A urinary piece of land infection ( UTI ) is an infection that occurs in any portion of the urinary system. Patients with indwelling urinary catheters have an increased hazard of geting a urinary piece of land infection. Seventy-five per centum of infirmary acquired urinary piece of land infections are associated with patients that have or have had an indwelling urinary catheter during their infirmary stay. Approximately 15-25 % of infirmary patients receive urinary catheters during their infirmary stay ( Centers for Disease Control and Prevention. 2010 ) . The sum of clip the catheter remains inserted is the major hazard factor for geting a UTI ( Elpern et al. . 2009 ) . A catheter-associated urinary piece of land infection ( CAUTI ) occurs when bacteriums enters any portion of the urinary system doing an infection due to the catheter’s presence. Catheter associated urinary piece of land infections cause unneeded hazards to patients including the hazard of decease. increase their clip spent in the infirmary and increased cost of their infirmary stay. Problem Statement/Study Purpose
Urinary piece of land infections account for 32 % of all infirmary acquired infections ( Elpern et al. . 2009 ) . In the Medical Intensive Care Unit of Rush University Medical Center the National Healthcare Safety Network ( NHSN ) informations indicated that the unit’s monthly rates of CAUTIs in 2006 exceeded the NHSN 50th percentile ( Elpern et al. ) . The unit wanted to find if diminishing the urinary catheter device yearss whether that would do the CAUTI rates to diminish. This survey was relevant because it attempted to measure an intercession determined by the nursing unit as to the inappropriate usage of urinary catheters. The unit wanted to analyze to see if diminishing the device yearss would diminish the rate of catheter associated urinary piece of land infections. and if proven to be important would impact all nursing unit’s protocols of urinary catheter usage. Research Question/Hypothesis
The survey by Elpern. et Al. titled “Reducing Use of Indwelling Urinary Catheters and Associated Urinary Tract Infections” the survey hypothesis is that the decrease of urinary catheter device yearss will diminish the rate of CAUTIs on the unit during the intercession period compared to the 11 months before the survey. Protection of Human Participants
The survey obtained the blessing from the Institutional Review Board prior to commencement. Informed consent was deemed unneeded. There were no benefits or hazards of engagement as identified by the survey. but holding the day-to-day rating of rightness of the urinary catheter was so a benefit for patients as evidenced by the result of the survey. Method
This survey was based on a before and after rating of an intercession. The research workers consisted of 3 senior staff nurses. 2 advanced practicians and the unit’s medical manager. The first measure of the survey was to find what the appropriate indicants for indwelling catheter interpolation would be for the unit. The survey population consisted of all patients admitted to the unit between the day of the months of December 1. 2007 to May 2009 who had an indwelling urinary catheter. Every twenty-four hours the figure of patients with urinary catheters was recorded. The ground for the catheter was evaluated each twenty-four hours by confer withing the primary nurse of each patient. and so deemed appropriate or inappropriate by the research workers this measure was repeated each twenty-four hours until the catheter was removed. Data direction and Analysis
CAUTI rates were defined as the figure of CAUTIs divided by the figure of device yearss. multiplied by 1000. The figure of monthly device yearss before the intercession was 311. 7 compared to 238. 6 during the intercession which represented a lessening of 73. 1. Of the 238. 6 device yearss. 32 % were considered to be inappropriate. During the survey intercession period there were zero CAUTIs compared to 2. 5 in the period before the survey which indicates a important difference back uping the hypothesis ( Elpern et al. . 2009 ) .
The consequences of the survey indicated that the continuance of urinary catheterisation and the figure of CAUTIs can be reduced with the execution of protocols related to the demand for indwelling urinary catheters. These protocols should be reviewed day-to-day for each patient to find rightness. This is a alteration in theoretical account compared to the unit’s current pattern. During the survey period it was besides found that due to less indwelling catheter interpolations that the unit needs extra resources as a consequence such as increased demand for options to indwelling catheters. linens. and bath and tegument attention merchandises. Study Strength/Weakness
The strength of the survey is that the information of inclusion or exclusion into the survey was clear ; if the patient had an indwelling catheter they were included in the survey there was no prejudice involved. One identified failing of the survey is that the survey was limited to merely one unit ; there was no control group in the survey. The device yearss and infection rates were compared to a clip period before the intercession which there is no manner of cognizing whether other factors were present to act upon the rate of infection. Besides the variables of finding what was considered appropriate usage of indwelling catheters was non based on evidenced based pattern. but the sentiment of the research workers involved in the survey. Study Implication/Conclusion
As indicated by the 2009 Centers for Disease Control’s updated guidelines for bar of catheter related urinary piece of land infections. which was released after the day of the month of this survey. besides reflected many of the same indicants of the appropriate and inappropriate usage of urinary catheters ( Centers for Disease Control and Prevention. 2009 ) as was used in this survey. The survey did non turn to any techniques for interpolation nor any specific type of antimicrobic catheters. Bedside nurses play a major function in surveillance and remotion of inappropriate usage of indwelling urinary catheters and lessening of catheter associated urinary piece of land infections. Recommendation for farther surveies would be the probe of the usage of indwelling urinary catheters in association with incontinency and the development of force per unit area ulcers ; make the benefits outweigh the hazard of catheter associated urinary piece of land infection? Does the interpolation technique for interpolation of the indwelling urinary catheter play a important function in the CAUTI rates? Hospital acquired infections are a direct contemplation of nursing attention. and nurses play a major function in cut downing the rates of infection.
Centers for Disease Control and Prevention ( 2009 ) . Guideline for bar of catheter-associated urinary piece of land infections. 2009. Retrieved November 27. 2012. from hypertext transfer protocol: //www. Center for Disease Control and Prevention. gov/hicpac/cauti/002_cauti_toc. hypertext markup language Centers
for Disease Control and Prevention ( 2010 ) . Catheter-associated urinary piece of land infections ( CAUTI ) . Retrieved November 27. 2012. from hypertext transfer protocol: //www. Center for Disease Control and Prevention. gov/HAI/ca_uti/uti. hypertext markup language Elpern. E. H. . Killeen. K. . Ketchern. A. . Wiley. A. . Patel. G. . & A ; Lateef. O. ( 2009 ) . Reducing usage of indwelling urinary catheters and associated urinary piece of land infections. American Journal of Critical Care. 18 ( 6 ) . 535-542. Retrieved November 18. 2012 from CINAHL Plus database.