...occurrence of catheter associated urinary tract infections (CAUTIs). One of the most prominent initiatives is to decrease the number of catheters being inserted and remove the catheters as quickly as possible. Stamford Hospital located in Connecticut, USA, implemented a CAUTI reduction project after noticing that education-based approaches and handwashing efforts had not decreased the incidence of CAUTIs. They implemented a nurse’s checklist for justified use of catheters and timely removal of urinary catheters as well as added a specific catheter charting module in the electronic health record, and held biweekly meetings with...
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...the Prevention of Catheter-Associated Urinary Tract Infections. Urologic Nursing, 34(5), 238-245 8p. doi:10.7257/1053-816X.2014.34.5.238 An Evidence-Based Approach To the Prevention of Catheter-Associated Urinary Tract Infections. Urinary tract infections account for at least 35% of all hospital acquired infections with 80% of them being associated to indwelling catheter. Each day an indwelling catheter is in situ increase pose a 3% tom 10% risk of developing an infection. Early discontinuation of the catheter reduce the risk of acquiring infection and in this study, infection rate drop from 4 cases in second quarter to none in the fourth quarter in the protocol implementation (Carter, N. M., Reitmeier, L., & Goodloe, L. R. 2014). 2...
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...An APIC Guide 2008 Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs) Developing and Applying Facility-Based Prevention Interventions in Acute and Long-Term Care Settings About APIC APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The Association’s more than 12,000 members have primary responsibility for infection prevention, control and hospital epidemiology in healthcare settings around the globe. APIC’s members are nurses, epidemiologists, physicians, microbiologists, clinical pathologists, laboratory technologists and public health professionals. APIC advances its mission through education, research, consultation, collaboration, public policy, practice guidance and credentialing. Look for other topics in APIC’s Elimination Guide Series, including: • • • • Catheter-Related Bloodstream Infections Clostridium difficile Mediastinitis MRSA in Long-Term Care Copyright © 2008 by APIC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the publisher. All inquires about this document or other APIC products and services may be addressed to: APIC Headquarters 1275 K Street, NW Suite 1000 Washington, DC 20005 Phone: 202.789.1890 Email: APICinfo@apic.org Web: www.apic.org ISBN: 1-933013-39-7 ...
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...Catheter associated urinary tract infection Introduction: A urinary tract infection is an infection, most commonly caused by E. coli, of either the lower or upper urinary tract. Urinary tract infections are the most common hospital acquired infection and the majority of the urinary tract infections acquired are associated with an indwelling urinary catheter. Recently, hospitals and other healthcare facilities have taken a special interest in the prevention of catheter associated urinary tract infections which is likely due to recent healthcare reforms. Facilities will usually have to cover the cost of any hospital acquired catheter associated urinary tract infection, hence why most facilities now have strict guidelines to prevent CAUTI. CAUTI not only is a financial problem for healthcare facilities but it is also a serious problem for the health of their patients. CAUTI increases mortality and morbidity on those who acquire it. The CDC has published a guideline to prevent CAUTI. CAUTI statistics: * Accounts for 36% of all hospital acquired infections * 10% mortality rate with 13000 associated deaths annually * It increases the length of a patient’s stay at the hospital to about 2-4 days on average * Urinary catheters are used on about 60-90% of the patients on an ICU * About 40-50% of urinary catheters do not have a valid indication for use * The risk of getting a UTI while catheterized increases about 3-10% daily, so by day 30 you will have...
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...Retrospective analysis of catheter-acquired urinary tract infection (CAUTI): Relationship to stroke diagnosis Abstract Background: Eighty percent of hospital-acquired urinary tract infections are associated with urinary catheters (Joint Commission Resources, 2011). Catheter-acquired urinary tract infections (CAUTI) continues to be at the forefront of the fight against hospital-acquired infections (HAI). Despite ongoing efforts to decrease the incidence of catheter-acquired urinary tract infections (CAUTI) in the acute care setting, overall standardized infection rates (SIR) for CAUTI have decreased only 7% since 2009 (Centers for Disease Control and Prevention (CDC), 2013). Purpose: The purpose of this study was to compare patients with a diagnosis of stroke to patients without a primary diagnosis of stroke to determine if patients diagnosed with stroke had a higher incidence of CAUTI infection. A secondary aim was to examine use of antibiotics, steroids, length of hospital stay, catheter days, and ICU length of stay in both stroke and non-stroke patients. Methods: The study method is a retrospective chart review analysis uses data from an 874-bed large teaching hospital located in the Southeastern United States from 2011 and 2012. After approval from both the Nursing Scientific Advisory Committee and the Institutional Review Board of the institution, analysis of data began. Results: 600 patients were potential candidates for analysis. Of the 600 patients...
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...Catheter Associated Urinary Tract Infections (CAUTIs) By: Janelle Davidson & Liz Ellis Picot Question Thesis Preventing catheterization Nursing Initiatives Nursing Initiatives Continued Aseptic Technique Current Practice P: Any catheterized patient in the health care setting. I: Special initiative for prompt catheter removal. C: Versus routine procedure for catheter removal. O: Decrease catheter associated urinary tract infections. T: During the patient's length of hospital stay. Preventing catheterization, aseptic technique, nursing initiatives, and prompt removal are all factors that contribute to the decline of indwelling catheter infections. No clear protocol for catheter placement. Criteria included in the research: -Urinary retention (neurogenic bladder) -Urine Tract Obstruction (blood clots, enlarged prostate, urethral problems) -Close monitoring of urine output of critically ill and immobile patients. -Urinary incontinence that poses a risk for a stage 3 pressure ulcers. -Comfort care for terminally ill patients. Overall reduces the risk for infection Competency Based Training -Wash hands -Don sterile gloves -Maintain sterile technique while cleaning the meatus and upon insertion. Important factors: Keep the tubing unclamped, disinfect the drainage spigot after emptying the bag, and place the bag below the bladder at all times. 1.Concept map for management of urinary retention -Daily checklist was applied to see if the catheter was still needed...
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...Review of Literature: Decreasing Catheter Associated Urinary Tract Infections Urinary Tract Infections are one of the most common hospital-acquired infection and many are associated with an indwelling catheter. For each day a catheter is in place the risk of developing a CAUTI increases 3%-7% (Kahnen, Flanders, & Magalong, 2011 ). Although indwelling urinary catheters are widely used in hospitalized patients and can provide an appropriate means of therapeutic management, they are often used without clear indications putting the patient at a risk for complications during their hospitalization. Complications related to a urinary catheter include physical and psychological discomfort to the patient, bladder calculi, renal inflammation and most frequently CAUTI (Bernard, Hunter, & Moore, 2012, 32(1)). Not only does the urinary catheter cause complications to the patient and put them at a higher risk for morbidity and mortality they also increase the hospital costs. Therefore CAUTIs are considered by the Medicare and Medicaid Services to represent a reasonably preventable complication of hospitalization and as such will not provide any additional payment to hospitals for CAUTI treatment (American Association of Critical Care Nurses, 2012). A great amount of attention has been placed on improving quality of care and minimizing preventable harms that are occurring in the healthcare setting. With the passage of the Deficit Reduction Act of 2005 and the implementation...
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...Catheter Associated Urinary Tract Infections (CAUTIs) By: Janelle Davidson & Liz Ellis Picot Question Thesis Preventing catheterization Nursing Initiatives Nursing Initiatives Continued Aseptic Technique Current Practice P: Any catheterized patient in the health care setting. I: Special initiative for prompt catheter removal. C: Versus routine procedure for catheter removal. O: Decrease catheter associated urinary tract infections. T: During the patient's length of hospital stay. Preventing catheterization, aseptic technique, nursing initiatives, and prompt removal are all factors that contribute to the decline of indwelling catheter infections. No clear protocol for catheter placement. Criteria included in the research: -Urinary retention (neurogenic bladder) -Urine Tract Obstruction (blood clots, enlarged prostate, urethral problems) -Close monitoring of urine output of critically ill and immobile patients. -Urinary incontinence that poses a risk for a stage 3 pressure ulcers. -Comfort care for terminally ill patients. Overall reduces the risk for infection Competency Based Training -Wash hands -Don sterile gloves -Maintain sterile technique while cleaning the meatus and upon insertion. Important factors: Keep the tubing unclamped, disinfect the drainage spigot after emptying the bag, and place the bag below the bladder at all times. 1.Concept map for management of urinary retention -Daily checklist was applied to see if the catheter was still needed...
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...indwelling urinary catheters” (Nix, Denise, and Ann Marie Pettis. 2012). This expose the patients to the risk of acquiring catheter associated infection. In this paper, the author discuss the trend of CAUTI infection, its impact on patient care outcome, morbidity, mortality and related treatment cost. Different studies reveal that use of a protocol guiding insertion, care and prompt discontinuation of urinary catheter has the ability to reverse the current trends. Catheter Associated Urinary Tract Infection (CAUTI) accounts for 70-80% of all urinary tract infections. The risk of developing a urinary tract infection increase by 3% for each day the urinary catheter is left...
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...patients who are in the hospital have urinary catheters and 75% of urinary tract infections are associated with a urinary catheter. The most vital risk for acquiring a catheter-associated UTI (CAUTI) is the extended use of a urinary catheter. Catheter-associated urinary tract infection (CAUTI) causes an increase in morbidity, mortality, hospital cost, and length of stay. There are approximately 380,000 infections and 9000 deaths related to CAUTI’s per year. CAUTI’s can increase a patient’s hospital stay by 2-4 days. The cost, in United States hospitals, per year, is over 500 million dollars to treat CAUTI’s (Centers for Disease Control and Prevention, 2012). Having a urinary tract infection can lead to unnecessary antimicrobial use, and the urinary drainage system of the urinary catheter can harbor multidrug-resistant bacteria, which can spread to other patients (Centers for Disease Control and Prevention, 2012).This paper, the nursing research utilization proposal, will focus on preventing CAUTI’s. The key resolution to prevent CAUTI’s is to implement a quality improvement (QI) program to improve the appropriate use of indwelling catheters and to reduce the risk of CAUTI’s based on health care organization’s risk assessment. A quality improvement program will make sure that catheters are being used appropriately. The program will identify the need of the urinary catheter and inform staff of the placement date, and when to remove catheters that are no longer needed. The program...
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...Urinary Catheterization in Nursing Research task 2 RN to BSN Feb 25th, 2016 Western Governors University The current procedure that is being performed in my facility for the insertion of a urine catheter with one licensed professional is as follows: Introducing yourself to the patient, wash your hands, identify the patient by date of birth and first and last name, and informing them of the procedure that is about to take place. The patient lays down in a supine position and legs are spread apart. After opening the kit the sterile gloves are placed on. One hand is placed on the genital area which no is longer sterile, the other hand is used to clean the area with the provided swabs in the sterile box. The urethral area is swabbed three times from the center of the urethral outward. Once cleaned the catheter is then lubricated and placed inside the urinary tract until you see the return of urine. Once you see the return, the balloon is inflated in order to hold the catheter in place. A secure clip is attached to the patient’s leg and bag is hung below the level of the bladder. The current process that is being performed in the facility is a procedure that has been used for the past 50 years but just recently the infection rate has increased drastically that it needs to be changed. An article that was published in Infection Control & Hospital Epidemiology discusses how aseptic techniques were unsuccessful many times. “A total of 81 insertion attempts among...
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...Introduction The primary focus of this study is to assess the effectiveness of a simple reminder system to aid clinicians and nurses in remembering that a patient has a urinary catheter can decrease the duration of time that a patient is catheterised and successfully reduce the rates of CAUTIs. The study was completed by a team medical doctors and registered nurses with the aim of confirming the efficacy of this simple reminder intervention. Both the title and the abstract of the article give the reviewer a clear idea of the purpose and intent of the study. Purpose of the study The purpose of this study was to assess whether, if simple interventions were used properly they will reduce the number of catheter associated urinary tract infections. The researchers found that there were a lot of catheter associated urinary tract infections; particularly in the duration of indwelling catheterization was a factor. The researchers found many hospitals in the United States did not monitor the duration of catheter use. Nor were the physicians aware of patients who were catheterised for some duration. The research also notes that there was a cost factor involved with lengthy duration of indwelling catheters. Method - Design and Data collection The study follows a quantitative analysis, using a controlled trial method. A pre intervention and post intervention study was conducted and the data was collected over three time periods. The Pre intervention commenced September 2008 followed...
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...Urinary tract infections (UTIs) are the most common nosocomial infection; accounting for up to 40% of infections reported by acute care hospitals. Up to 80% of UTIs are associated with the presence of an indwelling urinary catheter. Catheter associated urinary tract infections (CAUTIs) represent the largest proportion of healthcare associated infections (HAI). Catheter-associated urinary tract infection (CAUTI) increases hospital cost and is associated with increased morbidity and mortality .CAUTIs are considered by the Centers for Medicare and Medicaid Services to represent a reasonably preventable complication of hospitalization. As such, no additional payment is provided to hospitals for CAUTI treatment-related costs.CAUTIs can lead to complications including cystitis, pyelonephritis, gram-negative bacteremia, prostatitis, epididymitis, septic arthritis, endophthalmitis, urosepsis and even death (Centers for Disease Control [CDC], 2009). The Centers for Medicare and Medicaid Services (CMS) considers CAUTI a preventable complication and no longer reimburses for the extra costs of treatment (CMS, 2010). Nursing as a profession has an interest in following the best evidence based practice to improve outcomes and decrease cost, including reducing CAUTIs. The indwelling urinary catheter increases access of micro-organism to the bladder and inhibits complete bladder emptying. The inflated balloon which keeps the catheter in the bladder allows a small amount of urine to remain un-drained...
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...guidelines reduce or decrease, “Never Events”, while improving quality care and patient safety. The purpose of this paper is to review the guidelines that has been developed to address the Urinary Tract Infections (UTI) problem, it’s importance and significance to nursing practice, as well as its impact on the patients and community, and the differences in care based on evidence. “Patients with indwelling catheters, even with current standards of care and evidence-based practice, urinary tract infections continue to be a problem”(Kevin J. Ribby, June 2006). Practice setting problem Urinary tract infections continue to be a problem in healthcare. The numbers of patient’s with urinary tract infections are still too high. “A plethora of articles have been written about nosocomial urinary catheter-related infections, management of the catheter, and proper placement of the indwelling catheter in the male patient 4 but little about the impact of nursing education on outcomes related to decreasing UTIs and usage of indwelling urinary catheters” (Doyle B, Zubina M, Horgan M, 2001). There are a various reasons for why nurses continue to see urinary tract infections like incorrect perineal cleaning, a break in aseptic technique when inserting urethral catheters, and the amount of time a urethral catheter remains in a patient. There have been various evidence-based practices that...
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...PREVENTING CATHETER ASSOCIATED URINARY TRACT INFECTION Elizabeth Quartey Abstract According to the CDC estimates in 2002 there were 1.7 million Healthcare-Associated Infections (HAI), and 99,000 HAI- associated deaths in the hospital. The report stated that the four largest categories of HAI, responsible for more than 80% of all reported HAI, are central line-associated bloodstream infections (CLABSI, 14%), ventilator-associated pneumonia (VAP, 15%), surgical site infections (SSI, 22%), and catheter-associated urinary tract infections (CAUTI, 32%). HAI are a great financial costs to health care facilities. The Centers for disease Control and Prevention (CDC) estimates the medical cost of HAI in the U.S. hospitals as $6.65 billion in 2007, and that number has increased to almost $10 billion a year currently. Statement and Significance of the Problem One in 20 patients who are admitted to a hospital will be a victim to an infectious agent they are exposed to during their hospitalization according to the Centers for Disease Control (CDC) (Goodman, Brenda, 201, Hospital-Acquired Infections cost $10 Billion a year). The five most common infections are surgical site infections, infections associated with the use of devices like central lines, catheters, ventilators and clostridium dificile are costing the health care System in the USA almost $10 billion a year to treat. In the article Vitamin D has the potential to reduce the risk of Hospital-Acquired...
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