TranslatingEvidence into Practice
TranslatingEvidence into Practice
Thisresearch paper seeks to find ways of preventing catheter-associatedurinary tract infections (UTI). To help achieve this objective, thefollowing is the primary PICOT question to be answered:
Inadult hospitalized patient with Foley catheter (P), does the use ofthe aseptic technique by nurses during Foley catheter insertion (I),help prevent or lower the number of infections (O), compared to usualstandard (C) for the period of six months (I)?
Thisquestion is important in nursing practice, as it will show ways thatcan be used to ensure maximum healthcare and results especially forhospitalized patients who are more prone to developing urinary tractinfections. As stated earlier, the problems of healthcare cost,quality of treatment, and the safety of patients are vital in nursingpractice.
Theresults from a study conducted by Ellingson et al. (2014) show thathand washing with soap and water will go a long way in preventingCAUTI. This is in comparison with the use of hand sanitizers alone,which is less effective in preventing CAUTI. This is just one way toensure that this problem is solved. However, to ensure acomprehensive practice, several issues and methods for safety willhave to be included.
Personssuffering from UTIs are not up to their full potential in terms oftheir productivity. This is because their daily living is limited dueto the pain they endure. Treatment of UTIs is costly as it can resultin prolonged hospital stay, morbidity, and in some instances, evenmortality. It is, therefore, essential to ensure that healthcaregivers give their maximum care and attention to reduce such cases andgreatly prevent them.
Thisstudy seeks to show that aseptic techniques used in the handling ofUC can greatly maximize positive results and reduce CAUTI cases orprevent them altogether. Proper educational guidelines offered todoctors and nurses will ensure that cases of carelessness, forexample, long periods of UC indwelling, can be prevented. Knowledgeis power, and with the correct kind of information, it is easy todistinguish practices that help and those that worsen situations.
Handwashing is a personal technique. When a person prevents himself orherself from acquiring infections, this may prevent another personfrom acquiring such infections too. Hand washing with soap and water(not with antiseptics alone), before inserting a UC, and properhandling of the UC will go a long way in preventing UTIs fromoccurring.
Thestudy shows that where proper education in UC management is in place,CAUTI cases reduce considerably and in most cases, they are evenprevented. Whereas there are many factors that cause or contribute tocause CAUTI, proper education has been identified as the one way thatcould ensure decreased rates in CAUTI. A caregiver needs to realizethat the risk of CAUTI begins from the initial step of inserting theUC and the care given thereafter. This will ensure responsibility ofthe caregiver to the patient and hence prevent mistakes or neglectthat could occur in UC management.
Educationon proper UC insertion and removal goes a long way in the reductionof CAUTI cases. Underwood (2015) proved that teaching nurses theproper catheter insertion technique, daily assessment, and care canhelp reduce the CAUTI rate. A study conducted by Underwood (2015) ineducatingnurses on Foleycatheter insertion technique, its maintenance, and care resulted in a19% reduction in CAUTI cases.
Theuse of the aseptic technique by nurses has gone a long way inpreventing, or rather, lowering the number of UT infections. This isbecause proper educational procedures were provided on how to insertand remove the CT while utilizing aseptic techniques.
Thestudy by Fakih et al. (2010) that looked into creating guidelines andeducation on CT insertion and education showed that according to theeducational intervention that was conducted, there was a remarkabledecrease in CAUTI related causes. This was because the educationoffered guidelines into insertion and removal of UCs and the properutilization of aseptic technique. This led to a more informed doctorsand nurses and the practices now used ensured maximum care andprotection of a patient hence the reduction of UTIs.
Theexperimental study by Renagin et al. (2016) supported the notion thatusing aseptic technique lowered the number of cases of UT infections.Their study was supported by evidence in the reduction of CAUTIinfections from 7.0 to 0.9 infection rate per 1000 patients. Thisgoes on to show that proper education with regards to catheterinsertion and removal, monitoringinappropriate use of the UC and removal its removal as soon as it wasnot needed could sustain and even decrease the rate of CAUTI.
Thereis, basically, and as studies have shown, a direct relationshipbetween educational guidelines with regards to UC cases and areduction in CAUTI cases. Accordingto CDC (2016), whenhealthcare providers are trained to know that the risk of infectionstarts once the UC is in place, they will do more to control UTI,which will lead to a decrease in CAUTI in all hospitalized adultpatients. This shows that education for enhancing and ensuring safetyand encouraging maximum healthcare will go a long way in preventingCAUTI.
Inasmuchas education guidelines were offered, all healthcare professionalsinvolved with a particular patient will need to work together and beon the same page. Negligence of one individual could result in morecases of UT infections. Sax et al. (2016) have supported thisargument by stating that the major risk factors of CAUTI are causedby the prolonged indwelling of the UC. CAUTI causes more problems foran individual like prolonged hospital stay. This means more expensesfor the patient and can or may even result in death.
Aseptictechnique is easy to follow once it has been put in place. This isbecause it is a very routine procedure. Routines make it easier forsomeone to remember particular steps involved. Inserting and removingthe UT catheter is a routine that a nurse or any other caregiver caneasily follow. With proper educational guidelines in place, theconcerned caregivers will ensure that patients never suffer as aresult of CAUTI and in the same way, reduce the inappropriate use ofUC.
Usinghard evidence, I would present my case to my colleagues and encouragethem to use this aseptic method to try to curb CAUTI. This willresult in offering comprehensive healthcare. Should I be met withopposition due to the changes in practice, I would use my work andthe results as an example to show how aseptic method works andhighlight its positivity. I am certain the number of CAUTI relatedcases involving patients I am directly handling would reduceconsiderably when applying this method. Positive results speak morefor themselves than any other form of convincing, which is why, Iwill have to manage resistance to adopt my method by showing theresults of the method.
Centersfor Disease Control and Prevention (2016). Catheter-associatedUrinary Tract Infection (CAUTI) Toolkit.Retrieve from http://www.cdc.gov/HAI/pdfs/toolkits/CAUTItoolkit_3_10.pdf
Fakih,M., Pena, M., Shemes, S., Rey, J., Berriel-Cass, D., Szpunar, S., &… Saravolatz, L.
(2010).Effectof establishing guidelines on appropriate urinary catheter
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Regagnin,D. A., da Silva Alves, D. S., Cavalheiro, A. M., Camargo, T. Z., S.,Marra, A. B., da Silva Victor, E., &Edmond, M. B. (2016).Sustainabilityof program for continuous reduction of catheter-associated urinarytract infection. American Journal of Infection Control,44(6), 642-646.doi:10.1016/j.ajic.2015.11.037
Sax,H., Kuster, S. P., Tehrany, Y. A., Ren, R., Uçkay, I., Agostinho,A., & … Pittet, D. (2016). Eight-yearsustainability of a successful intervention to prevent urinary tract infection: A mixed-methods study. AmericanJournal Of Infection Control, 44(7), 820-824 5p. doi:10.1016/j.ajic.2016.01.013
Underwood,L. (2015). TheEffect of Implementing a Comprehensive Unit-Based Safety
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