Evidence-based practice in nursing is important for the provision of care that optimizes outcomes. Nurses utilize their experiences in the care process and leadership to identify issues that can be addressed and improved with evidence-based interventions. Organizations strive to create environments that support the use of best practices to enhance safety, quality, and efficiency outcomes.
Health problems such as catheter-associated urinary tract infections (CAUTIs) have considerable impacts on the patient’s health, health systems, and nursing care. Specific populations such as those with chronic conditions admitted in long-term care facilities have an increased risk of developing CAUTIs. Nurses should explore and adopt best practices to prevent CAUTIs among this population.
This paper reviews the literature on the use of best practices, including CAUTIs bundles for CAUTIs prevention and rates in long-term care settings. CAUTIs are among the most common healthcare-associated infections in health institutions. It develops among patients with indwelling catheters. CAUTIs develop due to factors such as prolonged catheterization, use of unsterile procedures in catheter insertion, and contamination from bowel movements (Shadle et al., 2021).
CAUTIs act as a source of significant disease burden to patients, families, and health organizations. CAUTIs contribute to about 9% of all hospital-acquired infections in health organizations. CAUTIs contribute to increased care costs due to prolonged hospitalization and the demand for complex care. CAUTIs also cause complications such as those affecting the bladder, septicemia, and premature mortalities. CAUTIs are preventable. Bundle interventions have demonstrated effectiveness in preventing and reducing CAUTIs in healthcare (Decker et al., 2021). However, their effectiveness has not been explored in the practice site, hence, the focus of the project.
In the dilapidated patients admitted to long-term care units and using indwelling catheters, how does the use of CAUTI bundles compared to securing and positioning of catheters affect CAUTI rates within eight weeks?
Two quantitative studies were used in this literature review. They include the studies by Decker et al. (2021) and Shadle et al. (2021). The study by Shadle et al. (2021) investigated the effectiveness of a bundle-based approach in preventing CAUTIs in the intensive care unit. The increase in the number of CAUTIs above the benchmark data informed this study. Accordingly, the institution reported 13 CAUTIs against the hospital benchmark of 4 or fewer CAUTIs annually. The project targeted a 30% reduction in CAUTIs, a 20% reduction in urinary catheter days, and a 75% compliance rating in catheter-related documentation in the intensive care unit.
The methods used in the research by Shadle et al. (2021) were appropriate. The researchers adopted a pre-post design over 2 consecutive 4-month periods. The intervention targeted critically ill patients aged 18 years and above and admitted to the intensive care unit and catheterized. The bundle interventions included staff education, nurse-driven removal protocol for indwelling urinary catheters, and an electronic daily checklist.
The obtained data was analyzed using mixed statistics such as Fisher exact tests and independent sample t-tests. The use of methods such as a pre-post design is appropriate for the project aim because it shows the impact of the bundle interventions on the rate. The selected bundled interventions also support the use of best practices to address CAUTIs.
The other quantitative study selected for the literature review is the research by Decker et al. (2021). Decker et al. (2021) investigated the effect of bundle interventions on CAUTIs in critical care units. Decker et al. (2021) study was conducted in Boston Medical Center to decrease CAUTI rates in the intensive care units using five bundles.
The bundles included new processes for catheter insertion and maintenance, indications for catheter insertion, appropriate testing for CAUTIs, alternatives to indwelling devices, and sterilization techniques. Unit nursing supervisors performed daily rounds to determine appropriate catheter use in the unit. The interventions by Decker et al. (2021) are appropriate since they demonstrate the effectiveness of nurse-led bundle interventions in addressing CAUTIs.
Qualitative studies by Quinn et al. (2020) and Parker et al. (2020) were included in the literature review. The study by Quinn et al. (2020) explored persistent barriers to detecting and removing unnecessary catheters in healthcare settings.
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