Decreasing CAUTI

Topics: Urinary catheterization, Foley catheter, Catheter Pages: 7 (1620 words) Published: February 4, 2015


Decreasing Catheter Associated Urinary Tract Infections
By Reducing Indwelling Catheter Use and Duration
Ryan Bellomy
East Tennessee State University

Abstract
The majority of catheter associated urinary tract infections (CAUTI) are a result of inappropriate use and excessive duration of indwelling catheters which can burden the hospital with uncovered expenses and cause complications in regards to patient health and well-being. Using a task force to do extensive research and to further ensure that the nurse-driven protocols are being used in the hospital setting, the evidence of increased risk factors and how to reduce the risks have proven results that aim to protect the patient from any extra risk associated with their length of stay. Evidence shows that placing indwelling catheters only in patients who meet strict criteria, removing the catheter as soon as the therapeutic intention is complete, as well as insuring proper catheter care are invaluable against lowering the risk of CAUTI. The biggest challenge appears to be from the nursing staff and the physicians as not every patient needs a catheter to make the hospitalization easier for the staff and the patient. This paper refers to the research provided by Bernard, M. S., Hunter, K. F., and Moore, K. N (2012) as well as the authors from two other peer reviewed journals and will focus on identifying risk factors and how to decrease the prevalence of CAUTI.

Decreasing Catheter Associated Urinary Tract Infections
By Reducing Indwelling Catheter Use and Duration
The increase in unnecessary use of indwelling catheters in the hospital setting has led to a prevalence of catheter associated urinary tract infections. “[T]he rate of unnecessary urethral catheterization has been reported between 21% and 50%” (Bernard, Hunter, and Moore 2012, pg. 30). Bernard et al. also reports that the “majority of inappropriately placed catheters are initiated and inserted in the emergency department”. Nurse driven protocols have been implemented to reduce the use and duration of indwelling catheters allowing the nurse to remove the catheter if the patient no longer meets the criteria for having one. “The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter” (CDC, 2012). The CDC (2012) also states that urinary tract infections are the leading cause of hospital associated infections with as much as 75% being related to the use of indwelling catheters. A few of the valid indications for an indwelling catheter are (but not limited to): “a) urinary retention, b) obstruction to the urinary tract, c) close monitoring of the urine output of critically ill patients, d) urinary incontinence that poses a risk to the patient because of Stage 3 or greater ulcer to the sacral area, and e) comfort care for terminally ill patients” (Bernard et al. 2012, pg. 30). Nazarko (2012) also notes that having a neurological bladder failure and to enable chemotherapy to be administered are also valid reasons for urinary catheterization. (pg. 11, box 1.)

Implementing a task force appears to be the most logical step in establishing better understanding and control of when to use indwelling catheters appropriately, proper procedure and insertion techniques, and using assessment and reminder tools for determining if the patient continues to meet the correct criteria for continuing the catheter. In research to implementing a task force that resulted in a successful reduction of unnecessary use of the indwelling catheter and as a result, a decrease in catheter associated urinary tract infections, I will focus on the Academic journals of Urologic Nursing and MedSurg Nursing with the concentration of the two articles being reducing the risk of catheter associated urinary tract infection. In the journal of Med Surg Nursing the article: A-Voiding Catastrophe: Implementing a Nurse-Driven Protocol, reports that “three months prior to...

References: 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), 29-37. Retrieved November 2, 2014 from
http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2011460104&site=eh ost-live
Catheter-associated Urinary Tract Infections (CAUTI). (2012, May 17). Retrieved November 10, 2014, from http://www.cdc.gov/HAI/cauti/uti.html
Mori, C. (2014). A-Voiding Catastrophe: Implementing a Nurse-Driven Protocol. MEDSURG Nursing, 23(1), 15-28. Retrieved November 4, 2014 from
http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2012491333&site=eh ost-live
Nazarko, L. (2012). Catheter-associated urinary tract infection. Nursing & Residential Care, 14(11), 578-583. Retrieved November 4, 2014 from
http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2011757345&site=eh ost-live
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