Catheter-Associated Urinary Tract Infection (CAUTI)
Decreasing the health care-associated urinary tract infection (UTI) is a goal that most hospitals and doctors are trying to do. The purpose of this project was to create a gathering count starting point to forecast clinically major UTIs that develop in hospitalized patients that are women. There were a lot of cases looked into but 20 women were chosen for this investigation. These women were interviewed and answers were recorded. A lot of the data taken had a lot to do with subjective complaints, WBC count, urinalysis, clinical signs and symptoms, attendance of an indwelling urinary catheter, and urine culture outcomes. Because there is a rising development in urinary tract infection, it was obvious that research needed to be done as to find out how these women are getting this disorder and what would need to be done about it in order to reduce the incidences.…...

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References

Recommendations on Prevention of Catheter-associated Urinary. (2010, March 12). Retrieved from Scientific Committee on Infection Control, and Infection Control Branch, Centre for Health Protection, Department of Health:  http://www.chp.gov.hk/files/pdf/recommendations_on_prevention_of_catheter-associated_urinary_tract_infection_r.pdf 

Catheter-Associated Urinary Tract Infection (CAUTI) Event. (2011, May 26). Retrieved from National Healthcare Safety Network:  http://www.cdc.gov/nhsn/PDFs/pscManual/7pscCAUTIcurrent.pdf 

Catheter-Associated Urinary Tract Infection (CAUTI)Prevention Toolkit. (2011, March 6). Retrieved from Amerinet: http://www.amerinet-gpo.com/Documents/Catheter-Associated%20Urinary%20Tract%20Infection%20CAUTI%20Toolkit.pdf

Institute for healthcare improvement. (2012, May 7). Retrieved from Catheter-associated urinary tract infection:  http://www.ihi.org/explore/cauti/Pages/default.aspx

C-BSIs
Preventing Catheter-elated Bloodstream Infections

Hadaway (2006) sought to provide practice guidance to nurses for catheter-related bloodstream infections (C-BSI). The points of emphasis included short peripheral catheters, but the main focus was infections associated with central venous catheters (CVC) because these occur more often and result in more severe adverse outcomes. To support these practice recommendations, Hadaway relied on CVC best practice guidelines published by the Institute for Healthcare Improvement (IHI). The information provided is designed to assist nurses to implement best practices in the area of C-BSI. In addition, infection rate statistics and recommendations from the Centers for Disease Control and Prevention (CDC) were presented to show why this is important.

Hadaway (2006) discusses the five IHI guidelines for reducing the incidence of C-BSIs. This is the best practice for reducing C-BSIs and this is why. The argument is the best practice is improving hand hygiene, barrier precautions, antiseptic use, insertion site…...

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References

Hadaway, L.C. (2006). Best-practice interventions: Keeping central line infection at bay. Nursing, 36(4), 58-63.

As contributive to further research, researchers may be interested in singling out the various C-BSI-reductive variables used in the multi-faceted programs and seeing the effect of CHG in contrast to the others. Note too, that a teaching / training program was the constituent of the two multi-faceted programs, whilst the study of the independent training program, in reality, also incorporated the other 2 programs in that participants were induced to practice instructions. On the other hand, some of the questions involving the study of the training program was that since it was a self-module it depended on voluntary motivation of individuals to complete modulus and one cannot know how many of them actually did or with what degree of concentration. The fact that their baseline and post-test examinations showed differences in results cannot be conclusively traced to effect of training program.
That all studies were nested can also be indicated…...

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References

Berenholtz, SM et al. (2004) Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med Vol. 32, No. 10, 2014-2020

Bleasdale, SB et al. (2007) Effectiveness of Chlorhexidine Bathing to Reduce Catheter-Associated Bloodstream Infections in Medical Intensive Care Unit Patients Arch Intern Med.;167(19):2073-2079

Coopersmith CM et al. (2002). Effect of an education program on decreasing catheter-related bloodstream infections in the surgical intensive care unit Crit Care Med Vol. 30, No. 1, 59-64

Pronovost,, P. et al. (2006) An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU N. Engl J. Med 355;26, 2725-2732

Catheter-elated Infections
Central Catheter-related ICU Infections

Central Catheter-elated Infections in ICUs

educing Central Catheter-elated ICU Infections in Michigan

educing Central Catheter-elated ICU Infections in Michigan

Teams of clinicians at five hospitals across Michigan reported their efforts to reduce the frequency of catheter-related bloodstream infections in intensive care units (ICUs) through the implementation of five patient safety measures: (1) hand washing, (2) full barrier precautions during insertion of central venous catheters, (3) use of chlorhexidine to clean the insertion site, (4) avoid using a femoral site for catheter insertion, and (5) never leaving unnecessary catheters in the patient (Pronovost et al., 2006). The intervention was based on the published research findings from five research groups: Berenholtz et al., 2004; Cohran et al., 1996; Eggimann et al., 2000; Warren et al., 2004; and Warren et al., 2006. Three of these studies investigated the efficacy of interventions on catheter-related bloodstream infections in an ICU setting, while the…...

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Reference

Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S. et al. (2006). An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine, 355(26), 2725-2732.

CAUTI-catheter-Acquired urinary tract infections)
Identify a work-setting problem.

• Describe a problem or issue that needs a solution.

Basic infection prevention along with antimicrobial stewardship is necessary to investigate due to the global need for interventions that will impact HAIs, including urinary tract infections. "The basics of infection prevention and control are the necessary underpinnings of programs, policies, and protocols that impact HAI" (APIC, 2008, p. 5). One aspect that specifically needs continual focus is formation of antimicrobial stewardship programs. Antimicrobial stewardship has a chance of generating positive outcomes through minimization of potential adverse outcomes of occurrences like CAUTIs. The reason for this is the development of colonization, biofilms, and asymptomatic bacteriruria, and symptomatic urinary tract infections which are typical in regards to urinary catheter use.

What often occurs in a health care setting where CAUTIs have a chance of forming are inappropriate choice and utilization of antimicrobials. Not only does the misuse…...

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References

APIC (2008). Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs). Retrieved from  http://www.apic.org/Resource_/EliminationGuideForm/c0790db8-2aca-4179-a7ae-676c27592de2/File/APIC-CAUTI-Guide.pdf 

Shekelle, P., Wachter, R., & Pronovost, P. (2013). Chapter 9 Reducing Unnecessary Urinary Catheter Use and Other Strategies To Prevent Catheter-Associated Urinary Tract Infections: Brief Update Review. In Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. Retrieved from  http://www.ncbi.nlm.nih.gov/books/NBK133363/

This is important because the cost of hospital acquired infections run high. The cost to care for a patient with a hospital acquired infection is almost three times the amount to care for a patient without a hospital acquired infection (Hassan et al., 2010).
Since hospital acquired infections can be attributed to the hospital, Medicare and Medicaid will no longer cover payment of these infections beginning in 2008. Medicare and Medicaid reimbursements are designed to set payment rates that are consistent with hospital costs (Malatestinic et al., 2003). An acquired hospital infection is not considered a cost to Medicare or Medicaid since the patient contracted the infection through no fault of his own, but while under the care of the hospital staff. Deutsch does not agree with this decision and states that Medicare and Medicaid are doing more harm to the patients by withholding hospital payments and instead should invest…...

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Bibliography

Allen, S. (2005). Prevention and control of infection in the ICU. Current Anaesthesia & Critical Care, 16(4), 191-199.

Boscart, V, Levchenko, A., and Fernie, G. (2010). Defining the configuration of a hand hygiene monitoring system. American Journal of Infection Control, 38(7), 515-

Bystrom, C. (2005). Reduction of nosocomial catheter-associated urinary tract infection

(CAUTI) in a U.S. Southeastern teaching facility with an all-silicone silver Foley catheter. American Journal of Infection Control, 33(5), E57-E58.

Urinary Catheterization
Urinary catheterisation: indwelling catheters

Urinary catheterization: indwelling catheters

In the medical field, the uses of indwelling catheters have become a common patient care intervention (Clinical Review, 2009). In addition, this intervention has proven to have substantial risks; infection is the most common. However, nurses can assist in prevention of catheter-associated urinary tract infections by incorporating aseptic methods when doing insertions, following best practice by quickly changing catheters, and embracing hand hygiene when doing insertion or handling catheters. In addition, catheterization is a painful process; therefore, the patient should consent to the procedure, after they are made aware of the benefits and risks associated with the procedure.

Urinary catheterization is the practice of inserting a hollow tube into a bladder using an aseptic method to enable drainage of urine or instillation of fluids as an intervention in the medical field. Some 3000 years ago, owing to inadequate resources and knowledge, people used reeds…...

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Bibliography

Bhardwaj, R., Pickard, R., & Rees, J. Documented Adherence to Standards and Guidelines:

An Audit. British Journal of Nursing. 19(18).pp. 26-30.

Bhatia, N., Daga, K.M., Garg, S., & Prakash, K.S. (2010). Urinary Catheterization in Medical

Wards. Journal of Global Infectious Diseases. 2(2).p. 83-90.

Evidence-Based Policy and Practice: Central Venous Catheter -- Sterile vs. Clean Techniques
Central line infections can be serious and even life threatening but the threat is largely preventable when proper cleaning techniques are used. This paper provides a description of this problem, a review of the relevant literature concerning central venous catheters and the sterile vs. clean technique to demonstrate that the latter is the superior approach. Finally, a description of the central venous catheter process that is currently in use at a tertiary healthcare facility is followed by a summary of the research and important findings concerning these issues in the conclusion.

Chronic intravenous therapy introduces a number of significant challenges for patients and caregivers alike who are required to become proficient with the sterile preparation of the medication, operation of the pump, and care of the central venous catheter to prevent catheter-related bloodstream infections (Doran, Ivy, Barst, Hill & Murall,…...

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References

Carratala, J., Niubo, J. & Fernandez-Sevilla, A. (1999). Randomized, double-blind trial of an antibiotic-lock technique for prevention of gram-positive central venous catheter-related infection in neutropenic patients with cancer. Antimicrobial Agents and Chemotherapy,

43(9), 2200-2204.

Doran, A.K., Ivy, D.D., Barst, R.J., Hill, N. & Murali, S. (2011, July 4). Guidelines for the prevention of central venous catheter-related blood stream infections with prostanoid therapy for pulmonary arterial hypertension. International Journal of Clinical Practice

Supplement, 8(160), 5-9.

Jones, 2006), a qualitative study, to (Humar, 2001), a quantitative study, both studies were conducted for the same problem of serious venous catheter-related infections. oth studies were conducted for the same purpose of determining effective methods for venous catheter-related infection prevention. And, both studies used theoretical research of review of previous studies of venous catheter-related infections. oth studies identified limitations in previous studies and (Humar, 2001) identified limitations in the present study.
Where (Jones, 2006) was focused on examining weaknesses and findings of previous studies compared to standard best practices in data collection, (Humar, 2001) was a randomized control trial that tested two antiseptic solutions to determine which one was the most effective at preventing infection in central venous catheter sites. The different designs caused different data analysis where (Humar, 2001) used a statistical analysis of data collected and (Jones, 2006) used an analytical analysis of the instruments used, techniques…...

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Bibliography

Benefits of Qualitative Research. (2013). Retrieved from BendfitOf.net:  http://benefitof.net/benefits-of-qualitative-research 

Benefits of Quantitative Research. (2013). Retrieved from BenefitOf.net:  http://benefitof.net/benefits-of-quantitative-research 

Ethnography, Observational Research, and Narrative Inquiry. (2013). Retrieved from Colorado State University:  http://writing.colostate.edu/guide/guide.cfm?guideid=63 

Humar, A. e. (2001). Prespective randomized trial of 10% povidone-iodine versus 0.5% tincture e of chlorhexidine as cutaneous antisepsis for prevention of central venuous catheter infection. CID 2000;31, 1000-1007.

Deficiency: Catheter Care
Insufficient urinary catheter care is a cause for concern among nurses working in the senior care environment. Catheter-cased urinary tract infections account for more than a third of all health care associated infections in the United States (Fink, Gilmartin, ichard, et al., 2012). To reduce the number of infections in a nursing home, staff need to reduce the number of unnecessary catheterizations performed and remove unnecessary catheters. When catheters are necessary, nurses need to practice evidence-based catheter maintenance.

Catheter maintenance is relatively straightforward. Wilson, Wilde, Webb et al. (2009) found that there are several effective methods to reduce the risk of catheter-based urinary tract infections including daily cleansing of the meatus using soap and water or an appropriate cleanser and maintenance of a closed urinary drainage system. Other methods of infection prevention include wearing gloves, hand washing, maintaining a sterile barrier, and using the "no-touch insertion technique," (Fink, Gilmartin,…...

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References

Fink, R., Gilmartin, H., Richard, A. et al. (2012). Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals. American Journal of Infection Control 40(8): 715-720.

Meddings, J., Rogers, M.A.M., Macy, M. & Saint, S. (2010). Systematic review and meta-analysis. Clinical Infectious Diseases 51(5): 550-560.

Rothfeld, A.F. & Stickley, A. (2010). A program to limit urinary catheter use at an acute care hospital. American Journal of Infection Control 38(7): 568-571.

Willson, M., Wilde, M., Webb, M. et al. (2009). Nursing Interventions to Reduce the Risk of Catheter-Associated Urinary Tract Infection: Part 2: Staff Education, Monitoring, and Care Techniques. Journal of Wound, Ostomy, and Continence Nursing 36(2): 137-154.

Research Proposal for Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.

Research question

The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.

Background and Significance of the Problem

It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within the hospital setting. According to…...

As to catheter straps, if fastened too tightly they can act as tourniquets, cutting off the needed flow of blood and presenting. And at least theoretically, use of straps brings about a risk of increasing the complications such as "…deep vein thrombosis and pulmonary embolism" in those patients with "impaired lower extremity circulation" (Billington 504). Research presented in this article shows that the problem of infection due to poorly attached catheters can be reduced significantly through the use of a product called "Bard StatLock" -- which, the authors insist, is an effective stabilization device because it allows movement (through a swivel clip), because it is a "sterile latex-free, tug-resistant product" (Billington 504). An article in the journal RN, incidentally, states that treating "hemodialysis catheter-related bacteremia" can cost a hospital up to $45,000.

ashing "Bloody Hands": An article in the Australian Nursing Journal asserts, "…hand hygiene is the single most effective method…...

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Works Cited

Aziz, a.M., Ashton, H., Pagett, a., Mathieson, K., Jones, S., & Mullin, B. (2009).

Sharps management in hospital: an audit of equipment, practice and awareness.

British Journal of Nursing, 18(2), 92-98.

Billington, a., Crane, C., Jownally, S., Kirkwood, L., & Roodhouse, a. (2008).

Challenges and Opportunities The major challenge is how to keep track of any inserted urinary catheter in a patient. It has been shown that most times physicians and nurses will forget about a urinary catheter, and this is one of the major causes of infections in patients. Therefore, there should be a strategy in place for monitoring any urinary catheter that has been inserted in a patient and ensuring that it is removed when it is no longer needed. Removal of unnecessary catheters ensures that HAIs associated with the catheter is prevented. Another challenge is the time it takes to recognize that a catheter is in place and the physician determines it is no longer needed and issues a removal order. This might take hours or days. According to (Meddings et al., 2014) any delay in removing a catheter increases the patient's risk of infections and catheter-associated complications.
Maintaining awareness of any…...

Wilde, M. et al. (2015). Self-management intervention for long-Term indwelling urinary catheter users. Nursing Research, 64(1): 24-34.
The method employed in this quantitative study is the random clinical trial and the research tradition was congruent with the methods used to collect and analyze the data: the researchers collected data during face-to-face home interviews and follow-up phone interviews with more than 200 participants involved over a 12-month period; and analysis was generated using generalized estimating equations. Thus the sample size was consistent with a standard quantitative study and the duration was of sufficient length to monitor changes/developments alongside a control group. There was no evidence of reflexivity, as the self-management approach to catheter use eliminated problems.

The sample was adequately described: the participants were adult long-term urinary catheter users split between the trial group testing the effectiveness of the self-management treatment and the control group receiving normal treatment. Thus triangulation was achieved in…...

Quality Evidence From ickard, C.M., et al. (2012)
The objective of this study is to critically appraise quality evidence in the work of ichard, et al. (2012) which focuses on routine vs. clinically indicated replacement of peripheral intravenous catheters: A andomized Controlled Equivalence Trial. The focus of the critique will be on the methodology, results, implications for clinical practice and further research.

Schultz et al. (2010) reports that randomized controlled trials "when they are appropriate designed, conducted, and reported, represent the gold standard in evaluating health care interventions." (p.1) However, the absence of methodological rigor results in biased results in randomized trials. In order for a trial to be accurately assessed, there must be clear and transparent information presented in the study's methodology and findings. Due to the absence of adequacy in the reporting of studies, the Consolidated Standards of eporting Trials (CONSOT) was developed in 1996 and revised in 2001.…...

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References

Rikard, CM, et al. (2012) Routine vs. clinically indicated replacement of peripheral intravenous catheters: a randomized controlled equivalence trial. The Lancet. Vol. 380. 22 Sept. 2012.

Schulz, KF et al. (2010) CONSORT 2010 Statement: Updated Guidelines For Reporting Parallel Group Randomized Trials. Open Medicine 2010;4(1);E60.

Advanced Practice Nurses: Catalysts for Enhanced Patient Outcomes in Healthcare Settings

Advanced practice nurses (APNs) are highly educated and specialized nurses who play a pivotal role in improving patient outcomes within healthcare settings. Their advanced clinical knowledge, diagnostic capabilities, and prescriptive authority empower them to provide a comprehensive range of services, enhancing the efficiency, accessibility, and quality of healthcare delivery.

1. Expanded Scope of Practice and Independent Care:

APNs possess a broader scope of practice compared to traditional registered nurses, enabling them to independently assess, diagnose, and manage patient conditions. This expanded role allows APNs to:

Order and interpret diagnostic tests
Prescribe medications....

Radiology specialists use a variety of imaging techniques such as X-rays, CT scans, MRI scans, ultrasound, and nuclear medicine scans to diagnose and treat medical conditions accurately. These imaging techniques allow radiologists to visualize internal organs, tissues, and bones in a non-invasive way, providing detailed images that help identify abnormalities, tumors, fractures, infections, and other medical conditions.

Radiologists interpret these images to make accurate diagnoses and develop treatment plans for patients. They can track the progression of diseases, monitor the effectiveness of treatments, and guide minimally invasive procedures such as biopsies or drainage of fluid collections. Additionally, imaging techniques can also....

Advancements in Technology and their Impact on Cardiac Surgery Outcomes

Introduction:
Cardiac surgery, once a highly invasive and risky procedure, has undergone a transformative evolution due to technological advancements. These innovations have significantly enhanced patient outcomes, reduced complications, and improved the overall quality of life for those undergoing cardiac surgery.

Minimally Invasive Techniques:

Robotic Surgery: Robotic systems provide surgeons with enhanced precision and dexterity, enabling them to perform complex operations through small incisions. This results in less scarring, reduced pain, and faster recovery times.
Endoscopic Surgery: Endoscopes allow surgeons to access the heart through natural orifices or small incisions. This approach minimizes tissue....