EBP_TASK_2.docx - 1 EBP AND APPLIED NURSING RESEARCH TASK 2...

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EBP AND APPLIED NURSING RESEARCH: TASK 2 –
URNARY CATHETER INSERTION GUIDELINES
C:361 EVIDENCE BASED PRACTICE AND APPLIED NURSING RESEARCH
TASK 2
NEDRA LUSK-SHORE
WESTERN GOVERNOR’S UNIVERSITY

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EBP AND APPLIED NURSING RESEARCH: TASK 2 –
URNARY CATHETER INSERTION GUIDELINES
A1. HEALTHCARE PROBLEM
Indwelling urinary catheters in the hospital has been shown to be a patient safety problem.
Each year there are more that 449,334 Catheter-associated urinary tract infections affecting
patients in the hospital. Out of these numbers, at a minimum 13,000 urinary catheter deaths occur
in the United States. (Henry, 2017, p.22). This type of infection is top of the list of morbidity
and mortality rates; compared to other hospital acquired infections. The list consists of CVL,
central venous line catheters, surgical site infections, hospital acquired pneumonia. The
(CAUTIs) are approximately 40% of the hospital acquired infections. These CAUTIs occur
usually in the critical care areas of the hospital.
The Centers for Medicare & Medicaid Services (CMS) has researched the cost of the urinary
infections. Approximately, four hundred and twenty-four million ($424) to four hundred and
fifty-one million ($451) a year. The hospitals in the United States have reported the cost per
patient to be estimated at five hundred ($500) to seven hundred ($700) dollars. If the patient
adjunctly develops an organ system infection, the rates can be triple. The government has set
reimbursement guidelines for treatment of this condition. If and when the patient is admitted to
the hospital, develops a urinary tract infection from the use of a Foley catheter, the government
will no longer pay additional monies for the additional diagnosis related code.
The Centers for Disease Control and Prevention (CDC) has stated the urinary tract infection
as involving the following organs: kidneys, urethra, ureters, or bladder. The symptoms present

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EBP AND APPLIED NURSING RESEARCH: TASK 2 –
URNARY CATHETER INSERTION GUIDELINES
frequented by abdominal pain, fever, urgency in passing urine, blood in the urine, cloudy, smelly
urine, chills and shivering. The National Healthcare Safety Network and CMS use the CDC
definitions for the classification and scrutinizing of CAUTIs. The definition states a CAUTI is a
urinary tract infection that occurs in a patient with an indwelling urinary catheter in place for
more than forty-eight (48) hours. Specifically, a catheter inserted into the bladder, with a
connection tube to a drainage bag, closed collection system. They exclude supra-pubic catheters,
intermittent catheter insertion, nephrostomy tubes, condom catheters and ileoconduits.
Factors that contribute to the urinary infection could include: the age over 65, avoidable use
of the catheter, leaving the catheter indwelling for an extended period of time, female, using a
long-term dose of systemic antibiotics. If the catheter is no cleaned on a routine basis at the
meatal site, there is an accumulation of bacteria. The bacteria will then migrate up the catheter
tube from the urethra to the bladder. Inadequate hygiene in the hospital and the lack of isolation