute kidney infections, they are harmful. This is why long-term health needs a quick diagnosis and treatment. CAUTIs are one of the most severe diseases associated with the hospital. Many healthcare organizations, therefore, focus significantly on prevention (Gould, et al., 2010, pp. 322-323).

The following are some strategies to prevent the CAUTI in hospital

  • Recent CAUTI Prevention Techniques are focused on a ‘ patient party ‘ introduction. A treatment kit is a collection of treatments that have resulted in significant and sustainable decreases in CAUTIs for all patents for urinary catheters (WHO, 2018, p. 3).
  • Urinary catheterization: health workers should be trained in appropriate procedures for urinary catheters insertions and maintenancebased on local written protocols (WHO, 2018, p. 4).
  • Catheters in various sizes are available. The smallest catheter in diameter should be used to allow free urine flow. The greater width, which leads to trauma and ischemic necrosis, is more likely to produce unnecessary pressure on the urethral mucosa. Urological patents, as well as some other patent groups, may require larger-scale catheters, which should only be used on the advice of specialists (WHO, 2018, p. 4).
  • Urinary catheterization with sterile or high-level devices and aseptic treatment should always be done. A safe lubricant or local anesthetic cream should be used to alleviate urethra damage and patent irritation (WHO, 2018, p. 4).
  • Urinary meatus cleaning should be done so that there are no encrustations in the meatus. Cleaning is enough with soap and water; the use of antimicrobial ointments or urethral meat disinfectants is noxious and needs to be avoided (WHO, 2018, p. 5).

 

References

Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G., Pegues, D. A., & Committee, H. I. (2010). Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control & Hospital Epidemiology, 31(4), 319-326. Retrieved from https://stacks.cdc.gov/view/cdc/49910/cdc_49910_DS1.pdf

Lo, E., Nicolle, L. E., Coffin, S. E., Gould, C., Maragakis, L. L., Meddings, J., . . . Yokoe, D. S. (2014). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(5), 464-479. Retrieved from https://www.jstor.org/stable/pdf/10.1086/675718.pdf

Lo, E., Nicolle, L., Classen, D., Arias, K. M., Podgorny, K., Anderson, D. J., &Burstin, H. (2008). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infection Control & Hospital Epidemiology, 29(S1), S41-S50. Retrieved from https://www.jstor.org/stable/pdf/10.1086/591066.pdf

Meddings, J., Rogers, M. A., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2014). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ quality & safety, 23(4), 277-289. Retrieved from https://qualitysafety.bmj.com/content/qhc/23/4/277.full.pdf

WHO. (2018, May). Advanced infection prevention and control training. Retrieved from WHO: https://www.who.int/infection-prevention/tools/core-components/CAUTI_student-handbook.pdf

 

 

 

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