Approaches to Lessen CAUTIs in PACU at BJH

Literature Review
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Literature Review
Indwelling urinary catheters (IUC) are utilized in managing urine leakage and holding, eliminating post-operative bladder malfunction linked to surgeries, immobility, and anesthesia. Wanat et al. (2020) assert that in critically ill patients, individuals with severe skin conditions who develop full-thickness wounds and patients who endure pressure ulcers, IUCs are routinely utilized to quantify correct urine output. IUCs are also utilized with patients who have multiple sclerosis or spinal injuries, get massive infusions or diuretics following surgery, as well as individuals who need comfort measures for end-of-life care. IUCs are the main reason surgical and medical patients get nosocomial infections. Although catheter-associated urinary tract infections (CAUTIs) are frequent, they may be avoidable with the proper IUC use, placement, care, and treatment. Prolonged use, improper placement, and upkeep increase the likelihood of CAUTI in patients. IUC length is a key risk element for CAUTIs.
This paper outlines approaches to lessen CAUTIs in PACU at BJH by executing nursing-led protocols with patients whose treatment needed IUC. Barnes Jewish Hospital (BJH) had thirteen CAUTIs last year, surpassing its benchmark of four incidents yearly. The project aims to reduce CAUTIs rates by thirty percent, lessen urinary catheter days by twenty percent, and seventy-five percent conformity rating in catheter-linked documentation in PACU amid the intervention stage. This paper discusses the execution of the nurse-driven protocols (NDPs) to lessen CAUTIs using the PICOT Question: In the post-acute care unit (PACU), adult patients with indwelling urinary catheters, how do evidence-centered nurse-led program interventions, Compared to ordinary care affect Occurrence and ratio of CAUTIs in seven months?
Methods of Searching
The researcher used a literature review to identify nurse-led evidence-centered practices in preventing CAUTIs. A literature search was done to prove how nurses can lead interventions in reducing CAUTIs ratios. The researcher did a database search in PubMed, Cochrane, CINAHL, and MEDLINE for clinical practice directives, meta-analyses, primary research exploration, and systemic reviews. The search terms comprised CAUTI AND nurse-led procedures, CAUTI OR deterrence, and CAUTI AND protocol. The articles used were limited to English and published in 2018. The researcher chose ten articles that were pertinent to the PICOT question. After the ten articles were reviewed, two themes were heightened premised on the frequency of CAUTIs deterrence: (a) nursing-led protocols and education and (b) using tools such as checklists and protocols. The exclusion criteria comprise articles that did not indicate positive results, were not peer-reviewed and were published over six years ago.
Project Proposal Topic
The topic of the project proposal is nursing-led interventions in CAUTI deterrence. It is anticipated that nurses will play an essential part in preventing CAUTIs. However, according to scientific findings, the nurses' clinical proficiency and care canons have been regarded as below expectations. To better equip nurses with the skills and information required to avoid CAUTIs, this study will pinpoint the risk elements for CAUTIs and evaluate the several nursing interventions that may be effective. The nurses must be confident in their knowledge, abilities, and clinical expertise to carry out a sterile catheterization aseptically. To do their jobs well, nurses need a suitable support system (Nace et al., 2018). However, nurses are frequently overworked. Long shifts, stressful jobs, fatigue, and time constraints are a few other instances of performance impediments. As a result, nurses should act systematically to improve the efficacy of sterile catheterization.
Review of the Literature
Several studies indicate that the CAUTI bundle is the most efficient intervention for CAUTIs deterrence. The CAUTIs bundle comprises reminders, checklists, and diagrams with appropriate clinical signals for inserting an IUC are included in the CAUTI bundle. Additionally, competency tests are implemented for catheter insertion, aseptic method, recording, maintenance, ongoing catheter need monitoring, and catheter withdrawal. According to Wood (2018), applying the CAUTI bundle reduced catheter usage as well as demonstrated that CAUTI rates were lower when the catheter was removed early. Both Ashraf et al. (2020) and Meddings et al. (2019) agreed that the CAUTI bundle's deployment raised nurses' identification of patients who had IUCs in situ and prompted them to consider if the IUC was still necessary. According to Hernandez et al. (2019), the bundle deployment revealed that 30% of the IUCs patients did not match the IUC's eligibility requirements. This data proves that a CAUTI preventive bundle used in an NDP can reduce patient HAIs.
The nurse drive protocol (NDP) CAUTI considerably lowers the infection prevalence rate and the CAUTI bundle. According to Whitaker et al. (2022), early catheter extraction with an NDP dramatically decreased the incidence of CAUTI. The outcomes showed that the rates of CAUTI were directly correlated with the usage of an NDP, catheters, dwell timescale, as well as other factors. Leticia-Kriegel et al. (2019) concurred that adopting an NDP might give nursing professionals the authority to actively campaign for clients who already with an IUC and withdraw catheters as soon as a patient does not match the requirements.
Studies show the value of patient education in preventing CAUTI. Li et al. (2018) investigated a CAUTI mitigation bundle implemented throughout the hospital. Any endeavor to improve the process must include education. Checking and feedback, however, are equally crucial. Hernandez et al. (2019) evaluated the efficacy of the CAUTI deterrent bundle intervention using a maintenance checklist for routine urinary catheter. The opportunity to give quick, constructive criticism improved practice and was a pricel...