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CAUTI

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The article asserts that CAUTIs are more prevalent in long term catheter use as opposed to short term us.  Statistics reveal that 25-40% of the patients that are who undergo catheterization on the long term, are likely to contract CAUTIs as a direct result. The article does not give examples of mortality or other effects that the shortage of nurses in the general population causes, and especially with specific respect to CAUTIs. Getliffe (2008) asserts that the use of silver alloy- coated catheters would go along way towards preventing the occurrence of CAUTIs both in hospitals and in communities.

In this article, Potter (2006) points out the issues that increase the prevalence of CAUTIs and  those that have led to the continuing rise of the same. Potter further challenges health care personnel to be professional and to pay attention to all possible avenues that they may use to decrease the occurrence of CAUTIs. This includes the use of stipulated guidelines and the taking of all preventative measures, and the use of all available tools to do the same both in hospitals and in communities. The article remains silent on the effect of shortage of nurses in relation to the condition. Potter (2006) however does suggest strict adherence to the rules of catheter insertion and the provision of appropriate care for it as way to combat CAUTIs.

Godfrey H; Fraczyk L; Preventing and managing catheter-associated urinary tract infections. British Journal of Community Nursing, 2005 May; 10 (5): 205-6, 208-12 (journal article - pictorial, tables/charts).

In this article, Godfrey(2005) explores current literary material on the issue of indwelling urinary catheterization. He notes that this issue needs to be considered seriously in light of the rising life expectancy trends. He therefore emphasizes the need to come up wit strategies to both prevent and manage CAUTIs using the best practice guidelines.

 It is noted that catheters, more specifically the Foley catheter have become one of the greatest sources of hospital –acquired infections with long term urinary catheter –associated infections accounting for about 4% of the nurses’ time (Godfrey, 2005).The article draws attention to the need to research and investigate effects of long term urinary catheterization in the community with a view to finding better prevention and management methods of CAUTIs.

The article discusses the use of nitrofurazone(nitrofural)-impregnaetd catheters in the prevention of CAUTIs. It is noted that its ability to combat a wide range of increasing-resistant bacteria and its multiple mechanisms of action might help to fight bacteriuria.No data however is presented on the use of nitrofurazone (nitrofural) in the prevention of CAUTIs. It is considered that the nitrofurns may be a unique weapon in the fight against the CAUTI war as resistance to it has not been formed by bacteria despite many years of its use.

The article describes an investigation of silver Foley catheters with a view of combating CAUTIs. A change to silicon silver ionic catheters from the traditional latex catheters revealed a marked decrease in the occurrence of CAUTIs. The facility trialed an ionic silver Foley catheter finding that it dramatically reduced the incidence of CAUTI in their patient population.

According to Sauter (2012), CAUTIs account for 40% of all nosocomial infections. A multidisciplinary team implemented evidence-based guidelines and a urinary catheter bundle, focusing on optimizing the use of urinary catheters through continual assessment and prompt catheter removal. Data was obtained on catheter device days, compliance with urinary catheter regulation, and computer documentation of continued catheter indications. Results included an overall reduction of 71% in catheter device days and a 56% reduction in catheter use. ‘long duration of catheterization, urine retention, female gender, older age, a history of diabetes, immunocompromise, and being catheterized during childbirth’ are leading causes of CAUTIs ( Sauter,2012).

The article focuses on the role of education of nurses in the prevention of UTIs and specific catheter protocols in the effort to reduce CAUTIs.Studies conducted reveal a decrease in CAUTI with increased efficiency in the following of indwelling catheter protocols.

The actual number of CAUTI after this education was tracked and the outcomes suggest a decrease in the overall incidence of CAUTI in patients due to increased efficiency.

Salomao R; Rosenthal VD; Grimberg G; Nouer S; Blecher S; Buchner-Ferreira S; Vianna R; Maretti-da-Silva MÂ; Device-associated infection rates in intensive care units of Brazilian hospitals: findings of the International Nosocomial Infection Control Consortium. Revista Panamericana de Salud Publica. , 2008 Sep; 24 (3): 195-202

Through the use of cohort surveillance, a study is done to measure the number of mortalities that are attributable to device-associated infections (DAIs) in three Brazilian hospitals.  The article reports that ‘Between April 2003 and February 2006, 1 031 patients hospitalized in five ICUs for an aggregate 10 293 days acquired 307 DAIs, a rate of 29.8% or 29.8 DAIs per 1 000 ICU-day’. The article does not give any example of mortality or any other effect of shortage of nurses on the general population. The DAI rates were high in the ICUs of the Brazilian hospitals included in this study. Patient safety can be improved through the implementation of an active infection control program comprising surveillance of DAIs and infection prevention guidelines. These actions should become a priority in every country.

This article discusses the merits of using the silver alloy-coated Foley catheter in reducing the risk of CAUTI in an acute general hospital. The use of the silver alloy-coated Foley catheters proved to be cost-effective given the recognized additional costs of CAUTI and prolonged in-patient stay (Plowman et al, 1999).A total of 117 newly catheterized patients were actively monitored for signs and symptoms of CAUTI and revealed a decrease of occurrence with silver ally catheter use. A statistical data of mortality is not identified. The silver alloy-coated Foley catheter is recommended as the catheter of choice for use with acute patient admissions requiring short-term catheterization.

Burns, Allison C. BS a; Petersen, Nancy J. PhD a; Garza, Armandina BS a; Arya, Monisha MD, MPH a,b; Patterson, Jan E. c,d; Naik, Aanand D. MD a,e; Trautner, Barbara W. MD, Accuracy of a urinary catheter surveillance protocol.  AJIC: American Journal of Infection Control. 40(1):55-58, February 2012.

The article compares the use of documented adapt about device days in catheterization as a more efficient method of providing urinary catheter data as opposed to visual inspecting of  the urinary catheter at the bedside Individual chart review in the electronic medical record provided very accurate data on urinary catheter use.

Tiwari, Manish M. MD, PhD, MPH a; Charlton, Mary E. PhD a; Anderson, James R. PhD a; Hermsen, Elizabeth D. PharmD b; Rupp, Mark E. MD a, Inappropriate use of urinary catheters: A prospective observational study. AJIC: American Journal of Infection Control. 40(1):51-54, February 2012.

The article indicates that data on risks factors associated with inappropriate use of urinary catheters is scarce. The article presents a study in which ‘157 urinary catheters in 144 patients was observed. A total of 557 urinary catheter-days were recorded in these patients, of which 175 (31.4%) were found to be inappropriate, based on the study criteria. The total number of catheters used and the total duration of catheterization were risk factors for inappropriate urinary catheter use (Tiwari,Charlton,Anderson,Hermsen &Rupp, 2012, p.5).  Inappropriate catheter use was not readily associated with such adverse events as mortality and ICU admission but rather with a trend towards extended periods of hospitalization with the study presenting direct correlations between the two. The article did not note any increased risk in UTIs with gender. Instead it points out age as a leading risk factor of UTI contraction.

The study aims to focus on the advice that nurses give to indwelling catheter users in the community concerning use of sterile urinary drainage bags. A survey was targeted to nurse members of the International Continence Society including nurses from Australia, Canada, Belgium, Switzerland, the U.K, and the U.S.A, who specialized in managing incontinence. Statistical data is not identified. Results the study presented variability in the advice nurses give.

Bernard, Michael S.; Hunter, Kathleen F.; Moore, Katherine N.; A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter- Associated Urinary Tract Infections. Urologic Nursing, 2012 Jan-Feb; 32 (1): 29-37 (journal article)

This article reviews evidence on possible prevention of CAUTIs. This is mainly by ensuring the prompt removal of catheters when they’re not necessary. A study done identifies nurse-led interventions and informatics-led interventions as possible ways to reduce duration of indwelling catheters.

Burton, Deron C. MD, JD, MPH 1; Edwards, Jonathan R. MStat 1; Srinivasan, Arjun MD 1; Fridkin, Scott K. MD 1; Gould, Carolyn V. MD, MSCR 1 Trends in Catheter-Associated Urinary Tract Infections in Adult Intensive Care Units-United States, 1990-2007. Infection Control & Hospital Epidemiology. 32(8):748-756, August 2011.

The Healthcare Infection Control Practices Advisory Committee recently revised its guideline for the prevention of CAUTI. This has been an effort among many in the last twenty years to prevent and manage CAUTIs.in a study done, significant reductions in SUTI rates occurred in all ICU types between the year 2000 and 2007, except cardiothoracic ICUs.The authors recommend the need to invest in prevention strategies that may lead to the prevention of CAUTI. They also advocate for the implementation of a new CAUTI guidelines.

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