CAUTI Paper

Author

McCoy, C., Paredes, M., Allen, S., Blackey, J., Nielsen, C., Paluzzi, A., Radovich, P. (2017).

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Qualitative study

Aim of Article/Paper

The aim of the paper is to come up with preventions strategies towards Catheter Associated Urinary Tract Infection within the inpatient oncology population by implementing part of the evidence based nurse driven protocol used in the discontinuation of the indwelling urinary catheters.

Conceptual Framework (if any)

The conceptual framework is based on the findings from the literature review which has openly demonstrated that ensuring staff education is very fundamental to the CAUTI prevention and also ensures a reduction of the IUC duration. 

Study Design &

Method

●       The study conducted a literature review that analyzed 45 articles on the said topic.

●       From the selection, eighteen articles were not used on the ground that there was poor research done and the quality or relevance of the article was also low in respect to the clinical question.

●       All the articles used during the literature review were based on the development of the protocol in levels I and III which as ranged from good to high quality.

Population/

Sample/ sample size

Setting

Since the study methodology was based on a literature review of previous done studies there was not population sample.

Major Variables and their definitions

CAUTI rates:  being able to come up with a particular number of infections in regard to the number of urinary catheter line days, multiplied by 1000, it is important to mention that the CAUTI rates are often mentioned per the catheter days.

Measurements/

Instruments/

Tools

Knowledge of Inpatient Oncology team:  the study made use of a survey to check level of knowledge they had on CAUTI.

Understanding institutional policies:  it was also important for the study to investigate the role that institutional policies play in the current application in the management of CAUTI.

Data Analysis

The study analyzed the implementation of compliance strategies which showed the need collaboration between different professional in regard to lack of reduction in the IUC days.

Findings

●       There was a significant presence of nurse knowledge on the compliance with guidelines towards the CAUTI procedures.

●        There was however lack of understanding on the IUC related complications among other healthcare providers with affected the outcome.

Study limitations:

●       Data was not reliable since it was a literature review and no primary data was collected.

●        

●        

Appraisal:

Level of Evidence

Quality

Author

Mori, C. (2014). A-Voiding Catastrophe: Implementing a Nurse-Driven Protocol;. Medsurg Nursing, 23(1), 15-28.

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Quantitative study

Aim of Article/Paper

The main aim of the paper was to provide an evaluation of the effectiveness of the nurse-driven indwelling  Urinary catheter removal protocol in an acute care setting.

Conceptual Framework (if any)

The conceptual framework was on Donabedian rational of assessing the organizational procedure and policy structure.  This was also used to implement a workable urinary catheter policy regarding removal within the particular structure. In the end it is expected that this will produce a positive outcome in relation to prompting the catheter removal and the catheter needs assessment.

Study Design &

Method

●       The study made a retrospective chart review for measuring the prevalence of the catheter usage dwelt time.

●       It also measured CAUTIs before and after implementation.

●       Tabulation was done for indwelling catheter.

●        The sum were divided by patient days X 100 to get the percentage and total tabulation was done.

●        The number was CAUTI was then multiplied by 100 to get the percentage of the CAUTI.

Population/

Sample/ sample size

Setting

The sample was collected from 150 bet community hospitals from mother united states.

Major Variables and their definitions

CAUTI rates:  this was measured by the percentage.

Measurements/

Instruments/

Tools

Prevalence of catheter usage- done by the new measuring the percentage.

Use of retrospective chart review and computer database:  this was important in reviewing the patient demographic information.

Data Analysis

This was done through reviewing the computer database and calculating the prevalence catheter usage.

Findings

●       There is relevance in using the nurse driven protocol as a way of reducing the incidents of  urinary cauterization to reduce incidents of CAUTI

Study limitations:

●       Lack of  a nurse driven protocol saw a reduction of duration on use of indwelling catheters

●        

Appraisal:

Level of Evidence

Quality

Author

Ferguson, A. (2018). Implementing a CAUTI Prevention Program in an Acute Care Hospital Setting. Urologic Nursing, 38(6), 273. doi:10.7257/1053-816x.2018.38.6.273

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Qualitative study

Aim of Article/Paper

This paper aimed at implementing an interactive CAUTI prevention educational program through two main units in regard to an acute nurse knowledge by looking at the appropriateness if the indwelling urinary catheter care. The paper also looked to find ways of reducing the incidences of CAUTI experience in respect to patients.

Conceptual Framework (if any)

Study Design &

Method

●       The study made use of a Pre/past study design in assessing the knowledge of nurses on indwelling urinary catheter care and the incidences of CAUTI in each unit.

●       The study made use of two units within a 393 bed acute care hospitals which were also selected on the basis of high rates of the CAUTI.

●        

Population/

Sample/ sample size

Setting

The sample size consisted of unit nurses in a one hour interactive, multifaceted CAUTI prevention. The sample consisted of 53 nurses.

Major Variables and their definitions

Knowledge assesment, acquisition of skills and the demonstration of competency.

Measurements/

Instruments/

Tools

Knowledge of the prevention Methods:  In this study, the issue of education was important and began with the presentation of the research team and the development protocol at the staff meeting. The study also included various case studies that engaged the bedside oncology nurses in viewing this through the evidence based IUC indication in addition to the nurses driven removal protocol. Also education is addressed in the IUC care component including the new charting requirement. 

Also Read : Nursing Writing Services

Data Analysis

Data was analyzed through a paired t test which significantly informed the knowledge of nurses through a summary score across the three knowledge subscale scores.  The CAUTI rates were observed declining to zero from 7.49 and 1.56 from 4.12.

Findings

The study was very consisted with the evidence base literature as it demonstrated an interactive, multifaceted CAUTI prevention education program which can help in increasing the knowledge of nurses in the most appropriate and indwelling urinary catheter care and incidence decrease of CAUTI in regard to hospitalized patients.

Appraisal:

Level of Evidence

Quality

Author

Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012). A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter-Associated Urinary Tract Infections. Urologic Nursing, 32(1), 29. doi:10.7257/1053-816x.2012.32.1.29

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Qualitative study

Aim of Article/Paper

.

The aim of the study article was to make an evaluation of the current literature to investigate on the best’s strategies in reducing the length of time for the placement of catheter, the effects of strategies in regard to the duration and removal of catheters. It also looked at the incidences regarding the CAUTI

Conceptual Framework (if any)

Study Design &

Method

The study methodology was based on a review of electronic articles where a search was made using selected key words from 53 abstracts which were then appraised.  From the study, only 9 of the searches were found to be focusing on the reduction of the duration of the use of catheter and the incidences of CAUTI.

Population/

Sample/ sample size

Setting

Non since the paper was based on literature review of electronic articles

Major Variables and their definitions

CAUTI incidences: the paper investigated the evidence in regard to the reduction of the use of catheter.

Measurements/

Instruments/

Tools

Literature review

Data Analysis

●       This was done through a review of each literature then a discussion was made on the different literature supporting the project aim.

●       Data ways also analyzed by looking at the nursing led interventions and the informatics led interventions.

●       Discussion and conclusions were then made in regard to the different studies.

Findings

The study supported the informatics and the nurse led interventions in ensuring a reduction of the length of incidences of CAUTI and catheterization of the CAUTI.

Limitations

There was not specific interventions which clearly superior that the other.

Since this was a literature review based study, it is possible that the data was not reliable.

Appraisal:

Level of Evidence

Quality

Author

Andrade, V. L., & Fernandes, F. A. (2016). Prevention of catheter-associated urinary tract infection: implementation strategies of international guidelines. Revista Latino-Americana de Enfermagem, 24(0). doi:10.1590/1518-8345.0963.2678

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Qualitative study

Aim of Article/Paper

This research is meant to come up with different research strategies that healthcare professionals can use in regard to the implementation of the Center for Disearch control and prevention guidelines when it comes to the prevention of catheterism related urinary tract infection.

Conceptual Framework (if any)

The conceptual framework was based on the review of literature which informed the researchers that there was a high level of evidence regarding the matter being investigated.  The evidence was also divided to three important levels which was able to show continued validity regarding the problem resolution.

Study Design &

Method

●       The study was conducting through a systematic literature review in respect to the data from CINAHL. Other data came from Cochrane plus collection, Nursing and allied health collection, Mediclatina, Academic search complete, MEDLINE(r), Science direct, Nursing reference centre, willey only library. There was an also as sample of 13 articles that were selected.

●       As part of the research strategy, the research made use of different health descriptors that include infection, urinary tract, and catheter and nurse.  These descriptors were used in finding answers to the research aim, it was also important to find out how the nurses operationalized the center for disease and control recommendations in the intervention and praxis on CAUTI prevention.

Population/

Sample/ sample size

Setting

The study was based on a literature review meaning there was not sample that was collected apart from the literature review used.

Major Variables and their definitions

CAUTI rates:  This looked at the evidence of the major cause of increase rates of urinary tract infections and the prevention measures, looking at the ways that this has reduced the infections. The literature enabled the researcher to learn more about the best practices regarding the rates of infections.

Measurements/

Instruments/

Tools

The prevention mechanism: the study looked at the different prevention mechanism applied in different situations and ways that this reduced the rate of infection.

Data Analysis

The analysis was based on finding the different strategies that nurse’s use on responding to catheter related urinary tract infection. Literature from different studies was selected and analyzed based on the issue of prevention and control and ensuring that there is the improvement of safety for the individual that is looking for better health services using this technique.

Findings

●       The studies have actually shown that there is a reduction of the urinary tract infection in regard to catheterism using the reminder systems in decreasing in terms to individuals that submitted to urinary catherism, also this audits on bundles of expansion and nursing professional practice.

Study limitations:

●       The major limitation was that data was no primary meaning that some of the information could be unreliable.

●        

●        

Appraisal:

Level of Evidence

Quality

Author

Meddings, J., Saint, S., Krein, S. L., Gaies, E., Reichert, H., Hickner, A., Mody, L. (2017). Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. Journal of Hospital Medicine, 12(5), 356-368. doi:10.12788/jhm.2724

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Qualitative study

Aim of Article/Paper

The aim of this study is to provide a review of strategies that are used in the reduction of Urinary tract infections within the nursing home residents.

Conceptual Framework (if any)

The conceptual framework comes from the analysis of 20 records that discuss 19 interventions. This included 10 pre-post non-randomized interventions, 8 randomized controlled trials, and 1 non-randomized intervention that has concurrent controls.  The outcome definition also greatly varied. There were also thirteen strategies   that were employed in the reduction of catheter use and the improvement in regard to the care of catheter. There were also nine studies employed in regard to the general infection and strategies for prevention.

Study Design &

Method

●       The study methodology is based on a systematic review of literature from various medical source databases including Cochrane Library, Ovid MEDLINE, CINAHL and web of science.

Population/

Sample/ sample size

Setting

Since this study is based on a literature review on various source based on the study aim.

Major Variables and their definitions

CAUTI INCIDENCE:  The study conducted a review of various incidence of urinary tract infection caused by the catheter. It also looked at the different measure that health institutions take in prevention of the incidences.

Measurements/

Instruments/

Tools

The management of catheter related urinary tract infection:  the study looked at the different forms of managing catheter infections in hospitals which is applied in different rates of infection.

Data Analysis

The data analysis was done from the reviewed literature. Where the presence of CAUTI reduction was recognized and there were also nine studies which indicated reduction of UTI and reduction of bacteriuria.

Findings

Study limitations:

●       The study actually indicates that  various medical practice an actually see the reduction of UTI or CAUTI among the nursing home residents  like reduction and the improvement of catheter  use, improvement of hygiene, enhanced barriers to precautions among other factors.

●       The main limitation in the study was lack of collection of primary data as a way of verifying existing studies.

●        

Appraisal:

Level of Evidence

Quality

Author

Henry, M. (2018). Evaluation of evidence-based practice of catheter associated urinary tract infections prevention in a critical care setting: An integrative review. Journal of Nursing Education and Practice, 8(7), 22. doi:10.5430/jnep.v8n7p22

Type of Article/Paper

(EB guideline, systematic review, RTC, case study, etc.)

Qualitative study

Aim of Article/Paper

This article is based on the estimate 449,300 catheter associated tract urinary infection (CAUTI) incidents that affect patients in the united states and 13,000 CAUTI related deaths each year in the united states.  The main aim of this article thus was to provide an appraisal and integration regarding evidence based practice in the prevention of CAUTI intervention strategies to advice on the safety and quality related initiative in ensuring the improvement of patient care.

Conceptual Framework (if any)

The framework is based on conducting literature searches which the author conducted using the cumulative index in relation to Nursing an Allied Literature (CINAHL), PubMed database, Embase where the researcher explored various interventions in the prevention of CAUTI in regard to nursing practice as a way of ensuring the integration of best evidence based practices on the strategies used in the prevention of CAUT and improvement on the type of care given to the patient.

Study Design &

Method

●       In the study the researcher used a total of 20 articles which were compiled on the basis of inclusion an exclusion criteria.  The articles were also taken under study and the chosen articles were was done in regard to two areas: nurse education, improvement of knowledge and the CAUTI prevention.

Population/

Sample/ sample size

Setting

The study was based on the systematic review of literature.

Major Variables and their definitions

Nurse education:  the study investigated whether nurses with more knowledge and experience in CAUTI prevention were more likely to produce more results in terms of prevention than nurses without.

CAUTI prevention:  the paper looked at the issue of intervention and prevention practices.

Measurements/

Instruments/

Tools

CAUTI Prevention strategies: the study looks at different mechanisms used by medical practitioners as part of best practices towards prevention of UTI and CAUTI.

Data Analysis

The study articles selected were reviewed by the research and encompassed a review on the articles that provide the most relevant information in regard to catheter associated UTI and nurse competency.

Findings

The study indicated that there was potential lack of nurse’s compliance in regard to the prevention of CAUTI infection and control which is a problem in the nursing practice.  Thus to reduce CAUTI rates prevention is better than management.

Study limitations:

●       The paper is a systematic literature review which provide evidence based practice so there was no limitation.

●        

●        

Appraisal:

Level of Evidence

Quality

Were the study patients similar to my patients of interest?

 Yes        No        NA

Were all patient-important outcomes considered?

 Yes        No        NA

Were patient safety variable considered?

 Yes        No        NA

Were the outcomes objective and unbiased?

 Yes        No        NA

Are the likely benefits worth the cost & potential risk?

Yes         No        NA

How do the results fit with previous research in this area?

Yes         No        NA

Can the study be replicated at my facility?

Yes        No        NA

Are the results applicable to my patient population?

Yes        No        NA

Can I use the results in managing my patients?

Yes        No        NA