Catheter-Associated Urinary Tract Infection (CAUTI) Capstone Project

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[. . .] In another review, that was done on clinical trials that had something to do with 500 patients utilizing silver oxide-coated catheters, discoveries showed a decline of UTI occurrence merely among women not expending antimicrobial medications (20% p = 0.003) associated to those utilizing what is called the silicone coated catheter (1.56%). Owing to the differing outcomes from other reviewed studies, the authors recommended that development of less affluent catheters with anti-infective facades is the solution in positively stopping these infections (Citation: K. Ramakrishnan, 2005) .They also found out that there were other measures for instance documentation and intention of agents with aptitude of stopping formation and attachment of biofilm, and utilization of siderophores as some that will bloc the action of the bacterial virulence.

To bring down the incidence of biofilm production, catheters have been made covered by biomaterials, combined with antimicrobials (rifampin nitrofurazone, and minocycline,) or antiseptics (silicone and silver oxide). Others took a look at the clinical efficiency of silver alloy-coated and antibiotic-catheters for patients that were put on the long-term supra pubic when comparison to non-coated catheters in reducing UTIs and blockages (Elpern, 2011). Research shows that some methodology accepted and reviews of literature from key health technology evaluations for instance EuroScan and PubMed display that getting to the blockage on time makes a world of difference. Other research showed that 8 random or quasi-random trials were used in comparing numerous types indwelling urinary catheters utilized as short-term measure (up to 3 weeks) in hospitalized adults (Saint, 2009). Discoveries showed that silver oxide catheters are not connected to statistically noteworthy reduction in bacteriuria likened to non-coated catheters in short period practice.

On the other hand, silicone coated catheters utilized as a short-term amount exposed a statistically important reduction in bacteriuria for catheterization period beyond one week. These results were parallel to a systematic evaluation which involved 13 random and mock-random trials for nitrofurazone-coated urinary catheterization for a few weeks (Catheter-Associated Urinary Tract Infection (CAUTI) Event, 2011). It was decided that utilization of silicone-coated catheters for temporary use significantly takes the risk down in regards to catheter-related UTI. The reduction in infection seemed to recompense for the better prices of silicone catheters (Institute for healthcare improvement, 2012). The authors also came to the conclusion that antibiotics have a way of lessening the bacteria that are in catheterized hospitalized patients for length of below one week. These results propose that silicone-coated and silver-coated catheters saves rates associated to normal catheters.

Target Audience

Patients that are in acute care hospitals that are dealing with indwelling urethral catheters. The demographics take place in California. Sixty women were approached to take part in the interview study. Twenty seven decided to follow through with everything and 21 (aged 18-64, median 45) were interviewed before most of the information saturation was even reached.

Project Implementation

All of participants in the project were recruited from a large randomized trial of various kinds of management strategies, in which patients were randomized inside the discussion to one of five type of management groups such as: empirical delayed antibiotics, empirical antibiotic treatment, antibiotic pursued by indication total (two or more of urine that is cloudy, urine with unpleasant smell, reasonably bad dysuria, or nocturia); antibiotic consistent with the dipstick procedure (leucocytes or nitrites and a traces of blood); or mid-stream urine examination with symptomatic treatment up until culture and feeling outcomes were obtainable.

Empirical antibiotic treatment

This is the most everyday strategy in practice and was utilized as the control group. Most of the patients were recommended an antibiotic (trimethoprim 200 mg two times every day) for about four days. In any case that the patients happened to be allergic to the drug of trimethoprim then they would be given an alternative drug called (cefalexin or cefaclor) as this was not a pilot of antibiotics as such nonetheless a trial of management/advice approaches.

Empirical delayed antibiotics

Everyone of the patients had been advised to drink a lot of water and most of them were offered a deferred antibiotic medicine to be utilized if symptoms did not begin to get any better when their 48 hours were up (physicians were requested to leave a prescription at the front desk for patients to gather it needed, or they were able to discuss with the patient if they desired to take the medicine away). The basis is that 48% of patients with supposed urinary tract contagion do not have any type infection, and, even in those with research laboratory analyzed infections, the disease is probable to be self- controlling.

Evaluation

Following ethics of constant comparison, the researcher thematically analyzed interview data that was transcribed in an iterative way. This had something to do with moving back and forth among the interview transcripts, premature analytical memos/notes in regards to the procedure, and also the research literature (Institute for healthcare improvement, 2012). Horizontal and vertical familiarization of the interviews was assisted by creation of synopses of each. (Catheter-Associated Urinary Tract Infection (CAUTI) Event, 2011) After recurrent readings (while hearing the taped interviews) GML established an early coding outline founded on five transcriptions. "Crude counts" of explanations/themes delivered a suggestion of their occurrence. (Yoon, 2013) In a sample of interviews that have been transcribed, PL self-sufficiently observed the power of the early codes and the correctness/dependability of their claim to the recorded information. The constancy of coding/explanation was also checked throughout analysis by coming back to annotated transcripts at various time periods. Codes were iteratively established by every one of the authors and in due course every part of the data was systematized and codes combined to produce themes that caught the range of experiences and interpretations that were reported.

When it came down to the Catheter-Associated Urinary Tract Infection every one of those that participated had been asked what they believed caused the urinary tract infection. Fifteen of the 20 women that had been interviewed talked about earlier experiences of cystitis or urinary tract infection, however when asked to talks about the natural history/warnings and signs of urinary tract infection a lot of the women actually struggled. Responses also specified a need for greater than before chances for patients who go with a supposed urinary tract infection to deliberate the circumstance and the indication (and uncertainty) about the efficiency of antibiotic medicine.

One of the things learned was the limitations of the project. Those that were interviewed could have been holding back some therefore making it a little difficult is extracting the data needed for the investigation. Another learned was when diagnosing any disease; it is significant to utilize recognized criterions for disease description. The NHSN is an investigation arrangement of the Centers for Disease Control and Prevention that delivers statistics for prevention, tracking, and obligatory community recording of health care-related infections. The NHSN strategies for the analysis of suggestive UTIs are the acknowledged standard for identifying and recording nosocomial UTI occurrence in health care administrations. Upon completion of this activity you will be able to:

Describe at least 3 unintentional negative consequences of needless antibiotic use.

Describe the bacterial colony count best connected with a clinically important urinary tract infection (UTI).

List the clinical symptoms and signs and suitable to guide testing for the analysis of UTI.

Cite the danger of bacteremia related with UTI.

Some of the strengths of the project were the interviews of the 20 women. What made this strong were the answers and the detailed information that was extracted from each woman. Every one of those that participated was asked what they thought caused urinary tract infection and most were able to reply with a reasonable answer. What the researcher learned from this qualitative interview study as that they were able to discover that women that are suffering with urinary tract infection want to evade taking antibiotics and are open to other management strategies, as well as a delayed antibiotic medicine. These women actually valued the chance to evade the uninvited side effects related with antibiotics and to permit "natural" healing of the body. For most, postponed prescribing was comforting on two levels. Initially, having a prescription that is waiting in the general practice function was comforting for the reason that it meant that they could gather the antibiotic just in case their symptoms had gotten even worse. Secondly, being able to have a medicine accessible to them authenticated patients' involvements of their symptoms.

One of the unanticipated events came about with a few negative involvements of postponement, when being asked to "wait a long time" served to weaken the validity of their visit. In conclusion, the study point outs that women with and without preceding experiences of urinary tract infection may not completely comprehend the causes or could possibly draw on a theory of self -responsibility and carelessness, or both. Some women appeared to look at antibiotics as essential for… [END OF PREVIEW]

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Catheter-Associated Urinary Tract Infection (CAUTI).  (2013, May 27).  Retrieved February 20, 2019, from https://www.essaytown.com/subjects/paper/catheter-associated-urinary-tract-infection/4613183

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"Catheter-Associated Urinary Tract Infection (CAUTI)."  Essaytown.com.  May 27, 2013.  Accessed February 20, 2019.
https://www.essaytown.com/subjects/paper/catheter-associated-urinary-tract-infection/4613183.