Consider your topic of interest and the purpose for exploring this topic.
My topic of interest is how to avoid unnecessary urinary catheter use and effectively implement safe catheter care with chlorhexidine gluconate wipes to prevent Catheter-Associated Urinary Tract Infection (CAUTI) in Long Term Acute Care patients. CAUTI has been a menace to the healthcare settings. Inappropriate and prolonged use of indwelling urinary catheter is a major risk factor for CAUTI, as the IUC poses a “daily bacteriuria risk of about 3-7 percent which rises to 25 percent in one week, and quadruple to 100 percent if the IUC stays inserted” (Gesmundo, 2016). Additionally, the financial burden for treating CAUTI is huge on the healthcare facilities compare to the cost of prevention. Treatment is “approximately $1000 and Medicare has declined to reimbursed hospital for the cost” (Hollenbeak and Schilling, 2018). Thus, preventing CAUTI should be the goal.
Nurses occupy an important position in the prevention of CAUTI, as “they deliver a huge part of daily catheter cares” (Gesmundo, 2016). It is therefore essential that nurses are equipped with the necessary knowledge to critically assess patients, in all health care settings for therapeutic indications of IUC, and implement scientifically proven evidence-based catheter management care. This will change the current perception and culture of IUC, thereby enhancing safe catheter use and care.
What outcomes would you like to see emerge from this?
From this study, it would be expected that nurses have increased understanding of CDC recommendation and guidelines for appropriate use of an indwelling urinary catheter (IUC) by critically assessing patients for the therapeutic indication for IUC, perform efficient catheter care with CHG wipes during insertion and after, as well as ensure timely discontinuation of use to prevents CAUTI.
How would you measure these outcomes?
Aiken et. al (2016) submitted that outcomes can be measured using “patient mortality, patient ratings of care, care quality, patient safety, adverse events, and nurse burnout and job dissatisfaction”. For my study, the incidence of CAUTI after hospital admission, mortality, and morbidity due to CAUTI would be used in measuring the outcomes. Center of Diseases Control and Prevention (2020) submits that “15-25% of the hospitalized patient gets a urinary catheter inserted during their hospital stay and approximately 75% of Urinary Tract Infections (UTIs) acquired in the hospital is due to a urinary catheter”. Also, “more than 560,000 patients develop CAUTI each year, leading to extended hospital stays increased health care costs, patient morbidity, and mortality” (American Nurse Association, n.d). While measuring the outcomes, patients will be closely monitored, rate/prevalence of CAUTI, and morbidity and mortality associated with CAUTI documented. Nurses must ensure optimal care for hospitalized patients by preventing CAUTI thereby meeting the “US Department of Health and Human Services’ goals of reducing healthcare-associated infections” (Krein, Kowalski, Harrod, Forman, and Saint, 2013).