Week 1 Discussion Group B
The focus of my practice problem is Catheter-Associated Urinary Tract Infections (CAUTI) and it is based in my local community hospital, in a 30-bed step-down unit. It is estimated that 35%-40% of all hospital-acquired infections are caused by CAUTI-related deaths annually in the United States and between 15%-25% of hospitalized patients receive short-term indwelling urinary catheters that often do not align with appropriateindications for insertion (Mundle & Jeffs, 2019). Urinary tract infections are the most common type of hospital acquired infection reported, and among them, approximately seventy-five percent are associated with a urinary catheter, and most are preventable (CDC, 2016). CAUTI causes increased morbidity, mortality, prolonged hospitalization and increases cost of care (CDC, 2016). Research indicates that as many as one quarter of all hospitalized patients have an indwelling urinary catheter placed during their stay, and a significant portion of these are placed without appropriate indications (AHRQ, 2020). For the practice experience discussion, I met with my nurse manager Harison, quality improvement nurse Karl and infection disease nurse practioner Molsi. I discussed with each of them, the occurrence of CAUTI and the current measures that are in place for performance improvement. Our hospital began to convene system-wide, multidisciplinary teams to review the evidence for infections to help develop and create new best care bundles, or care processes, to help attain our goal for zero infections, all the time. Further, adding to this problem, research has shown that the prolonged use of a urinary catheter presents the highest risk for developing CAUTI (CDC, 2016).
I will be working closely with education department leaders to assess staff knowledge on CAUTI risk factors and competency on evidence-based infection prevention guidelines, policies and procedures. In addition, partnering with educators is necessary to facilitate, design and implement educational tools and training for staff to strengthen their awareness, knowledge and competency of infection control and prevention procedures. Promoting the mindfulness in improvement activities throughout nursing by consistent communication of expectations, concerns and outcomes in daily huddles and staff meetings. These quality improvement resources are easily accessible to all team members via the company intranet dashboard. An interprofessional approach to reduce CAUTI is beneficial in reviewing data, performing gap analysis and implementing corrective and preventative action plans (Stancovici & Galvan-Anderson, 2019). Once staff knowledge has been assessed and areas in need of improvement identified, educators can begin to develop and revise continuous education on evidence-based practice guidelines and incorporate this into annual competencies and new hire orientations.To effectively solve problems, people from different levels of the organization and from different work groups must collaborate (Spath, 2018).
References
Agency for Healthcare Research and Quality. Healthcare-Associated Infections Program. (2020). Retrieved 10/14/21, from https://ahrq.gov/hai/index.html
Centers for Disease Control and Prevention. Healthcare-Associated Infections. Catheter Associated Urinary Tract Infections. (2016). Retrieved 10/13/2021, from https://www.cdc.gov/hai/ca_uti.html
Spath, P. (2018). Introduction to healthcare Quality Management (3rd ed.). Chicago, IL: Health Administration Press
Stancovici, A., & Galvan-Anderson, B. (2019). Taking Every Precaution-an Interprofessional Approach to Reducing Catheter Associated Urinary Tract Infections in an Acute Care Medical Center. American Journal of Infection Control, Vol 47(6), p.s13
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My practice problem is catheter-associated urinary tract infections (CAUTI) in a 30-bed step-down unit at my local community hospital. CAUTI-related mortality account for 35-40% of all hospital-acquired infections in the US, and 15%-25% of hospitalized patients obtain short-term indwelling urinary catheters that often do not meet the appropriate reasons for installation (Mundle & Jeffs, 2019). Urinary tract infections are the most frequent hospital acquired illness, and around 75% of them are avoidable (CDC, 2016). CAUTI increases morbidity, mortality, hospitalization, and costs (CDC, 2016). According to research, up to a quarter of all hospitalized patients have an indwelling urinary catheter, and many of them are inserted without proper indication (AHRQ, 2020). On this topic, I met with my nurse manager Harison and infection disease nurse practitioner Molsi. I told them about CAUTI and the existing performance improvement strategies. As a result, our hospital began convening system-wide, multidisciplinary teams to examine infection evidence and build new best care bundles or care processes. Adding to the issue, evidence shows that extended usage of a urinary catheter increases the incidence of CAUTI (CDC, 2016).
Assuring staff knowledge of CAUTI risk factors and evidence-based infection prevention guidelines, policies, and procedures will be a top priority. Collaboration with educators is also required to develop and implement educational resources and training for staff to improve their awareness, knowledge, and skills in infection control and prevention. Consistently communicating expectations, issues, and outcomes in daily huddles and staff meetings. All team members can access these resources via the company intranet dashboard. Interprofessional collaboration is useful in reducing CAUTI through data assessment, gap analysis, and action planning (Stancovici & Galvan-Anderson, 2019). Incorporate evidence-based practice guidelines into yearly competency and new hire orientations after assessing staff knowledge and identifying improvement areas. To effectively address problems, employees from various levels and work groups must collaborate (Spath, 2018).
References
AHRQ Agency for Healthcare Research. HAI Program (2020). https://ahrq.gov/hai/index.html
CDC. Infections in Healthcare. Catheter-Associated UTIs (2016). http://www.cdc.gov/hai/ca uti.html
Spath (2018). Quality Assurance in Healthcare (3rd ed.). HA Press, Chicago.
(A.) Stancovici, & (B.) (2019). Interprofessional Prevention of Catheter-Associated Urinary Tract Infections in an Acute Care Medical Center. AJIC, 47(6), s13
