Scope and Impact of the Problem (Essay Sample)

Introduction
The common infections of all the reported cases are the Urinary Tract Infection, which is treatable by the primary care givers. The most common types of urinary tract infection are the cystitis and urethritis. However, indwelling catheter acquired urinary tract infection (CAUTI) is one major complication of nosocomial urinary tract infection accounting to more than five hundred thousand patients in United States representing thirty percent of health care related infections. Leave the over one million catheter-associated Urinary tract infection in United Kingdom alone, the statistics was conducted by the Center of Disease control and prevention (CDC) in 2009. The condition has led to unnecessary prolonged hospitalization and an increase in the cost of health care. Although, an estimated 69% of CAUTI is preventable with recommended control measures. Some of the patients are at risk to acquire urinary tract infection caused by the catheters while, in the hospital, these are nosocomial infections. These are infections acquired in hospital setting after a patient has been admitted and present itself two to three days after admission. The condition occurs especially to those patients that are diabetic, geriatric and those patients whose immune systems are compromised (Parker et al., 2009). Prevention of catheter-associated urinary tract infection relies on several factors such as using catheters as the last resort or has appropriately indicated. Secondly caring for the device properly when it has been inserted and lastly promptly removing them when necessary. The study seeks to find out the problems associated with catheter acquired urinary tract infection, its outcomes and the recommended preventive measures through the evidence -based practiced (EBP).
Scope and impact of the problem
Over the years, CAUTI has been identified as the most frequent infection in hospital settings. In a study conducted by (APIC,2008) CAUTI comprised o36% of all types of hospital Acquired Conditions(HAC). The worst part is that the Medicare doesn’t offer any payment for this condition because it is acquired in the hospital settings. Therefore, the patient is billed for the same. Most of the hospital does not follow consistently the recommended practice to address this treatable condition (Leapfrog, 2007). Some of the patients don’t have the pre-requisite knowledge of the conditions to warrant the use of catheters, others do not seek the necessary healthcare in time to prevent complications. While some patients insist on early discharge without proper analysis of the healing process with the indwelling urinary catheters are in place. Another problem that poses challenges to healthcare providers is the inappropriate use of catheters, for example, the use of the catheter has a substitute for nursing care of incontinence. Using catheter as a means of obtaining urine for laboratory analysis or to be used for patients receiving analgesia or epidural anesthesia. This challenge have prompted the health care givers like doctors and nurses and doctors especially urologists and nurses to have an in-depth understanding of the condition and how to prevent and properly manage it.
Literature review
Centre for disease control and prevention concluded in 2010 that patients who acquire CAUTI add approximately one thousand dollars in health care costs. These have made it so costly for many hospitals to offer treatment to patients developing these conditions.
Andreessen, Wilde & Herendeen in 2012 did an empirical quantitative research on the prevention of urinary tract infection caused by the use of Foley Catheters. This was done by choosing samples from patients who had Foley indwelling catheters placed for thirty days. A multi-disciplinary team was created comprising of a urologist, staff nurses, infection control nurses, surgical nurses and information technologist. The sample was taken from male patients who had indwelling urinary tract catheters, the data on insertion and removal of the catheters was recorded over a period of eight months. The pre-intervention phase included mandatory training for all the health care givers on the insertion and removal procedures that took two months to conclude. The post-intervention took one month that included data collection on establishing if the caregivers complied with daily routine of maintaining the catheters. The collected data was compared between pre- intervention period and the post-intervention period. The statistics comparison was to find out the outcome measures, as well as the process measures. The information received was the use of the Foley urinary tract catheter and the duration of the catheter use. The research implication was to investigate the recommended effective measures on using closed drainage system and catheter removal. The result showed that after these interventions there was a decrease in catheter duration of use (P=,002) in both pre and post intervention.
Another empirical study was done by the National Institute for Health Research in 2012, the research was done on twenty-four selected hospitals In United Kingdom in a randomized controlled trial. The selected patients were randomized to be catheterized by silver alloy, nitrofural-impregnated or catheter coated by PTFE. The primary outcome showed the presence of symptomatic catheter- associated urinary tract infection which required prescription of antibiotics. Secondary outcomes confirmed occurrence of bacteria after the removal of catheter and discomfort in the urethra area. Six thousand three hundred and ninety- four participants were analyzed, out of these twelve point six percent of the participant showed incidence of CAUTI. On those using alloy coated catheter compared to ten percent of those using the nitofugal catheter.
In 2012, the Association of professionals in infection control and Epidemiology conducted a qualitative research that included two hundred and fifty-five hospitals. The aim was to examine care practices intervention for CAUTI prevention. Electronic survey was employed to collect data on maintenance techniques, training of nurses, surveillance and removal of the catheters. The results showed that prevention practices involved the use of gloves (97%), hand washing (89%), sterile barrier maintenance (81%) and insertion without touch technique accounted for (73%) of all those sampled.
However, there are barriers to overcome towards successful implementation of CAUTI intervention measures. For instance, nursing workload was cited as one of the barriers related to insertion and removal of catheters in assisting patients during toileting. Another barrier noted was perception of nurses in relation to safety measures during a patient fall and catheter use; nurses were more concern on preventive measures rather than infection concern of the catheters. Another strategy to overcome these barriers is by emphasizing and focusing on the removal of the catheter has early as possible and its benefits to the patient.
Recommendations
The recommendations are based on the evidence of an intervention based on the studies conducted above.
To get rid of urinary tract bacteria entering through the catheter, a closed drainage system should be put into place. The system will act as a barrier(Leone et al.,2003).
Another recommendation is placing Povidone iodine in the bag that collects urine this will disinfect the bag. This will inhibit the invasion of microbial and eliminate the reservoir of bacteria on the catheter.
Moreover, to avoid Bacteriuria the disconnection of the drainage bag and the catheter must...