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RUNNING HEAD: C128 1 Task 3 C128 Western Governors University
C128 2 Evidence Based Practice Based on the given scenario, Hospital A has had an increase in nosocomial infections and the chief nursing officer (CNO) needs to address these increased infection. According to a study by Galiczewski and Shurpin (2017), over 40% of hospital acquired (nosocomial) infections are a result of indwelling urinary catheters. The CNO can begin focusing on reducing Catheter Associated Urinary Tract Infections (CAUTI) as a first step to reduce nosocomial infection. CAUTIs cost patients over 400 million dollars each year and an estimated 2 million patients are impacted by CAUTI annually. In order to reduce the incidence of nosocomial infections, the CNO will need to ensure that sterile all-in-one item packaging is used. For example, when placing an indwelling foley catheter, the product recommended based on evidence based practice is a sterile foley catheter kit. This kit is wrapped in a plastic bag and everything inside the bag is sterile. The kit includes all items needed for the foley catheter insertion which reduces the likelihood that the nurse will need to leave the bedside and break sterile technique to obtain needed items. Technology can also help facilities reduce the incidence of nosocomial infections by tracking the placement of central lines, IVs, and indwelling urinary catheters via electronic medical records (EMR). The CNO can implement an update to the EMR to prompt a reminder for nurses and physicians to remove urinary catheters within 24-48 hours. Using the EMR, nurses can know when a procedure was done. For example, if a patient has an indwelling urinary catheter, the computer system can include a prompt to remind nurses and physicians that the catheter should be removed within 24-48 hours of insertion if it is no longer indicated. This reminder can help reduce the rate of nosocomial infections by prompting the removal of
C128 3 catheters when no longer necessary. The same technology can be used to remind nurses of when a central line dressing needs to be changed to prevent infections in the central line site. According to a study by Mizerek and Wolf (2015), often in the emergency department, patients and their families request indwelling urinary catheters when they are not indicated so that the patient does not have to get off the gurney to use the bathroom or have to use an uncomfortable bed pan. Their study shows that nurses have to provide education to patients and their families about the risk of CAUTIs and that indwelling urinary catheters can only be placed under certain conditions due to the risk of infection. Educating the patient and their family about why a catheter is or is not required will help the patient and family be informed about the risk of interventions so that they can understand the rationale for either inserting or not inserting a catheter.