Running head: Evidence Based Practice Task Two Nursing Science1Evidence Based Practice Task Two Nursing ScienceHarrisEvidence Based Practice C361February 7, 2017
Nursing Science2The topic chosen is reducing catheter associated urinary tract infections. The problems associated with these infections spreads beyond the infection itself as most healthcare issues do. A patient that requires a catheter for monitoring of urinary output related to another comorbidity such as retention, wounds, or illnesses that require close monitoring of urine output, are often already immunocompromised. This fact makes them more susceptible to infection. The UAP which are typically responsible for perineal and catheter care are at times under educated on the importance of proper catheter care, not to mention just as nurses are often short staffed, UAP can also have this issue. When short staffing is an issue, shortcuts are taken, and even if catheter care is performed proper technique and thoroughness of care may be lost. There have been many advances that are aimed at reducing risk for infection, including new catheters coated in silver, alert systems for staff indicating the need for removal, facility policies and protocols for removal, and continued aims at education of nurses, doctors and UAP. The cost of treating a CAUTI is not being reimbursed by insurance as this is the case with any infection that may be deemed preventable. Urinary catheters in the acute care setting are a necessity, the issue that is most frequently associated with CAUTI is the length of time that they remain in place. As it relatesto many units in a hospital the need for a catheter is quickly eliminated, for example a simplesurgical procedure that does not require an extended stay will not likely contribute to the incidence of infection, or a labor and delivery/ mom baby unit is not likely to have much contribution. However almost every other floor in an acute care facility will have patients that require catheter insertion and the length of time they remain in place could greatly vary. The Joint Commission has identified timely removal as less than 30 days.
Nursing Science3In beginning research the terms searched included keywords such as CAUTI, randomized control trials, quasi experimental, and early removal of urinary catheter. There were nine hundred results available that ranged from current facility protocols, practice guidelines education, expert opinions, along with several that met the criteria. Some of the available articles had to be eliminated due to the date limitations provided. I viewed twenty-five articles to include several on expert opinion education. One such article was one that focused on alternatives to catheters, it was eliminated due to the fact that the study was narrowed to trauma surgical patients. Another was an article that used much of the same criteria that several articles used it was however too old to be included. The elimination of the level IV