Catheter Associated Urinary Tract Infection Essay.

Catheter Associated Urinary Tract Infection Essay.

 

Hospitalization or prolonged stay in hospitals is becoming one of the most dangerous ways of contracting catheter-associated urinary tract infections (CAUTI). Indwelling catheters cause this problem among patients.  An indwelling catheter is a tube-like structure inserted into a urethra of a patient. This tube drains patient urine from the bladder into a collection bag.Catheter Associated Urinary Tract Infection Essay. Patients who had surgery or are not able to control the functioning of their bladder require a catheter. It is very critical to monitor the amount of urine that kidneys produce. Limited resources at a healthcare facility are one of the most contributing factors to the prevalent of CAUTI. As a result, CAUTI causes an increased rate of hospitalization, 30-day readmission, poor quality care services, and increased healthcare costs.Catheter Associated Urinary Tract Infection Essay.

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After conducting a 20-minute interview with a hospital nurse leader and hospital manager, the outcome revealed that CAUTI is a leading challenge in the provision of quality care services and the enhancement of patient safety. These two leaders highlighted strong urine odor, chills, blood in the urine, unexplained fatigue, cloudy urine, and leakage of urine around the catheter are significant symptoms of a patient with CAUTI (Goldstein, MacFadden, Karaca, Steiner, Viboud, &Lipsitch, 2019). The two leaders stated that the diagnosis of CAUTI is challenging, especially when a patient has been admitted. The reason for diagnosis challenges are due to similar symptoms that may be part of a patient’s original illness.Catheter Associated Urinary Tract Infection Essay.

 

A nurse leader noted that when bacteria enter a patient’s urinary tract through the catheter, chances of being infected with CAUTI are high. When a catheter is contaminated, or a drainage bag is not frequently emptied often, a patient is also likely to get infected. Other ways in which an infection occur include a dirt catheter and a backward flow of urine in the catheter into the bladder. National Healthcare Safety Network (NHSN) Report indicates 449, 334 CAUTI cases yearly in the United States (Richards, 2017). The report further reveals that CAUTI rates range from 0.00% per 1,000 catheter days to high of 53.2 per 1,000 catheter days between location types, type of medical institute affiliation of the hospital, and location bed size.Catheter Associated Urinary Tract Infection Essay.

I work in the admission room at The Royal Children’s Hospital, where most of the Indwelling urinary catheter insertions (IDC) is done. Preparation of environment and equipment at the room ensure dressed trolley, catheterized pack and drapes, and sterilized gloves (HanCHett, 2012). Only a trained and competent nurse and doctor in urinary catheterization do the Insertion of an IDC. Between 12% to 16% of inpatients are likely to have indwelling urinary catheters during their treatment (hospitalization). Daily, a patient has a 3% to a 7% high risk of contracting CAUTI (Richards, 2017). More than 13, 000 deaths every year result from CAUTI according to the Center for Disease Control (CDC) statistics. A nurse leader and hospital manager identified CAUTI preventions outlined in the CDC, where preventive measures are given. These prevention measures are minimization of urinary catheter use and usage period among patients, avoiding the use of urinary catheters in patients to manage incontinence, and using urinary catheters in operative patients when critical.Catheter Associated Urinary Tract Infection Essay.

After an in-depth discussion on CAUTI, it was agreed that inappropriate uses of dewing catheters are worsening the situation and leading to the delivery of low-quality care services. For instance, the hospital manager identified a prolonged postoperative period with inappropriate indications as improper use of indwelling catheters. Also, a substitute for the care of a patient without incontinence is the wrong use of indwelling catheters. Nurses, clinicians, and doctors must ensure quality care services through an appropriate removal of urinary catheter insertion and cleaning perineal area frequently.Catheter Associated Urinary Tract Infection Essay.

Applying Process Improvement Models

I shall use the Plan-Do-Study-Act (PDSA) cycle as the process improvement model in developing my practice project on Catheter-Associated Urinary Tract Infections (CAUTI) management plan. The PDSA cycle was modified from Walter A Stewhart’ Plan-Do-Check-Act (PDCA) cycle by one W Edwards Edwards Deming. According to Deming, the ‘check’ phase in the PDCA cycle emphasized inspection over-analysis. PDSA has grown to become the most commonly used model for process improvement, and it encompasses completing the sequences, then repeating the process until the achievement of the desired outcomes (Spath, 2013). CAUTIs comprise one of the most prevalent hospitals acquired infections (HAI) globally. Furthermore, the prevalence of the cases is subject to changes. In my view, PDSA is the most appropriate model for long-term management of CAUTIs in hospitals because it caters for any changes that may come with a new infection conditions.Catheter Associated Urinary Tract Infection Essay.

1). Plan: The phase would involve objectives, processes, and action-plan establishment for the delivery of the results that are desired. CAUTI infections will be reduced through the creation and implementation of a multidisciplinary CAUTI prevention plan. The plan would be a master-piece on how the process improvement for CAUTI prevention would be implemented. There would also be a plan for performance measurements across the organization. There should be a plan to integrate CAUTI risk prevention strategies into the organizations’ processes.Catheter Associated Urinary Tract Infection Essay.

2). DO: The members of the the multidisciplinary team would include staff from all the concerned departments. Successful CAUTI prevention teams include a team leader, nurse, and physician champions, executive partners, frontline nurses, infection prevention and discharge planners or case managers, risk managers, etc. Apart from being in charge of the CAUTI management, the team of planners would give weekly, monthly, annual reports concerning the progress of their undertakings. Furthermore, they would be responsible for educating the staff and patients and their families regarding CAUTI infection preventions.Catheter Associated Urinary Tract Infection Essay.

Lastly, they shall be in charge of case risk evaluations and risk scoring throughout the hospital. Secondly, the CAUTI prevention team, all the staff, and patients, especially in the acute care unit, will have a weekly CAUTI risk meeting. All the case and risk reports will be dispatched to the concerned individuals, such as department managers, patients, and the Board, etc., on a weekly, monthly, annual basis.Catheter Associated Urinary Tract Infection Essay. A dedicated CAUTI risk management head shall be appointed to be in charge of the management of all cases, including prevention and treatment strategies. The prevention strategies would be based on evidence-based measures, including care for urinary catheter during placement, urinary catheters’ timely removal based on nurse-driven processes, and inappropriate short-term catheter use’ prevention (American Nurses Association, 2020).Catheter Associated Urinary Tract Infection Essay.

3). Study: The phase would involve analyzing the incident monitoring reports and other scoring tools to determine whether all the implemented prevention strategies for CAUTI have yielded any positive results. The necessary the information would be collected from the patients and their families, facility staff, prevention committee, hourly-round feedbacks, etc.Catheter Associated Urinary Tract Infection Essay.

4). Act: The phase would involve acting on the outcome or result gathered from the previous phase ad making appropriate and necessary changes. For instance, the facility would need to fine-tune the prevention measures to optimize the positive outcomes or find other alternative CAUTI prevention strategies if the current ones have not been successful.Catheter Associated Urinary Tract Infection Essay.