Risk Management in Catheter-Associated Urinary Tract Infection (CAUTI)
Healthcare associated Infections (HIAs) are infections contracted during hospitalization. According to the Centers for Disease Control and Prevention (CDC) HIAs are one of the leading causes of death in the United States (U.S.) (Guide, 2008). Uterine tract Infections (UTIs) are among the leading infections in hospitals. Of the total, 70% to 80% are catheter associated urinary tract infections (CAUTIs) (Clarke, et al. 2019). Close to 25% of inpatients have catheters placed during their hospitalization and are therefore at the risk of contracting CAUTIs (Clarke, et al. 2019). Moreover, healthcare facilities face significant financial impacts because medicaid services and centers for medicare penalize hospitals with high cases of CAUTIs. Therefore, hospitals should analyze the risk of CAUTIs caused by improper indication, lack of equipment, training, and education, and unnecessary use to establish strategies to manage the risks.
The Problem
CAUTIs are common among hospitalized patients. They are common because the technique of placing catheters is used without proper indication, lack of equipment, and unnecessary use (Andrade & Fernandes, 2016). They are caused by indwelling catheters which are tubes inserted into the urethra. External interventions like compulsory public reporting of infections and zero tolerance for HIA led to an increased interest in CAUTIs. In light of this, hospitals realise the need to follow guidelines that relate to reducing unnecessary catheterization, providing proper equipment, training, and education to prevent the risk of CAUTIs.
The Setting
The New-York Presbyterian Hospital is a leading hospital that offers various services including cancer programs. It admits thousands of emergency room patients annually and performs numerous inpatient and outpatient surgeries and thousands of births every year. Moreover, it provides 24 hour- emergency services seven days a week to children and adults in trauma centres, psychiatric emergency and burning centers for New York. Being such a large facility means that the hospital is bound to report many cases of CAUTI. Therefore, risk management in CAUTI is important for the facility.
The Solution
The project aims to provide guidelines and recommendations for preventing CAUTIs. The guidelines include the recommendations provided by the CDC on catheter use, insertion and care and the implementation of initiatives to prevent CAUTI (Lo et al. 2014). The recommendations will be divided into basic practices and special practices. Basic practices include requiring health facilities to provide efficient equipment for preventing CAUTI, ensuring that only skilled professionals insert catheters. Others include educating and training healthcare professionals in the insertion and maintenance of catheters. Lastly, performing a CAUTI risk assessment to come up with effective risk management strategies.
Effects of the Problem and the Initiative
CAUTIs are the leading cause of infections in hospitalized patients with indwelling urinary catheters. They cause deaths and diseases among patients and attract hefty fines and suits on healthcare facilities. The initiative will reduce CAUTIs and risks associated with them through education and training of the staff that handle catheter insertion. Requiring health facilities to provide equipment for preventing CAUTI and coming up with effective risk management strategies.
Significance to Nursing Practice
Preventing CAUTIs is a significant challenge for U.S. hospitals (Fakih et al. 2014). It is critical to engage healthcare workers like physicians and nurses in fighting CAUTI. The initiative is important to the nursing practice because it provides education, training, and support to nurses, addressing the prevention of CAUTI.
References
Andrade, VLF, & Fernandes, FAV (2016). Prevention of urinary tract infection associated with catheterization: strategies in the implementation of international guidelines. Latin American Journal of Nursing , 24 .
Clarke, K., Hall, C. L., Wiley, Z., Tejedor, S. C., Kim, J. S., Reif, L., … & Jacob, J. T. (2019). Catheter-associated urinary tract infections in adults: diagnosis, treatment, and prevention. J. Hosp. Med, 14, E1-E5.
Guide, A. A. (2008). Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs).
Fakih, M. G., Krein, S. L., Edson, B., Watson, S. R., Battles, J. B., & Saint, S. (2014). Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm. American journal of infection control, 42(10), S223-S229.
Lo, E., Nicolle, L. E., Coffin, S. E., Gould, C., Maragakis, L. L., Meddings, J., … & Yokoe, D. S. (2014). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S32-S47.