Catheter-Associated Urinary Tract Infection Discussion
Catheter-Associated Urinary Tract Infection (CAUTI) among hospitalized patients is a pertinent issue that healthcare organizations are facing. It is important to note that CAUTI is among the most common hospital-acquired infections whose rates continue to increase leading to increased hospital stays, patient discomfort, and excess healthcare costs thus contributing to patient morbidity and high mortality rates (Connor, 2018). There are various causes of this condition that include poor hygiene and prolonged use of the catheter and therefore, it is important to ensure that preventive measures are followed by nurses to reduce CAUTI cases. Prevention of CAUTI cases in healthcare organizations helps in achieving improved patient experience, patient satisfaction, patient safety, and patient outcomes (Clarke et al., 2019). The use of a picot question is effective in developing an evidence-based nursing intervention that can be used to solve a healthcare problem. Additionally, it is important to note that a PICOT question is a problem-solving approach/strategy used by nurses and healthcare providers to establish a long-term solution for problems like CAUTI. This, therefore, leads to improvement of service quality because the interventions used are evidence-based and were derived from the research findings of the PICOT question.
Engaging in various research activities by nurses and healthcare practitioners has greatly helped in reducing the rate of infections. Critically looking at the risk factors for developing CAUTI and incorporating clinical guidelines as well as nurse-driven protocols like the use of anti-microbial catheters will play a significant role in reducing the number of CAUTI cases in healthcare facilities (Al-Qahtani et al., 2019)Catheter-Associated Urinary Tract Infection Discussion. Therefore, I formulated a picot question as follows:
PICOT QUESTION
Among hospitalized patients, how does the nurse-driven protocol of using anti-microbial catheters as compared to the use of the normal catheters effective in preventing catheter-associated urinary tract infections in six months?
Search Terms and Databases
The Walden University Library, MEDLINE, EMBASE, PubMed, Cochrane, and CINAHL are some of the databases that I used to search for important information for my research question. Some of the search terms that I used include catheter-associated urinary tract infections, hospitalized patients, catheter insertion, and aseptic techniques. Nine articles were found from the search and after refining the search further by adding other search terms like prevention of CAUTI using nurse-driven protocols like the use of anti-microbial catheters; the search resulted in 1580 articles. Upon adding the year 2016-2021, it was reduced to 289 articles and much less as 94 articles after prevention of CAUTI, AND nurse-driven protocols, AND aseptic technique of catheter insertion were added thus narrowing the language to English.
Strategies to Increase the Rigor and Effectiveness of Database Search
For researchers to increase the rigor and the effectiveness of database search, using the appropriate vocabulary while combining concepts and search terms by incorporating Boolean operators is an essential strategy (Foell, & Pitzer, 2020)Catheter-Associated Urinary Tract Infection Discussion. Additionally, evaluation of search strategies, using more than one database to search for information on the topic in question, and learning the search rules to bring out uniqueness are other important strategies that can improve the rigor and effectiveness of database search.
References
Al-Qahtani, M., Safan, A., Jassim, G., & Abadla, S. (2019). Efficacy of anti-microbial catheters in preventing catheter-associated urinary tract infections in hospitalized patients: A review on recent updates. Journal of infection and public health, 12(6), 760-766. https://doi.org/10.1016/j.jiph.2019.09.009
Clarke, K., Hall, C. L., Wiley, Z., Tejedor, S. C., Kim, J. S., Reif, L., … & Jacob, J. T. (2019). Catheter-associated urinary tract infections in adults: diagnosis, treatment, and prevention. J. Hosp. Med, 14, E1-E5. 10.12788/jhm.3292
Connor, B. (2018). Best practices: CAUTI prevention. American Nurses Association. Catheter-Associated Urinary Tract Infection Discussion
Durant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. American journal of infection control, 45(12), 1331-1341.
Foell, A., & Pitzer, K. A. (2020). Geographically targeted place-based community development interventions: A systematic review and examination of studies’ methodological rigor. Housing Policy Debate, 30(5), 741-765.
Assignment: Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.
To Prepare:
• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research. Catheter-Associated Urinary Tract Infection Discussion
THIS IS PICOT Question:
PICOT QUESTION
Among hospitalized patients, how does the nurse-driven protocol of using anti-microbial catheters as compared to the use of the normal catheters effective in preventing catheter-associated urinary tract infections in six months?
The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
Resources: Catheter-Associated Urinary Tract Infection Discussion
Response #2 Week 4 Discussion
Hello Marlen.
I enjoyed reading your discussion post. I agree that CAUTI is one of the most prevalent hospital-acquired infections (HAI) to date. Decreasing the incidence can save a lot of healthcare dollars, decrease mortality, and prevent other comorbidities. I came across several articles between 2018 and 2022 that discuss how utilizing an external female catheter such as Wick can help decrease the incidence of CAUTIs. I searched CINAHL plus regarding the use of WICK aiming to determine if this in fact decreased the incidence. I became familiar with this technology initially post-op total left hip in 2019. While searching CINAHL plus I began with HAI, CAUTIs, and female external urinary catheters, using AND and OR (Walden University, 2018).
Zavodnick, J., et al. (2020)Catheter-Associated Urinary Tract Infection Discussion, conducted a retrospective observational study with Female External Urinary Catheters (FEUCs) introduced in the ICU. The aim was to look at the effects of FECUs vs indwelling catheterizations and determine the rate of CAUTIs and catheter days with the use of FEUCs. The results were statistically significant in that CAUTI rates decreased from 3.14 to 1.42 catheter days/1000 catheter days. The authors further report that the use of FEUCs may, in some instances, be used to prevent the need for indwelling female catheters.
Goris, A. J., et al., (2020), looked at decreasing CAUTIs in two community hospitals with similar bed numbers using Female External Urinary Catheters hospital-wide. This was a retrospective review that compared data pre-implementation and post-implementation. The aim was to decrease the length of urinary catheterization time. The authors employed a device utilization ratio (DUR), and CAUTI numbers which were compared using CHI square analysis. The authors concluded that the implementation of female external catheters in two community hospitals showed a significant decrease in the use of indwelling urinary catheters, but the impact on CAUTI was not significant. However, the authors reported that utilizing female external catheters may improve patient outcomes, finances, and ratings.
I hope that this information can be useful to your research. I was surprised to see that there were several available peer-reviewed articles. The purchase of this equipment may be expensive but with more research finding positive outcomes, facilities may find that it will improve outcomes, quality of care, and save healthcare dollars Catheter-Associated Urinary Tract Infection Discussion.
References
Zavatnick, J. Harley, C., Zabriskie, K. Brahmbhatt, Y., (2020). Effect of a Female
External Urinary Catheter on Incidence of Catheter-Associated Urinary Tract Infection.
Cureus Publisher, [s. l.], 12(10). ISSN: 21688184 DOI: 10.7759/cureus.11113.
https://search.ebscohost.com/login_aspx?direct=true+AuthType=shib&db=mnh&AN
live&scope=site Database: PubMed PMID: 33240709
Goris, A. J., McMullen, K., Dunn, G. M., Wade, R. S., Leach, K. M., Lowe, I., (2020), Quick to
Wick: External Female Catheters and Urinary Catheter Utilization. American Journal of
Infection Control, 48(8), Supplement, p 57.
https://doi.org/10.1016/j.ajic.2020.06.152 Database CINAHL then ScienceDirect
Walden University, LLC. (Producer). (2018). Searching the Evidence [Video file].
Baltimore, MD: Author. Catheter-Associated Urinary Tract Infection Discussion