Catheter-Associated Urinary Tract Infection (CAUTI) Reduction and Care

Annotated Bibliography – CAUTI reduction and Care
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January 30, 2020
1 Gould, C., et al. (2010). Guideline for prevention of catheter-associated urinary tract infections in 2009. Infect Control Hosp Epidemiology, 31(4), 319-326.
Throughout the decades, the means and methods of preventing catheter-associated urinary tract infections (CAUTIs) have significantly improved the reduction of cases within the healthcare setting. These improvements include both technological, practical, and social innovations that address the different aspects of the provision of healthcare. Accordingly, Gould, et al. (2010), provided the different guidelines on how nurses and other healthcare professionals could reduce CAUTIs, based on the different studies conducted by the US Center for Disease Control and Prevention (CDC).
In line with this study, the author believes that the usage of these guidelines could prove beneficial for understanding possible gaps in the awareness and implementation of CAUTI guidelines within a particular healthcare setting. This would be beneficial because understanding the standards of implementation and current practices is crucial in order to know what improvements should be made. Lastly, the authors of this list can also be used to suggest future changes and research in terms of the technology used, workflow improvements, or awareness-raising based on evidence-based practices that are suggested in this publication.
2 Magill, S. S., et al. (2014). Multistate point-prevalence survey of healthcare-associated infections. N Engl J Med, 370(13), 1198-1208.
In this study, the authors utilized the National Healthcare Safety Criteria in order to create a prototype surveillance system that creates an “estimate of the burden of all types of healthcare-associated infections across acute care patient populations” (Magill, et al., 2014). This is in response to the deficiency in the monitoring system suggested by the authors at the start of the research. Nonetheless, the authors found out that; (1) around 4.0% of all patients experience at least one type of hospital-related infections, with device-related infections (i.e., CAUTIs) accounting for at least 25.6% of such infections; and (2) device-related infections must be addressed by increasing surveillance systems, which amplifies the role of prevention methods and techniques to prevent them.
In line with this study, the author believes that despite the generality of ‘device-related infections’ as used in Magill, et al’s (2014) article, this article could provide an insight about the related infections that would rule out gaps in CAUTI prevention as compared to gaps in ‘device-related infections’.
3 Nieva, V. F., & Sorra, J. (2003). Safety culture assessment: A tool for improving patient safety in healthcare organizations. Qual Saf Health Care, 2, 17-23.
Reducing CAUTIs is not only a matter of improving technological devices and/or practical approaches in the workplace. Rather, it also includes improving the overall system and culture of the workplace. In the article written by Nieva and Sorra (2003), they found out that by ‘transforming organizational culture’ into one that is focused on prevention and safety, then the provision of care can be improved generally on all aspects of the healthcare.
In line with this study, the author would like to note the fact that Nieva and Sorra’s (2003) study focuses specifically on ‘general safety’ as compared to methods on reducing ‘CAUTIs’. This presents some difficulty especially since the implementation of general safety procedures and CAUTI prevention techniques could present some gaps in terms of theoretical and practical knowledge. Thus, while this could be used in assessing possible social and organizational changes in reducing CAUTI, additional literature that focus solely on the latter should still be added.
4 Parker, V., et al. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Serv Res, 17(314), 1-9.
In this article, the authors reiterated (1) the role of inappropriate use of indwelling urinary catheters (IDCs) in increasing the CAUTIs in the hospital setting, and (2) the importance of nurse-professionals in initiating the use of Evidence-based approaches in order to reduce CAUTI. Their study stemmed from the fact that most of the infections associated with hospitalization happen due to the unnecessary and/or prolonged use of IDCs by healthcare providers. Accordingly, Parker, et al. (2017), used a “multiple pre-post control intervention design using a phased mixed-method approach” that aims to understand how improper uses of IDCs in acute care hospitals increases CAUTIs.
In line with this study, Parker, et al’s (2017) study could help in analyzing current guidelines and techniques used by healthcare professionals in using IDCs within the particular study setting. In turn, the authors could then make an analysis based on which guidelines could be changed relative to current standards and how can nurse-led initiatives be strengthened within the workforce.
5 Umscheid, C., et al. (2011). Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol, 32(2), 101-114.
CAUTIs, just like other HAIs (Healthcare-Associated Infections) are considered as ‘preventable diseases’. Yet, lapses in both implementation, guidelines, and facilities, among others increase both the human cost (i.e., lives) and the material costs (i.e., financial resources for litigation) for every stakeholder involved. Thus, in the article written by Umscheid, et al. (2011), the authors conducted a systematic review of different literature that estimates the costs of HAIs. They also provided a more specific estimate of its types such as CAUTIs. In arriving at their estimates, they used “infection, mortality, and cost figures with our ranges of preventability for each HAI”.
In line with this study, the author believes that understanding the costs of prevention versus the cost of treatment would give a stronger driving force for healthcare providers to prioritize methods that bank on prevention. To do this, Umscheid, C., et al (2011), could be used to arrive at initial estimates. Additionally, this could also be used to provide a cost-benefit analysis of the implementation of new social and technological techniques that would reduce CAUTI infections in the population chosen.
6 WHO. (2011). Report on the burden of endemic healthcare-associated infection worldwide. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf;jsessionid=B527B9530CCA4D8110F008228FF48AA4?sequence=1
This article discusses about the relationship between socio-economic status and the frequency of CAUTI infections (and risk factors in particular countries. Using a systematic review of different literature that studied CAUTI rates per country, the authors found out that there is a positive correlation between a country’s GDP and their CAUTI rates. In addition to this, the report provides different methods that would help address current problems in understanding endemic HAIs and methods for healthcare providers to evaluate and address them.
In line with this study, the author believes that understanding external factors that affect CAUTI rates could help in creating better approaches that would reduce cases relative to the country or region where it occurs. Despite this study’s local setting (mainly in the United States), WHO’s report can still provide additional insights regarding crictical factors that should also be discussed in this study. All in all, this would provide a more holistic approach to the methodologies employed by the author.
7 Blanck, A. W., et al. (2014). A quasi-experimental study to test a prevention bundle for catheter-associated urinary tract infections. Journal of Hospital Administration, 3(4), 101-108.
This study utilizes a “bundled approach” in evaluating and understanding the cause and effect of CAUTIs within a 3-month period in a critical care setting. By comparing results between a ‘pre-intervention’ phases and ‘post-intervention’ phases, the authors found out that CAUTI rates have decreased by around 50%. However, it must be noted that the authors found out that the results of such studies are not statistically significant, yet clinically significant as it led to a great reduction in the number of cases.
Accordingly, the author of this study believes that (1) the methods and the results of Blanck, et al. (2014), can be added to th...