Gould,
D., Gaze,
S.,
Drey, N.,
Cooper,
T.
Implementing
clinical
guidelines to
prevent
catheter-asso
ciated
urinary tract
infections and
improve
catheter care
in nursing
homes:
Systematic
review
2017
Systematic
Review
Cluster
Randomized
Meta-analysis
14 Long
term
care
facilities
Data and
reports of
CAUTI
incidence
from before
the study
and after
the study
III
B
The authors’
conclude that
there is a need
for CAUTI
prevention
guidelines to be
implemented in
long term
facilities. When
reviewing
previous
studies and
data, following
prevention
guidelines
resulted in
reduced CAUTI
rates.
Gupta, S.
S.,
Irukulla,
P. K.,
Shenoy,
M. A.,
Nyemba,
V.,
Yacoub,
D., &
Kupfer, Y.
Successful
strategy to
decrease
indwelling
catheter
utilization
rates in
an academic
medical
intensive care
unit
2017
Retrospective
Analysis
Multi-
variable
analysis
Quantitative
Meta-analysis
Descriptive
All
admitted
ICU pts
(20 bed
ICU)
from
January
2012 to
December
2016
Vibrant line
graphs that
correlate
incidence of
CAUTIs and
the
utilization of
IUCs.
Comparisons
of data
before and
after study
was
performed
III
B
Using a
multidisciplinary
approach, the
authors were
able to
implement an
effective protocol
including,
rigorous
assessments,
staff education,
and awareness to
reduce the rates
of CAUTI in their
ICU.
E. Recommended Practice Change
The popular conclusion amongst the authors is that indwelling urinary catheter utilization
and nosocomial infections are related. Of all hospital acquired infections, CAUTIs are a large
perpetrator. Among all the authors in the articles cited above, the intervention that is the most
mentioned and suggested is early removal. Other interventions include: proper assessment
C361
Task 2
8
prior to insertion, appropriate sterile techniques during insertion, and meticulous after care at a
minimum of 12 hours or after every bowel movement. By educating staff on IUC used an
appropriate placement, authors Wald, H. L. et al, were able to reduce catheter use in NICHE
hospitals by 16%. (Wald, H. L. et al., 2014). In another study by author, Underwood, L. suggests
that CAUTIs are a result of lack of follow up assessment and early removal. She was able to
observe a reduction of 19% over an 8 month period through early removal and daily
assessments.(Lindsay Underwood, 2015). Third author, Powers, J. supports the intervention by
researching data on appropriate sterile technique and after care. She was able to make the
observation that if interruption of the closed drainage system was necessary, aseptic techniques
should be adhered to to prevent the incidence of CAUTIs. (Powers, J., 2016) CDC guidelines
are the focal point of the next study. Authors Fink, R. et al, concluded that guidelines from the
CDC including, hand hygiene, integrity of sterile field, and appropriate use were being adhered
to in hospitals that participated in the study. However, there was room for improvement and
more observation to ensure enhanced compliance and prevention measures.(Fink, R. et al,
2013).Lastly the intervention noted by Dy, S. et al was the importance of collaboration between
