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Nursing Research Utilization Project Proposal

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Nursing Research Utilization Project Proposal
Tamra Sanders
Nur/598- Research Utilization Project
June 2, 2014
Patricia Dehof

Nursing Research Utilization Project Proposal
In the United States, 15-25% of patients who are in the hospital have urinary catheters and 75% of urinary tract infections are associated with a urinary catheter. The most vital risk for acquiring a catheter-associated UTI (CAUTI) is the extended use of a urinary catheter. Catheter-associated urinary tract infection (CAUTI) causes an increase in morbidity, mortality, hospital cost, and length of stay. There are approximately 380,000 infections and 9000 deaths related to CAUTI’s per year. CAUTI’s can increase a patient’s hospital stay by 2-4 days. The cost, in United States hospitals, per year, is over 500 million dollars to treat CAUTI’s (Centers for Disease Control and Prevention, 2012).
Having a urinary tract infection can lead to unnecessary antimicrobial use, and the urinary drainage system of the urinary catheter can harbor multidrug-resistant bacteria, which can spread to other patients (Centers for Disease Control and Prevention, 2012).This paper, the nursing research utilization proposal, will focus on preventing CAUTI’s.
The key resolution to prevent CAUTI’s is to implement a quality improvement (QI) program to improve the appropriate use of indwelling catheters and to reduce the risk of CAUTI’s based on health care organization’s risk assessment. A quality improvement program will make sure that catheters are being used appropriately. The program will identify the need of the urinary catheter and inform staff of the placement date, and when to remove catheters that are no longer needed. The program will make sure that hand hygiene is performed appropriately and that proper care of catheters is being conducted by health care practitioners. The quality improvement program will ensure that only properly trained practitioners insert urinary catheters using aseptic technique and sterile equipment. The program will also ensure that practitioners maintain urinary catheters using a closed drainage system, and that there is no obstructed urine flow (Centers for Disease Control and Prevention, 2012).
A proposed outcome measurement tool is to use an electronic medical record system, such as Visicu, Cerner, or Epic, to document indications for catheter placement and monitor dates and times of catheter insertions and removals. An electronic medical record system is used by all of the clinicians within the health care system. Providing a survey to clinicians, can also be an outcome measurement tool to improve monitoring, decrease frequency of using urinary catheters, and eliminate causing factors of CAUTI’s. The quality improvement program can use this information to make corrections and improve the electronic medical record system to decrease CAUTI’s. An electronic medical record could also alert clinicians, on the patient’s next admission, the risk factors of catheter placement, what antibiotics were used on the last admission, if the antibiotics were effective, how long the catheter was inserted, and other vital information.
In health care, there will always be urinary catheters, and the truth is that urinary catheters are convenient for providers and caregivers. According to Hanchett (2012), “And while mortality attributed to urosepsis has been reported, urinary catheters are viewed as low risk devices for which any potential complications can be readily and easily managed. These factors diminish a sense of urgency in addressing the problem, especially in healthcare environments confronting multiple, simultaneous patient safety risks.”

References
Catheter-associated urinary tract infections (CAUTI). (2010). Retrieved from Centers for Disease
Control and Prevention website: http://www.cdc.gov/HAI/ca_uti/uti.html
Hanchett, M. (2012). Preventing CAUTI: A patient-centered approach. Retrieved from the
Association for Professionals in Infection Control and Epidemiology (APIC) website: http://www.apic.org/Resource_/TinyMceFileManager/epublications/CAUTI_feature_PS_fall_12.pdf

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