Dissertation on "How to Reduce Catheter Induced Urinary Tract Infection in Jim Thorpe Rehab"

Dissertation 15 pages (5118 words) Sources: 25

[EXCERPT] . . . .

Reducing Catheter Induced UTIs

Reducing Catheter Induced Urinary Tract Infections

Catheter induced urinary tract infections are common occurrences in any hospital-like setting. Because of this, catheters should only be used when absolutely necessary and not because it is convenient for hospital staff. Although this type of infection is very common, it is also very preventable. Such things as the type of catheter used, proper hygiene, as well as frequent replacement of the catheter can go a long way in preventing any type of infection from occurring. The prevention and reduction of urinary tract infections due to indwelling catheters is of great benefit to the patient, not only medically, but for some monetarily also. This is because Medicare and Medicaid will no longer pay for any type of hospital acquired infections and urinary tract infections resulting from an indwelling catheter fall into this category.

IMPORTANCE OF TOPIC

This project is aimed at reducing catheter induced infections in patients. The reason for this is because it will reduce the morbidity rate of patients from this type of infection as well as reduce cost for the patient and the hospital. Catheter induced urinary tract infection is a universal problem and one way to combat it is the use of non-latex catheters since many patients have found to be allergic to latex. Instead, the recommended type of catheter is the all silicone, silver lined one. This catheter has been shown to reduce the rate of urinary tract infections in patients.

This issue is of great importance to nursing education because the nurses are generally the ones that insert the catheters and are responsible for the care of the patients with the catheters. Nurses must be educated on the necessity of the catheter and should determine if other, safer methods are available. They should also be aware of such things as proper hand hygiene in order to reduce the rate of infection because according to Deutsch, as many as 1.7 million hospital acquired infections occur in the United States annually resulting in at least 99,000 deaths (2008).

Jim Thorpe Rehab is affiliated with the Integris Southwest Medical Center. Southwest Medical Center has already implemented procedures regarding Foley catheters which have cut down on the number of days the patients need to keep the catheter in. Since certain information is classified and can only be viewed by hospital personnel, Jim Thorpe Rehab does not know of the policies. As a result, Jim Thorpe Rehab must come up with their own set of policies to implement. This is necessary because the facility has a large Medicare and Medicaid patient base and cannot afford an abundance of infections that they will ultimately be responsible for financially.

It should be mentioned that the rehabilitation facility does not have a high incident of catheter induced urinary tract infection patients, but procedures need to be documented for the benefit of the hospital and the patients. Also, beginning in 2008 Medicare and Medicaid will no longer pay for hospital acquired infections so the hospital staff must have written procedures on how to cut down on the rate of infection and the Medicaid and Medicare patients need to be informed of any financial obligations.

III. LITERATURE REVIEW

With regard to the type of Foley catheter used, much has been written about the all-silicone silver Foley catheter because of its ability to repel infections. The use of this type of catheter has been proven to reduce the incidence of catheter induced urinary tract infections as well as medical costs associated with these infections (Bystrom, 2005; Caudill, 2005; Davis, 2005; Foster, 2005; Hutchins, 2006; Mack, 2005; McArdle, 2005; and Sullivan, 2005). Many hospitals and healthcare facilities have switched over to the used of the silver coated Foley catheters, and although they are better than latex in the reduction of infections, there is still a chance that the patient will get an infection if other measures are not taken.

Drekonja notes that knowledge regarding the use of Foley catheters and ways to prevent infection has increased among nurses. An internet survey was administered to several nurses in Minnesota and the majority of them agreed that the use of the silver coated catheters as well as cleaning and replacement will cut down on the incident of the patient catching a urinary tract infection (2010). Graves did a study on the correlation between the length of the hospital stay and the incident of the patient getting a catheter induced urinary tract infection. He found that the greater the length of the hospital stay, the more likely the patient was to get the infection and that this coupled with older patients increased the likelihood of getting the infection even more (2007). For this reason, nurses and other staff should not assume that the silver plated Foley is a guarantee against infections. Proper care must still be taken for the patient involved.

Given that urinary tract infections account for approximately thirty percent of hospital acquired infections in health care settings, it makes sense to find ways to reduce this number. Rothfield states that of this thirty-percent, eighty percent of these infections are catheter related and those simple measures can be taken to greatly reduce this percentage. He says that in most health care settings catheters are overused and other methods for infection reduction are readily available such as using superabsorbent diapers instead. A study was conducted at a medical facility using the superabsorbent diapers and Rothfield reports that the rate of catheter induced urinary tract infections decreased from 48 patients to just 9 patients within a short amount of time (2010). The use of a diaper may seem an embarrassment to some, but a skilled nurse can explained tactfully how wearing the diaper gives the patient more freedom than the catheter would. They can also explain how the chance of getting the catheter reduced urinary tract infection has been eliminated because there is no catheter involved.

This issue is apparently prevalent in medical facilities worldwide. In Japan, a study was done by Tsuchida, et al., on the rate of catheter induced urinary tract infections and they discovered that many nurses in several medical facilities assumed that by using the all silicone silver plated catheters meant that they could provide less care and upkeep for the patient. As a result, the rate of infection increased which meant that the nurses should have been educated on this type of catheter before using them on patients (2008). Even though this type of catheter has been shown to reduce the rate of urinary tract infections, the same care and hygiene practices used for other types of Foleys should still be administered with the newer types of catheters. If not, the same situation that happened at the medical facilities in Japan is likely to happen elsewhere.

Although the type of Foley catheter used can help to prevent urinary tract infections, other steps and measures taken by hospital personnel can also be followed in order to reduce the risk of infection. Typically, when a patient is in the Intensive Care Unit (ICU) of a hospital or healthcare facility, he does not maintain the ability to use the bathroom facilities on his own. As a result, a catheter may be used. Allen found that a major cause of infection was due to cross contamination by hospital workers. He says that something as simple as washing hands in between patients can eliminate this, but may nurses and healthcare providers fail to do this simple step (2005).

Allen's example outlines why the need for a monitored hand washing system is necessary. A hand hygiene monitoring device was conducted at the Toronto Rehabilitation Institute in Ontario, Canada. Small monitoring devices were installed in patient rooms as well as restrooms and healthcare professionals wore a badge-like device which notified them to wash their hands upon leaving the room. The frequent washing of hands helped to reduce the spread of hospital acquired infections (Boscart, 2010).

It should be noted that washing hands with soap and water may not always be possible, so hospital should ensure that dispenser with anti-bacterial gel is easily accessible throughout the medical facility. This is due to the fact that in addition from spreading one patient's germs to another because of lack of hand washing, a healthcare professional my touch an object in the hospital that is not as clean as it should be. This is considered environmental contamination and this coupled with lack of hand washing can definitely increase the rate of infection (Carling, 2010). Education regarding the prevention of hospital acquired infections is crucial. The appropriate staff should be educated on issues such as proper care and cleaning of the catheter, hand washing hygiene and even when to determine whether or not a catheter should be used at all (Gokula, 2007).

The push to use the all silicon, silver coated Foley catheters as well as to eliminate hospital acquired infections is important because not only does it lower the morbidity rate, it also lowers costs. Although… READ MORE

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