Prevention of Catheter Associated Urinary Tract Infection

PICOT Question on Prevention of CAUTI
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Prevention of Catheter Associated Urinary Tract Infection in an Acute Care Setting
Catheter Associated Urinary Tract Infection (CAUTI) has emerged as the most prevalent and common infection that is hospital-acquired and identified as the leading cause of bloodstream infections , which is associated to increasing death rates in hospital. A study carried out by Western Maryland Health System in 2014 revealed that, all all the hospital-acquired infection, 80% are are attributable to an indwelling urethral catheter (Helber, 2015). The major source of this problem is considered to be Nurse’s lack of knowledge on the nurse-driven urinary catheter removal protocol, which has seen them defying physicians’ orders leading to inappropriate and unnecessary removal of urinary catheters. The solution to this problem will be guided by the PICOT question below:
P = for adult patients with an indwelling urinary catheter under long term acute care
I = does the implementation of a nursing-driven urinary catheter protocol on admission
C = compared to no protocol
O = reduce then rate of catheter,-associated urinary tract infections
T = over a patient’s hospital stay period.
For adult patients with an indwelling urinary catheter under long term acute care, will the implementation of a nursing-driven urinary catheter protocol on admission compared to no protocol reduce then rate of catheter associated urinary tract infections during the 3 months of patient’s hospital stay.
The suggested intervention is set to improve nurses’ knowledge on the appropriate procedures of employing the nurse-driven protocol to manage the removal inappropriate and unnecessary placed Urinary Catheters without requiring close physicians’ supervision to empower nurses and ultimately reduce rate of CAUTI infections (Helber, 2015).
Evidence Based Solution
In a peered reviewed study by Meddings et al (2013), the authors focused to establish the impact of using nurse-driven protocols as an intervention set to decrease unnecessary placement of urinary catheters on the rate of CAUTI infections. The rational of the program is that developing a catheter restriction protocol and improving nurses’ knowledge on the use of indwelling catheter removal protocol will boost both nurses’ awareness and moral obligations to adhere to the protocol (P, 2016). Others studies have also revealed that using a nurse-driven protocol to remove ineffective catheters have escalated the quality of patients care in an acute care setting. In addition, the approach seemed important as it helped to reduce time wastage involved in trying to obtain physicians discretions to remove the catheter.
Meddings’ study featured 60 patient fitted with indwelling catheters an episodes of CAUTI were recorded per every 100 catheter days before the intervention program. The units recorded were calculated into ratios and compare between the pre and the post-intervention outcomes. To improve the validity of the study, the rates of symptomatic and asymptomatic CAUTI were reported separately to use the former for meta-analysis. After the 27 participants completed the test after 1000 days, the mean of the reported case of CAUTI before the intervention had a mean of 8.41 and standard deviation of SD=.797. From the 27 participants, 23 were set in a posttest and generated a mean of 9.75 and standard deviation .442. ...