...of Catheter-Associated Urinary Tract Infections. Urologic Nursing, 34(5), 238-245 8p. doi:10.7257/1053-816X.2014.34.5.238 An Evidence-Based Approach To the Prevention of Catheter-Associated Urinary Tract Infections. Urinary tract infections account for at least 35% of all hospital acquired infections with 80% of them being associated to indwelling catheter. Each day an indwelling catheter is in situ increase pose a 3% tom 10% risk of developing an infection. Early discontinuation of the catheter reduce the risk of acquiring infection and in this study, infection rate drop from 4 cases in second quarter to none in the fourth quarter in the protocol implementation (Carter, N. M., Reitmeier, L., & Goodloe, L. R. 2014). 2...
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...u r na l of m e dic i n e Clinical Practice Caren G. Solomon, M.D., M.P.H., Editor Urinary Tract Infections in Older Men Anthony J. Schaeffer, M.D., and Lindsay E. Nicolle, M.D. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. From the Feinberg School of Medicine, Northwestern University, Chicago (A.J.S.); and the University of Manitoba, Winnipeg, Canada (L.E.N.). Address reprint requests to Dr. Schaeffer at the Feinberg School of Medicine, Northwestern University, 303 E. Chicago Ave., Tarry Bldg. 16-703, Chicago, IL 60611, or at jschaeffer@ a northwestern.edu. N Engl J Med 2016;374:562-71. DOI: 10.1056/NEJMcp1503950 Copyright © 2016 Massachusetts Medical Society. An audio version of this article is available at NEJM.org 562 A 79-year-old community-dwelling man presents with urinary frequency, dysuria, and fever. Culture reveals extended-spectrum beta-lactamase Escherichia coli. He had a similar infection several months ago, with the same organism isolated, and he had a response to nitrofurantoin treatment. How would you further evaluate and manage this case? U The Cl inic a l Probl em rinary tract infection in men without indwelling catheters is uncommon among men younger than 60 years of age, but the...
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...Melissa Flores Seriousness of Bladder Infections on Infants I. Introduction A. (Attention Getter) UTI (unary tract infection) is the most common serious bacterial infection in childhood, in which is bacteria that travels up to the urethra into the bladder and multiply, resulting in an infection; many affected children, particularly infants, have severe symptoms Approximately 7 to 8% of girls and 2% of boys have a urinary tract infection during the first 8 years of life. B. (Reason to Listen) Antibiotic treatment of children with urinary tract infections has almost eliminated the risk of death, which was approximately 20% among children hospitalized for severe kidney infections in the early 20th century. Some 50 years ago, one study described scarring found in the functional tissue of the kidney in 210 of 597 children treated for recurrent urinary tract infections. Another study in that era reported on an 11-to-27-year follow-up of 72 children hospitalized for urinary tract infections; 18% had died, 8% had progressive kidney damage, and 22% had persistent untreated or recurrent infection. C. (Speaker Credibility) The North American Pediatric Renal Trials and Collaborative Studies21 list primary diagnoses for 9854 children who had received transplants over the previous 20 years. D. (Preview) 1. First, I will discuss what’s the long term consequences a UTI can have if left untreated. 2. Second, I will cover the cause of a UTI. 3. Third, I will...
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...in the crude or processed state as active ingredients and may contain excipients. (WHO, 1996a; Busse, 1999). Combinations with chemically defined active substances or isolated constituents are not considered herbal preparations (Busse, 2000; GNDP, 2004). According to the European Medicine Evaluation Agency (EMEA), herbal preparations are medicinal products containing exclusively herbal drugs or herbal drug preparations as active substances (WHO, 1996b; Busse, 2000). Several chemical constituents with different pharmacological targets are involved in the therapeutic action of herbal preparations. This may be an advantage compared to single isolated compounds, especially when the underlying disease has a multifactorial etiology which is the case in many chronic illnesses. Herbal preparations may include comminuted or powdered plant material, extracts, tinctures, fatty or essential oils of herbal materials. Herbal preparations are made from different plant parts such as roots, bark, stems, leaves, and fruits whose production involves a fractional, purification, or concentration process (Evans, 1989; Evans, 1996). They also include preparations made by steeping or heating herbal materials in alcoholic beverages and/or honey, or in other materials. Based on the European Medicine...
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... ------------------------------------------------- Urinary tract infection (UTI) incorporates a range of conditions including acute pyelonephritis or kidney infection. It is almost invariably caused by bacteria (Brown et al 2005, Le 2004). The incidence of this disease in pregnancy has decreased in recent years (Dawkins et al 2012), possibly due to improved antenatal care. However, it remains one of the most common complications in pregnancy (Hill et al 2005) affecting 1-2% of pregnant women (Dawkins et al 2012, Hill et al 2005, McCormick 2008). Acute Pylonephritis is the most serious urinary tract infection in pregnancy (Le 2004, McCormick et al 2008) and successful treatment usually requires hospital admission (Jolly and Wing 2010). It is most often seen in nullparous and younger women and there appears to be a link with lower socioeconomic status, diabetes and sickle cell disease, although not with ethnicity (Hill et al 2005, Jolley et al 2012). It is more common in the 2nd and 3rd trimester (Archabald et al 2009, Hazhir 2007, Hill et al 2005) as the presence of urinary pathogens seems to increase as pregnancy advances (Hill et al 2005). There does appear to be an association between repeated urinary tract infections and sexual activity (Bernard et al 2011, Pfau and Sacks 1992). If not effectively treated, acute pyelonephritis may have serious consequences for both the mother and fetus. Urinary tract infections in pregnancy may lead to septic shock, anaemia, respiratory...
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...ASSOCIATED URINARY TRACT INFECTION Elizabeth Quartey Abstract According to the CDC estimates in 2002 there were 1.7 million Healthcare-Associated Infections (HAI), and 99,000 HAI- associated deaths in the hospital. The report stated that the four largest categories of HAI, responsible for more than 80% of all reported HAI, are central line-associated bloodstream infections (CLABSI, 14%), ventilator-associated pneumonia (VAP, 15%), surgical site infections (SSI, 22%), and catheter-associated urinary tract infections (CAUTI, 32%). HAI are a great financial costs to health care facilities. The Centers for disease Control and Prevention (CDC) estimates the medical cost of HAI in the U.S. hospitals as $6.65 billion in 2007, and that number has increased to almost $10 billion a year currently. Statement and Significance of the Problem One in 20 patients who are admitted to a hospital will be a victim to an infectious agent they are exposed to during their hospitalization according to the Centers for Disease Control (CDC) (Goodman, Brenda, 201, Hospital-Acquired Infections cost $10 Billion a year). The five most common infections are surgical site infections, infections associated with the use of devices like central lines, catheters, ventilators and clostridium dificile are costing the health care System in the USA almost $10 billion a year to treat. In the article Vitamin D has the potential to reduce the risk of Hospital-Acquired Infections, the...
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...prescribe them as the traditional drug of choice for urinary tract infections and sexually transmitted diseases. Currently, the new development of antibiotics to combat illnesses caused by bacterial resistant strains and have limited the usefulness of Sulfa medications. Objectives Upon successful completion of this presentation you should be able to: • Understand and communicate your knowledge of Sulfonamides mode of action and bacterial resistance • Identify and understand the contra indications, common signs and symptoms of allergic reactions to Sulfonamides. • Identify 3 common trade names for sulfonamides and select indication for use between different patient population. Type and class of Pathogen Sulfonamides have been in use since the 1930's , these drugs are effective against both gram- negative and gram - positive bacteria. Sulfonamides are know as broad spectrum antimicrobial drugs; they are effective against a wide variety of microorganisms most Enterobacteriaceae, Chlamydia trachomatis, Nisseria, Haemophilus influenzae,, Norcardia, E.Coli , P. mirabilis some staphylococci, and many streptococci (with exception of Enterococcus faecalis). They are used for treatment of Protozoan such as Toxoplasma gondii, and mycobacterial. Sulfonamides are use for treatment and prophylaxis of Pneumocytis carinii and Shigella small bowel infections. Mode of Action Sulfonamides are bacteriostatic...
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...Case Study 7 Case 1 D.K. is being seen in the clinic for complaints of urinary frequency, urgency, and burning. She reports that her urine appears cloudy and smells abnormal. A urine culture is obtained, and D.K. is given a prescription for antibiotics. 1) What is the most likely cause of D.K.’s signs and symptoms? The most likely cause of the signs and symptoms is a urinary tract infection. 2) Was antibiotic therapy the appropriate treatment? What organism should the antibiotic be effective against since it is the most common cause of this disorder? Yes, antibiotics are indicated for symptomatic urinary tract infection. E. Coli causes about 80% of UTIs. 3) What factors predispose to development of this urinary tract disorder? Factors that predispose the development of a UTI are: sexually active women, failure to void after intercourse, incorrect hygiene (i.e. wiping from front to back), female anatomy, low estrogen in postmenopausal women, catheters, tubes or foreign objects placed in the urinary tract, pregnancy and diabetes mellitus. 4) What strategies could be suggested to help D.K. avoid recurrence of this problem? Strategies that will help to avoid the recurrence of an UTI: If sexually active void after intercourse, wipe perineal area from front to back, wear cotton crotch underwear, drink six to eight glasses of water a day, avoid bubble baths and highly perfumed soaps, avoid douches and feminine hygiene deodorants. Case 2 P.W. was...
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...The role of the registered nurse in relation to safe and effective decision making will be explored. A discussion of the decision making process which has been chosen for the patient will be noted and this will be related to known theoretical models of clinical decision making. It will also critically examine the importance of managing risk in health care to enhance the patient care and outcomes and this will be related to the chosen patient and clinical scenario. Finally it will also critically appraise the evidence base that supports the discussion. The chosen patient is a 42 year old male who has been admitted to the current clinical placement, which is the local spinal injuries centre, after numerous complaints of recurrent urinary tract infections. All patient identifiable information has been changed to protect the patients’ identity in accordance with the Nursing and Midwifery (NMC) guidelines regarding confidentiality (NMC, 2004). Mr Scott had previously been an inpatient to the Spinal Unit following a road traffic accident in September 2004, the outcome was that Mr Scott is now a wheelchair user after obtaining a spinal cord injury at the thoracic levels of 6 and 7 of the spine. Mr Scott has been previously performing his own intermittent catheters due to the effects of the spinal injury on the bladder. In a spinal care bundle which was produced in 2009 by the Midlands centre for Spinal Injuries, it is recommended that all patients should be...
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...Case Study: Ectopic Pregnancy A 28 year old female patient whom is about 8 weeks pregnant was rushed to the ER (Emergency Room) after noticing some vaginal spotting. She also had two abortions in the past 3 years. The patient has been diagnosed and treated for gonorrhea and chlamydia once. She’s been having chills throughout the night but no fever. Some nausea and vomiting was reported. Her weight is at 110 lbs and her BP (Blood Pressure) is 97/54 mmHg. She complained about cloudy urine and pain after urination. She was treated for recurrent UTI (Urinary Tract Infection) and bacterial vaginosis. The RN (Register Nurse) had her to take a urine test, draw blood and orders a CBC (Complete Blood Work) and following up with a pelvic exam. The examination revealed normal external genitalia. The patient was diagnosis for different test to rule out any UTI, GTI (Genital Tract Infection), Ectopic pregnancy, and normal pregnancy. The doctor ordered an ultrasound exam. Her hCG (Human Chorionic Gonadotropin) was at 15,900 mUI/mL. The radiologist reported the patient’s ultrasound shows a thickened endometrium and slightly enlarged uterus. The result shows increased vascularity adjacent in the right ovary while the left ovary was normal. The doctor rushed in the room and told the patient that ectopic pregnancy was suspected. After being rushed in the surgery room, they prepare the patient for surgery. During the diagnostic laparoscopy, a corneal pregnancy was noted on the left side. They removed...
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...hemorrhagic diarrhea. This diarrhea illness was first recognized when the CDC personnel isolated e-coli from patients in two separate outbreak one in Oregon and the other in Michigan. The illness also was associate with eating hamburgers at a restaurant of a national chain. Some people experimented inflammation and bleeding of the colon. Infections dealing with e-coli are more common during the summer season and in northern states. Some strains of e-coli bacteria can cause anemia of kidney failure which leads to death. Other strains of e-coli can cause infection throughout the body such as the urinary tract and many more. By coming into contact with the feces, or stool of humans and animals you can get e-coli.it is normally inhabitant in small intestines and colon but do not cause diseases in the intestines. But can cause a disease if spread outside the intestines. For example the urinary tract which cause bladder or kidney infections or it can also get in the blood stream. Nearly every urinary tract infection is caused by e-coli. E-coli is a major health problem. Researchers suggest that it only takes a small number of e-coli to cause an infection in...
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...Ryan Chavez Patho 2 Case study 7 Case1 1. Due to D.K.’s signs and symptoms she probably has a urinary tract infection or urinary cystitis. 2. Since E. coli is the most common cause of urinary treat infections, antibiotics are an appropriate treatment for D.K. because she is symptomatic with frequency, urgency and burning upon urination. 3. The factors that predispose the development of a UTI are sexually active women,the us of a diaphragm, failure to void after intercourse, improper hygiene, female anatomy, low estrogen levels in postmenopausal women, catheters or a foreign object placed in the urinary tract for a long period time, pregnancy, and diabetes mellitus. 4. The strategies that D.K can take to avoid the recurrence of a UTI would be clean perineal hygiene, stay well hydrated, wear cotton crotched underwear, void after intercourse, avoid feminine hygiene deodorants, avoid harsh toilet paper, and avoid tight fitting pant. Case 2 1. Due to the loss of blood P.W is at risk for pre-renal acute renal failure and it may lead to poor renal perfusion. 2. The best type of treatment to prevent renal failure would be adequate fluid volume replacement with blood or any isotonic solution maintain proper blood volume circulation and to maintain adequate blood pressure and perfusion to the kidneys. 3. P.W. is in the stage of pre-renal oliguria. This means that the kidneys are functioning as the should if blood volume and pressure are low. The kidneys will conserve...
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...Straight Catheterization Straight catheterization is a task that many patients have to perform themselves after they are discharged home. The main issue with straight catheterization that was recognized was the occurrence of infections, such as urinary tract infections, and patients learning how to straight catheterize themselves once they are discharged home. The teaching project focuses on the actual insertion of the catheters among men and women, tips and tricks, and proper cleaning techniques for both genders. Identification of Clinical Issue Intermittent self straight catheterization is not a common practice for the everyday person therefore it is an important topic to teach patients that require this procedure before they leave the...
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...very common and debilitating disorder that affects the urinary system. These stones are formed from substances that are naturally occurring in the body, but become problematic when they reach highly concentrated levels in the kidneys. Although the formation of kidney stones are not fully understood it is believed that certain foods can increase the risk for developing this urinary disorder. Changes in dietary lifestyles have been shown to help prevent the recurrence of kidney stones. During the acute phase of kidney stones, patients may experience certain symptoms such as painful urination, blood in their urine, or have sharp pains in their lower back, flank area, or lower abdomen. In order to diagnose kidney...
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...Applications of Epidemiology-A case study Analyze Good Health Hospital’s records and itemize recent nosocomial infections that occurred within the past year. In your report, categorize the different parameters (i.e. person, time, place and ethnicity and gender) used in the compilation of data into the information summative. Hypothetically, Good Health Hospital is assumed to have possessed nosocomial infections as in any real hospitals where patients seek admission for treatment. According to Center for Disease Control and prevention (CDC), and Pennsylvania Department of Health (PADOH), a healthcare associated infection (HAI) which is also known as nosocomial infection is an infection that a person gets while staying as a patient in a hospital or other health care facility (PADOH, 2008). Hence, it is clearly understood that patients always acquired nosocomial infections during the process of receiving health care services from health professionals in any hospital or healthcare setting. PADOH has also confirmed that HAIs are the primary contributors of most sicknesses and mortalities in the world. For example, in American hospitals alone, HAIs account for about 1.7 million infections causing 99,000 deaths each year. Therefore, based on the analysis of Good Health Hospital records, research had shown that a great number of recent nosocomial infections that had happened before were identified. Among the different kinds of nosocomial infections verified, few infection type have been listed...
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