Urinary Tract Infection (UTI) is a Common Problem in the Medical Field

Urinary Tract Infection (UTI) is a Common Problem in the Medical Field
Urinary tract infection (UTI) is a common problem in the medical field with primary and secondary effects on the patients. UTI is an infection that affects the kidney, ureters, bladder, and urethra. However, among the UTI cases, 75% are associated with catheters (Ferguson, 2018). A catheter is a specific tube that health professionals for drain urine. Besides, approximately 20% of the patients are exposed to catheters due to urinary hospital complications. The critical risk factor is prolonged use of catheters which exposes the patients to premature mortalities and other secondary effects. CAUTI is the 4th leading health-related infection (Ferguson, 2018). CAUTI occurs among patients who experienced catheter insertion within two days before infection. Besides, 13000 annual deaths result from CAUTIs. The common effects of CAUTIs have increased mortality rates and patient discomfort. The infections are also costly; for instance, the US annual cost of addressing CAUTIs is $340 billion. Therefore, the listed effects and evidence of CAUTIs show that its management is appropriate and would positively restore the patient's health.
Additionally, the use of catheters is the major cause of increased health-related infections. The CAUTIs related deaths have risen since the catheters are used to reduce postoperative bladder dysfunction, retention, and incontinence. The catheters are also frequently used in measuring urinary output; thus, nurses have adequate information in managing them. Some highly risky patients are those suffering from spinal cord injuries and multiple sclerosis who must undergo surgeries and diuretics. Mainly, reducing CAUTIs requires adherence to best practices and guidelines to reduce exposing the patients to other risks. The key guidelines to reduce CAUTIs are continuous monitoring of urinary output among the patients suffering urinary incontinence and proper catheter insertion and maintenance. However, despite the guidelines, limited knowledge among nurses is a critical issue. Therefore, the paper focuses on nurse education as the suitable alternative to address CAUTIs and restore the health of the heavily affected patients nationally and globally.
Research problem and Clinical Question
I am interested in CAUTI prevention as my evidence-based practice project because it is the most common hospital-acquired infection. Besides, it causes an increase in unnecessary extended hospital stays related to contaminated specimens. Within the organization I practice, CAUTI is closely monitored by reviewing CAUTI usage daily and holding monthly CAUTI committee meetings. In my opinion, educating the nurses is optimal for preventing future occurrences. Improving technique by requiring a chaperone to ensure sterility during the procedure is the best way to prevent contamination. I believe that within the acute care setting, CAUTI is more prevalent. The prevailing occurrence within the acute care setting is related to nursing tasks and procedures completed with celerity. However, nurses completing their profession with extraordinary promptitude decrease sterile techniques in procedures such as catheterization leading to high infection rates. The goal is to disrupt further occurrences to place the catheter aseptically while ensuring nurses follow the appropriate procedures. Therefore, exploring the topic would have a positive benefit to my profession.
PICOT/Clinical Question: Does Nurse Education Reduce The Rate of CAUTI in Hospitals in Acute Care Setting?
Nurse education is the projected solution to CAUTIs since many causes are linked to a lack of knowledge among health professionals. According to Shadle et al. (2021), lack of viable knowledge is the major cause of CAUTIs since nurses play a critical role in inserting and maintaining catheters. Therefore, there is a need to transfer didactic knowledge to the nurses and implement the best guidelines for reducing CAUTIs. Nurse knowledge and assessment would be critical in resolving CAUTIs that have affected many medical patients. Answering the clinical question through a good evidence-based approach would significantly improve the annual deaths and secondary effects of CAUTIs.
Search Strategy
A search strategy is a critical aspect of evidence-based research. It determines the quality and the validity of the information the researcher analyzes. An appropriate search strategy is critical for the evidence-based project since CAUTI is a national and global issue that requires proper examination and analysis to reduce the escalated premature mortalities. The researcher used data based search strategy with specific inclusion and exclusion criteria. The database search strategy's main aim was to collect valid, time-bound, and reliable information for answering the clinical question.
The researcher uses a stepwise process to access the database. The first step involved establishing the clinical question: Does Nurse Education Reduce the Rate of CAUTI in Hospitals in Acute Care Setting? The second step involved breaking the question into main ideas and keywords. Some keywords used for the research are CAUTI prevention, CAUTI and nurse education, and CAUTI rates. Using such keywords was to access more resources and sample the most accurate and viable. After the search, the researcher sampled three critical articles attached in the annotated bibliography in appendix A. Therefore, the keywords and clinical questions were critical in the search strategy.
Lastly, the researcher considered specific limits to make the search strategy efficient. For instance, the inclusion criteria included (1) Articles produced within five years, (2) Peer-reviewed sources (3) Sources with primary data and lastly (3) sources which addressed CAUTI prevention mechanisms, especially nurse education. The exclusion criteria included (1) sources above five years, (2) abstract-related papers, and (3) non-peer-reviewed sources. The main databases used to collect information include PubMed, Embase, and MEDLINE. The choice of the three databases relied on their quality and peer-reviewed articles in the nursing and medical field. Therefore, with appropriate keywords, inclusion criteria, exclusion criteria, and databases, the research focused on high-quality, peer-reviewed, and relevant resources, as attached in Appendix A.
Review of Literature
The first article by Fabre et al. (2020) involved a study of the UrCx steward solution. The article is quantitative and assesses different adults with CAUTIs. It combined the educational and diagnostic stewardship as indicated in Appendix B. The article also assessed the role of the nurses in preventing the prevalence of the nurses. Fabre et al. (2020) found that the nurses must have adequate knowledge for managing CAUTIs. The article also analyzed the key requirements for high-quality CAUTI; the findings are unique from the other two articles in Appendix B. For instance, Fabre et al. (2020) also found that proper quality intervention reduces UrCx from 2.3 to 1.53. Therefore, the article mainly focuses on the need to reduce CAUTIs rates.
Ferguson (2018) found that nurse education is appropriate for reducing the increased rate of CAUTIs. The research span is nurse education implementation and its impacts on CAUTIs. The quantitative research focused on 393 patients admitted to acute care hospitals. Ferguson (2018) used a pre/post experimental design to identify the relationship between nurse education and CAUTI prevention. The researcher identified that with adequate knowledge among the nurses, the rate of CAUTI decreased from 7.49 to 1.56 (Ferguson, 2018). However, to achieve such a reduction, adequate education techniques are relevant. Therefore, the article answered the research question by linking nurse education and the low rate of CAUTIs.
Lastly, Shadle et al. (2021), in their article, based their research on the patient in ICUs. Shadle et al. (2021) used a pre-post design and patients above 18 years to understand the rate of CAUTIs in ICUs and how combining approaches reduces the rate. The key findings are reduced compliance among the nurses managing CAUTI and inadequate knowledge. Besides, the researcher also found that combining nurse education with other interventions such as proper catheters reduces the CAUTIs rate by 23%. Therefore, the key solution to CAUTIs is well-handled evidence-based practice.
Critical Appraisal for Evidence
Based on the literature, CAUTI is a critical problem that impacts a larger population globally and nationally. Ferguson (2018) states that the major cause of CAUTI is limited nurse knowledge. There are limited skills in the management of the indwelling urinary catheter. The past assessment also shows that only 57% of the nurses can adhere to the practice and guidelines for preventing CAUTIs. The remaining percentage have limited knowledge, thus exposing the patients to different risks in the acute healthcare setting. Ferguson (2018) recommends rampant education among nurses to avoid premature mortalities. Besides, only a few nurses take an active role in reassessing the patients for catheter removal, a problem that puts the life of the patients in danger. Therefore, the key intervention is teaching the nurses the practical guidelines which would allow the nurses to improve quality health delivery.
Additionally, Ferguson (2018) recommends multifaceted programs that allow the nurses to actively engage the patients in the acute care settings. A multifaceted educational program allows the nurses to address the key areas and practices exposing the patients to higher risks. The programs should also focus on the duration of catheter use and adherence to practice guidelines. Ferguson (2018) found that using a multifaceted educational program through face-to-face instructions allows the nurses to acquire and maintain CAUTI intervention skills, thus reducing the rate. Besides, some activities such as video clip training and power point approaches allow the nurses to retain key information for promoting high-quality healthcare delivery. Lastly, Ferguson (2018) recommends that the best alternative solution to reduce CAUTI deaths is proper education and skills acquisition in CAUTI management. Therefore, from the provided evidence and findings from the article, it is justifiable that CAUTI is a critical health issue that is only manageable through nurse education.
Shadle et al. (2021) also provide adequate evidence on nurse education's effectiveness in curbing CAUTI. However, the researchers focused on the acute care setting and the ICUs with the highest rate of CAUTIs. Shadle et al. (2021) found that implementing a bundle-based approach reduced CAUTIs by 23%. However, the bundle approach must constitute nurse education to achieve such a percentage. The research also focused on specific CAUTIs since 2018 to understand how they have been managed and the results. The researchers found that most interventions are singly handled. Therefore, the researchers recommend a combination of different approaches, such as nurse education, to counter the problem. Besides, the nurses found that reduced compliance among the nurses managing CAUTI and inadequate knowledge are the key reasons for CAUTIs. Therefore, utilizing the bundle approach with an emphasis on education reduces CAUTIs.
Lastly, the study by Fabre et al. (2020) provides valid evidence of educational techniques for reducing CAUTI cases. The key findings from the researchers have reduced knowledge of urine culture and CAUTI management. Fabre et al. (2020) view CAUTI as a critical issue that needs immediate and evidence-based practice to restore the high mortality rates. Besides, the research highlights the key areas which heavily experience CAUTI, especially ICUs. Fabre et al. (2020) also found that 13000 annual deaths result from CAUTIs with increased mortality rate and patient discomfort. The infections are also costly; for instance, the annual cost of addressing CAUTIs is expensive for most families. The key recommendations by the researchers are education on CAUTI management and patient reassessment. Therefore, from the evidence in the literature, the major gap that needs further studies is the link between CAUTIs and prolonged use of catheters.
Summary and Implications
Nurse education implies reduced CAUTI among patients in acute care settings. The evidence shows that a lack of nurse education causes increased CAUTI cases. Nurse education is the key solution to CAUTIs since many causes are linked to a lack of knowledge among the nurses. Limited skills in catheter management jeopardize the patient's health, especially in acute settings. Therefore, the nurses need to transfer knowledge and implement the best guidelines for reducing CAUTIs after evaluation and assessment. Besides, using a multifaceted educational program through face-to-face instructions allows the nurses to acquire and maintain CAUTI intervention skills, thus reducing the rate of premature deaths (Ferguson, 2018). Besides, some activities such as video clip training would adequately imply knowledge acquisition and allow the nurses to retain key information for promoting high-quality healthcare delivery. Therefore, rapid nurse education implies effective management of CAUTI and restoring patients' health.
Due to the listed implications, the first recommendation is to create awareness among the nurses about their need to acquire CAUTI management skills. Creating awareness through public health campaigns would mobilize the nurses to participate in the education program. Therefore, creating awareness is a key measure to restoring patients' hopes.
The second recommendation is the assessment of the nurses. An assessment is needed to understand whether the nurses have adequate catheter insertion and management knowledge. An accurate assessment is essential to avoid employing nurses with insufficient skills in acute...