Part 1
Catheter-Associated Urinary Tract Infections (CA-UTIs) is one of the most common healthcare-associated infections in the USA. CAUTIs can result in more adverse complications such as sepsis and endocarditis, and even death. According to Gomila et al. (2019), CA-UTIs account for more than 1 million cases annually in the US. They also account for more than 80% of UTIs originating in the healthcare setting. They are the most common causes of bacteremia in long-term care facilities and infection in patients with spinal cord injury. About 20% of hospitalized patients have a urinary catheter during admission, which increases the risk of CA-UTI by 3–7% daily (Gomila et al., 2019). The major risk factor for UTIs in hospital settings is the temporary insertion of an indwelling urinary catheter. CA-UTI develops due to the inoculation of microbes into the bladder by the urethral catheter, providing an environment for bacterial adhesion and causing mucosal irritation. The bacteria enter the bladder during insertion or manipulation of the catheter, the drainage system, and after removal.
CA-UTI is my topic of interest since it causes a significant burden on patients in terms of morbidity and mortality. In addition to the apparent harm posed to patients, governmental pressure has made hospitals across the country put more effort into reducing incidences of CA-UTI. According to Letica-Kriegel et al. (2019), CAUTI rates are included in both government quality ratings through the Centers for Medicaid and Medicare quality star ratings and financial penalties through the Hospital-Acquired Condition Reduction Penalty program. CA-UTI is relevant to advance nursing practice since advanced practice nurses (APRNs) have a responsibility of promoting better patient outcomes and improving patient safety by applying evidence-based research in clinical practice (Gomila et al., 2019). Nurses are the primary healthcare providers responsible for inserting and maintaining urinary catheters and promoting the desired outcomes. Consequently, they should have adequate knowledge about infection control in the use of urethral catheters, and their practice must adhere to healthcare setting’s guidelines on infection control (Gomila et al., 2019). Besides, PRNs are responsible for obtaining appropriate knowledge and practices of catheter care to prevent UTIs.
Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.)
| PICOT Question | ||
| P | Population | Hospitalized adult patients.
The population of interest is hospitalized adult patients because15–25% of hospitalized patients are catheterized at some point during their hospital stay. Catheter use is associated with most nosocomial UTIs. Patients with the highest risk of CA-UTI include those with extended periods of catheterization, errors in catheter care, microbe colonization of the drainage bag, catheterization late in the hospital course, and lack of antimicrobial therapy (Gomila et al., 2019). In addition, females, diabetic patients, patients with diarrhea, renal insufficiency, and immunocompromised state have a high risk of developing CA-UTI.
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| I | Intervention | Meatal cleaning with using 0.1% chlorhexidine solution before urinary catheterization.
The most effective way of reducing incidences of CA-UTI is reducing catheter use. Nonetheless, catheter use is unavoidable in some patients since it is part of disease management. The proposed intervention is to clean and disinfect the external urethral orifice using 0.1% chlorhexidine solution before urinary catheterization. According to Fasugba et al. (2019), cleaning and disinfecting the urethral meatus before inserting the urinary catheter is considered a potential solution to lowering the incidence of CA-UTI in patients. The intervention seeks to decrease bacterial colonization around the meatal area, preventing the introduction of opportunistic bacteria into the urinary tract during catheterization (Fasugba et al., 2019). Fasugba et al. (2019) conducted a study to evaluate the efficacy of 0·1% chlorhexidine solution for meatal cleaning before insertion of a urinary catheter in reducing the prevalence of catheter-associated asymptomatic bacteriuria and UTI. The study showed that using 0.1% chlorhexidine s Order this paper |