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Review of literature on urinary tract infection
Review of literature on urinary tract infection
Review of literature on urinary tract infection
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Recommended: Review of literature on urinary tract infection
Running Header: Literature Evaluation
Literature Review
Literature Evaluation
Christy Armes
American Sentinel University
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Literature Evaluation
A 2002 estimate by the Centers for Disease Control and Prevention (CDC) found that urinary tract infections were the most common health care associated infections (HAI?s). These infections account for >30% of HAI?s (CDC, 2009). The CDC further estimated the number of attributable mortalities at >13,000. CAUTI rates have increased from three percent between 2009 to 2012, to six percent between 2009-2013 (CDC, 2009). While at times urinary catheter may be a necessary intervention, studies have confirmed over half the patients who receive a urinary catheter do not have a valid indication
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The campaign included integrative education and training based on evidence based practices and applicable process revisions to address those practices (Gray, et al., 2016). Strategies incorporated applying tightly defined indications for indwelling catheterization into the electronic health record. Electronic alerts requiring daily review and orders for continued catheterization. Comprehensive training was required for nursing staff to include substitutions for indwelling foley catheters. Daily assessment of continued need for the urinary catheter while doing multidisciplinary rounds. Observation of maintenance bundle elements with real time education and case review of each CAUTI to identify opportunities for improvement.
The study was done using pre intervention CAUTI rate data from January 2010 to December 2012, and post intervention from January 2013 to December 2014. Staff members were also surveyed during the September 2014 to February 2015 to determine their perceptions on CAUTI and preventative methods before and after the
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Using evidenced based practices have shown decrease in infections. These articles indicated nurse driven protocols impressively decrease the duration of catheterization and CAUTI rate. Using the CDC evidenced based guidelines reduction in duration of catheterization and CAUTI rate. Multidisciplinary campaigns increase health care worker perspective toward prevention as a priority in the health care system.
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References
Barbadoro, P., Labricciosa, F., Recanatini, C., Gori, G., Tirabassi, F., Martini, E., . . . Propero, E. (2015). Catheter associated urinary tract infection: Role of the setting of catheter insertion. American Journal of Infection Control, 707-710.
CDC. (2009). Guideline for prevention of Catheter Associated Urinary Tract Infections 2009. Retrieved April 22, 2016, from Centers for Disease Control:
Gray, D., Nussle, R., Cruz, A., Kane, G., Toomey, M., Bay, C., & Ostovar, G. A. (2016). Effects of a catheter associated urinary tract infection prevention campaign on infection rate, catheter utilization, and health care workers perspective at a community safety net hospital. American Journal of Infection Control, 115-116.
Mori, C. (2014). A-Voiding Catastrophe: Implementing a Nurse-Driven Protocol. MEDSURG Nursing,
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.
Yacopetti, N., Davidson, P., Blacka, J., & Spencer, T. (2013). Preventing contamination at the time of central venous catheter insertion: a literature review and recommendations for clinical practice. Journal Of Clinical Nursing, 22(5/6), 611-620. doi:10.1111/j.1365-2702.2012.04340.x
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
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
Research shows that when healthcare facilities, care teams, and individual doctors and nurses are aware of infection problems, and take specific steps to prevent them, rates of some targeted HAIs can decrease by more than 70%. Participation in an ongoing system, established for monitoring and consumer reporting of health outcome data, [has resulted in] reduced rates of HAI, improved hospital outcomes, and reduced mortality, overtime. [For example / Studies have reported that,] compared to states with no reporting requirement, those units in states with voluntary reporting systems or with longer periods of mandatory reporting experience had higher infection rates at baseline and/[but] greater reductions in HAIs within six months. [That said / Still,] the challenge remains [however,] that [state legislation / current practices] varies widely regarding which HAIs to measure and report, how the data are collected and analyzed, and the public availability of disclosed
As such techniques were not used in this study, I defined a recurrent urinary tract infection as the presence of 2 10,000 col/ml of a single bacteria and one or more urinary symptoms occurring at least two weeks after the initial infection. This may lead to some misclassification of outcome; however, as long as the classification is not associated with the exposure(s) of interest the resulting measures of association should be biased toward the null hypothesis of no difference. The associations between hypothesized risk factors and repeat UTI were studied using multilevel contingency tables, with both stratification and multivariate techniques to control for confounding.3 I calculated six-month cumulative incidences of UTI, risk ratios (RR), and Mantel-Haenszel summary RRs. Exact 95 percent confidence intervals (CI) were calculated around each RR using the method of Gart.4 A three-level symptoms scale, (0 = no hematuria or urgency, 1 = urgency alone, 2 = hematuria and urgency) was developed and used both as a dependent and
It has also developed numerous courses that are intended to provide information and tools that may be needed to approach both significant nursing care and patient care issues. Given the scale of the population suffering with chronic kidney disease and the diversity of backgrounds in which patients are found, this curriculum may be of benefit to nurses caring for nephrology patients in many settings (ANNA, 2015). It supports, promotes among its members, and sponsors nursing research intended to develop evidence-based practice and to advance nursing science (ANNA, 2015). It strives to provide nurses with leadership opportunities, and encourages nurses to seize opportunities to advance and refine their leadership abilities (ANNA, 2015).
Scott II, D. R. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Nursing diagnosis Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). a. (book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa. Urinary tract infections occur when one or more microorganisms enter the urinary system and affect the bladder and/or the kidneys.
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
The Infection Prevention and Control (IPC) Program is an essential force maximizing quality, patient centered care, and safety throughout the Veterans Affairs North Texas Health Care System (VANTHCS). The VANTHCS “... is a progressive health care provider in the heart of Texas ... we serve more than 117,000 Veterans and deliver 1.4 million outpatient episodes of care each year to Veterans in 38 Texas counties and two counties in southern Oklahoma” (“VA North Texas,” 2016, para. 1). The purpose of the IPC Program is to guide a facility-wide approach toward identifying, preventing, controlling, and eliminating healthcare-associated infections (HAIs). This approach is facilitated through infection control (IC) practitioner’s role-modeling behaviors of assessing, supporting, guiding, and/or directing healthcare providers (HCPs) in the application of evidence-based practices (EBPs) to prevent HAIs. According to the Centers for Disease Control and Prevention (CDC), HAIs are often preventable adverse events that pose a major threat to patient safety (“Centers for Disease,” 2016). As a result, IC practitioners recognize the importance of preparing nurse faculty to engage clinical staff in the application of EBPs to prevent infections.
...d procedures are now being monitored to improve clinical processes. Ensuring that these processes are implemented in a timely, effective manner can also improve the quality of care given to patients. Management of the processes ensures accountability of the effectiveness of care, which, as mentioned earlier, improves outcomes. Lastly, providing reimbursements based on the quality of care and not the quantity also decreases the “wasting” and overuse of supplies. Providers previously felt the need to do more than necessary to meet a certain quota based on a quantity of supplies or other interventions used. Changing this goal can significantly decrease the cost of care due to using on the supplies necessary to provide effective, high-quality care. I look forward to this implementation of change and hope to see others encouraging an increase in high-quality healthcare.