Catheter Associated Urinary Tract Infections Essay
Following an operation, Catheter urinary may be inserted, for a short time, into the patient’s bladder to assist in emptying the bladder. Nevertheless, certain compelling medical circumstances may dictate long-term insertion of the Catheter Urinary to continue draining the bladder. These ways applied in Catheter Urinary maintenance are what turns to be referred to as ‘health care policies’. Lately, cases of Catheter Urinary overuse have been on the rise, despite the fact that the Indwelling Urinary Catheter (IUC), as it is also referred to, is designed for the purposes of effecting healing and diagnosis of the patient. The failure of executing a timely termination of IUC usage is chiefly attributed to the inability of the patient to move, nurses’ workload that hinders prioritization, urinary incontinence as well as limited knowledge regarding IUC risks. This has many at times, resulted in development of other Urinary Tract Infections which are commonly known as Catheter Associated Urinary Tract Infections (CAUTI).
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From literature, a considerable amount of evidence on the CAUTIs prevention is made available with main best recommendations for practice as follows: various coatings, including silver alloy, prevention of unnecessary insertions, and perineal hygiene is highly recommended for patients.
Focus plan for the nursing care in regards to UTI, is aimed at increasing knowledge on knowledge of prevention, compilations’ absence, regimen treatment and reducing both pain and discomfort. This will involve acute pain, hyperthermia, infection, deficient knowledge, uneasy sleep pattern and compromised urinary elimination Catheter Associated Urinary Tract Infections Essay.
Change Model Overview
The ACE star model of knowledge transformation facilitates quick and easy comprehension of the nature, sequences and knowledge characteristics applied in various elements of Evidence-Based Practice (EBP). Where knowledge transformation implies adapting findings of the research to influence health care upshots in a manner anchored in evidence oriented care Catheter Associated Urinary Tract Infections Essay. It portrays different stages that knowledge is transformed through to the stage where it is integrated into practice. The model generally has five broad phases namely, discovery research, evidence summary, translation to guidelines, integration into practice and lastly process and outcome evaluation by design.
With the EBP at the core of this model, nurses are encouraged to adopt this model as a guide to facilitate change. EBP is rapidly gaining momentum in the nursing practice. EBP emphasizes on more practice-related research, modifications in student education and handier working interactions between researchers and clinicians. Simply put, the application of evidence in defining best practices instead of supporting the current practices ensures nursing care remains updated with the modern advances in technology as well as ensuring nursing capitalizes on new knowledge improvements Catheter Associated Urinary Tract Infections Essay.
Define the Scope of the EBP
Cases of Catheter Urinary over use have been on the rise, despite the fact that the Indwelling Urinary Catheter (IUC), as it is also referred to, is designed for the purposes of effecting healing and diagnosis of the patient. The failure of executing timely termination of IUC usage has resulted into many IUC risks such as CAUTIs Catheter Associated Urinary Tract Infections Essay.
Based on the first stage of the ACE star model that encompasses the discovery research, a single study to investigate policies guiding replacement of long term IUC will be conducted among adult patients (Stevens, 2004). Catheter Associated Urinary Tract Infections Essay From the randomized control trials involving 107 participants conducted in three separate healthcare locations namely Israel’s geriatric center, Hong Kong nursing service for the army and the nursing home administration for the USA veterans as recorded in the Cochrane Collaboration, the following comparison pre-stated data was found. Different catheter replacement time intervals were evaluated by Priefer and colleagues (n= 17); different antibiotic prophylaxis replacement times were evaluated by Firestein and colleagues (n= 70); and different cleaning solution types were compared by Cheung and colleagues.
Generally, adoption of use or non- use of policy in the prevention of CAUTIs has a significant impact on the quality improvement in the care adults with IUC receive.
Stakeholders
The research will involve the following; the Infection Prevention specialists, Urology Specialists, Ward Managers/ Matrons and The entire Healthcare Staff Catheter Associated Urinary Tract Infections Essay.
Determine Responsibility of Team Members
The research members will perform their tasks respectively as follows; Urologists will offer competent training on current care as well as removal and insertion. The Infection prevention specialists will have roles ranging from auditing and inspecting use of catheter, CAUTI and dwell time. Ward Managers/ Matrons will be tasked with ensuring proper evidence-based training is given to all healthcare personnel dealing with catheter insertion, current care giving and removal. The responsibility of entire Healthcare Staff will be to set out learning as well as development needs besides taking accountability for the delegated tasks to non-registered member of staff.
Evidence
A thorough search for evidence in this proposal yielded Clinical Practice Guides, EBP guidelines, and Quality improvement data besides the Evidence summary Catheter Associated Urinary Tract Infections Essay. Very small methodological errors existed in all the three trials. Thus, new trials are required to so that they can answer research questions precisely.
Summarize the Evidence
The following three are some few evidence-based interventions discovered in the summary evidence that could become handy in the carrying out the project in future as suggested by (Faikh M G, et al., 2014) .
- Various coatings, including silver alloy, and constituent materials of catheters have been undertaken through numerous changes to boost comfort and prevent infection. In the Journal of Clinical Nursing, a review was conducted systematically and showed that silver alloy utilization in IUC reduced CAUITs. Most indwelling catheter kits were designed by hospitals with silver alloy coating as the main components (Lederer J W. Jarvis W R. Thomas L, et al., 2014).
- Prevention of unnecessary insertions of IUC as the practice was found by (Anema, C., Schalich, C., Skewis, L., et al, 2014), to be taking place in emergency departments without orders of the physician. Life-threatening complications such as urethral strictures, hematuria, urosepsis, and urethritis and bladder perforations occurred even after a short duration of use.
- Perineal hygiene is highly recommended for patients with indwelling catheters because the direct exposure they have towards microorganisms makes them highly vulnerable to CAUTIs. This can be achieved through daily cleaning of insertion points with water and soap during bathing or showering (Barsuk JH, Cohen ER, Pots S, et al., 2014) Catheter Associated Urinary Tract Infections Essay.
Develop Recommendations for Change Based on Evidence
It is recommended that the nursing healthcare personnel handling IUC cases to effect quality improvement that is based on evidence as well as ensure there is knowledge transformation in the practice Catheter Associated Urinary Tract Infections Essay. Care is supposed to be redesigned to ensure it becomes safe, effective and efficient. Nurses are expected to launch initiatives like training and curricular modifications, development of models and theories, participate in new fields of scientific research and develop a network of research nationally to promote improvement.
Translation
Action Plan
The plan to implement this project will involve working systematically through steps of infrastructural preparation, project stakeholders’ coordination and eventually monitoring the implementation outcome. Catheter Associated Urinary Tract Infections Essay The outcome evaluation plan will entail engaging stakeholders, program description, evaluation design focus, justification of conclusions and using and sharing lessons learned among the nursing staffs.
Process, Outcomes Evaluation and Reporting
The anticipated outcomes of this research are to encourage the use of evidence-based healthcare practice policies and procedures that will result into the overall improvement in the prevention of Catheter Associated Urinary Tract Infections. Patient satisfaction is also expected to rise as in correspondence to the quality care they receive. The outcome of this research will be communicated through written reports such as fact sheets, newsletters, annual reports, empirical publications and abstract and briefing. Reports prepared visually or orally will also become handy when it comes to communication of outcomes to stakeholders.
Identify Next Steps
There is relatively low morbidity and mortality resulting from CAUTIs as compared to other Healthcare Associated Infections. But occurrence of urinary catheters still high and could turn in the long run to be infectious or fatal Catheter Associated Urinary Tract Infections Essay. Therefore, the use of Urinary Catheter Protocol (UCP) is necessary though there is need to determine barriers hindering implementation of UCP so as to minimize catheter use and eventually eliminate CAUTIs.
To ensure implementation plans of CAUTIs prevention remain permanent, the healthcare personnel should be encouraged to embrace the change and apply it in their care plan. The staff resisting change should be reported to relevant departments for further education on the same.
Disseminate Findings
The research findings will be communicated internally through use of newsletters, meetings, and town hall. Externally, communication of the findings will entail use of posters, publications and conferences bringing together other personnel in the nursing profession.
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Conclusion
The exercise of simple nursing care in nursing and patient advocacy can, in the long run, lead to constructive change in patient results. There is need to revise policy as well as procedures within the institutional and the present-day evidence-based research. This can assist in developing an instrument that will help nurses adhere to proper insertion and maintenance of catheters. The nursing personnel will be required to undergo continuous education and training on appropriate maintenance of IUC and Chlorohexidine Gluconate (CHG) bathing to bring about efficient change in this project. Catheter Associated Urinary Tract Infections Essay. The ACE star model for knowledge transformation will be incorporated to help implement, reinforce, and preserve changes of this project. All ACE star model processes as mentioned in the foregoing such as summary evidence, translation into practice guidelines and practice integration as well as process outcome evaluation will be applied. When this project will be successfully completed, the results will not just be limited to prevention of CAUTIs, other areas like duration of stay, fall, and cost will reduce as well as delirium will decline too (Frampton G. K.,Harris P., Cooper K., et al, 2014)
References
Anema, C., Schalich, C., Skewis, L., et al. (2014). Best evidence of suprapubic catheter and exchange. The Nursing Voice, 6.
Barsuk JH, Cohen ER, Pots S, et al. (2014). Dissemination of a simulation-based mastery learning intervention reduces central line-associated bloodstream infections. BMJ Qual Saf., 47-52.
Beattie M. and Taylor J. (2011). Silver alloy vs. uncoated catheters: A systematic review of literature. Journal Clinical Nursing, 20(15-16) Catheter Associated Urinary Tract Infections Essay.
Faikh M G, et al. (2014). Avoiding potentialharm by improving appropriateness of urinary catheter use in 18 emergency departments., 761-8.e1.
Frampton G. K.,Harris P., Cooper K., et al. (2014). Educational interventions for preventing vascular catheter bloodstream infections in critical care evidence map, systematic review and economic evaluation. Health Technological Assessment., 1-365.
Godfrey H, Fraczyk L. (2004). Preventing and managing catheter-associated urinary tract infections. British Journal Community Nursing, 205-212.
Gokula et al. (2007). Emergency room staff education and use of urinary catheter indication sheet improves use of Foley catheters. American Journal Infection Control., 589-593.
Lederer J W. Jarvis W R. Thomas L, et al. (2014). Multicenter Cohort Study to Assess the Impact os a Silver-Alloy and Hydrogel Coated Urinary Catheter on Symptomatic Catheter Associated Urinary Tract Infections. Wound Ostomy Continence Nursing .
Stevens, K. R. (2004). ACE Star Model of EBP: Knowledge Transformation. Retrieved from Academic Center for Evidence-Based Practice: http://www.acestar.uthscsa.edu.com
Wilson M, Wilde M, Webb L, et al. (2009). Nursing intervention to reduce the risk of catheter-associated urinary tract infection. Wound Ostomy Continence, 137-154 Catheter Associated Urinary Tract Infections Essay.