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CAUTI reduction: What can we do? Amber Edwards Walden University NURS 4100-4 Quality and Safety through Evidence-Based Practice May 9, 2017 As a nurse, we face clinical practice problems daily. As stated by the Agency for Healthcare Research and Qua $9.49   Add to cart

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CAUTI reduction: What can we do? Amber Edwards Walden University NURS 4100-4 Quality and Safety through Evidence-Based Practice May 9, 2017 As a nurse, we face clinical practice problems daily. As stated by the Agency for Healthcare Research and Qua

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CAUTI reduction: What can we do? Amber Edwards Walden University NURS 4100-4 Quality and Safety through Evidence-Based Practice May 9, 2017 As a nurse, we face clinical practice problems daily. As stated by the Agency for Healthcare Research and Quality, an estimated 560,000 patients dev...

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  • December 8, 2022
  • 19
  • 2022/2023
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CAUTI REDUCTION 1


CAUTI reduction: What can we do?


Amber Edwards


Walden University


NURS 4100-4 Quality and Safety through Evidence-Based Practice


May 9, 2017


As a nurse, we face clinical practice problems daily. As stated by the Agency for

Healthcare Research and Quality, an estimated 560,000 patients develop hospital-acquired UTIs

per year.


We use evidence-based practice to research and develop solutions to problems. Brown

states that evidence-based practice is the use of care methods that have been endorsed by an

agency because available evidence indicates they are effective (Brown, 2018). In nursing we use

research to determine the best way to solve a clinical problem (Nieswiadomy, 2008). Nurses use

evidence-based nursing to look for solutions (Nieswiadomy, 2008). Evidence-based nursing

practice is defined (Nieswiadomy, 2008) as “nursing practice that is based on the best available

evidence, particularly research finding” (p. 401). The purpose of this assignment is to reflect how

nursing studies are used to come to a solution to everyday problems.


The letters in PICO represent the terms population, intervention, comparison, and

outcome, and together they help summarize research questions that explore the answer to a

clinical problem. The population in a PICO question is the subjects that are involved in your

research question, where the intervention is the treatment or what is planned to be done to the



Page 1 of 19

,CAUTI REDUCTION 2


population to determine its effectiveness against the problem. Comparison is the control group

that you are comparing the intervention to that determines if you get the desired outcome that

represents and examines the effectiveness of the intervention (Brown, 2018). The PICO question

in this assignment is: Does removing urinary catheters less than 24 hours after placement reduce

the risk of developing catheter associated urinary tract infections (CAUTI’s) compared to having

urinary catheters in greater than 24 hours in hospitalized patients?


Catheters are used daily in healthcare settings. They are often used unnecessarily though

just for convenience of the medical staff. Urinary tract infections are the most common health

care associated infection, estimating at around 560,000 per year, with 387,550 of those being

preventable CAUTIs (Agency for Healthcare Research and Quality). The purpose of this paper is

to appraise multiple pieces of literature regarding the benefits and risks of catheter use and what

we can do to reduce CAUTIs.


I feel that the sooner a catheter is removed, the less chance of a CAUTI occurring. My

goal when starting this was to provide proof from studies performed showing this to be true. By

measuring the rate of CAUTIs occurring and the number of days the indwelling catheter was in

place, would help validate my statement.


The first study I chose, “A Review of Strategies to Decrease the Duration of Indwelling

Urethral Catheters and Potentially Reduce the Incidence of Catheter- Associated Urinary Tract

Infections”, was published in the Journal of Urologic Nurses. It qualifies as a systematic review.

The article focused on the duration and removal of catheters in comparison to CAUTI occurrence

(Bernard, Hunter, & Moore, 2012). An online database was used with specific keywords to narrow

the results. A total of 53 articles originated, but only 9 were used as the sample.


Page 2 of 19

, CAUTI REDUCTION 3


The study proved that nursing led interventions were successful in decreasing CAUTI

occurrence (Bernard, Hunter, & Moore, 2012). The length of time a catheter is in place is

concerned one of the greatest factor in getting a CAUTI (Bernard et al., 2012). More than one

study showed that by reducing the length of urinary catheter duration caused a decrease in the

incidence of CAUTI’s (Bernard, Hunter, & Moore, 2012). There was not enough evidence to prove

that this intervention reduced the occurrence more than any other interventions noted during

the study though. More evidence, from a larger sample, would be beneficial to effectively

determine the best intervention to use to reduce the rate of CAUTI’s in acute-care settings

(Bernard, Hunter, & Moore, 2012).


The second article titled, “Nurse-directed interventions to reduce catheter-associated

urinary tract infections”, goal was to develop and implement interventions to decrease the

amount of CAUTI incidence (Oman et al., 2012). It is always interesting to see the numbers on

paper: Nearly 25% of hospitalized patients are catheterized yearly, and 10% develop urinary tract

infections (Oman et al, 2012). Therefore, EBP guidelines are put in place, but the truth is, that

they are not always followed. A qualitative study was completed by performing a pre/post

intervention design. The sample design was unclear, but the article stated that they used one

hospital and the patients were on two separate units who had an indwelling urinary catheter

placed and they did not use any patients who had underdone urologic surgery. They performed

statistical tests on the data to determine the effectiveness of each intervention used to decrease

the rate of CAUTI occurrence. Only a few trained infection control nurses were used to collect

the data in order to preserve the validity of the data.




Page 3 of 19

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