Project On Catheter Associated Infection



Preventing Catheter-Associated Urinary Tract Infections

The United States of America in known for its advanced medical practices and equipment, however, hospital-associated infections (HAIs) have a tremendous impact to the healthcare system. According to Healthy People 2020, Healthcare-associated Infections (HAIs) are related to increasing cost of health care in the United States as well as mortality and morbidity. These types of infections are preventable. Indwelling catheters count for about 80% of urinary tract infections (CDC, 2013). As healthcare professionals and adhering to the principle of nonmaleficence, we are obligated to make efforts to implement strategies to avoid any risks to harm patients. Proper assessment of patients regarding indwelling catheter insertion need, maintenance and care requires the collaboration of the entire interdisciplinary team. Evidenced-based practices (EBPs) have found a relationship between chlorhexidine (CHG) wipes usage and CAUTI reduction. This project’s goal is to provide safe-centered patient care in prevention of CAUTI through utilizing CAUTI Surveillance Bundle and implementing new interventions such as daily Chlorohexidine Gluconate (CHG) bathing for patients with Foley catheter. The author of this proposal will be providing an in-depth investigation into the background problem, discussion of the implementation of CHG wipes instead of regular wipes for perineal care for CAUTI prevention, as well as presenting evidence-based research reviews that support the project and potential barriers to success.


Even though, measures to decrease the incidence of HAIs is the priority of many healthcare organizations, acute care facilities reported 54,500 cases of CAUTIs in the U.S in 2012, which represents a 3 percent fold increase from 2009 (Knudson, para. 1, 2014). Factors associated with the prevalence of CAUTIs is the inappropriate use of indwelling catheters, in addition to improper insertion techniques, and inadequate and poor catheter maintenance (Strouse, 2015). Preventing CAUTI by employing CHG wipes for perineal care has been proven to be effective. By using CHG wipes for perineal care the colonization of bacterial could be eliminated. One key reason for CAUTI is the overgrowth of bacteria that invade the lower urinary tract. CHG wipes have an antiseptic component that inhibits the growth of bacteria in the body (Flores-Mireles, Walker, Caparon, & Hultgren, 2015). The integration of best practices, patient involvement, and ongoing education and training for the nursing and medical staff in CAUTI prevention is imperative.

Problem Statement

The problem at hand is the difficulty that this author’s facility is experiencing in reducing the rates of urinary tract infections (UTIs) despite the implementation of indwell-catheter care bundles. The most common and costly healthcare related infection that prolongs the length of

stay and comorbidity is catheter-associated urinary tract infections (CAUTI). Furthermore, it is

one of those conditions that the Center for Medicaid and Medicare Service (CMS) no longer

reimburses the extra cost of treatment if a patient develops it during hospitalization (CMS, 2012).

Regardless of how hard many organizations put energy to reduce CAUTIs; the U.S. Department

of Health and Human Services indicates CAUTIs rate has increased by 9% between 2010 and

2013 (AHRQ’s, 2008). With all the penalties from CMS and continued effort from hospitals to

implement the best practices to reduce CAUTIs, Foley catheter use and Catheter-associated

Urinary Tract Infections continue to grow (CDC, 2010). Improving the adherence to healthcare policies and procedures in order to help prevent CAUTI needs further revision (see Appendix A). The evidence-based proposal arose from the clinical question in relation to the use of CHG wipes in comparison to regular wipes to decrease bacterial colonization in the external catheter and thereby reducing the incidence of CAUTI. One of safety goals set forth by the Joint Commission, is the reduction in the incidence of CAUTI (The Joint Commission, 2015).

Purpose of Proposal

The project’s purpose is to create consciousness of the devastating health complications associated with CAUTI. This project aims to reduce CAUTI occurrence and the process begins the moment the patient is admitted with orders to insert a urinary catheter, and the process ends with discontinuation of the urinary catheter. By working on the process, we expect to achieve the following:

· Prevent and decrease Catheter-associated Urinary Tract Infections

· Reduce indwelling catheter days

· Improve patients’ outcome, quality of care, and safety

· Decrease CAUTI and urosepsis

· Cut MDRO’s and C. diff that result from antibiotic treatment

· Reduce length of stay (LOS) and readmission

· Decrease cost

· Improve patient satisfaction

CAUTI is not a benign infection. It is important to work on this project because every

patient deserves to receive quality care that is safe, cost effective and is evidenced based.

After reviewing several research articles pertaining to CAUTI prevention, it was concluded by many of the researches that CHG wipe usage help reduce CAUTI rates. The proposed changed would also comply with the EBP guidelines of the American Association of Critical-Care Nurses (AACN, 2017), which support the use of CHG wipes for reduction of bacterial colonization and multi-drug resistant organisms. Lastly, a key objective to this evidence-based proposal for practice is to improve patient outcomes and safe lives.

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