...Assessment task 2- Scenario 2 Urinary tract infection is one of the most common infections diagnosed among women in the world. There has been increasing concern for alternative method to treat urinary tract infection over antibiotics since misuse of antibiotics can led to bacterial resistance(Scholes et al., 2004). This essay will establish PICO (population, intervention, comparison and outcome) question in the given scenario where a 22 year old Susan visits the GP with symptoms of urinary frequency, dysuria, lower back pain and shivering. She was diagnosed with Urinary tract infection (hereby referred as UTI) and antibiotics were prescribed. However after developing thrush due to antibiotics for urinary tract infection previously, she is reluctant to take antibiotics. On surfing the internet she read about cranberry juice being used to treat UTI and is considering to stop her antibiotics. PICO question development In order to provide the right pathway to commence our research and ensuring that every questions are suitable and relevant, PICO model will be used which is Population, Intervention, Comparison and Outcome(Bronson and Davis, 2011). In the given scenario, population would be women suffering from UTI. Similarly intervention is using cranberry juice to prevent UTI and comparison is to use antibiotics. Richardson et al., 2014 mentioned that the outcome would analyze the effectiveness of the intervention. Therefore the outcome would be effectiveness of cranberry...
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...because there have been many problems and issues that the healthcare setting have encountered. Theses guidelines reduce or decrease, “Never Events”, while improving quality care and patient safety. The purpose of this paper is to review the guidelines that has been developed to address the Urinary Tract Infections (UTI) problem, it’s importance and significance to nursing practice, as well as its impact on the patients and community, and the differences in care based on evidence. “Patients with indwelling catheters, even with current standards of care and evidence-based practice, urinary tract infections continue to be a problem”(Kevin J. Ribby, June 2006). Practice setting problem Urinary tract infections continue to be a problem in healthcare. The numbers of patient’s with urinary tract infections are still too high. “A plethora of articles have been written about nosocomial urinary catheter-related infections, management of the catheter, and proper placement of the indwelling catheter in the male patient 4 but little about the impact of nursing education on outcomes related to decreasing UTIs and usage of indwelling urinary catheters” (Doyle B, Zubina M, Horgan M, 2001). There are a various reasons for why nurses continue to see urinary tract infections like incorrect perineal cleaning, a break in aseptic technique when inserting urethral catheters, and the amount of time a urethral catheter remains in a patient. There have been various evidence-based practices that...
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...Urinary Tract Infection in the Geriatric Population Elizabeth Shultz Abstract The geriatric population is very vulnerable to Urinary Tract Infection (UTI) and its negative consequences. If left untreated, UTI in the elderly patient can have negative consequences such as delirium or even death. UTI can also contribute to the onset of acute or chronic kidney infections, which could permanently damage the kidneys and result in renal failure. In view of this, the purpose of this paper is to review related literature to find current evidence or best practices related to UTI in the geriatric population and to objectively critique the evidence. CINAHL and MEDLINE computer databases were mainly searched from January, 2005 to January, 2015 using a combination of manual and computer-based methods. Keywords: elderly, urinary tract, elderly infection management, urinary tract infection prevention, elderly and UTI. Introduction By convention, a Urinary tract infection (UTI) is defined either as a lower tract (acute cystitis) or upper tract (acute pyelonephritis) infection (Nicolle, 2014). Urinary tract infection (UTI) is the most common infectious problem among older adults both in the community and institutional settings (Midthun, Paur, Bruce, & Midthun, 2005). The elderly population is most likely to experience UTI due to many reasons, not the least of which is their overall susceptibility to all infections...
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...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...
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...An APIC Guide 2008 Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs) Developing and Applying Facility-Based Prevention Interventions in Acute and Long-Term Care Settings About APIC APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The Association’s more than 12,000 members have primary responsibility for infection prevention, control and hospital epidemiology in healthcare settings around the globe. APIC’s members are nurses, epidemiologists, physicians, microbiologists, clinical pathologists, laboratory technologists and public health professionals. APIC advances its mission through education, research, consultation, collaboration, public policy, practice guidance and credentialing. Look for other topics in APIC’s Elimination Guide Series, including: • • • • Catheter-Related Bloodstream Infections Clostridium difficile Mediastinitis MRSA in Long-Term Care Copyright © 2008 by APIC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the publisher. All inquires about this document or other APIC products and services may be addressed to: APIC Headquarters 1275 K Street, NW Suite 1000 Washington, DC 20005 Phone: 202.789.1890 Email: APICinfo@apic.org Web: www.apic.org ISBN: 1-933013-39-7 ...
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...CHAPTER ONE 1. INTRODUCTION 1.0 DEFINITION OF TRADITIONAL MEDICINE, HERBAL PREPARATION AND FINISHED HERBAL PRODUCTS The World Health Organization (WHO) defines traditional medicine as the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures. Traditional medicine is used in the maintenance of health the prevention, diagnosis, improvement or treatment of physical and mental illness, whether explicable or not and is passed on from generation to generation. Herbal Preparations contain plant parts or plant material 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...
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...recently developed a poster and video approach with special focus on alternatives to urinary catheterization, removing catheters early, and the reinforcement of sterile technique prior insertion and foley catheter care were used to educate nursing staff and improve outcomes. The purpose of this paper is to educate nursing on how to be proactive with this issue and to inform the providers when there is no further need for the catheters to reduce infections in patients. Practice setting problem Urinary tract infections (UTIs) account for approximately 35% of nosocomial infections but are the lowest in mortality and cost (Burke, 2003). Patients with UTIs as a secondary diagnosis have an average length of stay of 9.1 days versus those without a urinary catheter of 4.7 days. As individuals live longer, the probability of them being hospitalized and requiring specialized care services is increased (Hobbs, 2001). Hospitalization of any aged person increases the risk for them to have a urinary indwelling catheter, which predisposes them to a nosocomial urinary tract infection (Saint, 2003).Nurses are responsible for placing and maintaining the indwelling catheters. Often non-licensed staff are being delegated these tasks, without the proper training and education on routine catheter care and catheter insertion. Importance of the clinical problem and its significance to nursing practice Nosocomial infections more than double the mortality and morbidity...
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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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...A hospital-acquired infection (HAI) or nosocomial infection is an infection whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff. In the United States, the Centers for Disease Control and Prevention estimated roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year. In Europe, where hospital surveys have been conducted, the category of Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to attack with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital. HAI is sometimes expanded as healthcare-associated infection to emphasize that infections can be correlated with health care in various settings (not just hospitals). Nosocomial infections are commonly transmitted when hospital officials become complacent and personnel do not practice correct hygiene regularly. Also, increased use of outpatient treatment in recent decades means that a greater percentage of people who are hospitalized today are likely to be seriously ill with more weakened immune systems than in the past. Moreover, some medical procedures bypass...
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...collecting system. It usually begins with an infection and colonization in the lower urinary tract through the ascending urethra. The types of patients at risk are patients who require frequent catheterization or the use of an indwelling catheter. This could potentially expose the patient to the different bacteria that are likely to cause pyelonephritis. Those bacteria types are E. coli, Proteus, Klebsiella, or Enterobacter. If the patient experiences recurrent episodes it can lead to the kidneys being scarred and becoming dysfunctional, it will have progressed from acute to chronic pyelonephritis. (Lewis, Ruff Dirksen, Mclean Heitkemper, Bucher, & Camera, 2011, pp. 1127,1128) Assessment The patient is a 70 year old female who is a resident of a local nursing home. She has been complaining of unilateral flank pain, which she states gets more intense in the evenings. There at also been times when observed by staff at the nursing home when she seemed increasingly confused or disoriented. During the assessment she stated her flank pain was 8 out of 10, a fever was also noted at 38.9 degrees Celsius. As the assessment furthered she also stated that she has had a decrease of appetite and some GI discomfort. She stated this has been going on for about 4 days, she does require in and out catheterization which she performs herself. Nursing Diagnosis The patients nursing diagnosis is: Acute pain r/t inflammation of the urinary tract aeb patient states her pain level is a 8/10...
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...KOT TASK 2 FINAL PAPER According to medicare.gov, Medicare insurance coverage is governed by federal and state laws, and the decision of whether a service is covered, or not, is made by Medicare. Moreover, insurance coverage/decisions are handled by local companies that process Medicare claims. These companies will make the decisions of whether procedures, and/or interventions recommended, are medically necessary, and whether that particular service is covered in their area (Medicare.gov). Scenario# 1 A1. Medicare Part A Explaining insurance coverage to Mrs. Zwick, and her daughter, must be done in a simple and informative manner, keeping in mind that insurance coverage is a complex process that often varies. However, below are some pointers to be addressed during the Mrs. Zwick’s discussion. Medicare Part A, A.K.A. hospital insurance, insures hospital services days (inpatient care, general nursing care, meals, medications, semi-private/private room if medically necessary, and supplies), and up to 100 days of coverage in a Skilled Nursing Facility (SNF). To qualify for Medicare Part A coverage, the physician orders must include the amount of midnights (count) needed to treat the illness and/or injury. Patients must stay in the hospital for over 72 hours (admitted for inpatient medical care). Hospital stay less than 72 hour, will be considered as outpatient care, and a disqualifier for coverage. At discharge, the primary care physician (PCP) must write an order...
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...Hygiene Change Project Capstone NU296 September 18, 2013 Introduction The lack of hand washing and/or hand sanitizing is a leading cause of nosocomial infections in healthcare facilities not only here in Nevada, but across the United States. Hand washing is one of the biggest contributing factors in stopping the spread of infections throughout the healthcare environment. Nosocomial infections could be dramatically reduced by monitoring and enforcing hand washing and/or “gel in, gel out” policies of each facility. This could also lower the length of stay per patient, and greatly reduce the medical care cost per patient. Analyze the current situation and provide evidence based resources to support the need for change and your proposed plan. Include ethical, legal, or standards of care implications. Washing hands as promptly and thoroughly as possible between patient contact and after contact with blood, bodily fluids, secretions, excretions, and medical equiptment contaminated by patients is a huge element in infection control. Hand hygiene is recognized by infection prevention and control experts as the single most important intervention in decreasing the spread of infection in healthcare facilities. Unclean hands are the main transporters for germs between people and inanimate objects (i.e. blood pressure cuffs, bed rails, call lights, etc…). It is imperative to practice frequent...
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...This assignment reflects on one day’s care delivered to a patient during my practice as a healthcare support worker (HSW). It presents anatomy and physiology of the urinary system and focuses on the patient’s catheter use, urinalysis, regular intake of medication and legal issues associated with delivery of care to the patient without mental capacity to make crucial decisions in his life. For the purpose of this care study, I use the pseudonym Chris for the patient in order to protect his identity and maintain confidentiality (NMC, 2008). There is also a legal obligation under Data Protection Act (1998) not to disclose patient’s personal details. Chris is a 73 year old male, who I worked with in a residential home for people with learning disabilities and challenging behaviour, where he was residing. Chris has been diagnosed with a learning disability (LD), which means that he has significantly. reduced ability to understand new or complex information and learn new skills (Department of Health, 2002). He has a reduced ability to cope independently due to recent leg amputation and the LD. Amputation is the surgical removal of a limb or body part (Mosquera, 2010). It was performed on Chris’s right leg above the knee to relieve the recurring pain caused by a severe case of peripheral artery disease (PAD). The PAD is a form of peripheral vascular disease in which there is partial or total blockage of an artery, caused by deposits of fat built up along its walls (Patient UK...
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...Preventing Hospital Associated Infections April Shannon Walden University NURS 4000 Section 04, Research and Scholarship for Evidence-Based Practice November 18, 2012 Change in Practice: Preventing Hospital Associated Infections Benjamin Franklin was quoted as saying “an ounce of prevention is worth a pound of cure.” With the increasing costs of healthcare and the emergence of multi-drug resistant organisms this truth still resonates today. Hospital associated infections (HAIs), have been a complication in hospitals for many years. The purpose of this assignment is to address this problem in nursing practice, and discuss evidence on practices that will address this issue. The problem Hospital associated infections (HAIs) can be defined as an infection acquired in hospital by a patient who was admitted for a reason other than that infection. An infection occurring in a patient in a hospital or other healthcare facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility (central line associated bloodstream infections, catheter associated urinary tract infections, surgical site infections, ventilator associated pneumonia, etc.) (World Health Organization, 2002). HAI’s have become one of the leading caused of hospital related deaths in the United States. However, these infections have been proven to be...
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...chromosomes from the father and twenty-three chromosomes from the mother combined, resulting in forty-six chromosomes in each cell. A congenital abnormality that results from an extra copy of chromosome eighteen is called Edwards’ disease or Trisomy eighteen. During Meiosis, chromosome eighteen is duplicated three times, causing developmental issues that are life threatening. This genetic defect in most cases causes the fetus to be stillborn at birth (Trisomy 18 foundation, 2010). According to Thomas Weiss, “Edwards' syndrome is associated with a broad spectrum of abnormalities which consist of greater than one-hundred and thirty discrete defects involving the brain, heart, craniofacial structure, kidneys and stomach.” The purpose of this paper is to examine what Edward’s syndrome is: diagnosing, symptoms, treatment/management and prognosis. Diagnosing Diagnosing a Trisomy Eighteen infant, starts with genetic testing when the infant is in utero. A Trisomy Eighteen chromosomal defect occurs one out of every six thousand births. Genetic testing is preformed after ultrasound detects abnormalities. An ultrasound alone is not able to diagnosis an infant with Edwards’ Syndrome. This is used as a routine check-up to look at the growth and development of the fetus. Ultra sounds can...
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