Project Description
Catheter-Associated Urinary Tract Infection (CAUTI) in recent years has been a predominant infection acquired by patients hospitalized in the Emergency Centre (EC). A CAUTI in most cases develops during the placement of the urinary catheter, preservation, and period of catheterization (Bary et al., 2017). The aim of this project is to reduce the rate of inpatient CAUTI cases by promoting awareness in the Emergency Centers, training of staff and provision of materials that will promote holistic healing. By analysis of the nursing articles on research and methods that can be used in hospitals to reduce cases of CAUTI, this project is able to devise long-term solutions for this epidemic. The EC staff will also get educated on the necessary measures to take in order to reduce the rate of occurrence of CAUTI in patients (Bary et al., 2017).
Project Rationale
This project was created not only in an effort to reduce the rate of CAUTI but also, to create awareness of this deadly epidemic that occurs in most hospitals in the U.S. Recent studies show that about 91% of urinary catheters placements occur in patients in the EC in just a period of 24 hours. This is because, in most cases, patients in the EC are usually unconscious and in critical conditions, only a third of this case usually have documented physicians' instructions to do so, and almost half of them are incorrect. As such, unnecessary urinary catheter placement being done on patients who did not require it, Exploitation may be reduced if the patients out of the Emergency Centers are evaluated for catheter necessity before placement at the time of transfer in the entire hospital (Bradway et al., 2016).
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Limiting the number of urinary catheter placement is crucial in reducing CAUTI cases occurrences', which is because the number of placements is directly proportional to the number of urinary tract infections that occur. Notably, in an attempt to reduce the rate of CAUTI cases, it is crucial for a proper diagnosis to be done to ensure that the urinary catheter placements are only done to patients who require the procedure (Huber et al., 2016).
The patients and the hospital will both benefit from this project since the cases of CAUTI will reduce. As such, patients will not incur extra expenses while treating the infections; this also saves the hospital time and resources that they usually use in the treatment of CAUTI. Patients' mortality and morbidity rates also significantly reduce (Huber et al., 2016). Nurses and other healthcare workers in the EC will not be left out either because it will save their time; therefore, enabling them to focus on other patients under critical conditions.
Personal Expectations
As a nurse, I can relate to this project on a personal level. Through this project, I hope to promote the awareness of CAUTI and the need to reduce its occurrences not only to my peers but also to my co-workers. My main aim is to be able to establish a procedure that prevents CAUTI cases and work for its implementation in hospitals.
Project Goals
Through this project, I want to reduce the patient's morbidity and mortality rate. It is possible only when care is taken during the placement of urinary catheters by ensuring they are sterilized and cleanliness during the procedure. I hope my co-workers will get educated on the necessary precautions that need to be undertaken in order to control CAUTI cases. Notably, this project will explore all possible methods that can be adopted in staff training and tactical methods to ensure they work towards the same course. In this case, the methods proven in the study will be applied. For instance, having a specified group of nurses that ensure a proper diagnosis is done before doing a urinary catheter placement. As the nurses carry out the diagnosis, another group of nurses will still be attending to the patients ensuring their health condition stabilizes. Through consistency in educating the hospital staff and implementation of policies, the CAUTI cases will reduce this saves both the patients and the hospitals time and resources.
PICO (T) Question
How do precautions such as proper sterilization, cleanliness during urinary tract placement, and proper diagnosis before the procedure reduce the rate of CAUTI cases in patients as compared to the existing unreliable measures?
Research
The articles I used in my research were from PubMed. The first article cited reducing the number of inappropriate and unnecessary urinary catheterization as the most convenient method of reducing CAUTI cases. In most cases, this leads to the creation of otherwise avoidable patient uneasiness, suffering, pain accompanied by extra costs and hospitalization time. Through the study, it establishes the decrease in the number of CAUTI after implementation of appropriate diagnosis of the patient before the procedure (Wentink et al., 2016).
The second article identifies timely catheter removal, holistic maintenance, and avoiding contamination during catheter insertion as other ways of reducing CAUTI cases. Cases of CAUTI were observed to be prevalent in patients who stayed with the catheter for more than the required time. The catheter used should be pre-sealed, and the insertion method should be sterilized. After insertion, it is imperative to make sure that the flow is not obstructed by checking for coiling or looping, the bag should also be emptied regularly.
The third article stated the proper care of the catheter to be the most convenient method of avoiding CAUTI cases. This is by the use of the standard catheter that is sterilized, ensuring the hands are clean before catheterization and ensuring that the catheter does not come into contact with other surfaces before the procedure (Wentink et al., 2016).
Finally, the fourth article encourages proper staff education and awareness on CAUTI as the most reliable in the fight against this scourge in hospitals. In this regard, when workers are made aware of the relevance of reducing CAUTI cases and how to control the situation, they are able to work together towards the same course. The current project analyzes each case study, and it also enables implementation of the most reliable method in preventing CAUTI cases locally among hospitalized patients in the Emergency Centers.
Procedure
Controlling CAUTI in any hospital may turn out to be a hard task; thus, the key reasons and barriers should be identified. Overcrowding in the Emergency Centre is viewed as one of the unique structural barriers to patient well-being and understaffing. After the identification of relevant barriers, solutions on how to get rid of these should be created and implemented.
The major resource required in the implementation of this project locally will be my project and most important research articles that have confirmation. The research articles can be acquired online through PubMed. After the acquisition, the local Emergency Centre workers need to be educated on why they need to embrace change in their hospital. The procedure is to be carried out by the head departments to the administrative officers and, finally, the managers. Educating them may take a period of five to six weeks. Implementation is the final step after the managers and administrators have been provided with the necessary research articles including the project. They will have a look at the articles then come up with the necessary resources required for the execution of the required implementations. As such, the whole process will take a period of between four to five months before it is fully implemented.
Recommendations
Extensive education and creation of policies that promote the reduction of CAUTI cases will help in ensuring the local workers embrace change. Any major policies should only be implemented after approval of the Emergency Centre head and the necessary administrators. A multidisciplinary team that promotes the prevention of CAUTI should be created. The team will act as the project coordinators that will actively engage nurses, medical workers, and physician champions as well as participate actively in data collection. It will also ensure the CAUTI policies that have been implemented are followed to the latter during the day-to-day activities. The performance of the policies should be tracked on a daily basis, and if they turn out to be successful, they are spread to other hospitals. A unit is selected that is appropriate is enhancing the spread out of the policy that they discovered to be useful in other hospitals. Sustainability of the situation and the success you will obtain should also be put into consideration.
Physician champions selected by the multidisciplinary team will assist in controlling the conditions of the catheters by ensuring they are sterilized and handled under clean conditions. They will also promote the reduction of urinary catheter use, control complications that occur due to prolonged stay of catheter use and also ensure that there is a diagnosis of the patient before the procedure is done on them. The use of condom catheter as opposed to the urinary catheter will also come in handy in the fight against CAUTI (Bradway et al., 2016).
Evaluation
This project will be termed as a success after there is an evident decrease in the rate of CAUTI cases. Overall evaluation is done by looking at the number of CAUTI cases before the implementation of the policies and later on compares them with the new number of CAUTI cases. In case the new number turns out to be higher, the policies will not be working, and if the cases are lower in number, then the project will be a success. In order to make this possible the urinary catheter should be viewed as risky to your patient because it causes both infectious and non-infectious damage to them. Several practices will enable the decrease of urinary catheter use although; it will not be easy avoiding catheter use should be your major priority. At the outset, both socio-adaptive and technical issues should be put into consideration before the procedure. Most importantly the only way to prevent cases of CAUTI is through teamwork not only from the local co-workers but also, from the administrators and the managers.
References
Barry, J., Allen, C., Chlebeck, M., Siebenaler, R., Wick, K., & Gunderson, W. (2017). Implementing a Two Person Insertion Technique and Indwelling Urinary Catheter Insertion Competency Assessment to Reduce Catheter Associated Urinary Tract Infections. American Journal of Infection Control , 45 (6), S60.
Dy, S., Major-Joynes, B., Pegues, D., & Bradway, C. (2016). A nurse-driven protocol for removal of indwelling urinary catheters across a multi-hospital academic healthcare system. Urologic nursing , 36 (5), 243-250.
Huber, K., Moore, M., Steinberg, J., Bertuzzi, R., & Sood, G. (2016). Catheter Associated Urinary Tract Infection Reduction: Performance Improvement or Definition Improvement?. American Journal of Infection Control , 44 (6), S51.
Wentink, J. E., Thompson, R., & Sampathkumar, P. (2016). Comparison of CAUTI Cases by 2014 and 2015 National Healthcare Safety Network Definitions. American Journal of Infection Control , 44 (6), S51.
