Practice Experience Discussion -Catheter Associated Urinary Tract Infection
Hospitalization or prolonged stay in hospitals is becoming one of the most dangerous ways of contracting catheter-associated urinary tract infections (CAUTI). Indwelling catheters cause this problem among patients. An indwelling catheter is a tube-like structure inserted into a urethra of a patient. This tube drains patient urine from the bladder into a collection bag. Patients who had surgery or are not able to control the functioning of their bladder require a catheter. It is very critical to monitor the amount of urine that kidneys produce. Limited resources at a healthcare facility are one of the most contributing factors to the prevalent of CAUTI. As a result, CAUTI causes an increased rate of hospitalization, 30-day readmission, poor quality care services, and increased healthcare costs.
After conducting a 20-minute interview with a hospital nurse leader and hospital manager, the outcome revealed that CAUTI is a leading challenge in the provision of quality care services and the enhancement of patient safety. These two leaders highlighted strong urine odor, chills, blood in the urine, unexplained fatigue, cloudy urine, and leakage of urine around the catheter are significant symptoms of a patient with CAUTI (Goldstein, MacFadden, Karaca, Steiner, Viboud, & Lipsitch, 2019). The two leaders stated that the diagnosis of CAUTI is challenging, especially when a patient has been admitted. The reason for diagnosis challenges are due to similar symptoms that may be part of a patient’s original illness.
A nurse leader noted that when bacteria enter a patient’s urinary tract through the catheter, chances of being infected with CAUTI are high. When a catheter is contaminated, or a drainage bag is not frequently emptied often, a patient is also likely to get infected. Other ways in which an infection occur include a dirt catheter and a backward flow of urine in the catheter into the bladder. National Healthcare Safety Network (NHSN) Report indicates 449, 334 CAUTI cases yearly in the United States (Richards, 2017). The report further reveals that CAUTI rates range from 0.00% per 1,000 catheter days to high of 53.2 per 1,000 catheter days between location types, type of medical institute affiliation of the hospital, and location bed size.
I work in the admission room at The Royal Children’s Hospital, where most of the Indwelling urinary catheter insertions (IDC) is done. Preparation of environment and equipment at the room ensure dressed trolley, catheterized pack and drapes, and sterilized gloves (HanCHett, 2012). Only a trained and competent nurse and doctor in urinary catheterization do the Insertion of an IDC. Between 12% to 16% of inpatients are likely to have indwelling urinary catheters during their treatment (hospitalization). Daily, a patient has a 3% to a 7% high risk of contracting CAUTI (Richards, 2017). More than 13, 000 deaths every year result from CAUTI according to the Center for Disease Control (CDC) statistics. A nurse leader and hospital manager identified CAUTI preventions outlined in the CDC, where preventive measures are given. These prevention measures are minimization of urinary catheter use and usage period among patients, avoiding the use of urinary catheters in patients to manage incontinence, and using urinary catheters in operative patients when critical.
After an in-depth discussion on CAUTI, it was agreed that inappropriate uses of dewing catheters are worsening the situation and leading to the delivery of low-quality care services. For instance, the hospital manager identified a prolonged postoperative period with inappropriate indications as improper use of indwelling catheters. Also, a substitute for the care of a patient without incontinence is the wrong use of indwelling catheters. Nurses, clinicians, and doctors must ensure quality care services through an appropriate removal of urinary catheter insertion and cleaning perineal area frequently.
Goldstein, E., MacFadden, D. R., Karaca, Z., Steiner, C. A., Viboud, C., & Lipsitch, M. (2019). Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states. International journal of antimicrobial agents, 54(1), 23-34.
HanCHett, M., & Rn, M. (2012). Preventing CAUTI: A patient-centered approach. Prevention, 43, 42-50.
Richards, D. E. (2017). Catheter-Associated Urinary Tract Infection (CAUTI) Targeted Assessment for Prevention (TAP) Effective Practices. American Journal of Infection Control, 45(6), S10-S11.