Research Proposal for Catheter Associated Urinary Tract InfectionsCatheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.

Research question

The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.

Background and Significance of the Problem

It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within the hospital setting. According to the CDC, more than 12% of acute care infections are caused by CAUTI. They further report that 12%–16% of acute care patients require indwelling catheter during their hospital stay (Shaver et al., 2018).

Statement of the Problem and Purpose of the Study

The purpose of this study is to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months. Bearing that, as CDC postulates, there are as many as 16% of acute care patients that require indwelling catheters, there is urgent need in the medical practice to ensure that the indwelling catheters are beneficial to the patients and not causing more harm or infections. The 12% infection rate caused by the indwelling catheters is too high hence the urgent need for multifaceted approach in curbing the infections.

This proposed research is grounded on the premises that the prevention of CAUTI is not absolutely upon the medics within the hospital but greatly lies on the reliability of the in-hospital patients to take care of themselves and implement the medical directions given to them by the nurses, hence the CAUTI education for such patients. Once the intervention as will be explained herein is implemented, the UTI cases and their severity among the research participants will be observed and the new data compared to the pretest outcomes in order to see if there is significant difference after the intervention and also to seek if the difference can be directly associated to the education among the intervention patients.

Education is an effective way to address gaps in knowledge; nurse educators or clinical nurse specialists are the primary educators for these innovations. Providing data to clinical staff specific to CAUTI data from their unit/facility and then educating on ways to reduce the knowledge gaps could be an effective way to reduce CAUTI in acute care patients. CAUTI reduction programs with evidence based protocol driven guidelines which are educated to the staff are also effective to help reduce CAUTI. There is also financial savings that can be considered with the reduction in CAUTI (Scanlon, 2017). The education will be nurse driven but patient focused in nature. Here, the nurse will strive to impart the requisite knowledge of what CAUTI is and the care and caution that the patient needs to take in order to avoid the infection as long asthey are still with the indwelling urinary catheter. The patient will be educated on the dry bag concept and why it is important for their health, this will be followed up frequently among the intervention patients as will be discussed herein. The patients will also be educated on the perineal care practices, the maintenance and insertion techniques so that the patients can effectively manage their indwelling catheters within or outside the hospital setting.

Literature Review

In Carr (2017), they review CAUTI prevention with a nursing intervention bundle (CAUTI bundle) that all hospitals likely adopt. The bundle would be based on standardized, evidenced based practice and allow for consistent care and maintenance of indwelling catheters.Part of this bundle would include medical record review of those who have an indwelling urinary catheter and daily assessment by nursing and the physician to determine medical necessity the catheter. For those patients with a catheter, Foley care every eight hours and as needed aseptic cleaning. Other interventions in these bundles include hand hygiene, leg strap in place for management of catheter tubing and avoiding kinks in the tubing.

Fletcher (2016), conducted...

The research focused on the importance of the CAUTI Guide to Patient Safety (GPS) in the CAUTI prevention activities among some units in different hospitals. Participants from 2 units within 4 hospitals were included in the research. The researchers collaborated with nursing staff and interviewed nurse managers with specific questions after completing the CAUTI guide to patient safety (GPS). Based on results they debriefed the nursing staff discussing CAUTI preventative initiatives. Nursing staff was agreeable that the CAUTI GPS was an effective tool. The limitations for this study were the small hospital sample size. The results of the study included steps to engage physicians and encourage sharing of data about unit-level performance trends and goals. Another finding was that the GPS may be used to foster discussion among stakeholders to encourage CAUTI identification and implementation of treatment and prevention strategies for further improvement.
Peter (2018) evaluates the effectiveness of clinical practice guidelines on maintenance of indwelling catheters among an experimental and control group using a pre and posttest using evaluative approach was measured in this study. The objective of the research was to assess the insertion practice of the indwelling urinary catheter and asses the maintenance practice of the indwelling catheter. This was a quasi experimental non- equivalent control group pre test and post test design used over a period of one year. Demographic data were collected from nurses and patients. The present study showed that clinical practice guidelines regarding CAUTI were effective in participants to improve their practice of infection control and reduce the occurrence of CAUTI in the hospitals. This research conclusions show the need to support clinical nurses and the need for nurse education to help with implementation and monitoring of infection prevention and control standards. Their demographic and quantitative data has value to look at the demographics of the types of RNs used in this study.

Safdar (2016) presents a qualitative study to assess patient perspectives of indwelling urinary catheters using a semi-structured interview. Results were that patient awareness and engagement about indwelling urinary catheters and the potential risk for CAUTI could be improved in the hospital setting. Suggestions included implementing educational programs incorporating patient preferences for both health care workers and patients. This can increase the involvement of a patient in their care and awareness about the risk of CAUTI. The study found that 75% of patients perceived that they had not received adequate education about indwelling urinary catheter consequences. All patients surveyed felt that alternative methods of excretion were not discussed, and 65% of patients felt that they had not received adequate information on the risks of CAUTI due to an indwelling urinary catheter. Limitations of this study are the small sample size, but the qualitative information provided an opportunity for improvement in discussing indwelling catheters with their patients.

Scanlon (2017) used quantitative data collection to measure the success of their healthcare systems program by measuring the standardized infection ratio, incidence, and the number of catheter days of a healthcare system. The research was also to show quality improvement focusing on developing best practices and transferring them across the healthcare organization. The benefits of this study show the decrease in catheter days and also the reduction in the number of CAUTIs. The primary goal and objective of this study was to reduce hospital ICU catheter days by 25% within 12 months and 50% within 18 months of implementation.

Shaver (2018) discusses the fact that indwelling catheters are a part of many care of plans, specifically for emergent and critical care patients. According to the CDC, more than 12% of acute care infections are caused by CAUTI. They further report that 12%–16% of acute care patients require an indwelling catheter during their hospital stay. They performed education and developed “Best Practice Champions”while using a skills checklist. These super users worked one-on-one clinical nurses to reinforce appropriate Foley catheter insertion and maintenance techniques.

Research Questions, Hypothesis, and Variables

There are several considerations for research questions in this proposal. According to Melnyk & Fineout-Overholt (2015), “Research questions are directional and bring with them a sense of expectation of what will be found in the…