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Evidence based practice in nursing
Evidence based practice in nursing
Evidence based practice in nursing
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The topic that I chose is interventions used to reduce catheter associated urinary tract infections(CAUTI). This type of infection is acquired from the use of urinary catheter while in the hospital. According to the Institute for Healthcare Improvement, urinary tract infections are responsible for 40 percent of all hospital-acquired infections annually, with 80% of these hospital acquired infection caused by use of indwelling urinary catheters. When any type of tubes or catheters are introduced in the body it serves as a medium for infection. Urinary catheters are used during surgery to prevent injury to the bladder. It is also used for urinary retention or bladder obstruction. The implementation of evidenced based practice when providing care 2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
BioPatch, and alternatives like Tegaderm CHG, are an important first step in helping prevent catheter-related bloodstream infections (CBIs). As CBIs rank among the most frequent and potentially lethal nosocomial infections, the need for a device to cut down infections at the insertion site has increased. The growing numbers of infections has driven companies to consider a three-tiered approach: a maximal aseptic barrier at insertion, proper site maintenance, and hub protection. With BioPatch and alternative products catheter sites receive that maximal aseptic barrier to prevent bacteria growth.
5), many hospitals in conjunction with the Joint Commission's 2012 National Patient Safety Goals has been rallying for hospitals to use evidenced-based practices (EBP) to the prevention of CAUTIs because evidence is growing showing that many are avoidable. Such practices such as utilizing a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter to determine how long a patient should have an indwelling catheter and when to discontinue it. Several factors have been identified that pose as risk factors to CAUTI which include but not limited to drainage bag not being below the level of the bladder, healthcare personnel not practicing standard precautions and utilizing aseptic techniques during insertion of catheters, unsterile equipment, and unnecessary placement of urinary
The Foley Catheter has allowed for people to excrete their urine. Not being able to excrete your urine can cause higher chances of urinary retention, not being able to empty your bladder completely, Urinary tract infections, your bladder will fill up until it bursts open inside your body, and you won’t get rid of the waste and excess water
The key to conducting successful clinical research involves five steps. These steps are: “asking answerable clinical questions, searching for the evidence, critically appraising the evidence for its validity and relevance, making a decision by integrating the evidence with your clinical expertise and the patient’s values, and evaluating your performance” (Heneghan, & Badenoch, 2006, p.2). To develop my research question I used the evidence- based model PICO. PICO stands for: P ( Problem: high infection rate by the spread of bacteria in ICU), I (Intervention: hand washing with soap and water or the use of hand sanitizer), C (Comparison: the use of gloves, gown, mask), O (Outcome: reduction of infection due to the spread of bacteria). With these elements as refrence I formulated the question: Is the use of soap and water or alcohol-based rubs more effective than the use of protective gear (gloves, mask, ...
The goal was chosen, background obtained, literature review done, methods established, and implications for nursing practice reviewed. They wanted to implement one-on-one discussions with bedside nurses related to behavioral justification for restraint use, use of least restrictive restraint, and prompt removal when clinically justified, along with coordination of information-sharing with nursing leadership to promote a data driven approach to reduction in restraint usage. Outcomes were that as a result of monthly discussions, there was a sustainability of reduction in usage of restraints in the adult ICU’s. Another initiative was the nurse driven urinary catheter removal protocol. The goals were to reduce catheter associated urinary tract infections through early removal of indwelling urinary catheters and increase compliance to the Surgical Care Improvement Measure Urinary Catheter Removal through a nurse driven protocol that standardizes care and sanctions catheter removal based on approved criteria. A pilot was conducted at two hospitals to assess efficacy of implementing the plan system wide. A plan was developed with interventions, a urinary catheter removal algorithm, and documentation compliance parameters. Outcomes were lower catheter days and reinsertion rates, decreased catheter utilization ratio, and infection rates
In this section the researchers explain the complications that can occur based on non-adherence to a proper self-catheterization regimen. A spinal cord injury can cause an interruption in neural pathways which affect the function of the bladder causing urinary incontinence, urinary retention, urinary reflux, and recurrent urinary tract infections. These problems can ultimately lead to an increase in renal morbidity and mortality (Shaw & Logan, 2013) Later, in the discussion section of the article, the authors focus on the importance of nursing education to teach patients proper methods to perform and cope with ISC in order to eliminate these common occurrences in patients suffering from SCIs (Shaw & Logan, 2013). The perception of performing this task may vary from patient to patient. This research helps identify various educational approaches that could be taken to accommodate all patients. Therefore, the research is significant to nursing due to the fact that nurses are considered the primary educators and are expected to address practical issues with patients performing ISC and help them manage the psychological issues that are faced with this
• Keep the skin around your catheter clean and dry and check every day for signs of infection. Check for:
Hospital-acquired bladder infections. These infections, occur in people in a medical care facility, such as a hospital or nursing home. Most often they happen in those who have had a urinary catheter placed through the urethra and into the bladder to collect urine, a common practice before surgical procedures, for some diagnostic test, or as a means of urinary drainage for older adults or people confined to bed.
Urinary incontinence is a common problem that is often under reported due to the embarrassing nature and social stigma attached. (Berman et al. 2003) It is classed as chronic disease which can pose a serious social problem. Kinchen et al. (2007) has carried out extensive research which shows that women in particular take a long time to report their symptoms. Urinary incontinence can have a considerable effect on an individual’s quality of life – but can be significantly improved with correct assessment, treatment, and management.
Therefore, implementing evidence-based knowledge focused on arriving at positive goals for better patient outcomes should be a priority. Additionally, if nurses are to decrease the incidences of central-line infections, then hospitals need to be focused on prevention through clinical reasoning and preventive action. It is the responsibility of nursing care to provide the best care possible and to follow infection control standards.
A urinary tract infection is a very common infection that can happen to anybody. A urinary tract infection usually occurs when bacteria enters the urethra and multiples in the urinary system. The Urinary tract includes the kidneys, the thin tubes that carry urine from the kidneys to the bladder (ureters), and the main tube that carries the urine from the bladder (urethra). Women, men, and children are all immune to this infection. Women have the highest chances of getting it. In the Urinary tract, the main links of the ureters help get rid of any bacteria that tries to enter the urine, and the bladder helps prevent urine from backing up into the kidneys.
The purpose of this paper is to provide research to support that infection, with urinary catheter use, is an ongoing issue, in many hospitals. Carter et al., 2014 defines a urinary catheter as an indwelling tube that runs through the urethra and into the bladder allowing for the passive drainage of urine from the bladder. A balloon at the inner end of the catheter is inflated with sterile water to hold the catheter in place. Catheterization is a sterile procedure, which if broken, could compromise the patient; however, catheter insertion may not be the only problem contributing to hospital-acquired infections. Studies have shown that indications for catheter use may not be medically necessary, also putting the patient
A catheter is a long and narrow tube that is inserted through the urethra and into the urinary bladder. Under healthy conditions the inside of a urinary bladder is clean and sterile. Bacteria normally tend to hang around the urethra, but no harmful bacteria or any other type of microorganism that can be found in the bladder, and there is no way that they can enter the bladder. During a procedure when a catheter is inserted into a patient, bacteria can be picked up by the catheter and taken inside the bladder which can cause an infection. This type of contraction is the most common to occur in patients. Another way in which a UTI can occur is from a fungus, Candida. This mostly affects patients whose immune system is not in the best working condition, therefore putting them at risk. The continuous use of antibiotics has an effect on weakening the immune system which then harbors this fungus.
The author of the research study used a standardized test to determine the knowledge of ICU nurses on surgical site infections. The introduction allowed the readers to realize there is a country wide issue with surgical site infections (SSI). During the research, the quantitative approach was attempted by having a group of nurses take a multiple choice knowledge test consisting of three possible answers and the fourth choice of being I do not know. The test consisted of questions based on prevention guidelines. The group of 809 nurses attending the Flemish Society for critical care nurses were included in the study. Although, the test was timed the questions were reviewed by seven experts to determine the clearness of the questions. Statistics
For this discussion post, I decided to research urinary tract infections. I chose this topic because at the assistant living I work at, there is quite a few residents that suffer from this. And I believe its always good to have more knowledge with something that is more common to us. The medication that is most common used to UTIs is amoxicillin. Amoxicillin is a medication that is used to treat most infections caused by bacteria. Amoxicillin acts through the cell wall then leads to the death of the bacteria. However if the patient is allergic to any penicillin, this medication is a no. Some side effects to this medication would be headache, stomach pain, vomiting and/or vaginal pain.