Shannon Ludwig Evidence-Based Practice & Applied Nursing Research Task 2 A. Urinary catheters are frequently used for patients in hospital settings. They are utilized to relieve urinary retention and urinary incontinence. Although these devices were originally designed for short-term use, urinary catheters are now frequently used in the long-term setting. The most significant complication related to urinary catheters are catheter-associated urinary tract infections (CAUTIs). CAUTIs pose a significant problem to both the patient and care facility, resulting in longer hospital stays and increased medical costs. Costs for treatment of CAUTIs include antimicrobial therapy, increases in length of stay during hospitalization and more frequent physician visits. Symptoms of CAUTI range from mild (fever, cystisis) to severe (acute pyelonephritis, bacteremia). Left untreated, these infections can lead to urosepsis and death. Current practice related to CAUTI prevention includes both decreasing the use of indwelling catheters and preventative measures when an indwelling catheter is required. Alternatives to indwelling catheters include condom catheter, intermittent straight catheterization, and suprapubic catheters. The most effective preventative measure to reduce the risk of CAUTI is removal of the catheter as soon as medically possible, so current practice includes reevaluating need on a regular basis. Insertion is done using aseptic technique by qualified personnel, and hand hygiene is performed before and after touching or manipulating the catheter tubing or drainage system. Best practice currently includes maintaining a closed drainage system and replacing system after any breaks. Routine care consists of scheduled perineal care and emptying collection bag at predetermined intervals.
CAUTIs effect both the organization and the patients. There are increased medical expenses for both the patient and the organization due to longer hospital stays and the need for antibiotic therapy. Patients may also have the additional burden of loss of ability to work for an extended period, which can contribute to financial strain. If there is an associated increase in the length immobility, this may affect the patient’s rehabilitation and mental status. There are no obvious affects to the patient’s cultural background in relations to CAUTIs. B. The databases used in the research process were PubMed, CINAHL, and Google Scholar. The key search terms used were “CAUTI prevention”, “CAUTI prevention non research”, “CAUTI bundling” and “indwelling urinary catheter”. The search was then limited to articles that were published in the last 5 years. The articles chosen were all peer reviewed and were chosen according to their credibility, significance, and applicability to the PICO question.
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- Spring '19
- urinary tract infection, Catheter, Urinary catheterization