One of the major activities that a DNP nurse participates in is research, usually evidence-based research. As indicated earlier, my interest is in researching reducing catheter-associated urinary tract infection (CAUTI). This condition is a clinical issue that needs to be mitigated to ensure that the patients have better health outcomes. This write-entails a summary and synthesis of two peer-reviewed articles obtained through the Walden Library search pertaining to reducing catheter-associated urinary tract infections.
One of the articles with the title “Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomized controlled trial” reported by Fasugba et al. (2019) entails reducing CAUTI. The report compares the efficacy of the use of normal saline and 0.1% chlorhexidine solution in cleaning the meatal area prior to inserting urinary catheters in lowering the incidences of CAUTI. The study used a cross-sectional randomized control trial in the hospitals for a period of three weeks, with a total of 1642 research subjects recruited in three hospitals (Fasugba et al., 2019). While 58% of them were in the intervention period, the remaining 42% were in the control phase. Among the findings is that among the control group, 13 cases of CAUTI were recorded as compared to only 4 cases among the intervention group; hence the intervention was connected to a 94% reduction of the rates of catheter-associated urinary tract infections.
More recently, a study has been reported by Nassikas et al. (2020) with the title “Intensive care unit rounding checklists to reduce catheter-associated urinary tract infections” This study purposed to determine whether the use of rounding checklist in an intensive care unit lowers the incidences of catheter-associated urinary tract infections. These researchers used a retrospective before-and-after study design. Done in an academic community hospital with a 16 bed ICU unit, the intervention used was an ICU rounding checklist which ensured that the caregivers addressed the use of the indwelling catheters. Analysis was then done to compare the pre-intervention duration with the post-intervention after implementing the checklist. Pre and post-intervention strategy is one of the best ways of determining the efficacy of an intervention in the management of a condition or disease (Spurlock, 2018). Among the findings obtained from the research is that before the intervention, the unit recorded nineteen CAUTI cases per one thousand catheter days. The rate was found to reduce to 2.12 after the intervention from 4.62 before the implementation of the checklist.
The findings of Fasugba et al. (2019) implies that by taking care of the meatal area through thorough cleaning, the rates of CAUTI incidences can greatly be reduced. By employing the normal intervention of using the 0.9% saline solution, whose efficacy has also been shown in previous studies (Khahakaew et al., 2019), this current research was able to demonstrate that the use of 0.1% chlorhexidine solution is more efficacious hence introducing better evidence to practice. Indeed, the findings are in agreement with other studies (Mitchell et al., 2019). However, the findings also differ from other reports where the use of chlorhexidine did not lead to lower incidences of CAUTI, even though that study was a single-site randomized control site.
Several interventions exist for controlling CAUTI. Patients at the ICU particularly need to be free from the infections to give them a better chance of healing; therefore, the study by Nassikas et al. (2020) is significant. They were able to demonstrate that using the checklist in the ICU setting can be vital. These findings can be generalizable in an ICU setting in other locations since the intervention focuses on just using a checklist. It is important to note that this intervention is relatively cost effective, even though at first it may lead to increased use of indwelling catheters, eventually it allows for lower usage rates. The findings are also supported by other studies. For instance, a study done to combine checklist and education intervention effectively reduced the rates of CAUTI (Menegueti et al., 2019).
Fasugba, O., Cheng, A. C., Gregory, V., Graves, N., Koerner, J., Collignon, P., … & Mitchell, B. G. (2019). Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. The Lancet Infectious Diseases, 19(6), 611-619. Doi: 10.1016/S1473-3099(18)30736-9.
Khahakaew, S., Suwanpimolkul, G
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