Translating Evidence Into Practice

Running Head: LITERATURE REVIEW 0

COURSE PROJECT: PART 2- LITERATURE REVIEW

LITERATURE REVIEW

Introduction

Catheter-associated urinary tract infections (CAUTI) can be broadly defined as a urinary tract infection affecting any part of the urinary system including the urethra, bladder, uterus and the kidney as defined (Saint, 2015). Unlike most common urinary tract infections, CAUTI are acquired in health care facilities. About 20% of all CAUTI cases occur in acute health facilities while 50% occur in long term health facilities this is according to Saint (2015). The most effective way of reducing catheter infections is by reducing the use of catheter tubes during clinical procedures and where necessary, minimum catheter exposure time should be considered. Moreover Infection Programs aimed at controlling catheter urinary infections, should be included in all the health facilities so as to monitor its use. Coming up with appropriate indicators of catheter and its complications is also paramount.

Catheter urinary tract infections can be addressed in different perspectives, such as 1) considering its symptom, 2) preventive mechanisms for acquired infections, and 3) monitoring of infections related to CAUTI.

A common and frequent way of CAUTI transmission is the through urethral catheter, which normally inoculates organisms into the tissues, provide a surface for bacterium which later cause mucosal irritation. According to Nall (2016), once a catheter is placed, the daily incidence for bacterium rise from 3% to 10% to...30% in three days. Patients who go through catheterization for 2-4 days tend to develop an array of bacteria and are asymptomatic. About 90% - 100% of patients who are for long time have been exposed to catheter develop these bacteria. The common systems of CAUTI are particularly similar to a typical urinary infection. CAUTI symptoms are Back pains, Cloudy urine, and blood in the urine, pain in the vomiting and unexplained fatigue among others. According to Brusch (2015) AUTI symptoms might be hard to identify. This is especially if the patient has been hospitalized with an illness with symptoms similar to CAUTI.

A number of recommendations to reduce or eliminate the infection caused by the use of catheter include avoiding the use of a catheter, guidelines in the insertion and maintenance of catheter, surveillance of catheter use and CAUTI, catheter selection and recommendation of quality indicators (Brusch, 2015). Infrastructure to support different programs aimed at preventing transmissions should be made. This include staff education, adequate staffing and sufficient supplies of catheter replacements. A survey conducted in 15 developing countries showed that with proper handling of catheters, and with proper education of catheter insertion and maintenance, the number of CAUTI were reduced by 35% (Broker, 2015) Avoidance of the use of a catheter is a major way of eliminating CAUTI. The use of a catheter tubes should only be considered when necessary and the right procedures and equipment used for insertion. The use of a catheter is considered a must under the following condition; Hourly monitoring the patient’s urine, during a Urology surgery, as Diuretics during surgery, Surgery on contiguous structures of genitourinary parts, and when Monitoring infections

Documentation of catheter use and complication on is important in controlling CAUTI in a facility and effectiveness of prevention and allow for comparison with benchmark tests

Core data elements collected for effective surveillance should include catheter insertion and removal data, urinal catheter results, and monitoring bacteria. The most important indicators should be CAUTI incidences, CAUTI bacteria incidences and the proportion of catheter meting indicators accepted.

Monitoring the use of catheter according conducted in Germany health centers was successful in reducing the cases of CAUTI infections (Nicolle, 2015). Surveillance with benchmarking was reported. Though the level of CAUTI was minimal compared to the other infection reported in health care facilitate.

Catheters are important medical devices with a huge range of clinical uses but they are also associated with a number of urinary tract infections in health care facilities. Indwelling of the urethral catheter causes the spread of bacteria. Hence, health facilities should come up, develop, and implement infection preventive programs. In addition they should come up with policies to monitor and use practices that minimize infection that come with the use of the device. The most prevention practices should focus on limiting the use of indwelling urethral catheters and timely removal.

References

Broker, K. J. (2006). Critical Care Nursing: Monitoring and Treatment in Advanced Treament

New York: John Wiley and Sons Copyright.

Broker, K. J. (2006). Critical Care Nursing: Monitoring and Treatment in Advanced Treament .New York: John Wiley and Sons Copyright.

http://emedicine Brusch, J. L. (2015, August 15). Retrieved April 21, 2017, from Medscape:.medscape.com/article/2040035-overview

Nall, R. (2016, Feburary 29). Catheter Associated UTIs. Retrieved April 21, 2017, from Healthline: http://www.healthline.com/health/catheter-associated-uti#treatment6

Nicolle, L. (2015, July 25). Catheter Associated Urinary Tract Infections. Retrieved April 21, 2017, from Bio Med Mentral: https://aricjournal.biomedcentral.com/articles/10.1186/2047-2994-3-23

nursing, c. c.

Saint, S. (2015, October 16). Center for Disease Control and Treament. Retrieved April 21, 2017, from CatheterAssociated Urinary Tract Infections: https://www.cdc.gov/hai/ca_uti/uti.html