reassessing their patients for IUC removal at transfer to the hospital, admission, or shift change E Evidence supports that the adoption of a nurse led indwelling catheter removal guideline not only reduces indwelling urinary catheter days but in turn reduces CAUTI rates. My recommended practice change would be to have my facility adopt the removal guideline. In the first article by Chen, “One of the most important strategies to prevent CAUTIs is minimizing the time a urinary catheter is in place” (2013). The second article by Regagnin (2016) was focused on reducing CAUTI’s with the implementation of a 3 phase reduction process. The study concluded that CAUTI infection rates in the ICU’s and SDU’s were decreased to 0.9 and 1 UTI per 1000 catheter days respectively. The third article by Vega (2016) he concluded that there is one main modifiable risk factor when it comes to CAUTI’s and that is dwell time. In the fourth article by Zavalkoff (2015) the study was conducted in a pediatric intensive care unit where their CAUTI rates were above the 90 th percentile. They hired a clinical champion and compared infection rates. The champions first policy was to do daily rounds to determine continued necessity of the catheter. The author concludes that a safety champion can reduce catheter rates. In the fifth article by Viswanathan (2015) where emergency department staff comprised of nurses, physicians, and midlevel providers and were surveyed to access knowledge, attitude and
Task 2 practice when it comes to indwelling urinary catheter use. In total 129 medical professionals were surveyed and were asked to rank their answers on a 5-point Likert scale. The author concludes that despite appropriate knowledge on use of indwelling urinary catheter’s, emergency department nursing is not up to date with standards of care and best practice. F1 The first stakeholder to get involved in the decision to implement a nurse led indwelling catheter removal guideline would include my unit manager. I would present my research and evidence that proves that this guideline reduces the incidence of CAUTI’s. Then gain her permission on implementing this protocol. The second stakeholders to get involved would be the floor nurses. They would need education on the new protocol, and the current research that proves we are an important asset in protecting our patients. A third stakeholder to get involved would be my hospitals infection control nurse. After presenting her with the research and showing her how this benefitted my unit then a hospital wide guideline could be implemented. F2 Barriers that may be encountered maybe pushback from nurses themselves being resistant to change. They may think the way things have been done for the past however many years they have been a nurse can’t be improved on. Another barrier that may arise would be pushback from physicians. They may not like nurses taking the initiative to act without a specific order from them.
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- Spring '18
- Nursing, urinary tract infection, Catheter, Urinary catheterization, Foley catheter, urinary catheter