Catheter-associated Urinary Tract Infections (CAUTI) Essay
I’m not a great writer and I’m not expecting an A paper. Preferably a B. Create a summary paper for journal article. Topic: CAUTI (Catheter-associated urinary tract infection) Write your Summary Paper using these guidelines please; Use APA guidelines, no abstract page required but please format your title page, running header, citations and reference page correctly. (OWL Purdue APA is a great resource). No more than five pages, not including cover page Use only Nursing journals, not older than eight years (Do not use medical journals, social work journals, Nurse practitioner journals). You must cite the reference in APA format specifically writing out the journal name. If you provide a link to the article, it must be able to take another person viewing your paper, directly to the journal article you used. Articles that are nursing care focused, help you understand what it takes a bedside nurse to maximize or improve patient care.
Catheter-related urinary tract infection (CAUTI) will typically occur because catheters provide an environment suitable for bacterial adhesion. They are among the most common healthcare-associated infections and occur then the urethral catheter inoculates organisms into the patient’s bladder in turn promoting colonization. The presence of the urethral catheter is the most significant risk factor for bacteriuria. Once a catheter is placed, there is a 3-10% chance of bacteriuria incidence (Durant 2017). Up to 30% of patients who undergo catheterization for two to four days develop bacteriuria, with many being asymptomatic. Complications resulting from CAUTI have been found to increase the length of stay in the hospital by between two and four days. They are also associated with increased patient discomfort, increased cost of healthcare as well as increased mortality. Catheter-associated Urinary Tract Infections (CAUTI) Essay. Each year, an estimated $340–450 million is spent on complications arising from catheter-related urinary tract infection, which translates to roughly $1,300 to $1,600 in additional hospital costs per patient (Durant 2017). However, due to the fact that CAUTI is preventable, since 2008, the Centers for Medicare & Medicaid Services ceased to reimburse any cost associated with CAUTI acquired in hospital. To eliminate CAUTI and all related complications, however, best practice suggests a multiapproach strategy focusing on three issues. These are the prevention of any inappropriate short-term catheter use, urinary catheter care during placement, and nurse-driven timely removal of catheters. However, the above protocols will work best when within the scope of a nurse-led Initiative, peer-to-peer teaching on CAUTI, its pathophysiology, rates, complications, and CAUTI related costs. The research in this study was majorly from sources in CINAHL, Medline, professional agencies, hand-searching, and also from expert consultation
Pathophysiology of Catheter-related urinary tract infection (CAUTI)
Urinary catheters and intravascular catheters are two of the most common medical devices inserted in the United States. They are similarly the most common causes of bloodstream infections of the nosocomial variety. Research has shown that biofilm formation on indwelling catheters is key to the pathogenesis of catheter-related infections (Durant 2017). Catheter-associated Urinary Tract Infections (CAUTI) Essay.
The organisms that are responsible for colonizing catheters and subsequently disseminating to a patient’s bloodstream, causing infection, have been seen to gain access to the device through four distinct routes. The first route is through an invasion of the insertion site in the skin. The organisms may also contaminate the catheter hub. The third route is through homogenous spread from a different site of infection. Finally, these organisms may occur due to contaminated fluids’ infusion through the catheter (Durant 2017).
Of these four sources, the first two are significantly more important. The catheter hub and skin site infection have been seen to become contaminated by the endogenous skin flora of the patient by exogenous flora that is present in the hands of the nurse. Unlike organisms that access the skin through the skin insertion site, which migrate along the eternal surface of catheters, those inoculated into the hub tend to migrate along the catheter’s internal lumen. Organisms like staphylococci, Pseudomonas, Stenotrophomonas, enterococci, and Candida are able to reach the site through a nurse’s hands. In contrast, Staphylococcus aureus and coagulase-negative staphylococci migrate to the surface of the catheter from the skin site.
Flora that spreads hematogenously from a distant site like the urinary tract, in contrast to both hub contaminants and skin site flora, is mostly a theoretical source of catheter infection rather than a practical one. Because it is rare for the hematogenous seeding of a catheter to occur, the catheter doesn’t need to be removed in the presence of an infection in the bloodstream from a secondary document source. While it is common for epidemics involving infusate-related sepsis to occur, they are very rare, especially compared to the bacteremia cases that arise from primary catheter infections (Durant 2017).
Studies involving the direct observation of catheters using electron microscopy have shown the presence of biofilm-embedded bacteria that appear on the catheter within the first day of insertion. However, the distribution of the biofilm was found to be directly related to the length of catheter placement. Skin-originating external surface colonization is more prominent in short-term catheters, which have been placed for ten days or less such as non-tunnelled and non-cuffed central venous catheters, peripheral intravenous lines, and arterial catheters. Hub contamination culminating in intraluminal colonization was seen to increase progressively with duration, and it becomes predominant only after the 30th day of placement of a long-term device. These devices include peripherally inserted central catheters, tunneled central venous catheters, and subcutaneous ports. Catheter-associated Urinary Tract Infections (CAUTI) Essay.
The preventive strategies described earlier in this paper can be arrived to by understanding the differences in pathogenesis between long-term and short-term intravascular device-related infections. Whether or not the process of colonization in catheters will progress to symptomatic bloodstream infection is understood to be a quantitative phenomenon. This is because of the correlation between the probability of catheter-related septicemia and the number of organisms that are recovered from the surface of a catheter using the roll-plate method.
The pathophysiology of CAUTI is evidently a multifaceted interaction and therefore calls for a multifaceted approach. This will involve the prevention of any inappropriate short-term catheter use, urinary catheter care during placement, and nurse-driven timely removal of catheters. Together, these interventions can significantly reduce the chances of CAUTI development in patients (Durant, 2017).
Complications arising from CAUTI
As earlier stated, CAUTI episodes are often asymptomatic. When an episode of CAUTI becomes symptomatic, the sequelae that result may range from mild to severe. The mild form can involve urethritis, fever, and cystitis. The severe form, on the other hand, could encompass renal scarring, acute pyelonephritis, bacteremia, and calculus formation. If untreated, the infection could lead to urosepsis and eventually to death. It is also common for these complicated infections to recur. When this happens, they will result in long-term morbidity. The morbidity is due to the presence of blockage and encrustation of the catheter by crystalline biofilms, which results in an increase in resistance to the immune response of the host as well as a resistance to antibiotics because symptomatic CAUTI occurrences are a significant health concern because of both the reoccurrences and complications associated with the research are being directed towards a better understanding of the pathogenesis which will hopefully culminate in not only improved diagnosis but also more effective prevention and treatment options (Durant 2017).
The Role of Nurses in CAUTI intervention
Given the interventions stated in this paper, it is important to highlight nurses’ role in reducing CAUTI incidences. Nurses can utilize quality improvement data, especially that relating to patients approach the thresholds of short-term and long-term catheter placement. Catheter-associated Urinary Tract Infections (CAUTI) Essay. This form of understanding will allow them to better understand the pathophysiology and avoid instances where catheters are placed for long, which is the biggest risk factor for CAUTI.
Another important role for the nurses is to foster an environment suitable for patient-centered care. Such an environment would improve patient safety and also reduce harm. It would also consider the values of the patient and their families, together with their preferences. Furthermore, it would encourage the nurses and the entire healthcare team to be proactive in CAUTI prevention. While urinary catheters are typically only prescribed for patients that re acutely ill, as soon the decision has been made that the catheter can be removed, prompt removal is for all parties’ best interest. For a nurse, CAUTI prevention will begin with educating the patient and members of their family on the patient’s current condition and explaining to them why the use of a urinary catheter is necessary. Nurses also need to explain all alternative options, including condom catheters, to all relevant parties.
Finally, a nursing intervention will be needed to achieve proper catheter displacement and nurse-driven timely removal of catheters. This will ensure that catheters are removed correctly and in a timely manner to avoid the development of the complications stated above (Durant 2017). Catheter-associated Urinary Tract Infections (CAUTI) Essay.
Fox et al. 2015 carried pout a study that would show significantly improved patient outcomes after the deployment of nurse’s hand washing compliance protocols. These protocols were applied both when entering a patient’s room and upon exit. The increase in adherence to hand washing protocols from 48% to 75% was seen to result in reduced rates of HAIs (CAUTI and CLABSI). Nurses were also seen to play a role in education of patients and their families on the importance of hand washing with either soap and water or with alcohol rubs.
According to (Durant 2017), the role of nurses can be greatly enhanced when nurses teach nurses, evaluate their practice and hold them accountable for the incorporation of best practice into their strategies and practice. As this paper has shown, the use of quality improvement strategies can also enhance the role of nurses in reducing CAUTI instances and complications that surround them up to and including death.
Durant, D. J. (2017). Nurse-driven protocols and the prevention of catheter-associated urinary tract infections: a systematic review. American Journal of Infection Control, 45(12), 1331-1341.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., … & Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care, 24(3), 216-224. Catheter-associated Urinary Tract Infections (CAUTI) Essay.