Criteria-Based Regulation Summary

Criteria-Based Regulation Summary
Journal Four The next article focused on a criteria–based reminder to help decrease the duration of catheterization and increase proper catheter care,
causing a decrease in CAUTIs (Chen et al., 2013). The criteria–based reminder was used to remind the nurse to check if the catheter could be removed
and also reminds them the catheter needed to be properly cleaned. The research method was a randomized control trial (Chen et al., 2013). The sample
of this study was from two respiratory ICUs in a medical center in Taiwan. The study involved 231 patients who had catheters inserted in the ICUs and
130 patients who had catheters inserted on other units (Chen et al., 2013). Data was collected by having urine specimens taken from urinary catheter
patients on the unit, they then tested for urinary tract infections (Chen et al., 2013). Two groups of catheter patients were tested, one with the
criteria–based reminder implemented and one without (Chen et al., 2013). The study showed that the criteria–based reminder group had a 21.8%
incidence of UTIs, and the group without the reminder had a 32.8% incidence of UTIs (Chen et al., 2013). The study also showed the reminder
method dropped CAUTI rates by ... Show more content on Helpwriting.net ...
Journal one and Journal two focus on the education and attitudes of health care workers to decrease rates of CAUTIs (Justus et al., 2016; Saint et al.,
2016). Journal four's focus is the use of a reminder method to decrease CAUTIs (Chen et al., 2013). This method helps to increase the use of proper
catheter interventions in hospitals by reminding health care workers about them daily. Journal three and journal five both focus on the use of certain
interventions to decrease rates of UTIs in catheterized patients (Fakih et al., 2012; Saint et al., 2013). Articles three and five evaluate if certain
interventions used in hospitals now are helpful in decreasing rates of
... Get more on HelpWriting.net ...

Catheter Associated Urinary Tract Infection
Catheter Associated Urinary Tract Infection (CAUTI) is defined as the occurrence of a urinary tract infection (UTI) in patients with a urinary catheter
in the past 48 hours. Published guidelines by the Infectious Diseases Society of America (IDSA) further defines CAUTI by the presence of significant
bacteriuria of в‰Ґ 103 CFU/ml found in the urinalysis and signs and symptoms of a UTI without the presence of another cause for these findings.
Signs and symptoms of CAUTI could include: altered mental status, fever, chills, flank pain, costovertebral angle tenderness, and hematuria. If the
catheter has been removed in the past 48 hours the symptoms could also include urgency and frequency (Fakih et al., 2016).
A2. Significance of the problem
The most common health care associated infection (HAI) is CAUTI. Forty percent of all hospital–acquired infections are UTIs and 80% of these are
directly linked to having an indwelling urinary catheter in place (Underwood, 2015). Urinary catheters are required in up to 25% of hospitalized
patients and bacteriuria results in about 25% of patients with a catheter for greater than 5 days and this number increases by 1 to 5% for each day the
catheter is in place after that. The harmful consequences of CAUTI include increased length of stay, higher health care cost, and increased mortality.
CAUTI is known to cost health care in the U.S. $400–$500 million annually (Leuck et al., 2015).
A3. Current Practice
The growing concerns over

Cauti
Urinary tract infections (UTIs) are the most common nosocomial infection; accounting for up to 40% of infections reported by acute care hospitals. Up
to 80% of UTIs are associated with the presence of an indwelling urinary catheter. Catheter associated urinary tract infections (CAUTIs) represent the
largest proportion of healthcare associated infections (HAI). Catheter–associated urinary tract infection (CAUTI) increases hospital cost and is
associated with increased morbidity and mortality .CAUTIs are considered by the Centers for Medicare and Medicaid Services to represent a
reasonably preventable complication of hospitalization. As such, no additional payment is provided to hospitals for CAUTI treatment–related
costs.CAUTIs can lead to ... Show more content on Helpwriting.net ...
Not maintaining a sterile technique during insertion and closed drainage system after insertion.
4.The drainage bag of the bacteriuric patient is a reservoir for organisms that may contaminate the environment and be transmitted to other patients.
5.Outbreaks of infection with resistant gram–negative organisms attributable to bacteriuria in catheterized patients have also been reported.
PREVENTION
1.Limiting catheter use and, when a catheter is indicated, minimizing the duration the catheter remains in situ are primary strategies for CAUTI
prevention.
2.Ensure that only trained, dedicated personnel insert urinary catheters.
3.Implement a system for documenting the following information in the patient record: indications for catheter insertion, date and time of catheter
insertion, individual who inserted catheter, and date and time of catheter removal
a.Include documentation in nursing flow sheet, nursing notes, or physician orders. Documentation should be accessible in the patient record and
recorded in a standard format for data collection and quality improvement purposes.
4.Ensure that there are sufficient trained personnel and technology resources to support surveillance of catheter use and outcomes.
5.Educate healthcare personnel involved in the insertion, care and maintenance of urinary catheters about CAUTI prevention, including alternatives to
indwelling catheters and procedures for catheter insertion, management, and removal.
6.Maintain

The Similarities And Differences Between Rcis And Rces
The Similarities and Differences of RCIS and RCES Seeking cardiovascular technician who are able to monitoring patients and assisting doctors
with performing angiograms, PCIs, Interventional Radiology procedures, and Electrophysiology procedures. Minimum requirement: Registered
Cardiovascular Invasive Specialist (RCIS) or Registered Cardiovascular Electrophysiology Specialist (RCES). This is an example of the many job
posting for cardiovascular technician. What do these individuals have in common that cardiac laboratory can accept either credentials? What set
them apart to have different credential title? It is easier to discuss the similarities of both RCIS and RCES registrant since they are so similar.
Similarity It is easier to discuss the similarities of both RCIS and RCES individuals since they are so alike. The first similarities of RCIS and RCES
individuals is the amount of extensive cardiovascular education they receive through a 2 years program which include didactic and skills labs. Both are
credentials through Cardiovascular Credentialing International (CCI) with upon passing the RCIS or RCES exam. Since the field of invasive and
electrophysiology is still expanding, new techniques and equipment are continually being research, released and revised. As a results, RCIS and RCES
individuals pursue continue education (CEUs) in order to be informed and proficient with innovative techniques and equipment. Furthermore, CCI
required both RCES and RCIS registrants

Symptoms And Treatment Of Vascular Closure
Background
Vascular closure devices following cardiac catherization through the femoral artery have been gaining significant traction since its use in the
mid–1990s. Compared to the previous gold standard of manual compression, VCDs allow for shortened time to ambulation, decreased duration of
hospitalization post procedure, and increased patient comfort. The devices have also shown safeness comparable to manual compression. Despite the
many advantages and variety of devices available, there are still complications to take into account. More common issues include device failure,
bleeding, and hematoma. Less common but more serious complications include infection, ischemia, limb loss, and death.
Case Report
Our patient is a 74–year–old ... Show more content on Helpwriting.net ...
Due to these findings patient was directly admitted to the hospital and placed on a heparin drip. On physical exam patient had absent pulses below the
right femoral artery. However, there was no discoloration, change of temperature, or sensory as well as motor deficits of the right lower extremity.
Patient was taking a low–dose aspirin and red yeast rice for cholesterol management at that time.
The following morning the patient underwent successful angioplasty of the right common femoral artery with thrombectomy and a 6 x 20 mm
balloon angioplasty, reducing a 90% stenosis to less than 30%. A spider catheter was deployed to perform the thrombectomy, however an atrial blazer
catheter failed to retrieve the spider device as it was unable to completely collapse. As a result the patient was taken to the OR for vascular surgery.
The spider basket was retrieved through the wall of the common femoral artery with its contents.
The specimen was sent to pathology, which noted a foreign body device surrounded by soft tissue attached to the spider device. The foreign body was
noted to be a Angio–Seal plug from the left heart catheterization that had been presumed a thrombus.
Discussion
Promising results have shown that the Angio–seal VCD has excellent efficacy and safety after routine catheterization and intervention. However, clear
indications of use and risk of complications need to be evaluated and monitored.
Advantages to using a closure

The Threat of Catheter-Related Infections
Clinical problem: Catheter–related infections pose a detrimental threat to adult patients in intensive care units with a central line. Effects of an infection
include: an increase in the patients' length of hospital stay, morbidity and mortality rates, and hospital readmission rates.
Objective: To determine if the evidence based practice interventions studied and published can help to decrease the rate of infection occurring in central
lines.
Data sources: The search engine that was used to find three randomized controlled trial articles and support my PICOT question was PubMed. Key
terms that were used to search for them included intensive care unit infections, chlorhexidine dressings, antiseptic solutions, and prevention methods for
catheter–related infections. A clinical guideline for the prevention of intravascular catheter–related infection was retrieved from the Agency for
Healthcare Research and Quality (AHRQ).
Results: The clinical guideline from the AHRQ encouraged interventions like the chlorhexidine impregnated sponge, antiseptic solution, and other
precautious measures in order to reduce catheter–related infections. The research completed by Atahan and colleagues (2012), Timsit and colleagues
(2012), and Timsit and colleagues (2009) concluded that the use of 2% chlorhexidine gel tegaderm dressing, chlorhexidine impregnated sponge, and the
antiseptic solution has significantly helped to reduce infection rates in catheters.
Conclusion: After synthesizing the

Cardiac Catheterization: A Short Story
Dr. Hughes smiled. "That is also a catheterization but this is a Cardiac catheterization. What that involves is inserting a catheter into the vessel of
the heart usually from the groin or the arm. If we find we need to put a stent in, then we will do it at that time." "So I will be here for only one
day?" Adam asked holding Tammy's hand a little tighter. "I am hoping for one night but again that will depend on what the test results show. Let's
hope that is all he will need," Dr. Hughes said. "I'll come by again shortly." He nodded, walked out of the room, and walked into the room across the
hall. They could hear him talk to that patient, now. "Well that is settled. I'll sleep here tonight." Adam looked up at Tammy. She looked back with a look

Patient Dissatisfaction Of Piv Catheter Replacements
Introduction
In a local San Diego County hospital, on a 28 bed progressive care unit specializing in cardiac telemetry, the current protocol for replacing peripherally
inserted intravenous catheter is every 72 hours or less if clinically indicated. The average daily census of patients on the unit is roughly 23 patients with
an increase of 5% during the winter months. There are nearly 50,000 patients admitted annually to this unit with 47,670 discharged home. The hospital
is located in Serra Mesa and serves the residents of this region as well as the surrounding area with a mean age of the patient being 52. The patients
seeking care are mostly English or Spanish speaking, but represent a wide variety of cultures. The RNs on this unit are working with patients in a 4:1
ratio leading to a fast–paced workflow and heavy workload for the nurses.
Staff nurses on the unit expressed their frustration with the current practice regarding the frequency of PIV catheter replacements, stating that it was
"time–consuming" and contributed to "patient dissatisfaction." The process of replacing a PIV can often be time consuming and may take multiple
attempts in order to successfully insert a new PIV. Research supports a change in practice that address these concerns. A pilot study performed in 2012,
by Rickard, Webster, Wallis, Marsh, McGrail, French and Whitby indicated that replacing PIV catheters only when clinically indicated did not lead to
catheter–related complications, as previously

Prevention Of Catheter Associated Urinary Tract Infections...
Prevention of Catheter Associated Urinary Tract Infections
In the Healthcare Setting
Dayna Menard
Mount Vernon Nazarene University
Prevention of Catheter Associated Urinary Tract Infections In the Healthcare Setting
A Urinary Tract Infection (UTI) is a serious problem in the clinical setting. "UTIs are mostly associated with catheterization" (Hooton, 2010, p. 629).
The infection can be described as bacteria invading the urinary tract. More so, the bacteria accounts for nosocomial bacteremia since the patient obtains
the infection in the hospital (Hooton et al., 2010). ACatheter Associated Urinary Tract Infection (CAUTI) is common because nurses do not find this
problem at the top of their to–do list during their shift. It can be easy for the nurse to become accustomed to a slight deviation from the correct method.
Any break in the chain of infection has opened the opportunity for microorganisms to reproduce in a susceptible host. Research has proven that when
hospitals, long–term care facilities, and other healthcare settings intervene with making positives changes, less of the patients developed a UTI with
catheterization. Infection control with catheterized patients can be implemented and resolved with collaboration and education among healthcare staff.
There has been a reoccurring incidence of staff members using urinary indwelling catheters for unnecessary reasons and convenience. More so, the
nurses did not think of the issue as the most

The Antibacterial And Antiseptic Impregnated Catheters
Methodology
Extraneous Variables
It is very important for the researcher to control the extraneous variable that could affect the study results. The extraneous variables that would affect
the results in this study include, the catheter material, the catheter care, and the method of obtaining the urine sample. To control the catheter material,
this study will be using the antimicrobial and antiseptic–impregnated catheters instead of the standard catheters as recommended by the Centers for
Disease Control and Prevention (CDC) 2009 guidelines because they are effective in reducing the risk of CAUTIs. To control the catheter care, the
study will follow the CDC guidelines for routine catheter care by ensuring that all the indwelling urinary catheters (IUC) maintain a sealed drainage
system, and an unobstructed urine flow. In addition, the nursing staff will be cleansing the meatal area daily with warm soapy water instead of
antiseptics, while maintaining the standard precautions including hand hygiene and wearing of gloves while performing peri–urethral care. To control
the procedure for obtaining urine sample, the study will use the CDC recommendation for collecting the urine sample aseptically, by aspirating the
urine from the sampling port with a sterile syringe after thoroughly cleansing the port with an antiseptic wipe (Gould et al., n.d.).
Instruments
Choosing an instrument to measure study variables is a very crucial in research. If a researcher chose to use an existing

Nursing Qsen Essays
In October 2005 the Quality and Safety Education for Nursing program was established. This program is funded by the Robert Wood Johnson
Foundation. QSEN was developed specifically for future nurses to understand and be aware of key challenges such as the knowledge, skills, and
attitudes that are essential to constantly advance the quality and safety of the way healthcare systems work. The goal for QSEN is to reshape the
identity of nursing so it includes the recommendations by the Institute of Medicine so there is a commitment to the quality and safety proficiency
(Dycus, 2009). QSEN has strived to place initiatives in pre–licensure programs so when licensed, they are up to date and educated on necessary skills.
For pre–licensure... Show more content on Helpwriting.net ...
Teamwork and collaboration with other healthcare providers is very important. To function effectively there needs to be mutual respect, open
communication, and shared decision making in the best interest of the patient. As a member of a team it is vital to know ones own strengths and
limitations, this way patients receive the best care. Evidence based practice is when recent research is integrated into the clinical setting for maximum
delivery of health care. A lot of evidence based practice was developed from research studies conducted by nurses such as decubitis ulcer prevention.
Knowing and demonstrating the scientific methods and processes will help to advance nursing care by providing better interventions for patient care.
Patient care plans should be developed based on evidence (Dycus, 2009). With monitoring outcomes from evidence based practice it can be determined
if the care caused improvement in the healthcare setting. Using quality measures such as charts and diagrams to understand performance. If care
provided to a patient is not safe, than the intervention is ineffective and therefore not helping to improve that patient's quality of life. To help provide a
safe environment, observation and communication are extremely important. Inform the patient and family of any interventions before proceeding with
them to insure the patient

TAVR Report: Cardiac Catheterization Lab
This past Friday in the cardiac catheterization lab I began my day with continuing the work that I was previously assigned to do last week where I
collected the data of patient's Cardiothoracic surgery. I continued to familiarize myself with the different types of Cardiothoracic surgery procedures,
however, the specific reports I was working with, they are called TAVR report (Transcatheter Aortic Valve Replacement). I later learned and was
explained to, the TAVR multiple procedures and its causes, which is aortic stenosis. As for the procedures, a valve needs to be placed in theheart and
each procedure delivers it a different way. The three ways the valve can be placed in the heart is through the heart's femoral artery (the transfemoral
approach),

Cardiac Catheterization Case Study
The suggested and safest course of treatment in order to fix this is Cardiac Catheterization. Other possible solutions would be medicine but that would
only reduce the symptoms of the defect. Another option would be open–heart surgery which is done by putting the patient under anesthesia and with
an incision through the chest in order to cover up the holes in the heart. Another option that is not preferred would be to wait it out and see if the holes
would cover themselves through time. Cardiac Catheterization would allow doctors to cover up the holes in the heart Brianna has with ease and
would erase the holes. Doctors would insert a narrow tube in a blood vessel in the groin. From there, they would guide the tube to the heart using
imaging

Cardiac Catheterization Report
This Friday at the Cardiac Catheterization Lab was a very productive and eventful one. First thing in the morning I went to watch a procedure, or
"case" as they call it that the hospital since there were not any patient files ready to be filed away. When I went to go to the control room with the
surgery happening, the patient was already on the surgery bed and the nurses and tech people (I do not know their professional name or title) were
preparing the equipment that they needed to perform the surgery. Also, when I walked in I saw one of the traveling tech people that I met a few
weeks ago and he said hi to me and explained that he was helping the doctor with the same type of procedure that I watched with him on the first day I
met him.

Reflection Paper Cath Lab
This Friday, September 29th, I had my second clinical observation experience in the Cardiac Cath Lab. I was there from 7:00 a.m. till noon, viewing
the flow and duties of the nursing staff on the unit, learning about the procedures done on this specialized unit. Throughout most of the morning I
followed Sara, an RN, who had been in the unit for eight years. It was an impressive experience that broadened my previously limited knowledge of
the roles and experience of a Cath Lab nurse. The Cardiac Catheterization Lab is a highly specialized area of work, and therefore does require some
specialized training for its nurses. Among the requirements include a background in intensive care nursing and having Advanced Cardiac Life Support
certification. Some nurses were also Cardiovascular Nurse–Board Certified, and had X–ray training and licensure. Because it can be a very high
intensity area, the VA does not accept new graduates to the Cath Lab. With its intensity, I inquired of several nurses what techniques they utilize to
cope with traumatic events. Sara discussed how much she relies on her fellow coworkers in emergent events to step up and be willing to jump in and
assist as needed. She also mentioned how each nurse attends a biweekly meeting with several other staff members to discuss any major successes or
errors which have occurred. Sara explained this time as an excellent learning opportunity, as well as an outlet when each person on the team can share
their thoughts.

Pediatric Cardiac Catheterization
Indications for pediatric cardiac catheterization have undergone significant changes over the last 3 decades. In early 1980s, with emerging of none to
less invasive diagnostic modalities and more specifically with current echocardiography diagnostic ability, cardiac catheterization is no longer
considered as a mainstay diagnostic tool for most cardiac anomalies except in rare occasions or when accurate hemodynamics measurements are
needed. But with dramatic improve in the quality and availability of instruments which can be used effectively for newborn, interventional
catheterization emerged as a preferred modality for comparing with cardiac surgery which has its well–known higher risk of mortality and morbidity in
neonates. In addition, it can be used effectively as an alternatives or adjuncts to surgical procedures (hybrid procedures) for few other conditions.
Thus, in the current era, It is much more common to perform interventional cardiac catheterization rather than for ... Show more content on
Helpwriting.net ...
2–Minor complications: blood loss requires transfusion, hypotension requiring IVF, deep venous thrombosis, pulse loss requiring heparin, transient heart
block, dysrhythmias requiring treatment, metabolic acidosis requiring bicarbonate administration, and balloon

My First Day Of My Independent Study Mentorship At The...
An hour or so into my first day at my internship and my mentor gets a call from the Emergency Room about an elderly patient who came in
complaining of chest pain. After running some tests and EKGs, the ER staff finds some abnormal results which slightly suggest that the patient might
be having a heart attack. The patient is rushed into the cath lab while my mentor has to leave to attend a case at another facility so he leaves me with
his partner Dr. Fernandez to watch the case. Dr. Fernandez starts the procedure of cardiac catheterization in which he plants a stent in the patient'sheart
in roughly 30 minutes. Although the patient suffered no heart attack, Dr. Fernandez found some narrowing the patient's heart. That was my first day of
my ... Show more content on Helpwriting.net ...
Pillai. Interventional cardiology is an incredibly time consuming and challenging specialty in medicine. I learned from my mentor what it is like to
see multiple patients in the hospital and in his office, perform procedures, study cases, all of which are followed by loads of paperwork, in the course
of just one day. After spending the past 10 weeks in this internship, I can certainly say that I can see myself taking care of hearts in the future.
So what actually inspired me pursue an internship in cardiology, due to the fact that last semester, during my internship in the Emergency Department
in Memorial Hermann, I saw many cases dealing with chest pain and heart disease. Due to my extensive exposure to heart patients and my research
on chest pain, I started to grow an interest for cardiology. My former mentor Dr. Kutsen referred me to his colleague, Dr. Pillai to continue my
internship in the field of cardiology. I choose cardiac catheterization as the topic of my study in this internship because it tends to be one of the most
accurate and effective procedure performed by Interventional Cardiologists. It can aid in earlier detection and treatment of coronary artery disease
which is essentially the number one killer in the United States. Throughout my internship, I learned what a typical Interventional Cardiologist does on
the daily basis. Dr. Pillai informed me about his educational background which seemed overwhelming to me at first. After

The Use Of Automatic Real Time Tracking And Augmented 3d...
The interest to detect and track the endovascular devices during X–ray guided interventional procedures spans over a decade. The recent developments
in real–time detection, tracking, visualization over an augmented reality with multi modality fusion has transformed the surgical environment.
However, it's quite challenging to combine robustness of automatic real–time tracking and augmented 3D visualization. In addition, various
endovascular procedures use different devices and tracking requirements (tip or whole catheter).
The important parameters that affect the detection and tracking can be classified in to 3 broad categories; endovascular devices, projection geometry
and motion. At first, the detection of various shapes and radio–opaque devices is a challenge. Secondly, the detection is challenged by image
magnification and image geometry by various projections (Cranio–caudal tilt). Thirdly, and importantly real–time tracking challenged by the patient
motion and the deformation of the vessel.
Over the years, many of these challenges were addressed with success limited to devices. However, the potential clinical benefits; to deploy the
fenestrated stent grafts accurately without blocking branches of abdominal Aorta (renal), to reduce contrast medium injected that might reduce the risk
of renal pathologies, to reduce the radiation exposure to the patient, personal and the environmental, sustains the research interest. In addition, a
successfully registered 3D

Cardiac Catheterization
Cardiovascular disease has long been the leading cause of death in the United States and is predicted to affect forty percent of the population by
2030 (Narang et al., 2016). Moreover, research states the cardiovascular workforce is inadequate to meet the rising demands of our aging population
(Narang et al., 2016). Nurses caring for patients in the cardiac catheterization laboratory are key members of the cardiovascular workforce. While there
is research to support the development of nurses working in the pre– and post–cardiac catheterization laboratory settings; current literature reveals little
information about the development of nurses working in the cardiac catheterization laboratory (Currey, White, Rolley, Oldland, & Driscoll, 2015)....
Show more content on Helpwriting.net ...
This ethnographic study will explore how new cardiac catheterization laboratory nurses learn the local knowledge necessary to communicate effectively
in the workplace. The data collected during this study came from face–to–face interviews with three nurses with different levels of cardiac
catheterization laboratory experience. First, Mary is a clinical manager of the cardiac catheterization laboratory with twenty years of expertise in the
department, as well as cardiovascular critical care experience. Second, John is a staff nurse with ten years of expertise in the cardiac catheterization
laboratory, as well as experience in the ADD his other experience. Third, Susan is a staff nurse with four months of cardiac catheterization laboratory
experience, who previously worked in the emergency department. Each interview had participants respond to predetermined open–ended questions and
dealt with medical knowledge and communication skills (See Appendix

Personal Narrative: My Experience Of Cardiac Catheterization
As Friday was my first day starting my experience at the cardiac catheterization lab, I was quite nervous and curious about the different things that
I would have to do considering in all my time volunteering at the hospital, I have been to the cath lab only one or two times. However, when I
went to the lab I was warmly welcomed by some of the staff and I later met many of the nurses and doctors there as well. Everyone was very
friendly and they were excited to have my help and to "train me." In fact, one of the doctors I met wanted me to do some research regarding cardiac
catheterization to "get me more involved in the field," which is pretty exciting because I'm not very familiar with anything related to cardiology but I
chose this specific

The Pathology Of A Cardiac Catheterization Laboratory Essay
Seth Kahn's (2011), article entitled, "Putting Ethnographic Writing in Context," identifies ethnography as the study of "relationships, rituals, values,
and habits that make people understand themselves as members of a group." Ethnographers adopt a stance of observation, as well as participation to
better understand the discourse among members within a particular group, or discourse community (Khan, 2011). This ethnographic research will
"connect what community members know and do, with what they say and how they say it" (Devitt, Bawarshi, & Reiff, 2003). The purpose of this
study is to explore how nurses, working in a cardiac catheterization laboratory, learn the 'local knowledge' necessary to communicate with a
multidisciplinary discourse community successfully. To protect the identity of participants in this study, the name of the laboratory included in the
study will be identified as the XYZ Cardiac Catheterization Laboratory. Cardiovascular diseases have long been the leading cause of death in the
United States (Narang et al., 2016). Research predicts the progression of cardiovascular disease will affect forty percent of our population by the
year, 2030 (Narang et al., 2016). Furthermore, research shows that the cardiovascular workforce is inadequate to meet the rising demands of this
patient population (Narang et al., 2016). In particular, a subset of cardiac nurses, a cardiac catheterization laboratory nurse is a key member of this
cardiovascular workforce.

This Friday was a very eventful and exciting day at the Cardiac Catheterization Lab. When I first arrived at the office I asked my mentor, Maria, if
there were any procedures that I could watch. After two phone calls, there was one surgery that had just begun that I could sit in and watch. When I
went to the control room, I had looked through the glass and I had noticed that there were at least six or seven people in the surgery room. After about
five minutes watching the surgery and the screen that projected the heart, the tech guy that I met a few weeks ago comes into the control room, says
hi, and tells me that this is a good case for me to watch because it is a different surgery than the ones I have previously seen. In this case, the patient

Letter To A Patient Hospital: A Case Study
It is with great pleasure I write this letter to give my highest recommendation to Ankur Sethi for your structural heart disease fellowship program. I was
introduced to Ankur in July, 2016 in the capacity of the Director, Endovascular Services of Cardiac Catheterization Laboratory at the Mount Sinai
Hospital and Associate Professor of Medicine at Icahn School of Medicine when he started his interventional cardiology fellowship. Over the years I
had an opportunity to know him both personally and professionally.
Without a doubt he is one of the brightest interventional fellows I have come across. He came to us very well trained in diagnostic coronary and
peripheral angiography and with a robust background in clinical cardiovascular medicine.

An Evidence Based Quality Improvement Project Using A...
I am writing to obtain permission to conduct an evidence–based quality improvement project using a pretest/posttest design in your facility with the
purpose of evaluating the effectiveness of an educational intervention regarding the importance and use of the nurse driven protocol on nurses '
knowledge and CAUTI rates.
This study will be done to fullfill requirements for completion of the Doctor of Nursing Practice degree at Regis University, Denver, CO. The
following information is an overview of the project: Can Empowered Nurses Decrease CAUTI rates?
This project will employ a Population–Intervention–Comparative–Outcome (PICO) fromat for development of the research question to be investigated:
Population: Nurses on the ... Show more content on Helpwriting.net ...
OA nurse–driven protocol is the recommended tool to be used by the nurse to remove catheters without orders following set CDC guidelines and
prevent CAUTI
ONurses are best positioned to make the decision to remove catheters as they are in direct and constant contact with the patient.
OAccording to Hospital Compare Cape Fear Valley Hospital is labeled as as "Worse than national bench mark" for CAUTI rates (Medicare.Gov, 2015)
OPotential for reduction in reimbursement by 1– % if it falls with other hospitals that rank among the lowest– performing 25 percent with regards to
Hospital Acquired conditions (HAC): CAUTI being of them.
OThe hospital already has protocols in place, but the need for education regarding these protocl is great.The need on these protocols are great Type of
Study: Pretest, education, posttest quality improvement
Participant Requirement: Full and part time nurses
Risks, Cost, and Benefits:
There no risk to the patients. Nurses may have to work longer hours to care for patients with CAUTIs. The hospital will have to pay for the cost of
re–education of staff and shoulder the intangible cost that may

Reflective Essay on Assessment and Management of Urinary...
REFLECTIVE ESSAY ON ASSESSMENT AND MANAGEMENT OF URINARY INCONTINENCE
INTRODUCTION
Incontinence is one of the major problems faced by the elderly. Nurses can play a significant role in discovering continence problems (Lea
R.et.al.2007). Urinary incontinence is the unintentional passing of urine. It is a very common problem and is thought to affect more than 50 million
people in the developed world.(NHS.UK). To identify the problem and provide necessary treatment at the early stage, a thorough physical assessment is
necessary. In my placement area I came across many residents using incontinence pads, urinary catheters and incontinence sheaths. I understood that,
incontinence was a major problem among the elderly and it made me select ... Show more content on Helpwriting.net ...
When I started my placement , Mrs . X who was suffering from Parkinsonism and dementia was on Indwelling urinary catheter for the management of
urinary incontinence. Adhering to the results from the literature review I planned for initiating several steps to control incontinence in Mrs. X. My
mentor was always with me with full support and guidelines. Fluid management was the first step started. An input output chart was kept and well
maintained. Then steps wre also taken to manage constipation. Exercises were the last method practiced and the final result was really appreciable as
she got a great reduction in the incontinence rate.
FEELINGS
After the experience I felt so glad and proud to myself as it was a great success towards its end. In the beginning, during the time of planning I thought
it may be bit difficult for a patient with parkinsonism and dementia to make follow our instructions and continue till the end of this practice. But when
we started the programme her response was so nice that she found very cooperative and

Amt Task2
Valerie Johnson
AMT2 Task 2
Western Governor's University
May 1, 2014
Trinity Community Hospital conducted a focused community health needs assessment centering on cancer, orthopedic and cardiovascular services.
The information was obtained through a multitude of sources including: epidemiological surveys, focus groups, interviews with healthcare
professionals and healthcare facilities' planning guidelines.
Risk Factors
Oncology Services The needs assessment revealed that 15% of the population will be older than age 65 within the next 5 years. 50% of men and 33%
of women are expected to develop cancer during their lifetime. New cases of cancer are expected to grow by 34% in the next 5 years.
Current physician practices that ... Show more content on Helpwriting.net ...
Angioplasties are expected to increase by 25.8%. There will be a need for additional catheterization labs, surgical suites and expanded cardiac
rehabilitation programs. There needs to be better coordination of care to ensure timely scheduling of procedures. Education programs need to be
developed emphasizing cardiac risk factors, healthy living and lifestyle modifications.
Addressing Needs
Trinity Community Hospital currently does not have any formal oncology, orthopedic or cardiology programs in place.
Oncology
Trinity, currently is not addressing the needs of the community in regards to oncology services. There are no oncologists that practice at Trinity
Community Hospital, but there are physicians who have expressed interest if a program was developed. The physician groups that offer oncology
services are at their capacity. The hospital currently does have imaging services, including a MRI scanner. Additionally, the hospital has a mobile PET
scanner 2 days per week. Trinity Community Hospital currently does not have any chemotherapy units or nurses that have experience with
chemotherapy. While, the other 2 hospitals in the area have cancer programs, there are no coordinators in place to facilitate the scheduling of patients.
The care of oncology patients is fragmented. Currently there are no prevention programs in place. There are educational programs in place, but they are
not offered frequently.
Orthopedic Services Trinity

Urinary Tractinfection
An APIC Guide 2008
Guide to the Elimination of Catheter–Associated Urinary Tract Infections (CAUTIs)
Developing and Applying Facility–Based Prevention Interventions in Acute and Long–Term Care Settings
About APIC APIC's mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The Association's more
than 12,000 members have primary responsibility for infection prevention, control and hospital epidemiology in healthcare settings around the globe.
APIC's members are nurses, epidemiologists, physicians, microbiologists, clinical pathologists, laboratory technologists and public health
professionals. APIC advances its mission through education, research, consultation, collaboration, ... Show more content on Helpwriting.net ...
Of these patients, approximately 3% will develop bacteremia. The 1997 APIC/SHEA position paper on urinary tract infections in long–term care (LTC)
identifies CAUTI as the most common infection in LTC residents, with a bacteriuria prevalence without indwelling catheters of 25% to 50% for
women, and 15% to 40% for men. Therefore, usage of indwelling urinary catheters in residents of LTC facilities can be expected to
ASSOCIATION FOR PROFESSIONALS IN INFECTION CONTROL AND EPIDEMIOLOGY
5
Guide to the Elimination of Catheter–Associated Urinary Tract Infections (CAUTIs)
result in higher CAUTI rates with an associated risk of CAUTI–related bacteremia, unless appropriate prevention efforts are implemented. The 2008
SHEA/APIC Guideline "Infection Prevention and Control in the Long–term Care Facility"3 notes that "guidelines for prevention of catheter–associated
UTIs in hospitalized patients are generally applicable to catheterized residents in LTCFs." Strategies contained in this resource will be helpful in any
healthcare setting, when the facility's infection risk assessment identifies CAUTI as an infection prevention priority.
Legislative Mandates and CAUTI Risk Assessment
The impact of external factors is germane to facility

Cardiac Catheterization Essay
Cardiac Treatment nowadays had devolved in both way invasive and noninvasive, complicated and risky procedure, cardiac catheterization and Cardiac
surgery had play major roles of cardiac coronary artery treatment ,cardiac catheterization can be diagnosis and treatment procedure which in–could
percutaneous transluminal coronary angioplasty, cardiac surgery of coronary artery bypass is another obtain if cardiac catheterization is not suitable.
Post–Surgery infection had significant infect on patient and hospital , for cardiac patient it is more complicated because of vascular disease which
eliminate blood flow and nutrition to the infected tissue ,Cardiac medication can interacted with other medication
(1) Retrospective evaluation for MR.Y'S unhealed wound, noticing that he is self–employed as ... Show more content on Helpwriting.net ...
(7) according to NCBI corticosteroids effect healing of the wound mediated by cytokines and antagonism of various growth factors that intrusive with
fibroblast proliferation, inflammation, , degradation, and collagen synthesis deposition of connective tissue ground substances, angiogenesis, wound
contraction, and re–epithelialization ,
For the chemotherapy dose not differentiate between cancer cell and healthy cell which in the end kill the bad and good cell targets dividing
cells–interferes with wound healing which pointed out to us by Cincovidas
(8) NCBI point out, There is many chemical inside the cigarette by looking to some as Nicotine which vasoconstriction that decrease the diameter of
artery which lead to decrease blood flow to skin causing tissue ischemia, also increased the risk of thrombotic which lead to occlude the blood supply
to the tissue which could be one of main reason of delay healing for MR

The Microbiology Of A Cardiac Catheterization Laboratory...
Seth Kahn (2011) writes in his article entitled, "Putting Ethnographic Writing in Context," that ethnography is the study of "relationships, rituals,
values, and habits that make people understand themselves as members of a group" (p. 176). Regarding a group's language use, Kahn (2011) adds
ethnographers will adopt a stance of observation, as well as participation to better understand the discourse among members within a particular group,
or discourse community. Furthermore, Bawarshi (2003), explains that ethnographic research connects what community members know and do, with
the language used by the community. The purpose of this ethnographic research is to explore how nurses, working in a cardiac catheterization
laboratory learn the 'local knowledge' necessary to communicate with a multidisciplinary discourse community successfully. To protect the identity of
participants in this study, the name of the laboratory included in the study will be identified as the XYZ Cardiac Catheterization Laboratory.
Cardiovascular diseases have long been the leading cause of death in the United States (Narang et al., 2016). Moreover, research predicts the
progression of cardiovascular disease will impact forty percent of the nation's population by the year, 2030 (Narang et al., 2016). The literature also
shows that the cardiovascular workforce is inadequate for meeting the rising demands of the cardiovascular patient population (Narang et al., 2016). In
particular, a subset of

Essay about Cardiac Catheterization
Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at
and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see
how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through
the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the
movement of the walls of the heart to see if the pumping action of the heart is normal. The primary application of cardiac catheterization is to ... Show
more content on Helpwriting.net ...
The stent will be placed where it can be expanded to hold the artery open. Some stents are designed to simply keep the artery held open. Other stents
used are drug–eluting stents. These stents are coated with pharmacologic agents that work to prevent restenosis of the artery. Another form of PCI is
artherectomy. This is a procedure that has a cardiologist using a cutting blade that spins rapidly or a laser beam to cut away or burn away plaque that
is blocking a branch of the coronary arteries. To perform a cardiac catheterization the patient is brought to the cardiac catheterization lab. These
procedures are performed by specially trained cardiologists, nurses and radiologic technologists. The procedure is performed on a specialized table with
fluoroscopy equipment, cardiac monitoring equipment, and the use of computerized technology to assist in data and image collection and analysis. To
perform a cardiac catheterization the cardiologist will insert a sheath, or a short tube usually into the femoral artery. A long very thin catheter will then
be fed through the sheath and guided through the arteries until it is in the heart and coronary arteries. The physician uses fluoroscopy equipment to
guide the catheter into the coronary arteries. To allow for clear viewing of the coronary arteries, contrast material is injected into the catheter. As the
contrast material flows through the heart chambers and coronary arteries x–rays are taken. The

This Friday at the Cardiac Catheterization Lab was a bit more uneventful than most of the previous days and compared to most of the experiences
I have had in the past. My mentor was not there this week, nor will she be here this week but there was still a lot for me to do and I know many of
the other employees in the cardiology department so they put me to work which was great. Since I was not here during spring break and the other
volunteer that works in the cardiac office on Wednesdays (or Thursdays) was not there either, so all the completed patient files had piled up in the
bins and outside of the bins. I normally only have about ten to twenty files to put away, however, I had about forty to fifty or so patient files to file
away and it

The Prevention Of Catheter Associated Urinary Tract Infection
This literature review essay will demonstrate a review of four different research articles and research related methodology The articles and review are
based on the prevention of Catheter–associated Urinary Tract Infection (UTI). The aim of this literature review is to review publications concerning the
management of Catheter–related to UTI 's including the prevention. Articles reviewed include the various precaution and preventions concerning
Catheter–associated urinary tract infection (CAUTI) The article evidence summarized bellow was generated using a literature search conducted for
Randomised Controlled Trials, Systemic Review or quantitative and qualitative research.
A catheter is used in an event of an individual that has either had trauma or surgery and as a result has temporary urinary retention (Patton &
Thibodeau, 2013)
General strategies for the prevention of CAUTI include measures such as hand hygiene and adherence. Strategies used for the prevention of CAUTI
include using an aseptic technique for catheter insertion, limiting the duration of urinary catheters, and following standard infection control precautions
for catheter care. Successful achievement implementation of these measures will result in a decrease of CAUTI 's (Bennett, 2014).
CAUTI are a big problem within the clinical settings. Up to about 80% of individuals develop a UTI due to the presence of a urinary catheter
(American Association of critical Care, 2015). Long lasting catheterization

Business Case For Quality And Inadequate Nursing Care
Business case for quality
Inadequate nursing care can be a result of staffing issues or under educated nurses. Errors can be made that not only affect the patient's well–being, but
can affect the financial standing of a hospital. This paper will describe a business case for quality by discussing the current situation in need of change,
the proposed program, a market analysis, an implementation plan, a timeline for implementation, and an evaluation plan, including relevant financial
data of the proposed program.
Current Situation Summary
The current practice for post op cardiac catheterization (cath), to include percutaneous coronary intervention (PCI) is to provide the initial recovery in
the cath lab, then transfer to the floor for the ... Show more content on Helpwriting.net ...
These patients can be receiving blood transfusions or can be on cardiac drips with minimal titration. The acuity level of the average patient is
relatively high. Taking into consideration the acuity of the patients already assigned to a nurse, if a post op cardiac cath patient is admitted, the
potential for error, or missed vitals and site checks, is elevated. In the past 90 days, there have been four post op complications, varying from site
bleeding to decreased blood pressure. All incidents required intervention and increased the patient's length of hospital stay. According to Schuman
(2014), high risk, high volume negative patient events often occur as a result of several factors, including workforce shortages and lack of
knowledge. Vascular complications expose patients to additional discomfort, extended hospital stay, and higher hospital costs, including additional
treatment, such as blood transfusions and vascular surgery ("Strategies to minimize", 2007). The cost of applying a femstop device to the bleeding
site on average is $74 per device (James, 2013). The average daily hospital stay is $1450 per day (Oh, 2012). Adding these costs together, a single site
post op bleeding episode can cost upwards of $1500. This does not include the cost of blood transfusion or medication, therefore the cost could escalate
to near $2500 relatively quickly. With the new affordable care act laws, the potential for preventable conditions not reimbursed by

Cardiac Catheterization Reflection
This past Friday at the Cardiac Catheterization Lab my mentor was not there but I still got to do everything that I enjoy doing, like watching
procedures and talking to the doctors, nurses, and staff. When I arrived I knew my mentor would not be there so I had asked another one of the
ladies in the office if there were any surgeries that were going on for me to watch. After I was given scrubs to change into I was able to go into
where the surgeries are happening. I went into the control room that I was told to go and the nurses and other staff were preparing the patient and
setting up the computers and everything they needed before the doctor arrived. The surgery overall was one I have seen before and not as exciting as
some of the more unique and different ones that I have seen previously.... Show more content on Helpwriting.net ...
One of the control rooms had people in them and I saw nurses preparing in the operating room, so I went in and was told that there would be a case
occurring soon. While waiting for the patient to come into the operating room I was talking with one of the staff members and the guy he was
training, and funny enough, the guy in training was a biomedical engineering major too. He was also telling me how if you go into any field in
engineering you can find a career path that you are interested in because of how broad and diverse each engineering field is. After talking for a bit the
patient came in the room and the doctor started operating, everyone had headsets so I could not hear what they were saying but what I was watching
on the screen was nothing I have seen before but it was very interesting (and

Ethical Dilemma In Nursing
Introduction
The choice of right versus wrong is instilled throughout childhood. However, there are some situations where you have to choose between the two
because both choices have their advantages and disadvantages. This is an ethical dilemma. An ethical dilemma involves morals that clash between each
other, and some involve the legal aspect of the choices (Grohar– Murray). Everyone faces some sort of ethical dilemma. There are some professions
that have to battle ethical dilemmas every day. Amongst those professions the nursing occupation and other healthcare related titles have to keep in
mind several different laws, rules, and regulations that effects these decisions. The nurse also must remember their primary duty is to the ... Show more
content on Helpwriting.net ...
What happens when the patient is legally incompetent and the patient's family agrees to the treatment while the patient is refusing? The next section,
2.1: Primacy of the Patient's Interests, explains what to do "when the patient's wishes are in conflict with those of other." In these situations "the nurse's
commitment remains to the identified patient" (2015). Simply put the nurse must listen to the desires of the patient that is admitted to the hospital or
care facility over the patient's family.
Background
On this particular floor, there was a patient who was legally incompetent. This patient has a history of being noncompliant with his medicines and
hypertension. He has a drug issue and a list of medical problems. Those health problems include a left middle cerebral artery infarct with a hemorrhagic
conversion, ejection fraction of 30%, and a heart rhythm of atrial fibrillation. Occasionally this patient's heart rhythm would switch to sinus tachycardia
during the shift. Along with the pervious complications listed this patient had other symptoms associated with strokes. The healthcare team was not
sure as to what was the cause of the sudden spikes in heart rate. The increase happened while the patient was in the bathroom, however, the
cardiologist advised his heart rate should not drastically increase as it did from a bowel movement.
The cardiologist decided to perform a heart catheterization (Heart Cath) on this

The National Patient Safety Goal
This paper, will discuss the National Patient Safety Goal NPSG 0.7.06.01 entitled " Use proven guidelines to prevent infection of the urinary tract that
are caused by catheter" (The Joint Commission, 2015). It will identify reasons why this National Patient Safety Goal was chosen as well as the type of
organizations that utilize urinary catheters. It will look into financial implications of implementing educational process versus the hospital cost of
Catheter–Associated Urinary Infections (CAUTI). The Advanced Practice Nurse (APN) will demonstrate method on how to gather data, design
educational tool, implement standard practice and create a committee by collaborating with other health care discipline. Effectiveness of the
educational process will be evaluated through data collection. Finally, future health care delivery implications will be explored.
Description of Goal
The National Patient Safety Goal NPSG 0.7.06.01 entitled " Use proven guidelines to prevent infection of the urinary tract that are caused by
catheter." was selected (The Joint Commission, 2015). Gould et al. (2010) reported that in an acute care hospital, a urinary catheter is the most
commonly used medical devices (as cited in Acker, 2014). What is a urinary catheter? Urinary catheter is a thin tube inserted into the bladder to drain
urine. A collection system bag is connected to the catheter (Centers for Disease Control and Prevention, 2010). Gokula et al. (2014) asserted,
short–term and long–term

Cardiac Catheterization Essay
Cardiac Treatment nowadays had devolved in both way invasive and noninvasive, complicated and risky procedger, cardiac catheterization and Cardiac
surgery had play major roles of cardiac coronary artery treatment ,cardiac catheterization can be diagnosis and treatment procedger which in–could
percutaneous transluminal coronary angioplasty, cardiac surgery of coronary artery bypass is another obtain if cardiac catheterization is not suitable.
Post–Surgery infection had significant infect on patient and hospital , for cardiac patient it is more complicated because of vascular disease which
eliminate blood flow and nutrition to the infected tissue ,Cardiac medication can interacted with other medication
(1) Retrospective evaluation for ... Show more content on Helpwriting.net ...
After opening wounding, the blood vessels in the wound site had spasm which caused clot to formed, after that blood vessels then dilate to allow white
blood cells to move through, enzymes and nutrients to reach the wounded area. This leads to a rise in exudate levels so the surround It, erythema, heat,
edema, pain and functional disturbance
During proliferation, which MR Y,S is going through the wound is restored with new tissue which is comprised of collagen and extracellular matrix
and into which a new net of blood vessels develop. Healthy granulation tissue is dependent upon blood vessels supply. Healthy granulation tissue is
granulose and uneven in texture; it does not bleed easily and is pink / red in co. The color and condition of the granulation tissue is often an indicator
of how the wound is healing. Dark granulation tissue can be indicative of poor perfusion, or infection. Epithelial cells lastly resurface the wound.
Maturation is the last phase and occurs once the wound has closed. This phase involves renovation of collagen from type III to type I. Cellular activity
reduces and the number of blood vessels in the wounded area retreat and

Business Case For Quality And Inadequate Nursing Care
Business case for quality
Inadequate nursing care can be a result of staffing issues or under educated nurses. Errors can be made that not only affect the patient's well–being, but
can affect the financial standing of a hospital. Creating a business case for quality, would make changes benefitting the hospital as a whole. This paper
will describe the current situation in need of change, discuss the proposed program, and provide a market analysis, an implementation plan, a timeline
for implementation, and an evaluation plan, including relevant financial data of the proposed program.
Current Situation Summary
The current practice for post op cardiac catheterization (cath), to include percutaneous coronary intervention (PCI) is to provide the initial recovery in
the cath lab, then transfer to the floor for the next several hours of monitoring. PCI is the placement of a stent into a narrowed cardiac artery with
administration of high dose anticoagulants to maintain patency. Initial recovery consists of the first hour post cath, with vitals and site checks every
15 minutes ("Fort Walton Beach Hospital", 2014). The current policy states that if the first hour post op is stable, which means minimal changes in
vitals and unchanged site checks, then the next several hours of recovery can be provided on the progressive care unit (PCU). According to the policy,
after the first hour, vitals and site checks will be completed every 30 minutes times 4, then every hour times 4 ("Fort Walton

The Change Theory Of Nursing Model
Framework The Change Theory of Nursing Model will be used to facilitate change in the unit because it will drive the patient in a desired direction
(Nursing Theory, 2016). The model, developed by Kurt Lewin, uses three stages of change. Before change can be implemented the agent goes through
unfreezing, experiencing the change, and refreezing (Nursing Theory, 2016). Unfreezing This phase involves focusing on the staff's mindfulness for
the necessity of change based on the evidence collected by an infection control committee. This phase is necessary to overcome the tensions of
individual resistance and group compliance (Nursing Theory, 2016). Using three methods is how this phase is achieved. First, redirecting the behavior
away from the existing situation. Second, reducing the restricting forces that have a negative affect on the movement. Lastly, using a combination of
the two methods mentioned above. Experiencing the Change This stage is where the staff will be required to view the education power point on the
new CAUTI prevention tool. The staff will then take a post education competency test to demonstrate proficiency of the risks and complications of
CAUTIs as well as the prevention tool. Nurses are encouraged to assess the need to continue the Foley each shift and offer patients an urinal,
commode, or bedpan when needed. When indications are no longer met, the RN is to call the doctor for Foley removal. Refreezing This is where
establishing the change

Criteria-Based Regulation Summary

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