frequently place indwelling catheters but there are times when the need arises that we must place a foley catheter for traumas or acute urinary retentions that require medical intervention. Utilizing my nursing manager, I would discuss with her how our department plays a role with preventing CAUTIs for our hospital. While the placement of an indwelling catheter may be unavoidable at times, it is still a device that would need to be managed during the course of the patient’s treatment and having an automated stop order that would follow the patient throughout the hospital would be vital in decreasing our overall CAUTI incidences as well as promoting a multidisciplinary approach to infection management between different departments.As such, the nursing supervisor can help implement this change within different departments and help facilitate a change in nursing culture to identify potential CAUTI risks and utilize evidence-based practice to decrease those risks. The nursing supervisor can also help provide education and act as a resource to nurses within different departments on how to interact and manage the stop order.Lastly, the medical director would be in contact with the software development team for our hospital and can help facilitate the stop order to auto-populate should a healthcare provider select the order for an indwelling urinary catheter. F2. Barriers to ImplementationOne barrier I may encounter is the fact that some nurses would not feel comfortable removing the catheter and may keep it in place while disregarding the stop order. Secondly,
8another barrier to this practice change is if patients request for the catheter to remain in place past the recommended timeframe. Both of these barriers directly impede the goal of removing the urinary catheter as soon as possible to prevent CAUTI incidences.F3. Strategies to Overcome BarriersOne strategy to overcome the first barrier is to provide education to nurses regarding howto utilize the stop order to provide best patient care as well as discussing the purpose of discontinuing the indwelling catheter with evidence-based practice to expand their knowledge. Another strategy to overcome the second barrier is focusing on patient-nurse engagement and providing patient education on infection risks and the best practice of removing the catheter to help manage their hospitalization with provider support.F4. Measuring OutcomeOne indicator to measure the outcome of the recommended change practice is to measure the incidences of CAUTIs after a 4 month period of utilizing this stop order post insertion 7 days.In measuring the outcome, we can have statistical differences between CAUTI incidences prior to an automated stop order in comparison to CAUTI incidences utilizing an automated stop orderfor our hospital.
9ReferencesDurant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: A systematic review. AJIC: American Journal of Infection Control, 45(12), 1331–1341.