Catheter Associated Urinary Tract Infections

To this effect, many efforts have been geared towards reducing or better eliminating CAUTIs in catheterized patients considering an increased scarcity of resources directed to patient medication and overall treatment (Clarke et. al. There is need, therefore, to reduce CAUTIs so as to lower the cost of treatment for patients who are at high risk. For many years, insertion of catheters in the urinary tract encompasses a common procedure after an operation. Some of the interventions to reduce CAUTIs include application of antibiotics on catheter, aseptic insertion of the catheter, prevention of backflow of urine and maintain asepsis when collecting urine samples. Patients have had to stay longer in hospitals as a result of CAUTIs hence significantly raising treatment costs. Similarly, hospitals incur additional costs in managing these infections and they are not reimbursed for the same (Underwood, 2015).

All the interventions that have been previously employed to reduce CAUTIs have in one way or another involved Catheters. One fact about CAUTIs is for an infection to occur, catheters must be there, and therefore eliminating catheters is the first step in preventing Catheters Associated Urinary Tract Infections (Clayton, 2017). The PICOT Question Formulated In hospitalized orthopedic patients with indwelling urinary catheters, what is the effect of removing indwelling urinary catheters post-op day one or two, compared to leaving them in till discharge in the reduction of catheter associated urinary tract infection during hospitalization stay for a period of 6-months? Search Strategy Conducted This project will be research using EBP articles through acceptable studies such as CINAHL, Cochrane, and South University library.

al. (2013) a systematic review and meta-analysis level 1V evidence was used to examine the possibility and cost effectiveness of catheter-associated urinary tract infection. To reduce CAUTIs, a bundle of four interventions is applied and reduction of the period of indwelling catheter is as well suggested (Clarke et. al. In Clayton (2017) qualitative research, strategies to reduce CAUTI was obtained by using level III evidence. Prompt removal of catheters soon after insertion helps prevents CAUTIs (Underwood, 2015). All the above articles will be used to support my PICOT question and will be used to evaluate CAUTI within 6 months among post-op orthopedic patients in my unit. Evidence Integrated with Clinical Expertise and Patient Preferences to Inform a Decision and Practice Change Implemented To integrate evidence with clinical expertise, a Multidisciplinary evidence committee will be set up.

The committee will ensure evidence based practice in removal of indwelling catheters on Day 1 or 2 after operation. Patient preferences are a priority and the patient together with family members will be involved in the course of the study. This has led to increased hospital stay, costing more to the hospitals and the government (Nicolle, 2014). With the above information, hospitals are no longer reimbursed if these kind of situations occur and I believe my hospital will save more money as they will receive reimbursement from the state by putting this change of practice to reduce CAUTIs by meeting the standard guidelines as per CMS, my hospital will be recognized as one of the hospital with safe practices. Outcome Evaluated The incidence of CAUTIs in patients who had catheters removed on day 1 or 2 after operation will be evaluated.

The rate of reduction of CAUTIs in orthopedic patients following implementation of change will also be assessed. Any significant changes in the incidence of Urinary Tract infection due to shortening the period of catheterization will be recorded. Time of placement or removal of catheter should be included in the hand over report prior to transferring patient to the next level of care (Clayton, 2017). For this project, I will focus on removing the catheters on Day 1 or 2 after operation of orthopedic patients so as to reduce the incidence of CAUTIs. To implement this I will involve nurses and the nurse in charge who will make sure that catheters are removed post op Day 1 or 2. Any reasons for retaining a catheter past Day 2 need to be noted down and explanations for doing so made.

Standing orders will be made by the nurse in charge to have any catheter removed by Day 2. This intervention has been put to practice in several hospitals with great results being seen. It is high time that every hospital adopts this intervention to reduce Catheter Associated Urinary Tract Infections and subsequently lower treatment costs in susceptible patients. Evidence based practice has succeeded in improving healthcare quality and this is not an exception. It is important to indicate the time of placement and removal of catheters in the hand over report when patient is being transferred from one phase of treatment to the next. Unit to unit coordination is therefore necessary to ensure success of this plan (Underwood, 2015). 1016/j. purol. 006 Clarke, K.