Practice Experience Discussion CAUTI
In this week’s Discussion, you shared your experiences with health care practice problems as a consumer and/or as a practitioner. Now, consider your current practice setting and think about something specific and relevant to your practice setting that you would like to see improved or changed. Interview a key leader in your practice setting who can confirm that your practice problem is one that should be addressed to enhance delivery or performance in the field. It is important to remember from the beginning that your practice problem must be measurable, and that you identify data that suggests a problem exists, and although this comes up more specifically in Week 2, it is important to consider this from the start.
This will be the problem discussed in your Practice Experience Project, Capstone Paper, and Storyboard.
By Day 4
Identify a measurable patient-centered practice problem related to quality or safety and relevant to your practice setting that you will also focus on in your Capstone Paper, and post a brief description of the problem and an explanation of why you selected it. Explain how the conversation you had with the key leader in your practice setting impacted your decision to address this particular practice problem. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from your practice area and describe the data that is available.
You will not be collecting any data during the practice experience project; you will use data already available to you in your workplace or other practice setting. Think about the different kinds of data that is shared with you in your work area. For example, data may include patient satisfaction scores, medication error rates, fall, CLABSI or CAUTI rates. Analyzing the data available to you is how you will identify that a quality problem exists. Data identifies potential areas for improvement, and monitors the effectiveness of any changes. It is important to obtain baseline data before beginning a quality improvement project and to analyze results during and at the end of a projec
Week 6 Assignment: EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.
Name: __________Lishan Brown___________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)
The topic is hospital acquired infections. The nursing practice issue is catheter associated urinary tract infections and the high incidence on an acute rehabilitation unit.
Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.
The nursing practice issue I would like to investigate is healthcare associated infections (HAI), particularly catheter associated urinary tract infection (CAUTI). CAUTI is very important to investigate because I believe HAI’s can be decreased, if not prevented. Being that nurses are educated on the possible causes or symptoms of HAI’s, we can be more proactive in our treatment plans. If a patient falls, that can be an unpredictable event but HAI’s are more so predictable. With CAUTI, making sure that the perineal area is cleaned on a regular, consistent basis is important. Providing proper interventions to not keep an indwelling catheter in longer than necessary is also important.
Urinary tract infections are one of the most common hospital acquired infections. At least 80% of urinary tract infections an be attributed to an indwelling urinary catheter. There are approximately 13,000 annual deaths associated with catheter associated urinary tract infections (CAUTI). CAUTIs can lengthen hospital stays, increase morbidity and mortality, and raise healthcare costs.
Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate your PICOT question.
The practice problem is members of the healthcare team are not properly cleaning the perineal area of patients who have indwelling catheters and indwelling catheters are placed for unnecessary longer periods of time.
PICOT question- In (P) patients with an indwelling catheter on an acute rehabilitation unit, does (I) cleansing the perineal area every eight-hour period compared to (C) routine daily cleansing of the perineal area (O) decrease the catheter associated urinary tract infection with patients over a (T) six month period?
List the systematic review chosen from the Cochrane Database of Systematic Reviews from the Chamberlain library. Type the complete APA reference for the systematic review selected.
Interventions to improve professional adherence to guidelines for prevention of device‐related infections.
Reference
Flodgren G, Conterno LO, Mayhew A, Omar O, Pereira CR, Shepperd S. Interventions to improve professional adherence to guidelines for prevention of device‐related infections. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD006559. DOI: 10.1002/14651858.CD006559.pub2.
List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.
In my search for evidence, I found an article about nurse-driven CAUTI prevention. This evidence is relevant to my PICOT because I would like to find a way to decrease or eliminate the instances of CAUTI in a hospital setting. The article gives a history of prevalence of CAUTI then goes into costs related to CAUTI. The article also mentions ways of preventing CAUTI. The article also discusses an algorithm used to decrease the prevalence of CAUTI.
I also found an article about the causes of CAUTI and how to properly clean the perineal area as an educational tool.
Reference
Russell, J. A., Leming-Lee, T. ‘Susie,’ & Watters, R. (2019). Implementation of a Nurse-Driven CAUTI Prevention Algorithm. Nursing Clinics of North America, 54(1), 81–96. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1016/j.cnur.2018.11.001
Memorial Sloan Kettering Cancer Center (2018). Caring for Your Urinary (Foley®) Catheter. Retrieved from https://www.mskcc.org/cancer-care/patient-education/caring-your-urinary-foley-catheter
Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.
The main findings from the systemic review were that there weren’t sufficient evidence to properly corroborate the research. The trials were too small and there was inadequate reporting of information. Because the findings were too small, it was difficult to determine which intervention would be optimal in CAUTI care. The strength of the evidence was weak for the change process.
Outline one or two evidence-based solutions you will consider for the trial project.
An evidence-based solution would be the CAUTI Prevention Tool by the American Nurses Association. This streamlined evidence-based tool is used to reduce CAUTI by fewer catheters being used, timely removal, and insertion, maintenance and post removal care.
Reference
American Nurses Association (2009). Streamlined Evidence-Based RN Tool: Catheter Associated Urinary Tract Infection (CAUTI) Prevention. Retrieved from https://www.nursingworld.org/~4aede8/globalassets/practiceandpolicy/innovation–evidence/clinical-practice-material/cauti-prevention-tool/anacautipreventiontool-final-19dec2014.pdf
Star Point 3: Translation (Action Plan)
Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).
Care standards for urinary catheter care would be proper education to staff and those in use of the indwelling catheter (importance of infection prevention, symptoms of urinary tract infection, proper care of an indwelling catheter).
Provide written criteria for the necessity of an indwelling catheter by using the CAUTI Prevention tool.
Following procedures for the insertion and maintenance of an indwelling catheter (proper handwashing, use of aseptic techniques for insertion an removal of catheter, securing the tubing and drainage bag, maintaining sterility, replacement of supplies).
Having proper documentation of insertion, maintenance and removal.
Reference
The Joint Commission (2017). Requirements for the Catheter-Associated Urinary Tract Infections (CAUTI) National Patient Safety Goal for Hospitals. Retrieved from https://www.jointcommission.org/assets/1/6/R3_Cauti_HAP.pdf
List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5).
Nurse Leader- the person leading the trial, responsible for ensuring the success of the project and day to day intricacies of the project.
Nurse Manager- Person overseeing the trial to ensure the nurse leader and provide assistance as necessary.
Unit Nurses- team members who are assisting in carrying out the change process and day to day bedside care with patients with indwelling catheters.
Patient- consents to a clinical trial and helping to identify symptoms of CAUTI.
What specifically is your nursing role in the change process? Other nursing roles?
My nursing role in the change process is to be at the forefront of change process. As the nurse leader, I would want to ensure that all supplies, education, proper documentation is in place throughout the trial to ensure effectiveness. Unit nurses are responsible the placement of an indwelling catheter, the daily care management, and the removal of the indwelling catheter. Nurses are also responsible for specimen collection. Nurses are also the main person to diagnose a patient who is suspected of CAUTI.
List your…
