8
Catheter-Associated Urinary Tract Infections (CAUTI)
Walden University
Leadership Competencies in Nursing and Healthcare
NURS-4220-5
Catheter-Associated Urinary Tract Infections (CAUTI)
The healthcare system must provide safe and quality care to all patients. For years, hospitals nationwide have struggled with healthcare-associated infections (HAIs). Since HAIs are considered preventable events in a hospital setting the Centers for Medicare and Medicaid Services (CMS) established reimbursement changes and hospitals are focusing more on patient safety practices and improving processes to have better patient outcomes (Thornlow & Merwin, 2009). According to The Centers for Disease Control and Prevention (CDC, 2017), approximately seventy-five percent of hospital-acquired urinary tract infections are associated with a urinary catheter with a prolonged use being the most critical risk factor for developing a CAUTI. Also, CAUTIs can cause an overabundance of complications included but not limited to gram-negative bacteremia, sepsis, and mortality (Skanlon, 2017). In a long-term acute care hospital (LTACH), prolonged and unnecessary use of indwelling urinary catheters is interrelated with a higher risk of catheter-associated urinary tract infections (CAUTI) and extended lengths of stay (LOS) (Felix, 2016). The purpose of this paper is to reduce the usage of indwelling catheter days and decrease CAUTI rates from 2.48 to below the target rate of 1.71 by utilizing prevention practices in a 72-bed long-term acute care hospital emphasizing on the assurance of a continuous improvement process. This proposal consists of implementing alternatives before deciding to insert an indwelling catheter, utilizing maintenance bundles, and daily assessment of the necessity of the catheter. All these interventions are aiming at preventing and decreasing catheter-associated urinary tract infections (CAUTIs).
The role of nurses in the prevention of CAUTIs is critical; we are the frontline of patient care and safety. Although, sometimes we encounter situations where a CAUTI occurs, the quality of care we provide to our patients reflects by the interventions we take to prevent our patients from getting an infection. Every action we make while providing care for a patient is an essential step in the quality of their care. Most patients admitted into long-term acute care have wounds or infections that require long-term antibiotics. These patients come in from acute care hospitals, and in the majority of the cases patients already have an indwelling urinary catheter, however, there are situations where the patient doesn’t come with an indwelling catheter, and nurses get orders to place one on admission. Finding alternatives to either discontinue or insert a foley is an essential part of the daily nursing assessment and on the hospitalization of these patients. Important factors to consider while assessing the patient are mobility, cognitive status, gender, and wounds.
L.
8
Catheter-Associated Urinary Tract Infections (CAUTI)
Walden University
Leadership Competencies in Nursing and Healthcare
NURS-4220-5
Catheter-Associated Urinary Tract Infections (CAUTI)
The healthcare system must provide safe and quality care to all patients. For years, hospitals nationwide have struggled with healthcare-associated infections (HAIs). Since HAIs are considered preventable events in a hospital setting the Centers for Medicare and Medicaid Services (CMS) established reimbursement changes and hospitals are focusing more on patient safety practices and improving processes to have better patient outcomes (Thornlow & Merwin, 2009). According to The Centers for Disease Control and Prevention (CDC, 2017), approximately seventy-five percent of hospital-acquired urinary tract infections are associated with a urinary catheter with a prolonged use being the most critical risk factor for developing a CAUTI. Also, CAUTIs can cause an overabundance of complications included but not limited to gram-negative bacteremia, sepsis, and mortality (Skanlon, 2017). In a long-term acute care hospital (LTACH), prolonged and unnecessary use of indwelling urinary catheters is interrelated with a higher risk of catheter-associated urinary tract infections (CAUTI) and extended lengths of stay (LOS) (Felix, 2016). The purpose of this paper is to reduce the usage of indwelling catheter days and decrease CAUTI rates from 2.48 to below the target rate of 1.71 by utilizing prevention practices in a 72-bed long-term acute care hospital emphasizing on the assurance of a continuous improvement process. This proposal consists of implementing alternatives before deciding to insert an indwelling catheter, utilizing maintenance bundles, and daily assessment of the necessity of the catheter. All these interventions are aiming at preventing and decreasing catheter-associated urinary tract infections (CAUTIs).
The role of nurses in the prevention of CAUTIs is critical; we are the frontline of patient care and safety. Although, sometimes we encounter situations where a CAUTI occurs, the quality of care we provide to our patients reflects by the interventions we take to prevent our patients from getting an infection. Every action we make while providing care for a patient is an essential step in the quality of their care. Most patients admitted into long-term acute care have wounds or infections that require long-term antibiotics. These patients come in from acute care hospitals, and in the majority of the cases patients already have an indwelling urinary catheter, however, there are situations where the patient doesn’t come with an indwelling catheter, and nurses get orders to place one on admission. Finding alternatives to either discontinue or insert a foley is an essential part of the daily nursing assessment and on the hospitalization of these patients. Important factors to consider while assessing the patient are mobility, cognitive status, gender, and wounds.
L ...
Running head PICOT AND LITERATURE SEARCH 1.docxtodd581
Running head: PICOT AND LITERATURE SEARCH 1
PICOT and Statement Literature Search
Student’s Name: Yeni Hernandez
Date: 7/22/2018
Course: NRS-433V
PICOT and Statement Literature Search
Nursing Practice Problem
Doctors use urinary catheters to empty urine from patients who have impaired urinary system. Such patients might suffer from kidney failure due to pressure exerted on their kidneys, this is dangerous and can permanently damage their kidneys. The Urinary catheters, however, may cause potential complications on the patients. Research carried on BMC Urology shows that most patients end up suffering from urinary tract infections (UTI) after the use of indwelling urinary catheters. Other complications such as kidney damage, injury to the urethra, bladder stones, and blood in the urine, septicemia and allergic reactions may arise from the usage of the urinary catheter (Feneley, Hopley, & Wells., 2015).
Picot Statement
Prognosis/Prediction: For pediatric patients 65 years and older (P), how does the use of catheters for much longer time (I) compared to the use of indwelling catheters for shorter time(C) influence the risk of Catheter-associated urinary infections(O) during the first ten weeks of indwelling catheter usage(T)?
Most patients who are placed in indwelling catheters for more than the expected time have had the risk of developing urinary tract infections, allergic reactions and others experience challenges in their kidneys.
What are some of the practical methods used to ensure that catheter-related diseases are reduced?
This study aims to make sure that indwelling urethral catheters (IDC) are carried out in a manner that minimizes risks to infection and trauma (Conway & Larson, 2011).
1st study
Feneley, R. C., Hopley, I. B., & Wells, P. N. (2015). Urinary catheters: history, current status, adverse events and research agenda. Journal of Medical Engineering & Technology, 39(8), 459-470. doi:10.3109/03091902.2015.1085600
I chose this study because the there is a qualitative analysis of the article and the scale of the burden of urinary incontinence. Statistical data collected from the year 2006 to 2007 recorded millions of people in England with consistent problems, and in the year 2011, the number of patients had increased than the previous year. Studies show urinary infections have wider effects on the older generation, and those over 85 years of age suffered most, followed by those with over 65 years of age. Challenges emerge while an attempt is made to care for the old people and patients affected.
One study reveals that US nursing homes that received 420 admissions had 39% of patients experiencing a daytime urinary inconsistency most of them aged 65 years and above (Feneley, Hopley, & Wells., 2015).Clinicians often choose Catheterization as the last option due to high chances of urinary tract infections. In 2002, US had incidences of advance events of catheter induced_ infections occurring and causing deat.
Running head PICOT AND LITERATURE SEARCH 1.docxglendar3
Running head: PICOT AND LITERATURE SEARCH 1
PICOT and Statement Literature Search
Student’s Name: Yeni Hernandez
Date: 7/22/2018
Course: NRS-433V
PICOT and Statement Literature Search
Nursing Practice Problem
Doctors use urinary catheters to empty urine from patients who have impaired urinary system. Such patients might suffer from kidney failure due to pressure exerted on their kidneys, this is dangerous and can permanently damage their kidneys. The Urinary catheters, however, may cause potential complications on the patients. Research carried on BMC Urology shows that most patients end up suffering from urinary tract infections (UTI) after the use of indwelling urinary catheters. Other complications such as kidney damage, injury to the urethra, bladder stones, and blood in the urine, septicemia and allergic reactions may arise from the usage of the urinary catheter (Feneley, Hopley, & Wells., 2015).
Picot Statement
Prognosis/Prediction: For pediatric patients 65 years and older (P), how does the use of catheters for much longer time (I) compared to the use of indwelling catheters for shorter time(C) influence the risk of Catheter-associated urinary infections(O) during the first ten weeks of indwelling catheter usage(T)?
Most patients who are placed in indwelling catheters for more than the expected time have had the risk of developing urinary tract infections, allergic reactions and others experience challenges in their kidneys.
What are some of the practical methods used to ensure that catheter-related diseases are reduced?
This study aims to make sure that indwelling urethral catheters (IDC) are carried out in a manner that minimizes risks to infection and trauma (Conway & Larson, 2011).
1st study
Feneley, R. C., Hopley, I. B., & Wells, P. N. (2015). Urinary catheters: history, current status, adverse events and research agenda. Journal of Medical Engineering & Technology, 39(8), 459-470. doi:10.3109/03091902.2015.1085600
I chose this study because the there is a qualitative analysis of the article and the scale of the burden of urinary incontinence. Statistical data collected from the year 2006 to 2007 recorded millions of people in England with consistent problems, and in the year 2011, the number of patients had increased than the previous year. Studies show urinary infections have wider effects on the older generation, and those over 85 years of age suffered most, followed by those with over 65 years of age. Challenges emerge while an attempt is made to care for the old people and patients affected.
One study reveals that US nursing homes that received 420 admissions had 39% of patients experiencing a daytime urinary inconsistency most of them aged 65 years and above (Feneley, Hopley, & Wells., 2015).Clinicians often choose Catheterization as the last option due to high chances of urinary tract infections. In 2002, US had incidences of advance events of catheter induced_ infections occurring and causing deat.
8
Catheter-Associated Urinary Tract Infections (CAUTI)
Walden University
Leadership Competencies in Nursing and Healthcare
NURS-4220-5
Catheter-Associated Urinary Tract Infections (CAUTI)
The healthcare system must provide safe and quality care to all patients. For years, hospitals nationwide have struggled with healthcare-associated infections (HAIs). Since HAIs are considered preventable events in a hospital setting the Centers for Medicare and Medicaid Services (CMS) established reimbursement changes and hospitals are focusing more on patient safety practices and improving processes to have better patient outcomes (Thornlow & Merwin, 2009). According to The Centers for Disease Control and Prevention (CDC, 2017), approximately seventy-five percent of hospital-acquired urinary tract infections are associated with a urinary catheter with a prolonged use being the most critical risk factor for developing a CAUTI. Also, CAUTIs can cause an overabundance of complications included but not limited to gram-negative bacteremia, sepsis, and mortality (Skanlon, 2017). In a long-term acute care hospital (LTACH), prolonged and unnecessary use of indwelling urinary catheters is interrelated with a higher risk of catheter-associated urinary tract infections (CAUTI) and extended lengths of stay (LOS) (Felix, 2016). The purpose of this paper is to reduce the usage of indwelling catheter days and decrease CAUTI rates from 2.48 to below the target rate of 1.71 by utilizing prevention practices in a 72-bed long-term acute care hospital emphasizing on the assurance of a continuous improvement process. This proposal consists of implementing alternatives before deciding to insert an indwelling catheter, utilizing maintenance bundles, and daily assessment of the necessity of the catheter. All these interventions are aiming at preventing and decreasing catheter-associated urinary tract infections (CAUTIs).
The role of nurses in the prevention of CAUTIs is critical; we are the frontline of patient care and safety. Although, sometimes we encounter situations where a CAUTI occurs, the quality of care we provide to our patients reflects by the interventions we take to prevent our patients from getting an infection. Every action we make while providing care for a patient is an essential step in the quality of their care. Most patients admitted into long-term acute care have wounds or infections that require long-term antibiotics. These patients come in from acute care hospitals, and in the majority of the cases patients already have an indwelling urinary catheter, however, there are situations where the patient doesn’t come with an indwelling catheter, and nurses get orders to place one on admission. Finding alternatives to either discontinue or insert a foley is an essential part of the daily nursing assessment and on the hospitalization of these patients. Important factors to consider while assessing the patient are mobility, cognitive status, gender, and wounds.
L.
8
Catheter-Associated Urinary Tract Infections (CAUTI)
Walden University
Leadership Competencies in Nursing and Healthcare
NURS-4220-5
Catheter-Associated Urinary Tract Infections (CAUTI)
The healthcare system must provide safe and quality care to all patients. For years, hospitals nationwide have struggled with healthcare-associated infections (HAIs). Since HAIs are considered preventable events in a hospital setting the Centers for Medicare and Medicaid Services (CMS) established reimbursement changes and hospitals are focusing more on patient safety practices and improving processes to have better patient outcomes (Thornlow & Merwin, 2009). According to The Centers for Disease Control and Prevention (CDC, 2017), approximately seventy-five percent of hospital-acquired urinary tract infections are associated with a urinary catheter with a prolonged use being the most critical risk factor for developing a CAUTI. Also, CAUTIs can cause an overabundance of complications included but not limited to gram-negative bacteremia, sepsis, and mortality (Skanlon, 2017). In a long-term acute care hospital (LTACH), prolonged and unnecessary use of indwelling urinary catheters is interrelated with a higher risk of catheter-associated urinary tract infections (CAUTI) and extended lengths of stay (LOS) (Felix, 2016). The purpose of this paper is to reduce the usage of indwelling catheter days and decrease CAUTI rates from 2.48 to below the target rate of 1.71 by utilizing prevention practices in a 72-bed long-term acute care hospital emphasizing on the assurance of a continuous improvement process. This proposal consists of implementing alternatives before deciding to insert an indwelling catheter, utilizing maintenance bundles, and daily assessment of the necessity of the catheter. All these interventions are aiming at preventing and decreasing catheter-associated urinary tract infections (CAUTIs).
The role of nurses in the prevention of CAUTIs is critical; we are the frontline of patient care and safety. Although, sometimes we encounter situations where a CAUTI occurs, the quality of care we provide to our patients reflects by the interventions we take to prevent our patients from getting an infection. Every action we make while providing care for a patient is an essential step in the quality of their care. Most patients admitted into long-term acute care have wounds or infections that require long-term antibiotics. These patients come in from acute care hospitals, and in the majority of the cases patients already have an indwelling urinary catheter, however, there are situations where the patient doesn’t come with an indwelling catheter, and nurses get orders to place one on admission. Finding alternatives to either discontinue or insert a foley is an essential part of the daily nursing assessment and on the hospitalization of these patients. Important factors to consider while assessing the patient are mobility, cognitive status, gender, and wounds.
L ...
Running head PICOT AND LITERATURE SEARCH 1.docxtodd581
Running head: PICOT AND LITERATURE SEARCH 1
PICOT and Statement Literature Search
Student’s Name: Yeni Hernandez
Date: 7/22/2018
Course: NRS-433V
PICOT and Statement Literature Search
Nursing Practice Problem
Doctors use urinary catheters to empty urine from patients who have impaired urinary system. Such patients might suffer from kidney failure due to pressure exerted on their kidneys, this is dangerous and can permanently damage their kidneys. The Urinary catheters, however, may cause potential complications on the patients. Research carried on BMC Urology shows that most patients end up suffering from urinary tract infections (UTI) after the use of indwelling urinary catheters. Other complications such as kidney damage, injury to the urethra, bladder stones, and blood in the urine, septicemia and allergic reactions may arise from the usage of the urinary catheter (Feneley, Hopley, & Wells., 2015).
Picot Statement
Prognosis/Prediction: For pediatric patients 65 years and older (P), how does the use of catheters for much longer time (I) compared to the use of indwelling catheters for shorter time(C) influence the risk of Catheter-associated urinary infections(O) during the first ten weeks of indwelling catheter usage(T)?
Most patients who are placed in indwelling catheters for more than the expected time have had the risk of developing urinary tract infections, allergic reactions and others experience challenges in their kidneys.
What are some of the practical methods used to ensure that catheter-related diseases are reduced?
This study aims to make sure that indwelling urethral catheters (IDC) are carried out in a manner that minimizes risks to infection and trauma (Conway & Larson, 2011).
1st study
Feneley, R. C., Hopley, I. B., & Wells, P. N. (2015). Urinary catheters: history, current status, adverse events and research agenda. Journal of Medical Engineering & Technology, 39(8), 459-470. doi:10.3109/03091902.2015.1085600
I chose this study because the there is a qualitative analysis of the article and the scale of the burden of urinary incontinence. Statistical data collected from the year 2006 to 2007 recorded millions of people in England with consistent problems, and in the year 2011, the number of patients had increased than the previous year. Studies show urinary infections have wider effects on the older generation, and those over 85 years of age suffered most, followed by those with over 65 years of age. Challenges emerge while an attempt is made to care for the old people and patients affected.
One study reveals that US nursing homes that received 420 admissions had 39% of patients experiencing a daytime urinary inconsistency most of them aged 65 years and above (Feneley, Hopley, & Wells., 2015).Clinicians often choose Catheterization as the last option due to high chances of urinary tract infections. In 2002, US had incidences of advance events of catheter induced_ infections occurring and causing deat.
Running head PICOT AND LITERATURE SEARCH 1.docxglendar3
Running head: PICOT AND LITERATURE SEARCH 1
PICOT and Statement Literature Search
Student’s Name: Yeni Hernandez
Date: 7/22/2018
Course: NRS-433V
PICOT and Statement Literature Search
Nursing Practice Problem
Doctors use urinary catheters to empty urine from patients who have impaired urinary system. Such patients might suffer from kidney failure due to pressure exerted on their kidneys, this is dangerous and can permanently damage their kidneys. The Urinary catheters, however, may cause potential complications on the patients. Research carried on BMC Urology shows that most patients end up suffering from urinary tract infections (UTI) after the use of indwelling urinary catheters. Other complications such as kidney damage, injury to the urethra, bladder stones, and blood in the urine, septicemia and allergic reactions may arise from the usage of the urinary catheter (Feneley, Hopley, & Wells., 2015).
Picot Statement
Prognosis/Prediction: For pediatric patients 65 years and older (P), how does the use of catheters for much longer time (I) compared to the use of indwelling catheters for shorter time(C) influence the risk of Catheter-associated urinary infections(O) during the first ten weeks of indwelling catheter usage(T)?
Most patients who are placed in indwelling catheters for more than the expected time have had the risk of developing urinary tract infections, allergic reactions and others experience challenges in their kidneys.
What are some of the practical methods used to ensure that catheter-related diseases are reduced?
This study aims to make sure that indwelling urethral catheters (IDC) are carried out in a manner that minimizes risks to infection and trauma (Conway & Larson, 2011).
1st study
Feneley, R. C., Hopley, I. B., & Wells, P. N. (2015). Urinary catheters: history, current status, adverse events and research agenda. Journal of Medical Engineering & Technology, 39(8), 459-470. doi:10.3109/03091902.2015.1085600
I chose this study because the there is a qualitative analysis of the article and the scale of the burden of urinary incontinence. Statistical data collected from the year 2006 to 2007 recorded millions of people in England with consistent problems, and in the year 2011, the number of patients had increased than the previous year. Studies show urinary infections have wider effects on the older generation, and those over 85 years of age suffered most, followed by those with over 65 years of age. Challenges emerge while an attempt is made to care for the old people and patients affected.
One study reveals that US nursing homes that received 420 admissions had 39% of patients experiencing a daytime urinary inconsistency most of them aged 65 years and above (Feneley, Hopley, & Wells., 2015).Clinicians often choose Catheterization as the last option due to high chances of urinary tract infections. In 2002, US had incidences of advance events of catheter induced_ infections occurring and causing deat.
Improving Urinary Catheterization
Reducing Catheter-Related Infections at Amsterdam Nursing Home in New York
Group Members
Introduction
Urinary catheters are vital tools that collect urinary in a drainage bag from the bladder.
They are important for patients with a compromised urinary function.
Urinary Catheters are a double-edged sword:
On the one hand, they simplify the handling of a basic bodily function.
On the other hand, they subject frail patients to the risk of infection, which may lead to death, falls, or confusion. The infection is referred to as catheter-associated urinary tract infections (CAUTI) (Parker et al., 2017).
Problem Statement
Catheter-related infections at Amsterdam Nursing Home in New York are currently quite high.
This project aims to find solutions to lower the current infection rate to manageable levels.
The high infection rates are posing diverse risks to the patients in post-acute and long-term care.
The current situation is leading to negative patient outcomes. It also results in unnecessary high healthcare costs.
Aims Statement
This project aims to decrease the infection rates from the use of urinary catheters from the current 10% infection rate to a maximum of 2% infection rate by the end to a 3 month timeframe in the elderly population at Amsterdam Nursing Home.
Establishing Measures
The following measures will prove that the object is working:
A drop in the infection rates from 10% to 2%.
A significant drop in the current expenditure used to treat complications due to infections (at least 50%).
An increase in patient satisfaction based on a survey to be filled by clients (at least 75%).
Selecting Changes
Appropriate Urinary Catheter Use.
Catheters should only be used for appropriate indications as outlined by the CDC. Also, the duration of use should be minimized in high risk patients.
Proper Techniques for Insertion and Maintenance.
High hygiene levels should be maintained. This is in reference to hand hygiene, use of sterilized products, and general cleanliness in the nursing room.
Also, catheterization should only be done by authorized personnel.
Regular maintenance of the catheters should be done. Catheters should be replaced as necessary (Gould et al., 2010).
Selecting Changes
Quality Improvement (QI) Programs.
All practitioners should be routinely educated on the proper use of catheters.
Appraisal programs should e conducted regularly to evaluate effective catheter use in the nursing home.
Administrative Infrastructure.
Provision of relevant guidelines.
Education and Training.
Sourcing of Supplies.
Surveillance.
Testing Changes
Use of Interworking Model.
Model comprised of Donabedian’s conceptual framework, Watson’s Theory of Caring, and Lewin’s Theory of Change (D'Antonio, 2018).
This model is crucial in re-educating staff to enact change, emphasize a nurse-driven initiative, and to assess quality
Testing Changes
Plan
The objective of testing changes is to see if t ...
1-Evidence-based practice is what keeps the health care system usandibabcock
1-Evidence-based practice is what keeps the health care system up-to-date with technology and best-practices; these practices help improve patient outcomes. The first article that I read was research about improving the procedures for collecting and testing urine specimens. In the study, they observed how the collection method was carried out and how long it took for the specimen to reach the laboratory for testing. It was determined that not only were the collection methods flawed but the specimens were sitting too long at room temperature; both influenced the test results. Having contaminated specimens were producing unreliable test results and people were getting a wrong diagnosis with a wrong treatment plan. This study helped identify the major problems along with creating solutions to those problems: mid-stream clean catch, using straight-catheters, proper way to get a specimen from an indwelling-catheter, and appropriate time for the specimen to sit at room temperature. This research article helped improve patient outcomes because it increased the accuracy of the test results which yielded a more specific diagnosis; appropriate treatments increased patient outcomes. In our facility when we collect a urine specimen we keep the specimen in the refrigerator and call the labs for a stat pick-up.
The second article that I read was on improves patient outcome fall prevention in 65+ adults. A prevalent safety issue is injuries that occur from Falls. Elderly and frail have a higher risk of falls that can lead into hip-fractures or even death. Accidental falls can result from an unsafe environment or environmental risk factors for example low blood pressure, dehydration, impaired mobility, unstable gait to name a few. To prevent/reduce the risk for falls staff need to maintain awareness of the environmental safety. I work in an Assisted living facility we have Fall-Risk Assessment tool that we use for each of our residents. But our main intervention is communication with staff and residents. We ensure that there is no trip hazard, we lower the bed to the lowest position when they are in bed, check their rooms and facility for potential safety issues, have mats on the floors next to their bed.
2-Two areas of nursing practice that have been under scrutiny in my facility involve Catheter Associated Urinary Tract Infections (CAUTIs) and Standard precautions. Both seem like basic concepts, but in nursing, sometimes the “basics” get swept to the back of your mind when you are focusing on other issues involved in patient care. Both of these concepts are integral parts of patient safety, which is and should be our number one priority.
In the healthcare setting, the use of an indwelling catheter can be a necessity on many occasions. As nurses, it is imperative that we assess the need carefully for catheter placement, as well as continuously assess the need for the catheter to remain in place. According to a study put forth by BMC Health Services R ...
RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 2.docxaudeleypearl
RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 2
Research-Based Literature Support for CAUTI
Kamila Julian
Chamberlain College of Nursing
NR 505: Advanced Research Methods: Evidenced Based Practice
July 2019
Running head: RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 1
RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 8
Research-Based Literature Support for CAUTI
Preventing inappropriate use of a urinary catheter and the risk of patient harm associated with the use of indwelling catheters remains a significant challenge for healthcare facilities. The purpose of this paper is to provide research-based literature support from 10 (ten) different research-based references, on the prevention of CAUTI, evaluating interventions that support the use of nurse-driven protocols to reduce the incidence of CAUTI.
The following is the proposed PICO question: “How does the use nurse-driven protocol for evaluating the appropriateness and prevalence of catheter use or removal, compared with no protocol affect the CAUTI rates?”
The literature review from Fakih, Krein, Edson, Watson, Battles, and Saint (2014) aimed to engage healthcare workers to prevent CAUTI and prevent patient harm. A quantitative approach and a quasi-experimental design were used to assess the impact of guidelines for CAUTI prevention and reduce CAUTI rates in the state of Michigan through the use of a bladder bundle, promoting a daily evaluation of catheter indication (Fakih et al., 2014). The ability of the selected design to generate a cause and effect relationship collaborated in spreading educational insights and guidance to various stakeholders. A disadvantage of such design is the lack of control group, as internal validity is not easy to control once a probability of a stakeholder not following all the necessary steps of the protocol to generate true findings, for example nurses not consistent with their rounds to evaluate daily necessity of indwelling catheter, which are important in order to identify gaps and make appropriate and necessary modifications based on new evidence. Target population here are hospitalized patients from 163 units including ER, ICU, Surgical, and operating room from 71 acute care hospitals in the state of Michigan, with an equal probability of being selected resulting in random sampling and confidentiality (Fakih et al., 2014).
The aim of the study by Shehab (2017) is to analyze the impact of the protocol of care, from nurse’s knowledge, of patients that requires a urinary catheter. A quasi-experiment design was used to test assumptions of effective changes in nurse’s knowledge after caring out the protocol of care on patients with the urinary catheter by using a structured interview questionnaire and a nurse’s knowledge assessment tool (Shehab, 2017). An advantage of this study is to evaluate nurse’s readiness to follow protocols and to update their knowledge on how to provide the best EBP care for patients with a Foley catheter. ...
Running head DRAFT QUALITATIVE RESEARCH .docxtodd271
Running head: DRAFT QUALITATIVE RESEARCH 1
DRAFT QUALITATIVE RESEARCH 2
Draft Qualitative Research
Name: Vanessa Noa
Institution: Grand Canyon University
Draft Qualitative Research
Background of the Study
The first article talks about UTIs such as epidemiology, mechanisms of infection and the preferences available for the treatment. According to the article, there are indigenous sources of bacteria that cause CAUTI (Flores-Mireles et al., 2015). The contamination comes from the hands that are contaminated from the healthcare experts, meatal and vaginal colonization. The pathogens can pass through intraluminal route, extra luminal route or through the catheter from a bag that is contaminated. Introduction of the objects that are sterile has demonstrated a decrease in threat of bacteriuria in a closed urinary damage. Conversely, studies have demonstrated that bacteriuria can take place through the disruptions in the machines or through the extraluminal path (Flores-Mireles et al., 2015).
The other article focuses on reducing the urinary catheter usage and other approaches to avert catheter-connected urinary tract infection. The article provides qualitative highlights of some of the appropriate actions that a doctor must assume while executing the process of catheterization. When undertaking the supplement of the urinary catheter, a skilled professional should take extraordinary safeguards since speedy release of urine from the bladder may lead to hemorrhage. A clam needs to be out after every twenty minutes to permit more release of urine (Meddings et al., 2014).
Supporting Nursing Practice
The first article on urinary tract infections supports the nursing practice as it touches on the usage of the catheter. According to the article, people who urinate with the help of catheter have elevated risk of contracting UTIs (Flores-Mireles et al., 2015). Example of such group of people may include the people that are hospitalized as well as people who have neurological issues that make it hard to regulate their capacity to urinate and the paralyzed individuals. Having known that, it is important to take the necessary steps to decrease the threat of urinary tract infections. People can drink more liquid particularly water because it aids to dilute urine and confirms that one urinates regularly hence permitting the bacteria to be flushed from the urinary tract before the contamination can start (Flores-Mireles et al., 2015).
The next article that touches on the reduction of the urinary catheter usage and other approaches to deter urinary tract infection that are linked to catheter highlights optional approaches that are critical in the healthcare. It is the obligation of the healthcare providers to be aware that catheters may be in place through having catheter reminder intervention.
Running head ANALYSIS OF LITERATURE REVIEW 1ANALYSIS OF LITERA.docxhealdkathaleen
Running head: ANALYSIS OF LITERATURE REVIEW 1
ANALYSIS OF LITERATURE REVIEW 7
Literature Review
Atsede Iyasu
NRS-490- 0500- Professional Capstone and Practicum
Grand Canyon University
08/11/2019
Analysis of Literature Review
Introduction
Catheter-associated urinary tract infection (CAUTI) more so in the ICU seems to be an issue that is challenging hospitals and health care centers. Nurses are the healthcare staffs who are responsible for ensuring that patients do not acquire CAUTI in their stay in the ICU (Mody et al., 2015). There are proven techniques and methods identified to be effective at preventing the catheter associated urinary tract infection. One technique that is highly mentioned in the prevention of CAUTI is strict aseptic technique and hand hygiene. The technique can significantly help nurses reduce CAUTI in intensive care units and lessen the health burden of patients in the intensive care unit (Bradley et al., 2018).
In order to confirm whether the above-mentioned technique is effective at preventing CAUTI, a literature review was carried out. The review touched on these method as well as other known methods or techniques for preventing CAUTI. A total of eight studies were reviewed. All the reviewed studies were on publications made between 2014 and 2018. It is important that the studies reviewed are not over five years old. The above was important as it ensured only relevant and up-to-date information established from the review. Comment by Shanna Foley: Great introduction. Be sure your thesis discusses the purpose of the current paper, not the purpose of your change proposal.
A comparison of the research questions
There were three main research questions that were identified in the studies reviewed. The first main research question identified was whether there was an effective scientific method of preventing CAUTI (Purvis et al., 2014). Five of the studies reviewed were interested in answering whether there is a well-known and established medical interventions or scientific interventions that can effectively prevent CAUTI. All the five studies are driven by the hypothesis that CAUTI can be prevented and treated by given medication and it is for the above reason that all the five studies were seeking to confirm whether medical interventions can effectively prevent the infection.
The second main research question was what is the role of hospitals or health centers in the acquiring of CAUTI? According to a publication done in 2017 by Theobald and his colleagues, Hospital conditions are the primary reasons that patients acquire CAUTI. The conditions being mentioned above include; general hospital cleanliness practices and the handling of patients. The third main research question identified was whether the method of administering and removing the catheter was the main reason that patients were acquiring CAUTI. Three of the studies reviewed seemed to run on the hypothesis that the main reason that CAUTIs are acquir ...
Running head DRAFT QUALITATIVE RESEARCH .docxjeanettehully
Running head: DRAFT QUALITATIVE RESEARCH 1
DRAFT QUALITATIVE RESEARCH 2
Draft Qualitative Research
Name: Vanessa Noa
Institution: Grand Canyon University
Draft Qualitative Research
Background of the Study
The first article talks about UTIs such as epidemiology, mechanisms of infection and the preferences available for the treatment. According to the article, there are indigenous sources of bacteria that cause CAUTI (Flores-Mireles et al., 2015). The contamination comes from the hands that are contaminated from the healthcare experts, meatal and vaginal colonization. The pathogens can pass through intraluminal route, extra luminal route or through the catheter from a bag that is contaminated. Introduction of the objects that are sterile has demonstrated a decrease in threat of bacteriuria in a closed urinary damage. Conversely, studies have demonstrated that bacteriuria can take place through the disruptions in the machines or through the extraluminal path (Flores-Mireles et al., 2015).
The other article focuses on reducing the urinary catheter usage and other approaches to avert catheter-connected urinary tract infection. The article provides qualitative highlights of some of the appropriate actions that a doctor must assume while executing the process of catheterization. When undertaking the supplement of the urinary catheter, a skilled professional should take extraordinary safeguards since speedy release of urine from the bladder may lead to hemorrhage. A clam needs to be out after every twenty minutes to permit more release of urine (Meddings et al., 2014).
Supporting Nursing Practice
The first article on urinary tract infections supports the nursing practice as it touches on the usage of the catheter. According to the article, people who urinate with the help of catheter have elevated risk of contracting UTIs (Flores-Mireles et al., 2015). Example of such group of people may include the people that are hospitalized as well as people who have neurological issues that make it hard to regulate their capacity to urinate and the paralyzed individuals. Having known that, it is important to take the necessary steps to decrease the threat of urinary tract infections. People can drink more liquid particularly water because it aids to dilute urine and confirms that one urinates regularly hence permitting the bacteria to be flushed from the urinary tract before the contamination can start (Flores-Mireles et al., 2015).
The next article that touches on the reduction of the urinary catheter usage and other approaches to deter urinary tract infection that are linked to catheter highlights optional approaches that are critical in the healthcare. It is the obligation of the healthcare providers to be aware that catheters may be in place through having catheter reminder intervention ...
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2CENTRAL LINE-ASS.docxsleeperharwell
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature ReviewComment by Microsoft Office User: The heading of introduction is inferred in APA format
I. Introduction
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.
II. Questions Posed in the Studies
a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the
evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?
c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?
d. Srinivasan, Wise, Bell, Cardo,Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.
e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.
f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva.
Describe any assumptions that you may have about what the resear.docxsalmonpybus
Describe any assumptions that you may have about what the research-based evidence will reveal to be true.
An assumption is an “acceptance of something that is recognized and upholds scholars’ clear principle for the extent of investigation that if untrue can concede the credibility of the outcome” Gray, Grove, and Sutherland, 2017). For my PICOT question, the assumptions I have and was revealed by research-based evidence revealed to be true include various data to confirm the surge in catheter-associated urinary tract infection when an unnecessary indwelling urinary catheter is inserted without following the Center for Disease Prevention and Control’s guidelines for IUC insertion. Another assumption is the fact that nurses have the greatest responsibility of enhancing patients’ safety and prevent harm by IUC is inserted for a therapeutic indication using evidence-based practice approach during insertion and management. This places “nurses at the frontline in catheter management, as they deliver a major part of daily catheter cares” (Gesmundo, 2016).
Are you receptive to research findings that do not agree with your assumptions? Please explain
.
Yes, I am receptive to research findings that do not agree with my assumptions. Although these findings may not necessarily agree with my assumptions, they will likely provide information to support further studies or present a new approach to the topic from another point of view thereby giving more insight and understanding to the evidence-based problem.
Have you already formed your own conclusions and are you looking for evidence to support your claims? Please explain.
I have formed my conclusion that Catheter-associated urinary tract infections can be prevented through adequate education of nurses on avoiding unnecessary usage, if possible, and if not proper management with antimicrobial chlorhexidine wipes and prompt discontinuation of an indwelling urinary catheter is necessary to prevent CAUTI. This conclusion is also supported by various literature and studies that confirm that “the use of chlorhexidine for routine urinary catheter care and after bowel movements for patients with urinary catheters may significantly decrease catheter-associated urinary tract infections when compared with the standard of care using soap and water” (Schmudde, Olson-Sitki, Bond & Chamberlain, 2019).
.
Improving Urinary Catheterization
Reducing Catheter-Related Infections at Amsterdam Nursing Home in New York
Group Members
Introduction
Urinary catheters are vital tools that collect urinary in a drainage bag from the bladder.
They are important for patients with a compromised urinary function.
Urinary Catheters are a double-edged sword:
On the one hand, they simplify the handling of a basic bodily function.
On the other hand, they subject frail patients to the risk of infection, which may lead to death, falls, or confusion. The infection is referred to as catheter-associated urinary tract infections (CAUTI) (Parker et al., 2017).
Problem Statement
Catheter-related infections at Amsterdam Nursing Home in New York are currently quite high.
This project aims to find solutions to lower the current infection rate to manageable levels.
The high infection rates are posing diverse risks to the patients in post-acute and long-term care.
The current situation is leading to negative patient outcomes. It also results in unnecessary high healthcare costs.
Aims Statement
This project aims to decrease the infection rates from the use of urinary catheters from the current 10% infection rate to a maximum of 2% infection rate by the end to a 3 month timeframe in the elderly population at Amsterdam Nursing Home.
Establishing Measures
The following measures will prove that the object is working:
A drop in the infection rates from 10% to 2%.
A significant drop in the current expenditure used to treat complications due to infections (at least 50%).
An increase in patient satisfaction based on a survey to be filled by clients (at least 75%).
Selecting Changes
Appropriate Urinary Catheter Use.
Catheters should only be used for appropriate indications as outlined by the CDC. Also, the duration of use should be minimized in high risk patients.
Proper Techniques for Insertion and Maintenance.
High hygiene levels should be maintained. This is in reference to hand hygiene, use of sterilized products, and general cleanliness in the nursing room.
Also, catheterization should only be done by authorized personnel.
Regular maintenance of the catheters should be done. Catheters should be replaced as necessary (Gould et al., 2010).
Selecting Changes
Quality Improvement (QI) Programs.
All practitioners should be routinely educated on the proper use of catheters.
Appraisal programs should e conducted regularly to evaluate effective catheter use in the nursing home.
Administrative Infrastructure.
Provision of relevant guidelines.
Education and Training.
Sourcing of Supplies.
Surveillance.
Testing Changes
Use of Interworking Model.
Model comprised of Donabedian’s conceptual framework, Watson’s Theory of Caring, and Lewin’s Theory of Change (D'Antonio, 2018).
This model is crucial in re-educating staff to enact change, emphasize a nurse-driven initiative, and to assess quality
Testing Changes
Plan
The objective of testing changes is to see if t ...
1-Evidence-based practice is what keeps the health care system usandibabcock
1-Evidence-based practice is what keeps the health care system up-to-date with technology and best-practices; these practices help improve patient outcomes. The first article that I read was research about improving the procedures for collecting and testing urine specimens. In the study, they observed how the collection method was carried out and how long it took for the specimen to reach the laboratory for testing. It was determined that not only were the collection methods flawed but the specimens were sitting too long at room temperature; both influenced the test results. Having contaminated specimens were producing unreliable test results and people were getting a wrong diagnosis with a wrong treatment plan. This study helped identify the major problems along with creating solutions to those problems: mid-stream clean catch, using straight-catheters, proper way to get a specimen from an indwelling-catheter, and appropriate time for the specimen to sit at room temperature. This research article helped improve patient outcomes because it increased the accuracy of the test results which yielded a more specific diagnosis; appropriate treatments increased patient outcomes. In our facility when we collect a urine specimen we keep the specimen in the refrigerator and call the labs for a stat pick-up.
The second article that I read was on improves patient outcome fall prevention in 65+ adults. A prevalent safety issue is injuries that occur from Falls. Elderly and frail have a higher risk of falls that can lead into hip-fractures or even death. Accidental falls can result from an unsafe environment or environmental risk factors for example low blood pressure, dehydration, impaired mobility, unstable gait to name a few. To prevent/reduce the risk for falls staff need to maintain awareness of the environmental safety. I work in an Assisted living facility we have Fall-Risk Assessment tool that we use for each of our residents. But our main intervention is communication with staff and residents. We ensure that there is no trip hazard, we lower the bed to the lowest position when they are in bed, check their rooms and facility for potential safety issues, have mats on the floors next to their bed.
2-Two areas of nursing practice that have been under scrutiny in my facility involve Catheter Associated Urinary Tract Infections (CAUTIs) and Standard precautions. Both seem like basic concepts, but in nursing, sometimes the “basics” get swept to the back of your mind when you are focusing on other issues involved in patient care. Both of these concepts are integral parts of patient safety, which is and should be our number one priority.
In the healthcare setting, the use of an indwelling catheter can be a necessity on many occasions. As nurses, it is imperative that we assess the need carefully for catheter placement, as well as continuously assess the need for the catheter to remain in place. According to a study put forth by BMC Health Services R ...
RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 2.docxaudeleypearl
RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 2
Research-Based Literature Support for CAUTI
Kamila Julian
Chamberlain College of Nursing
NR 505: Advanced Research Methods: Evidenced Based Practice
July 2019
Running head: RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 1
RESEARCH-BASED LITERATURE SUPPORT FOR CAUTI 8
Research-Based Literature Support for CAUTI
Preventing inappropriate use of a urinary catheter and the risk of patient harm associated with the use of indwelling catheters remains a significant challenge for healthcare facilities. The purpose of this paper is to provide research-based literature support from 10 (ten) different research-based references, on the prevention of CAUTI, evaluating interventions that support the use of nurse-driven protocols to reduce the incidence of CAUTI.
The following is the proposed PICO question: “How does the use nurse-driven protocol for evaluating the appropriateness and prevalence of catheter use or removal, compared with no protocol affect the CAUTI rates?”
The literature review from Fakih, Krein, Edson, Watson, Battles, and Saint (2014) aimed to engage healthcare workers to prevent CAUTI and prevent patient harm. A quantitative approach and a quasi-experimental design were used to assess the impact of guidelines for CAUTI prevention and reduce CAUTI rates in the state of Michigan through the use of a bladder bundle, promoting a daily evaluation of catheter indication (Fakih et al., 2014). The ability of the selected design to generate a cause and effect relationship collaborated in spreading educational insights and guidance to various stakeholders. A disadvantage of such design is the lack of control group, as internal validity is not easy to control once a probability of a stakeholder not following all the necessary steps of the protocol to generate true findings, for example nurses not consistent with their rounds to evaluate daily necessity of indwelling catheter, which are important in order to identify gaps and make appropriate and necessary modifications based on new evidence. Target population here are hospitalized patients from 163 units including ER, ICU, Surgical, and operating room from 71 acute care hospitals in the state of Michigan, with an equal probability of being selected resulting in random sampling and confidentiality (Fakih et al., 2014).
The aim of the study by Shehab (2017) is to analyze the impact of the protocol of care, from nurse’s knowledge, of patients that requires a urinary catheter. A quasi-experiment design was used to test assumptions of effective changes in nurse’s knowledge after caring out the protocol of care on patients with the urinary catheter by using a structured interview questionnaire and a nurse’s knowledge assessment tool (Shehab, 2017). An advantage of this study is to evaluate nurse’s readiness to follow protocols and to update their knowledge on how to provide the best EBP care for patients with a Foley catheter. ...
Running head DRAFT QUALITATIVE RESEARCH .docxtodd271
Running head: DRAFT QUALITATIVE RESEARCH 1
DRAFT QUALITATIVE RESEARCH 2
Draft Qualitative Research
Name: Vanessa Noa
Institution: Grand Canyon University
Draft Qualitative Research
Background of the Study
The first article talks about UTIs such as epidemiology, mechanisms of infection and the preferences available for the treatment. According to the article, there are indigenous sources of bacteria that cause CAUTI (Flores-Mireles et al., 2015). The contamination comes from the hands that are contaminated from the healthcare experts, meatal and vaginal colonization. The pathogens can pass through intraluminal route, extra luminal route or through the catheter from a bag that is contaminated. Introduction of the objects that are sterile has demonstrated a decrease in threat of bacteriuria in a closed urinary damage. Conversely, studies have demonstrated that bacteriuria can take place through the disruptions in the machines or through the extraluminal path (Flores-Mireles et al., 2015).
The other article focuses on reducing the urinary catheter usage and other approaches to avert catheter-connected urinary tract infection. The article provides qualitative highlights of some of the appropriate actions that a doctor must assume while executing the process of catheterization. When undertaking the supplement of the urinary catheter, a skilled professional should take extraordinary safeguards since speedy release of urine from the bladder may lead to hemorrhage. A clam needs to be out after every twenty minutes to permit more release of urine (Meddings et al., 2014).
Supporting Nursing Practice
The first article on urinary tract infections supports the nursing practice as it touches on the usage of the catheter. According to the article, people who urinate with the help of catheter have elevated risk of contracting UTIs (Flores-Mireles et al., 2015). Example of such group of people may include the people that are hospitalized as well as people who have neurological issues that make it hard to regulate their capacity to urinate and the paralyzed individuals. Having known that, it is important to take the necessary steps to decrease the threat of urinary tract infections. People can drink more liquid particularly water because it aids to dilute urine and confirms that one urinates regularly hence permitting the bacteria to be flushed from the urinary tract before the contamination can start (Flores-Mireles et al., 2015).
The next article that touches on the reduction of the urinary catheter usage and other approaches to deter urinary tract infection that are linked to catheter highlights optional approaches that are critical in the healthcare. It is the obligation of the healthcare providers to be aware that catheters may be in place through having catheter reminder intervention.
Running head ANALYSIS OF LITERATURE REVIEW 1ANALYSIS OF LITERA.docxhealdkathaleen
Running head: ANALYSIS OF LITERATURE REVIEW 1
ANALYSIS OF LITERATURE REVIEW 7
Literature Review
Atsede Iyasu
NRS-490- 0500- Professional Capstone and Practicum
Grand Canyon University
08/11/2019
Analysis of Literature Review
Introduction
Catheter-associated urinary tract infection (CAUTI) more so in the ICU seems to be an issue that is challenging hospitals and health care centers. Nurses are the healthcare staffs who are responsible for ensuring that patients do not acquire CAUTI in their stay in the ICU (Mody et al., 2015). There are proven techniques and methods identified to be effective at preventing the catheter associated urinary tract infection. One technique that is highly mentioned in the prevention of CAUTI is strict aseptic technique and hand hygiene. The technique can significantly help nurses reduce CAUTI in intensive care units and lessen the health burden of patients in the intensive care unit (Bradley et al., 2018).
In order to confirm whether the above-mentioned technique is effective at preventing CAUTI, a literature review was carried out. The review touched on these method as well as other known methods or techniques for preventing CAUTI. A total of eight studies were reviewed. All the reviewed studies were on publications made between 2014 and 2018. It is important that the studies reviewed are not over five years old. The above was important as it ensured only relevant and up-to-date information established from the review. Comment by Shanna Foley: Great introduction. Be sure your thesis discusses the purpose of the current paper, not the purpose of your change proposal.
A comparison of the research questions
There were three main research questions that were identified in the studies reviewed. The first main research question identified was whether there was an effective scientific method of preventing CAUTI (Purvis et al., 2014). Five of the studies reviewed were interested in answering whether there is a well-known and established medical interventions or scientific interventions that can effectively prevent CAUTI. All the five studies are driven by the hypothesis that CAUTI can be prevented and treated by given medication and it is for the above reason that all the five studies were seeking to confirm whether medical interventions can effectively prevent the infection.
The second main research question was what is the role of hospitals or health centers in the acquiring of CAUTI? According to a publication done in 2017 by Theobald and his colleagues, Hospital conditions are the primary reasons that patients acquire CAUTI. The conditions being mentioned above include; general hospital cleanliness practices and the handling of patients. The third main research question identified was whether the method of administering and removing the catheter was the main reason that patients were acquiring CAUTI. Three of the studies reviewed seemed to run on the hypothesis that the main reason that CAUTIs are acquir ...
Running head DRAFT QUALITATIVE RESEARCH .docxjeanettehully
Running head: DRAFT QUALITATIVE RESEARCH 1
DRAFT QUALITATIVE RESEARCH 2
Draft Qualitative Research
Name: Vanessa Noa
Institution: Grand Canyon University
Draft Qualitative Research
Background of the Study
The first article talks about UTIs such as epidemiology, mechanisms of infection and the preferences available for the treatment. According to the article, there are indigenous sources of bacteria that cause CAUTI (Flores-Mireles et al., 2015). The contamination comes from the hands that are contaminated from the healthcare experts, meatal and vaginal colonization. The pathogens can pass through intraluminal route, extra luminal route or through the catheter from a bag that is contaminated. Introduction of the objects that are sterile has demonstrated a decrease in threat of bacteriuria in a closed urinary damage. Conversely, studies have demonstrated that bacteriuria can take place through the disruptions in the machines or through the extraluminal path (Flores-Mireles et al., 2015).
The other article focuses on reducing the urinary catheter usage and other approaches to avert catheter-connected urinary tract infection. The article provides qualitative highlights of some of the appropriate actions that a doctor must assume while executing the process of catheterization. When undertaking the supplement of the urinary catheter, a skilled professional should take extraordinary safeguards since speedy release of urine from the bladder may lead to hemorrhage. A clam needs to be out after every twenty minutes to permit more release of urine (Meddings et al., 2014).
Supporting Nursing Practice
The first article on urinary tract infections supports the nursing practice as it touches on the usage of the catheter. According to the article, people who urinate with the help of catheter have elevated risk of contracting UTIs (Flores-Mireles et al., 2015). Example of such group of people may include the people that are hospitalized as well as people who have neurological issues that make it hard to regulate their capacity to urinate and the paralyzed individuals. Having known that, it is important to take the necessary steps to decrease the threat of urinary tract infections. People can drink more liquid particularly water because it aids to dilute urine and confirms that one urinates regularly hence permitting the bacteria to be flushed from the urinary tract before the contamination can start (Flores-Mireles et al., 2015).
The next article that touches on the reduction of the urinary catheter usage and other approaches to deter urinary tract infection that are linked to catheter highlights optional approaches that are critical in the healthcare. It is the obligation of the healthcare providers to be aware that catheters may be in place through having catheter reminder intervention ...
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2CENTRAL LINE-ASS.docxsleeperharwell
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature ReviewComment by Microsoft Office User: The heading of introduction is inferred in APA format
I. Introduction
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.
II. Questions Posed in the Studies
a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the
evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?
c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?
d. Srinivasan, Wise, Bell, Cardo,Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.
e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.
f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva.
Describe any assumptions that you may have about what the resear.docxsalmonpybus
Describe any assumptions that you may have about what the research-based evidence will reveal to be true.
An assumption is an “acceptance of something that is recognized and upholds scholars’ clear principle for the extent of investigation that if untrue can concede the credibility of the outcome” Gray, Grove, and Sutherland, 2017). For my PICOT question, the assumptions I have and was revealed by research-based evidence revealed to be true include various data to confirm the surge in catheter-associated urinary tract infection when an unnecessary indwelling urinary catheter is inserted without following the Center for Disease Prevention and Control’s guidelines for IUC insertion. Another assumption is the fact that nurses have the greatest responsibility of enhancing patients’ safety and prevent harm by IUC is inserted for a therapeutic indication using evidence-based practice approach during insertion and management. This places “nurses at the frontline in catheter management, as they deliver a major part of daily catheter cares” (Gesmundo, 2016).
Are you receptive to research findings that do not agree with your assumptions? Please explain
.
Yes, I am receptive to research findings that do not agree with my assumptions. Although these findings may not necessarily agree with my assumptions, they will likely provide information to support further studies or present a new approach to the topic from another point of view thereby giving more insight and understanding to the evidence-based problem.
Have you already formed your own conclusions and are you looking for evidence to support your claims? Please explain.
I have formed my conclusion that Catheter-associated urinary tract infections can be prevented through adequate education of nurses on avoiding unnecessary usage, if possible, and if not proper management with antimicrobial chlorhexidine wipes and prompt discontinuation of an indwelling urinary catheter is necessary to prevent CAUTI. This conclusion is also supported by various literature and studies that confirm that “the use of chlorhexidine for routine urinary catheter care and after bowel movements for patients with urinary catheters may significantly decrease catheter-associated urinary tract infections when compared with the standard of care using soap and water” (Schmudde, Olson-Sitki, Bond & Chamberlain, 2019).
.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
1. Catheterization Research Paper
Catheters are tubes that are used to drain fluids from the body. They are often employed in removing
the fluid from the urinary bladder and therefore, are an important element in urology care. It is
important to understand their importance and correct use, if you are looking to take care of a patient.
It used in a variety of environments.
Here, we first look at how catheters are used and then discuss the problems that may appear when
they are not used in the proper manner.
Catheters in Urology Care
Catheters are basically connected either to a bodily vessel or a cavity. They can be used to either
drain body fluids or push medicine into the body. Catheterization can be done, using a number of
needles and tubes. Some of them are soft while some ... Show more content on Helpwriting.net ...
They are easily employed by a patient or a trained caregiver at home and therefore, ensure that they
can be used in different circumstances. They are perfect for people who have lost their urinary
control due to a variety of reasons.
The advantage of this method is that you can avoid constant catheterization which is associated with
several problems, such as male infertility and tract infections. The method also ensures that patients
can keep their bladder pressure low throughout the day. These catheters do not cause prolonged
issues and can easily be avoided once the person is able to use ordinary methods.
Foley Catheter A Foley catheter is designed to be connected to the bladder through the urethra. It is
the most commonly used catheter in urology care. It has two channels with one open and the other
one with a balloon. The open channel is used to drain urine out while the closed channel is used to
inflate the balloon. The inflation keeps a Foley catheter in place. These catheters are created these
days from silicone rubber.
They should only be used when indicated by a medical practitioner. As they are inserted through the
urethra, they carry a greater risk of infections and other side effects.
Problems with
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2.
3.
4.
5. Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections
The purpose of this paper is to identify an issue identified by the National Council of State Boards
of Nursing NCLEX examination blueprint. The identified issue that I will be addressing for this
paper is catheter associated urinary tract infections and is under the category of safety and infection
control; according to (INSERT NCSBN CITATION) this issue falls under the overview of safe and
effective care for patients. The importance of addressing this issue is one that can potentially aid in
the patient having a higher satisfaction rate for the facility and the facility not potentially having to
pay for services not covered by insurance after the infection develops. ... Show more content on
Helpwriting.net ...
Taking a look at the patients that have increased rates tend to be of female gender due to the
shortened urethra which allows the bacteremia to travel at a shorter distance than that of males,
some of the other risk factors for higher catheter associated urinary tract infections include patients
that are of older age, prolonged catheterization and impaired immunity (Conway, Larson 2012).
With respect to cultural values that may affect this situation they are none that I could find
correlating with catheter associated hospital infections. Proposed Solution
Through extensive research into catheter associated urinary tract infections there are many different
approaches to reducing the modifiable risk factors and the incidence of catheter associated urinary
tract infections in the hospital setting that can be used in any unit to reduce the liability of catheter
associated urinary tract infections. According to (Gesmundo, 2016)) the prolonging of the catheter
removal is one of the major reasons for catheter associated urinary tract infections. When adopting
the principles of how to lower the rate the success begins at the time of admission and
... Get more on HelpWriting.net ...
6.
7.
8.
9. Indwelling Urinary
Joint Commission released national patient safety goals for hospitals in January of 2016. These
patient safety goals were "established to help accredited organizations address specific areas of
concern in regards to patient safety" (Facts about the National Patient Safety Goals, 2015). National
patient safety goal 07.06.01 focuses on the prevention of catheter associated urinary tract infections
(CAUTI) in hospitalized patients. Evidence based practice should be implemented to stop these
common infections occurring in patients nationwide. Indwelling urinary catheters are only
recommended in certain patients, for example to prevent further breakdown of sacral wounds or
pressure ulcers in incontinent patients, for comfort in end of life care ... Show more content on
Helpwriting.net ...
In 2013, a magnet recognized hospital, Baptist Health Lexington, reduced CAUTI rates in ICU
patients by 60% (Roser, Piercy & Altpeter, 2014). The study included six interventions that were
followed by the staff in the effort to reduce CAUTI. The six interventions included: "communication
of CAUTI data to interdisciplinary teams, a nurse–driven, physician approved protocol, problem
analysis using Lean principles, daily unit–based surveillance rounds, silver alloy urinary catheters,
and an antimicrobial bundle comprised of two cleansing products for patients with an indwelling
urinary catheter" (Roser, Piercy & Altpeter, 2014). The nurse–physician protocol allowed for nurses
to assess whether the catheter was still necessary and if found not to be, the nurse could discontinue
it. This resulted in a 58% decrease in the number of catheters used (Roser, Piercy & Altpeter, 2014).
An education session was implemented by nurses using principles from the Lean system that
checked the capability of nurses to understand just how dangerous CAUTI can be. It was found that
no single intervention alone could reduce the occurrence of CAUTI development. Nurses must
integrate several interventions to have an effective result at lowering the rates. However, this
particular study found that after the use of the antimicrobial bundle, rates of CAUTI did decline.
Roser et al. (2014) emphasized that education and awareness of
... Get more on HelpWriting.net ...
10.
11.
12.
13. Microbiology
Catheter associated urinary tract infection (Author's name)
(Institutional Affiliation)
Catheterization is a frequently part of care for various surgical procedures. The study confirmed that
patients lacked knowledge in catheterization and most of the patients were limited in decision
making on when the catheter was to be removed. The clinical problem and research problem that led
to the study being carried in the clinic was that the use of urinary catheter on patients, whom had not
vacated the hospital lead to progressive bacterial settlement of the bladder at speed of approximately
5% per day. The increasing threat of the CAUTI infection, in the National Health Service steered to
the ... Show more content on Helpwriting.net ...
Most of the references were recent, three to four years in difference from the year of the study and
also other references were older than five years, which helped in quantitative study for example
Lincoln (1985) contribution. In this study the author outlined some of the limitations of the study,
which included, a small section of patients from one surgical specialty was a limiting factor in the
study. Secondly the study did not combine methods such as questionnaire to increase the sample
magnitude. According to the findings of the study the information gathered was adequate to logical
argument about the fact that delayed removal of catheter was leading to patients' contraction of
infections through the examination of the symptoms shown by some of the patients. Most of the
uncertainties were associated with lack of information, as one of the female participant conveyed
dissatisfaction with information provided to her before surgery, which instigated to the need for the
search of information online, this information helped her after the surgery. The perspective, from
which the study was developed, revolved around the length of time catheter should take after
surgery before it is removed from the patient. The lengthier catheter stayed on the patient, the more
chances the patient was likely to be infected.
... Get more on HelpWriting.net ...
14.
15.
16.
17. The Importance Of A Nurse Driven Protocol On Nurses '...
Identify the need or problem you intend to solve through your capstone project
Nurses lacked knowledge in the use and was unaware of the importance of the underlying evidence–
base recommended criteria's indicated on the nurse driven protocol to remove inappropriate UC's. A
nurse driven indwelling catheter removal protocol is an evidence base tool recommended by
infection control organization and experts for the early removal of unnecessary or inappropriately
placed urinary catheters (UC). Evidence shows that urinary catheters are the source of catheter
associated urinary tract infection (CAUTI). CAUTI, is the leading cause of hospital acquired
infections in the United States. The purpose of this evidence–based quality project is to evaluate the
effectiveness of an educational intervention on the importance and use of the nurse driven protocol
on nurses ' knowledge and CAUTI rates.
Identity your PICO
PICO QUESTION
For nurses, (P) on 2 South caring for patients with urinary catheters, will education, on the
importance and proper use of a nurse –driven indwelling catheter removal protocol (I), change
knowledge on the use of the nurse driven protocol, as compared to knowledge before receiving an
education, (C), as evidenced by (O), change in knowledge in the use of the nurse –driven indwelling
catheter removal protocol, and CAUTI rates as evidenced by, pre and posttest scores and CAUTI
audits after three months? The project will utilize a
... Get more on HelpWriting.net ...
18.
19.
20.
21. Catheter Associated Urinary Tract Infections: Case Study
Catheter Associated Urinary Tract Infections
Kailey O'Connell
Denver College of Nursing
Catheter Associated Urinary Tract Infections in Healthcare Catheter associated urinary tract
infections (CAUTI) continue to be one of the largest medical problems occurring during care in a
hospital today. According to the Centers for Disease Control (CDC), 75% of UTIs acquired while
being in the hospital is associated with the use of urinary catheters (Centers for Disease Control,
2017). With the statistics showing a large increase in CAUTI globally, changes are being done to
reduce the amount of catheters placed and the protocol for when one needs to be placed.
Guidelines for Catheter Placement In 2009, with the national increase ... Show more content on
Helpwriting.net ...
A study done in Thailand showed that the longer a catheter is in place was the main factor that
increased the incidence of CAUTI (Danchaivijitr, Dhiraputra, Cherdrungsi, Jintanothaitavorn,
Srihapol, 2005). The first week of placement showed a 37.6% incidence of infection followed by
27.7% the second week (Danchaivijitr et al., 2005). These statistics reinforce the importance of only
placing a catheter when medically necessary. Catheters should only be placed for the length of time
absolutely necessary and not a second longer if
... Get more on HelpWriting.net ...
22.
23.
24.
25. Catheter Associated Urinary Tract Infection
Introduction
The purpose of this paper is to implement a policy that will aid in reducing foley catheter induced
infection by providing a guideline for the health care providers on how to care for patients with
foley catheters. Catheter Associated Urinary Tract Infection (CAUTI) are the most commonly
reported hospital acquired condition, and the rates continues to rise. According to American Nurses
Association, greater than 560,000 patients developed CAUTI each year. Registered nurses can play
a vital role in reducing CAUTI rates (ANA, 2015). Hospital acquired conditions are major threat to
patient safety with estimated cost of 33 million annually (ANA, 2015).
A policy is defined as documentation defining the minimal requirements for clinical ... Show more
content on Helpwriting.net ...
A universal precaution and a sterile field must be maintained during the procedure. All foley must
have a stat lock retention device placed to patient's inner thigh area to keep the foley stable. The
foley drainage bag and chamber must be placed below the knee at all times to avoid back flow of
urine into the bladder. The order set directs the nurses on how to document for care every eight
hours. The documentation includes checking the potency, including any twisting or kinking of the
catheter, emptying the foley every two hours, and performing foley care every 8 hours. As part of
the policy, every nurse is required to attend bi–annual skills fair
... Get more on HelpWriting.net ...
26.
27.
28.
29. 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 ≥ 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
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30.
31.
32.
33. Foley Catheter • Explain The Procedure
How to insert a Foley catheter You must explain the process to the patient before you began. Most
patients are not used to inserting any object into their urethra. It is often described as painful or
uncomfortable. So out of respect for the patient, explain the steps of the procedure to him/her before
beginning. Ask the patient to lay on their back. The patient's legs should be spread and their feet
should be together. The patient laying on their back relaxes the bladder and urethra, making easier to
insert the catheter. You can even assist the patient getting into the supine position. Wash your hands
and put on sterile gloves. Wearing gloves are very important in the health care field, there are used
to protect you and the patient from bacteria. The sterile gloves help ensure that bacteria do not get
into the urethra and the patient bodily fluids do not come into contact with your hands. ... Show
more content on Helpwriting.net ...
Foley catheters comes in a sealed sterile kit. Before opening the kit, make sure you have the right
size kit for your patient. They come in 12,14,16 French. (1French=1/3 mm). The smaller ones are
usually better for the patient's comfort but the larger ones will help against leakage. Sterilize and
prepare the patient's genital area. You have wipe the patient's genital area with disinfectant soaked
cotton swabs, to remove any debris. Repeat step if needed. For female patients, be sure to clean the
labia and urethral meatus (the outside of the opening of the urethra located above the vagina). For
the men clean the urethral opening on the penis. When you finish wiping down the patient, lay down
surgical drapes around the genitals, leaving yourself enough work
... Get more on HelpWriting.net ...
34.
35.
36.
37. Evidence-Based Nursing Practice
Running head: EVIDENCE–BASED NURSING PRACTICE
Evidence–Based Nursing Practice
Karen Medley
Walden University
NURS 4000 Section 05, Research and Scholarship for Evidence–Based Practice)
July 22, 2012
Abstract
For patients that have indwelling catheters, with the evidence–based practice and standards of care,
UTI's does still continue to be an ongoing problem today. In one of the large hospitals in my area
had recently developed a poster and video approach with special focus on alternatives to urinary
catheterization, removing catheters early, and the reinforcement of sterile technique prior insertion
and foley catheter care were used to educate nursing staff and improve outcomes. The purpose of
this paper is to educate nursing on ... Show more content on Helpwriting.net ...
The lower income communities are probably more affected. The cost of a single episode to treat
UTI's ranges from $980–$2900, depending on the presence of the bacteremia (Saint, 2000).
Differences in care based on evidence Sterile technique is required for insertion of an indwelling
urinary catheter in the hospital setting, but clean technique can be used for intermittent
catheterization in non–acute settings. By itself, sterile technique on insertion doesn't prevent UTI's.
Prevention of UTI's depends on knowledge of causes, proper care techniques, and early catheter
removal. Nurses are taught early on in school that sterile technique helps to reduce infections. It was
drilled in our heads the entire time and now to have the evidence tell us that early catheter removal,
along with proper technique good hand hygiene is the key to reduce UTI's.
Summary
UTI's is an all too common problem that causes unnecessary distress to patients and delays their
recovery during their hospital stay. All healthcare professionals should adhere to these good practice
points that could reduce the risk of UTI's and assure staff that they are demonstrating best practice in
their care.
References
Burke J.P. (2003). Infection control– a problem for patient safety. New England Journal Medicine,
348(7):651–656.
Hobbs F.B. (2001).The elderly population. US Census Bureau, Population
42. Foley Catheter Detection
Foley catheter insertion is a sterile procedure used for multiple reasons in the hospital. The CDC has
a list of appropriate indications for placement of an indwelling catheter. The catheter which is a thin
sterile tube placed into the urinary bladder through the urethra. It is important to remain sterile
throughout the insertion process to help prevent a catheter associated urinary tract infection
(CAUTI), which are the most common type of healthcare–associated infection (HAI). Due to Foley
insertion being an invasive technique it can only be performed by a trained and licensed personnel.
There must be a doctor's order indicating the need of a catheter insertion. Foleys are available in
different sizes so it is important to pick the smallest ... Show more content on Helpwriting.net ...
When inserting a catheter in a male or a female the cleaning process and the depth of insertion is
different. The patient should lie in the supine position. Before getting started wash your hands and
put on clean gloves. Open outer CSR wrap and remove the pad and lie it underneath the patient.
Next use the provided castile soap wash to clean the patient's per–urethral area. Remove gloves,
apply hand sanitizer, and place sterile gloves on both hands. Be sure to place fenestrated drape on
patient. Use the syringe with the green plunger to squirt lubrication in the tray. Remove the top tray
and place it next to the bottom box being sure to leave it on the CSR wrap. Screw the water–filled
syringe into the inflation port. Remove the catheter from the wrap and place it into the lubricant.
Clean the patient with the pre–saturated antiseptic swab sticks. Using a female for our example take
the first swab and move in a downward motion and clean the right labia minora and discard. Then
take the second swab and repeat on the left labia minora. For the third swab stick clean the middle
area between the labia minora. Proceed with the insertion of the catheter by inserting until urine
flow is noticed. Once there is urine flow insert two more inches and inflate balloon with all 10mL of
sterile water. Once inflated, pull the catheter until the
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43.
44.
45.
46. Personal Statement Of Utmb Nursing
Personal statement My name is Robin Parisher and I am applying to be a part of the UTMB Nursing
Program with Spring 2017 admission. It is within this personal statement, I wish to successfully
explore my drive for this career choice, past experiences, and future endeavors with you. Nursing, in
my opinion, takes full commitment from someone. One must be knowledgeable, dedicated, and
willing to help others at all cost. My mother is the greatest nurse I have ever encountered and has
been my inspiration since I can remember. She has been a nurse for over 20 years and I have been
captivated ever since. I was born to do this, to advocate and help others that are in need. Being able
to apply the knowledge and skills learned in a real hands–on situation has given me the utmost
motivation to fulfill my dreams of one day becoming a nurse. I was able to successfully complete
my rounds of clinical hours as part of my nursing program at various locations and departments. I
was assigned to MD Anderson, Harris County Psychiatric Center, and Silverado Memory Care
Community, where I was able to work with many different types of patients and become acclimated
to the environment. The duties in which I was able to preform varied location to location but
included, head to toe assessments, insertion/removal of Foley catheters, medication administration,
tube feedings, trachea suctioning, and numerous care plans just to name a few. I was able to interact
with patients one on one as a student which has instilled confidence and reassurance in my future. ...
Show more content on Helpwriting.net ...
I wish passionately that the turn of events that occurred this year were different but that is not
possible and I feel the need to explain myself and the reasoning behind my unsatisfactory
... Get more on HelpWriting.net ...
47.
48.
49.
50. Research Critique Essay
Moses Williams
NURS 450
Professor Peggy Melloh
Introduction
Catheter–associated urinary tract infection (CAUTI) is a fairly common complication in hospitalized
patients. Nosocomial infection prevention and patient safety promotion has been issued and many
researches have been conducted to improve patient's quality of life. In this article, Saint et al. (2005)
hypothesize that using a paper–based urinary catheter reminder can reduce the incidence of urinary
catheterization, and consequently this will enhance the patients' safety.
Critique Part 1 Research Questions or Hypotheses The background and significance of this study are
properly presented in the introduction. The research question is presented at the end of the ... Show
more content on Helpwriting.net ...
Review of the Literature This article does not provide the search strategy including a number of
databases and other resources which identify key published and unpublished research. In this article,
both the primary sources and the theoretical literatures are collected and appraised in order to
generate the research question and to conduct knowledge–based research. In the section of the
literature review, nineteen professional articles are appraised in order to provide the significance and
background of the study. Saint develops the research question based on these analyses. "Catheter–
associated urinary tract infections in surgical patients: A controlled study on the excess morbidity
and costs" is one of the primary sources written by Givens and Wenzel who conduct and analyze this
study. In addition, "Clinical and economic consequences of nosocomial catheter–related bacteriuria"
is a review of a literature article which is the secondary source. Although many studies state that
patient safety is a top priority and CAUTI can be controlled by the caution of health care providers,
the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and
colleagues uncovered is unawareness and negligence by health care
... Get more on HelpWriting.net ...
51.
52.
53.
54. Essay On Foley Catheter Care
Foley Catheter Care, Adult
A Foley catheter is a soft, flexible tube that is placed into the bladder to drain urine. For as long as
your catheter is in place, you will need to:
Care for the skin around your catheter.
Empty, change, and clean drainage bags.
Check on your catheter throughout the day to make sure it is working properly and the tubing is not
twisted or curled.
Taking good care of your catheter will keep it working properly and prevent infections and other
problems from developing.
HOW TO CARE FOR THE SKIN AROUND YOUR CATHETER
It is important to take good care of your skin when you have a catheter in place. To do this:
Clean the skin around the catheter at least once every day.
Shower every day. Do not ... Show more content on Helpwriting.net ...
A clean towel.
Adhesive tape or a leg strap.
Steps
Wash your hands with soap and water.
Wet a washcloth in warm water and mild soap.
Wipe the skin around where the catheter was put in with the washcloth. Wipe away from the catheter
in small circles. Do not wipe toward the catheter because this can push bacteria into the urethra and
cause infection.
55. Pat the area dry with a clean towel. Make sure to remove all traces of soap.
Attach the catheter to your leg with adhesive tape or a leg strap, making sure there is no tension on
the catheter. If you are using adhesive tape, first remove any sticky residue left behind by the
previous tape you used.
Place the drainage bag below the level of your bladder, but keep it off the floor.
HOW TO CARE FOR YOUR DRAINAGE BAGS
You should have received a large overnight drainage bag and a smaller leg bag that fits underneath
clothing. You may wear the overnight bag at any time, but you should never wear the smaller leg
bag at night. Empty your drainage bag when it is ⅓–½ full or at least 2–3 times a day. Change your
drainage bag once a month or sooner if it starts to smell bad or look dirty.
How To Empty a Drainage Bag
Supplies
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56.
57.
58.
59. Preceptor Experience Essay
The second half of my preceptorship went well and I learned a lot. I felt comfortable giving
medications, performing assessments, and caring for the patients. I was able to complete all of my
objectives. We were in the ER for one day, and the rest of the time my preceptor was the Charge
Nurse on the med–surg floor. I gave medications every day that I was precepting. When giving
medications I am very cautious. I verify the patient, and we scan the patient and medications. But
sometimes medications are split in half and I needed to make sure to set them aside during scanning.
One day I scanned an aspirin and the computer said it was for the wrong patient. I verified the
medication on the MAR, and it was the correct medication. My preceptor said that happens
sometimes, and we manually entered the medication. I feel comfortable giving medications, but will
continue to be cautious. I performed assessments every day of preceptorship. Lung sounds can be
difficult for me to identify, so I liked being able to listen and ask my preceptor if she heard the same
thing. I heard a whooshing sound over the heart of one of my patients and spent extra time listening
to it. I guess he noticed that I was confused because he told me that he has a Pig Valve. Some of the
other sounds I could verify were crackles and wheezes. ... Show more content on Helpwriting.net ...
This was awkward for me since I have never been around it. I did not help with post–mortem care
because they were not our patients and we were busy doing other things. My preceptor had to call
Lifeshare for organ and tissue donation, even though the patient was not an organ donor. This is
standard for all patients that pass away. The spouse of the patients insisted that the patient wasn't an
organ donor, but Lifeshare insists on talking to a family member. After telling Lifeshare that the
patient's religion was a Seventh Day Adventist, they didn't need to talk to the family because that
religion does not donate
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60.
61.
62.
63. Long Hand Charting for Iv Insertion and Removal, Trach...
Pt requires 20 gauge IV for _______. 20 gauge catheter inserted to the right anterior forearm, first
attempt. Flushed with 10 cc normal saline. Stat lock in place, covered with transparent dressing. Pt
tolerated well with no complaints of pain or irritation upon flushing, no visible swelling or bruising.
Sharps placed in approved container, patient's bed lowered as far as possible and assisted to
comfortable position. Reassessed in 5 minutes for bleeding , none noted.
Pt requires IV discontinuation d/t: pain / infiltration / expiration of indwelling time frame.
Discontinue 22 gauge IV catheter from L hand. Cannula intact. Pressure held for 3 minutes, assess
for continue blood loss, none noted. 2 x 2 gauze dressing with paper tape ... Show more content on
Helpwriting.net ...
Bed rail returned to upright position and bed lowered to lowest possible position.
Order written by _____ for a 16 F indwelling catheter for _(preop)__. Pt instructed on the need and
gave consent denies iodine allergies. Pt is positioned in the dorsal recumbent position, perineal area
cleaned with warm damp cloth and dried. Labia spread and meatus cleansed with betadine.
Lubricated catheter inserted immediate return of 500 ml of cloudy
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64.
65.
66.
67. Reflection About My Clinical Experience
Also, the objective is to find patient's document finding and correlate it with chronic disease process
of elderly adults. With this reflection, I will discuss what I've learned, and my strengths and
weakness in my clinical experience.
Day 1
On Thursday the 9th, I worked with a patient who is a 74 years old male, with general weakness.
His admitting diagnosis was caused by the metastasis of prostate cancer to the bone. Talking to the
patient was an amazing experience for me because we liked the same thing such as the NBA. He
told me that he was a lawyer and that all of his children are grown up and successful. He does a
wife, who I did not see during my rotation. But, it was easy to talk to communicate with him. I have
always had social anxiety growing up. Talking to people had always been my weakness because I
was always worried about how people would perceive me when I talked. However, now that I have
grown up, I learned to look past my social anxiety. I learned that from shutting my brain off that
caused me overthink, facilitated me to ... Show more content on Helpwriting.net ...
I was slightly familiar with the foley catheter, however, I need some slight guidance. I knew that I
needed to drain the foley bag because it was slightly full, but I did not know where to unclamp to
drain it. The nurse's aid taught me how to unclamp the bag so I can drain the urine. I also learned
that when moving the patient who has a foley bag, it was important to make sure that the patient is
not going to get a UTI. UTI can be caused by holding the foley bag at a higher positon causing the
urine to backtrack. It is important to keep that in mind as a healthcare worker. I have not been skill
checked on foley catheters, however, I need to practice working around foley catheters to protect the
patient. I could always go on youtube and search videos on foley catheters or I can use the perry and
potter book to learn
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68.
69.
70.
71. 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
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72.
73.
74.
75. National Patient Safety Goals ( Npsgs )
National Patient Safety Goals (NPSGs) were established in 2002 by the Joint Commission to help
accredited organizations address specific areas of concern in regard to patient safety ("Catheter–
Associated," 2015). NPSG.07.06.01 Implement evidence–based practices to prevent indwelling
catheter–associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission,"
2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing our CAUTIs
can be achieved with a strict goal, addressing the financial implications, interdisciplinary
collaboration, nursing leadership, a measurement tool, and discussing the future healthcare delivery
methods.
Goal
Urinary tract infections are the most common type of healthcare ... Show more content on
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Your morbidity and mortality rate increase 2.8–fold when acquiring a CAUTI, and can add up to
$1000 direct cost to your bill in the acute care setting. Medicare beneficiaries with CAUTI have a
higher median Medicare reimbursement of $1500 in the acute care setting, and up to $8500 in the
ICU setting, not to mention increasing your length of stay in the ICU an extra 8 days ("Catheter
Associated Urinary Tract," 2011).
Healthcare–associated infections account for nearly $45 billion yearly in the United States, because
CAUTI is one of the most common, CMS stopped reimbursing hospitals for additional costs
associated with CAUTIs in 2008 (Kennedy, Greene, & Saint, 2013). Costs incurred with CAUTIs
when symptomatic urinary tract infections are involved can average up to $911 per patient, and up
to $3824 per patient when bloodstream infections are involved (Kennedy et al., 2013). This includes
costs associated with oral medications, intravenous medications, and laboratory testing.
Interdisciplinary Collaboration
Fakih and Jones (2013) really bring home the fact that once you communicate to your colleagues
that infection reduction is an organizational priority, the first step to reduce CAUTIs is to implement
a Comprehensive Unit–based Safety Program (CUSP) developed by Johns Hopkins Medicine
Armstrong Institute for Patient Safety and Quality. This starts with senior leadership commitment,
then involves physicians, nurse leaders,
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76.
77.
78.
79. The Importance Of Prevention And Improvement Interventions
There are numerous current prevention and improvement initiatives taking place in the health care
system to reduce the occurrence of catheter associated urinary tract infections (CAUTIs). Some of
the most prominent interventions are to decrease the number of catheters being inserted and
removing the catheters as quickly as possible. Stamford Hospital located in Connecticut, USA,
implemented a CAUTI reduction project after noticing that education–based approaches and
handwashing efforts had not decreased the incidence of CAUTIs. They implemented a nurse's
checklist for the justified use of catheters and timely removal of urinary catheters. They also added a
specific catheter charting module in the electronic health record, and held biweekly ... Show more
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In the past, Foley catheters remained in place, and the need to continue them was not addressed on a
daily basis. But, with education and research this has changed. Education sessions offered in
hospital settings and huddles, for example, are perfect opportunities for the nurses to identify
patients with a Foley catheter on the unit and review strategies for decreasing infections (Clayton,
2017). Knowing when catheters are being useful and when they are becoming an issue and causing a
problem is the key to identifying CAUTI's. Preventing CAUTI's begins with avoiding unnecessary
use of urinary catheters, developing policies for insertion and maintenance of catheters, selecting the
appropriate catheter, and instituting surveillance of CAUTIs and catheter use. Protocols to eliminate
CAUTI's will decrease their incidence and ensure better quality care (Clayton, 2017). This research
found that out of 517 hospitals, 56% of them did not have a system to keep track of catheterized
patients (Clayton, 2017). It was also found that 74% of the hospitals did not keep proper records of
how long an indwelling catheter has been in a patient (Clayton, 2017). These flawed systems can be
costly to patient safety and quality of care.
Improper education for health care workers is dangerous for patient care. The next study focused on
working with educators to make sure nurses were properly educated on the proper care of urinary
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80.
81.
82.
83. Urinary Tract Infection Paper
The scope, history, and duration of catheter associated urinary tract infections is reviewed. The
scope of catheter associated urinary tract infections is when an individual acquires an infection that
has been caused by the insertion of a catheter. The individual may have had the catheter in place for
a short period of time and acquired it upon insertion related to the lack of sterile technique.
However, the individual also may have had the catheter in place over a long period of time and
acquired an infection. Roger, Feneley, Hopley, and Wells (2015) explain that the body's natural flora
is disrupted from ascending in the urinary tract and colonizing a bacterial infection during normal
bladder emptying. However, if a catheter is in place this allows for easy ascending bacteria to
colonize and form an infection, and ... Show more content on Helpwriting.net ...
The use of catheters to empty bladders dates to over 3500 years ago, and Foley indwelling catheters
have been used over the past 80 years (Roger, Feneley, Hopley, and Wells, 2015). The catheter was
first initiated for the use of male, intermittent self–catheterization purposes, it was rigid, and implied
for urinary retention (Roger, Feneley, Hopley, and Wells, 2015). Roger, Feneley, Hopley, and Wells
(2015) continue to explain that urinary incontinence was not a pertinent medical need to address,
and it wasn't until a urologist invented the Foley catheter that it was used for these purposes.
However, this intervention is great at assisting to prevent skin breakdown in the elder population
related to the effects of urine in constant contact with the skin, but indwelling catheters do not come
without several other medical problems that can result, as mentioned above (Roger, Feneley,
Hopely, and Wells, 2015). In addition to these problems, Foley indwelling catheters have been
associated with balloon fragments if the balloon bursts and urethral trauma (Roger, Feneley, Hopley,
and Wells,
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84.
85.
86.
87. Nursing Fluid Balance Report
The learning objective to be addressed in this essay is to be more adept at filling out a fluid balance
chart and understand its importance. I intend to use the Driscoll (2007) reflective cycle as I find the
root process of interrogating and assessing events the most helpful at being reflective. The fluid and
electrolyte balance monitoring and management are essential and highly significant to nursing care
as highlighted by Jevon and Ewens (2007). Patients suffering from a negative fluid balance is
understood as suffering in dehydration according to the definition of dehydration by Jevon (2010)
Some symptoms of dehydration, as described by Goertz (2006) include thirst, headaches, dry skin,
weight loss, fatigue and pyrexia. From this point onward ... Show more content on Helpwriting.net
...
Luckily enough, my mentor remembered and wrote down the urine output for that hour. I was
criticised by my mentor for forgetting to do so and she reminded me of the importance of keeping
rigorously accurate fluid balance chart as post–operative patients are at a higher risk of
hypovolaemia and oliguriaThey are at risk of hypovolaemia due to fluid loss during the procedure
Hypovolaemia, the decrease in the volume of blood circulating in the body, can lead to tachycardia.
A tachycardic heart rate is not efficient in oxygen delivery to the organs. The increase of work
demand and decrease of oxygen delivered on the heart can cause rate related ischaemia (Hutchins,
2013). A study conducted by Vaughn et. al (2014) showed that oliguria, which left untreated can lead
to tubular necrosis and acute kidney injury (AKI)..She reminded me of its importance in delivering
excellent care and ensuring the patient's good health. The chastisement that I received from my
mentor made me feel somewhat disappointed as I felt that such a simple mistake could have been
easily avoided. Her reminder of the importance of giving the highest quality of care also made me
realise the importance of little thing in the care of the patient. Little things, when put together, make
something big and significant. Although I was disappointed with myself for making such a trivial
mistake, I soon realised that my mentor gave me an important job which I should have been more
careful with. I understood that I am accountable for my actions and partly accountable for whatever
outcome may befall to the patient. Moments afterwards, I accepted my mistake and was soon eager
to prove myself and be worthy of such a
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88.
89.
90.
91. The Quality Improvement Nursing Process
The Quality Improvement nursing process that I have chosen to research is patient safety. I have
chosen to focus specifically on the topic of catheter associated urinary tract infections (CAUTI's)
during hospitalization and their preventions. It is estimated that 15–25% of hospitalized patients
receive a urinary catheter throughout their stay, whether or not they need it. A large 80% of all
patients diagnosed with a urinary tract infection (UTI) can be attributed to a catheter (Bernard,
Hunter, and Moore, 2012). The bacteria may gain entry into the bladder during insertion of the
catheter, during manipulation of the catheter or drainage system, around the catheter, and after
removal. The difference between men and women regarding UTI's related back to the human
anatomy. A man's urethra is 8 inches in length, while a woman's urethra is 1.5 inches in length.
Bacteria can quickly and easily make its way into a woman's bladder. This is why there is a large
percent of women UTI's when used in comparison to men (Mayo Clinic Staff, 2012). Catheter–
related urinary tract infection (UTI) occurs because urethral catheters inoculate organisms into the
bladder and promote colonization by providing a surface for bacterial growth. Brusch says, "Once a
indwelling catheter is placed, the daily incidence of bacteriuria can be between 3–10%." Another
large problem that results CAUTI's is that at times, catheters are left in a patient longer than
necessary. Prolonged use of
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92.
93.
94.
95. Urinary Catheter Education: A Case Study
Catheter Education:
A urinary catheter is a thin tube that is placed in the bladder to allow urine to drain. Urine flows
through the tube into a collection bag. A urinary catheter is often used for several purposes:
including the inability to void on one's own, unconscious patient, unable to ambulate, malformation
exists that prevents the flow of urine, or to keep an accurate record of the amount of urine being
voided. Foleys are also inserted during the surgical process, as seen in most critical care patients for
accurate measuring of urine output. During the intensive care admission, patients who have a
urinary catheter are more prone to acquiring a urinary tract infection than patients without a catheter
inserted (NICHE, 2012).
CAUTIs Education ... Show more content on Helpwriting.net ...
Remember catheters should be used only when required and should be removed as soon as possible.
According to the Nurses Improving Care of Health System Elders (NICHE) (2012), CAUTIs
prevention strategies emphasizes the crucial role of first–class nursing care in patient safety efforts.
NICHE (2012) stated that their focus is on the nurse–driven program that is planned to aid hospitals
and healthcare organizations to improve the care of the older patients. NICHE's vision focus on
sensitive, and excellent care that should be provided to all patients who are 65 and over. The task as
identified by NICHE (2012) is to deliver principles and tools that will motivate a change in the
culture of healthcare facilities. Such care is centered on the older adult. NICHE (2012) also provides
hospitals and other healthcare organizations with an evidenced–based clinical protocol that allows
for the Joint Commission alliances to be achieved and enhance the care of the patients and their
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96.
97.
98.
99. 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
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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
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100.
101.
102.
103. Orem 's Self Care Deficit Theory
Orem's Self–Care Theory Orem's Self–Care Deficit Theory (SCDNT) is complex and contains
various parts that help to explain how self–care can influence the overall health status of an
individual. The basics of SCDNT can be broken down into four interconnected parts: theory of self–
care, theory of dependent care, theory of self–care deficit, and theory of nursing systems (Berbiglia
& Banfield, 2014). Each theory can be integrated into how the nurse will interact and plan care for
patients. The nurse meets the patient's self–care needs by teaching, demonstrating, and supporting
the patient in performing basic self–care practices. Self–care can be defined as the practice of
activities that maturing and mature persons initiate and perform, ... Show more content on
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All of the nursing actions are developed around self–care and produce a therapeutic effect on that
patient. These relationships between the nurse and the patient guide care and help to develop an
understanding of what actions must be taken for each patient. Along with the four theories, Orem
also developed goals to be met with self–care using eight requisites. When nurses are assessing
patient's these eight areas should be included in the assessment: maintance of sufficient intake of air,
food, and water, provision of care associated with elimination processes and excrements,
maintenance of balance between activity and rest, and solitude and social interaction, prevention of
hazards to human life, human functioning, and human well–being, and promotion of human
functioning and development within social groups in accordance with human potential, known
human limitations, and human desire to be normal (Berbiglia & Banfield, 2014). Patient Assessment
The patient to be assessed is a 63–year–old male admitted to the hospital for a planned admission
for a transurethral resection of prostate (TURP) due to benign prostatic hyperplasia (BPH) with
obstruction. The patient's past medical history includes: infantile cerebral palsy affecting the right
side, sliding hernia that was repaired, tonsillectomy, and skin cancer at age 2.
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104.
105.
106.
107. 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). A Catheter 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
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108.
109.
110.
111. Foley Catheter-Personal Narrative
My clinical week was very interesting because I removed a Foley catheter. I was helping the nurse
give medications, and he asked me if I would like to remove the catheter with him. I felt an
adrenaline rush. I was excited but also worried I was not going to do it right. Nevertheless, I still
took the opportunity. The patient was complaining that she would love the catheter removed as soon
as possible because she had a bowel movement the night before, and the CNAs did not do a good
job at cleaning her. The nurse and I reassured her that we would remove the catheter and help her
clean up. At that point, I started regaining confidence, probably due the patient's lack of comfort. In
my mind, I was thinking "oh I will exactly as they taught us in
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112.
113.
114.
115. Urinary Retention: A Case Study
L: During my clinical experience, I was able to observe an intermittent catheterisation.
E: Initially, the nurse explained to us why the procedure was being completed. The patient was
experiencing urinary retention which is a result of the bladder's inability to empty fully (Wood,
2014, p. 1118). Additionally, there was a doctor's order for a specimen collection. First, the nurse
began the process by prepping for the procedure, this entails explaining the procedure to the patient,
cleaning the perineal area and setting up all the materials required. Following, the nurse lubricated
the tip of the catheter to decrease the friction while inserting the catheter through the urethral
meatus. Then the nurse retracted the labia to expose the urethral ... Show more content on
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p. 5). Assessing urine input and output can be an indication that the bladder is retaining urine
(Wood, 2014, p. 1123). We were able to drain approximately 400 mL from the bladder using an
intermittent catheter; however, the nurse stated there was approximately 300 mL still left in the
bladder. The use of an intermittent catheter has fewer risks associated with infection in comparison
to an indwelling catheter (RNAO, June 2004, p. 2). This is a result of an indwelling catheter
accumulating bacteria because it is used for long–term drainage (RNAO, June 2004, p. 2).
Therefore, the patient is more likely to be exposed to these harmful bacteria (RNAO, June 2004, p.
2). In this particular situation, I agree that the intermittent catheter was the best option for the patient
because of the reduced risk of infection. A nosocomial urinary tract infection will often result in an
extended stay of five to six day (RNAO, June 2004, p. 6). Moreover, the bladder was pocketing
resulting in urinary retention. It was crucial to remove this urine from the bladder so it does not
cause damage or patient discomfort (Wood, 2014, p. 1118). The intermittent catheter was able to
drain the urine into the bladder that was being
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116.
117.
118.
119. Time Management And Prioritization Is Important Aspects Of...
Time Management and Prioritization Time management and prioritization are important aspects of
nursing care. The Pareto Principle states that 20% of focused effort results in 80% of outcome
results and is an important principle for all nurses to practice in order to provide high quality care
(Maloney, 2011). The majority of a nurses' time is spent on documentation, followed by care
coordination, patient care activities, unit related activities, med administration, non–clinical
activities, and personal time (Maloney, 2011, p. 425). Judie and I prioritize our nursing care based
on each patient 's diagnosis and need. Patients with severe diagnoses are seen first and patients who
are the least severe are seen last. If a patient is in pain or needs immediate attention we see those
patients first. Nurses prioritize their care activities into seven levels; imminent concern, high
uncertainty, pain management, relationship management, documenting and patient support, cleaning
and/or prepping supplies, personal breaks and social interactions (Patterson, Ebright, & Saleem,
2011, p. 389). Flexibility to deviate from this framework at any time is important in providing high
quality, personalized care. I reprioritize patient care based on a number of factors. Throughout our
shift I care for the highest priority patients first then I see patients who do not require much attention
so I can designate the majority of my time to patients who do. High priority patients are categorized
by
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120.
121.
122.
123. Indwelling Catheter
This study focuses on whether the use of reminders assists in decreasing the use of urinary
cathethers and the occuruence of catheter associated urinary infections. UTI risk increases by 5
percent with the use of indwelling catheters. The Center for Disease Control and Prevention (CDC)
has recommended that patients receive catheters if indicated but over 41% of physicians have
ignored this and nursing staff have ignored evaluating when the catheter should be removed. Besides
noncompliance with the CDC, this study shows for patients who have catheters, the reminder system
will help to decrease the length of indwelling cathethers are potential UTI infection associated with
it. In previous studies, their has been different views as to whether ... Show more content on
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A stoma is an artificially creted hole in the abdomen that allows for the passage of stool and urine to
exit the body. Self–care is vital when one has a stoma. Perisotomal self–care is very important and
has been one of the main issues ostomates have experienced. The main characterisits seen with
peristomal site complications are discoloration, erosian, and tissue overgrowth. Previous studies, to
determine skin problems, with the use of SPSC have not been done. The hypothesis of this
randomized controlled study is that those who use SPSC will have a lower percentage of periostmal
skin problems (discolartion, erosion, and tissue overgrowth) than the CT group. To test out this
study, 81 elgible patients were chosen. Some of the Elibiity requirements included those who were
undergoing a colostomy or ilostomy, were 20–18 years of age, and understood why the study was
being done. These particpants were chosen from a single tertiary hospital. The 81 participants were
split into two groups, the SPSC (45 patients) and CT group (36 patients). Wound Ostomy Care
Nurses educated the each group on how they would care for their ostomies. Those with Standarised
Peristomal Skin Care (SPSC) use direct pouching on skin with powder if needed. Those with the
crusting technique use an artificial skin memberane over
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124.
125.
126.
127. Nurse Reimbursement
All staff involved in catheter insertion and care must be educated on proper care. Nurses must be
educated on the importance of decreasing catheter use and their right to question Foley catheter
insertion and maintenance. Choosing a "champion" among staff, or a certain peer to help influence
behavior will also help overcome resistance to change among nurses who are unwilling to change
for the sake of convenience or habit. Creating a peer–to–peer educational plan is also shown to
encourage and empower nurses to decrease catheter use (Meddings et al., 2014). Finally, behavior
must be analyzed to see if new protocols and policies are being followed. If they are not, a
discussion should occur to see if any new resistors to change have been ... Show more content on
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The team will oversee the evidence–based practice aspects of CAUTI prevention and will be set up
using aspects of the guidelines established by Andreessen et al. (2012). Several different types of
nurses will be recruited to assist including infection control (for evidence–based practice guidance),
nurse educators (to help set up the education program), and staff nurses (to advise from staff's point
of view) (Andreessen et al., 2012). Leadership including, nurse managers, clinical nurse leaders, and
the medical director, will assist with implementation. The team consisting of resource type
individuals such as urologists, will guide evidence–based practices and information technology will
assist to set up flow chart and tracking processes (Andreessen et al., 2012). The next step will focus
on educating the unit's staff. Employees that place an indwelling catheter will be required to go
through a refresher course on proper insertion technique, indications for catheterization, and catheter
care. Additionally, there will be a class on the new flow sheet created to track indwelling catheters
(Andreessen et al., 2012). Posters with information pertaining to catheter care, CAUTI prevention,
the new charting system, and alternative bladder management systems will be placed in highly
visible areas such as break
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128.
129.
130.
131. 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
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132.
133.
134.
135. Nursing Teaching Plan
Infection Prevention with Foley Catheter Care at Home: A Nursing Teaching Plan
Assessment of the Learner
Mr. D is a 77 year old, single, Caucasian male. He is retired from the Navy and completed an
Associate's degree in Criminal Justice and Business Administration at Durham Technological
Community College after his service. Mr. D smoked one pack of cigarettes per day for 20 years and
has a history of hypertension, atrial fibrillation, and skin cancer. Mr. D was hospitalized after a
transurethral resection of a bladder tumor (TURBT). The surgery also included bilateral retrograde
pylegrams. The pathology report stated that the bladder tumor was positive for cancer.
Mr. D normally lives by himself, but explained that a friend would be staying ... Show more content
on Helpwriting.net ...
D was finished with breakfast and morning care. When I entered the room, I explained that I was
there to provide information on taking care of the Foley catheter at home and ways to reduce
infection. I asked if this would be a good time to have a discussion and Mr. D replied yes. The door
to the room was closed, Mr. D reported no pain, and there were no other healthcare team members
in the room to distract from the teaching. I started the lecture portion of the teaching plan by
explaining that Mr. D would be discharged from the hospital with the Foley catheter still in place. I
reiterated that Foley catheters require special attention and care because they increase the chance of
infection. I began by addressing the first objective and described the various ways to properly care
for a Foley catheter. Next, I explained scenarios that would prompt a call to the doctor. Finally, I
addressed the second objective by describing the signs and symptoms of a urinary tract infection. I
concluded the teaching session by asking Mr. D if he had any questions for me, which he did
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136.
137.
138.
139. Summary: Hospital Acquired Infections
Research Problem Hospital acquired infections (HAIs) are infections a person get while in the
hospital, however the infection must occur forty–eight hours after admission because of the
incubation period of infections (Shang, Stone, & Larson, 2015). HAIs provide an unnecessary risk
to patient safety (Center for Disease Control and Prevention [CDC], 2016). Every day at least one
out of twenty–five patients in hospitals across the United States (U.S.) acquires an HAI (CDC,
2016). HAIs leads to many problems in hospitals across the U.S. One problem is HAIs can lead to
patients' deaths. In 2011 722,000 people developed at least one HAI, over half happened outside of
the intensive care unit, and around 75,000 of the 722,000 died while in the hospital ... Show more
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The study will take place at one hospital, South Georgia Medical Center, over three–months. The
independent variable will be the nurse to patient ratio on the medical surgical floors and the
dependent variable will be the percent of HAIs acquired on each floor, specifically foley catheter
associated urinary tract infections, central line associated blood stream infections, hospital acquired
pneumonia, and surgical wound infections. There will be four medical surgical floors in the study
and adult patients admitted or transferred to medical surgical floors will be randomly assigned to
one of the floors. On the first medical surgical floor the day shift (0700 to 1900) nurse to patient
ratio will be 1:4 and the night shift (1900–0700) ratio will be 1:5, on the second floor the day shift
ratio will be 1:5 and the night shift ratio will be 1:6, and on the third floor the day shift ratio will be
1:6 and the night shift ratio will be 1:7. The fourth floor will be the control group and nurse to
patient ratio will depend on how many nurses are scheduled to work on each shift, as previously
done at this hospital. Data will be collected on the percent of patients on each floor who gets one of
the four HAIs forty–eight hours after getting admitted or transferred to the medical surgical floor to
determine if nurse staffing has an impact on the percent of patients who gets an
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140.
141.
142.
143. Leadership Learning Experience : The Hospital 's Current...
Leadership Learning Experience PYT1
A1. Problem
The practice issue identified in collaboration with the MICU nurse manager for this task is non–
adherence to the current catheter associated urinary tract infection (CAUTI) prevention protocol.
A1a. Explanation of Problem
The hospital's current practice for CAUTI prevention includes the use of the HOUDINI protocol.
This protocol features the acronym for the strict indications required for the insertion and the
continued use of the urinary catheter (hematuria, obstruction, urologic surgery, decubitus ulcer,
intake and output, no code/comfort care, and immobilization). The physician places the original
order for the catheter with HOUDINI protocol and chooses the indication that applies. The order
empowers the nurse to assess the patient daily for the continued indications and to remove any
urinary catheter that no longer meets the indications. Hospital wide the protocol has been successful
at decreasing CAUTI rates, however the target for CAUTI rates is 0 and our current rate is 1.37 per
1000 catheter days. Intensive care units have higher urinary catheter usage than in medical surgical
or telemetry units (Halm, O'Conner, 2014). In MICU the most common indication for a urinary
catheter is the need for accurate intake and output on patients with hemodynamic instability. Staff
nurses are required to assess the patient daily and readdress the continued indications. In the past
month no urinary catheters were removed
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144.
145.
146.
147. The High Incidence Of Catheter Associated Urinary Tract...
The high incidence of catheter–associated urinary tract infections (CAUTI) during the patient's
admission can result in further complication and could potentially increase their hospital days. This
could delay the patient's recovery time, causing emotional and financial distress and possible death
if CAUTI goes unnoticed. There are research studies focusing on the prevalence of CAUTI and all
previous studies show that it is in the best interest of the patient to discontinue the Foley catheters as
soon as possible to decrease the rate of infections. In some health care organizations, different
approaches have been indicated to tackle this problem. CAUTI rounding teams have shown positive
results leading to a number of health care facilities to implement the rounding team into their
practice for the benefit of the patient population.
Keywords: catheter–associated urinary tract infections, CAUTI, urinary tract infection, UTI, Foley
catheter infection, infection control
Indirect Clinical Project
Catheter–associated urinary tract infections (CAUTI) have been studied in clinical situations where
it is in the best interest of the patient to discontinue as soon as possible to decrease the infection
rates. Prompt Foley catheter removal as soon as indicated improves patient outcomes (Magers,
2013). When a Foley catheter remains indwelling, there is chance for bacteria to migrate up the
urethra causing urinary tract infections (UTIs) (Glowicz, 2015). If gone
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148.
149.
150.
151. 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 ...
O A 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
O Nurses are best positioned to make the decision to remove catheters as they are in direct and
constant contact with the patient.
O According to Hospital Compare Cape Fear Valley Hospital is labeled as as "Worse than national
bench mark" for CAUTI rates (Medicare.Gov, 2015)
O Potential 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.
O The 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
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152.
153.
154.
155. Foley Catheter Lab
A Foley catheter is a thin, sterile tube inserted into the bladder to drain urine ( ). There are many
types of catheters such as a straight, indwelling, and condom catheters. A straight catheter is one that
does not stay inside the person. It is removed immediately after urine is drained. An indwelling
catheter is one that stays inside of the bladder for a period of time. And last, a condom catheter is
one that has an attachment that fits onto the penis. This catheter is changed daily or as needed. For
the purpose of this document, the care that is going to be performed will need to be performed on a
patient/resident with an indwelling catheter.
A patient/resident with an indwelling catheter also has a catheter drainage bag, as well, that all ...
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Bath thermometer
6. 2–4 wash clothes or wipes
7. 1 towel
8. Gloves
Instructions on how to provide catheter care to a patient/resident:
1. Wash your hands.
2. Remove or fold back top bedding. Keep resident/patient covered with bath blanket.
3. Test water temperature with thermometer or your wrist to ensure that it is safe. Water temperature
should be 105 degrees to 109 degrees F. Have your patient/resident check the water temperature as
well.
4. Put on gloves.
5. Ask the resident/patient to flex his/her knees and raise the buttocks off of the bed by pushing
against the mattress with their feet. Place a clean protective pad under the buttocks.
6. Expose only the area necessary to clean the catheter.
7. Place a towel or pad under catheter tubing before washing.
8. Apply soap to a wet wash cloth.
9. Hold the catheter near the meatus (any passage leading inside of the body). Avoid tugging it. Then
start to clean at least four inches of catheter nearest the meatus. Move only in one direction, away
from the meatus (Fig.1). Use a clean area of the cloth for each stroke.
10. Rinse at least four inches of catheter nearest the meatus. Move only in one direction, away from
the meatus. Use a clean area of the cloth for each
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