Nosocomial infections are referred to as a disease that occurs to patients within 2 to 3 days after admission and seven days after discharge. Its occurrence is in exclusion of previously contracted as well as incubated diseases during admission time. One of the most common infections associated with such cases is Urinary Tract Infection (UTI), developing countries have many incidences of such conditions (Rezai et al. 2017). In ICU, Urinary tract infections are linked to catheters; the occurrence of these infections leads to the prolonged time of treatment of patients as well as the high cost of treatment.
Many catheterizations in healthcare operations are known as the significant risk factor for UTIs, and therefore, it is an area in healthcare that requires attention based on the increasing incidences of this condition. Hospitals must engage in the development and implementation of various interventions to sustain the situation. Most research studies have shown that there is a high prevalence of Catheter-associated UTIs (CAUTI) in patients whose stay in the hospital takes an extended period. This situation demands a great concern from both the researchers and clinical practitioners to focus on intervention programs to reduce the number of these incidences. In most cases, women tend to develop CAUTIs than men since catheterization is frequently used for their case.
In hospitals, 75 % of the acquired UTIs are linked to urinary catheters as the primary facilitator of the infection (Rezai et al. 2017). A urinary catheter is a tube which doctors insert through the urethra to drain urine. Catheter-associated UTIs occurs in mostly because urinary catheters inoculate causative agents into the bladder hence creating an environment for the build-up of bacterial adhesion on the service, this causes mucosal irritation in along the urinary tract. Blood and pathogens that come in contact with the lining of the urethra through the perineum, catheter, and digestive system are also known as risk factors for this UTI. Commonly, Escherichia coli and Pseudomonas aeruginosa bacteria are the cause of UTI. This indicator has become a significant factor that requires consideration in ICU because high rates of catheter-associated UTIs are evident in these departments because of the frequent use of a catheter.
Measuring this indicator is essential in determining the necessary interventions for prevention. The incidences of this disease in the hospital is determined by the length of the patient's stay from the time of admission. Minimal application of catheters and well as the reduced duration for its usage can help in bringing down the number of CAUTIs incidences. This problem is adversely affecting the hospitalization of patients because most of its incidences develop during the treatment period. It has a considerate influence of patient's mortality and morbidity despite several interventions that have been put in place to reduce its occurrence. Healthcare professionals, as well as the development of antibiotics, has failed to contain the situation, and for this reason, this indicator is measured (Roney et al. 2017).
Many research studies have been conducted to provide evidence for the occurrence, preventions, and problems associated with CAUTIs in hospitals. Taha et al. 2017 identify some of the facts and problems associated with CAUTIs in hospital. In his study, the condition is identified as one of the biggest healthcare problems associated with hospitalization acquired infections. It is one o the leading cause of secondary blood circulation diseases which results to an increase in mortality as well as morbidity rates estimated as 13,000 number of deaths in a year and an increase in the light of stay in the hospital (Taha et al. 2017). Most of the patients who find themselves to have exceeded the number of days in the hospital complaining of unexpected raise in treatment bills as a result of the additional cost to cover for CAUTIs. Also, overuse of indwelling urinary catheters and the length of time taken to conduct catheterization in patients plays a significant role in the development of this infection. This inconvenience is a clear indicator of inappropriate healthcare personal; most of the clinical providers are unaware that their clients are exposed to catheters, which leads to prolonged and unnecessary use of it. According to this research, 60% of CAUTIs can be prevented as long as the recommended evidence-based disease prevention research is conducted (Taha et al. 2017). It is recommended that appropriate application of catheter can help in reducing cases of this condition in hospitals, these involve use of closed drainage, aseptic insertion and scheduled removal of indwelling catheters and proper maintain acne of hygiene.
Also, in another study regarding the use of electronic health record (EHR)- a method that is used to conduct evidence-based CAUTIs care operations identify this condition as one of the most infections that have led to a rise in hospital-acquired diseases. It accounts for 50% of the patients with CAUTIs who receives the indwelling catheter. In this case, patients do not have proper documentation regarding the evidence-based method of insertion and how decisions are made before practicing catheterization on patients (Meddings et 2014). According to this research, newer strategies focus on prevention of this infection through the limitation of the use of catheter as well as the duration of its usage. This can assist in reducing the incidences of hospital-acquired infections and increased cost of hospitalization. CAUTIs accounts for an additional cost of $676 to $283; this cost is unnecessary; hence, a big problem for both patients and the hospital (Meddings et 2014).
Furthermore, research shows that in every year about 721, 800 associated clinical diseases occur in the United States acute care departments accounting for an approximation of 75, 00 deaths. CAUTIs has led to about 449,334 of healthcare practices leading to acquired infections every year (Rhone et al. 2017). This condition causes unnecessary harm to the patients as it involves unexpected interventions to prevent unexpected infections. In recent, the recent report, an evaluation of an intervention strategy (use of antibiotic coated Foley catheter) has contributed to a decree of the occurrence of CAUTIs to 42%. Also, other interventions such as the use of a closed system method of urine collection and condom catheters have resulted in a consistent drop in CAUTIs occurrence.
The change in reimbursement policy by Centers of Medicare and Medicaid (CMS) has a considerate influence in the management of CAUTIs. This organization links the quality of service and the amount of payment. It stopped from reimbursing healthcare providers for additional treatment as a result of hospital-acquired diseases such as CAUTIs (Palmer et al. 2013).
In conclusion, CAUTIs is one of the leading hospital-acquired diseases that require thoughtful attention. The recommended interventions must be implemented to provide quality improvement. Measuring this indicator contributes to a better understanding of how this condition is caused, the impacts, and how various interventions strategies have worked. Prevention of CAUTIs must be part of a hospital initiative to reduce its occurrence and provide quality improvement.
Meddings, J., Rogers, M. A., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2014). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf, 23(4), 277-289.
Palmer, J. A., Lee, G. M., Dutta-Linn, M. M., Wroe, P., & Hartmann, C. W. (2013). Including catheter-associated urinary tract infections in the 2008 CMS payment policy: a qualitative analysis. Urologic Nursing, 33(1), 15.
Rezai, M. S., Bagheri-Nesami, M., & Nikkhah, A. (2017). Catheter-related urinary nosocomial infections in intensive care units: An epidemiologic study in North of Iran. Caspian Journal of internal medicine, 8(2), 76.
Rhone, C., Breiter, Y., Benson, L., Petri, H., Thompson, P., & Murphy, C. (2017). The impact of two-person indwelling urinary catheter insertion in the emergency department using technical and socioadaptive interventions. J Clin Outcomes Manag, 24(10).
Roney, J. K., Locke, L. M., Grossman, C. L., Crasta, R. D., Bazan, G. N., Love, K., ... & Long, J. D. (2017). Catheter-Associated Urinary Tract Infection (CAUTI) Prevention Strategy Using Education in an Intensive Care Unit (ICU).
Sen, A. I., Balzer, K., Mangino, D., Messina, M., Ross, B., Zachariah, P., & Saiman, L. (2016). Electronic surveillance for catheter-associated urinary tract infections at a university-affiliated children's hospital. American journal of infection control, 44(5), 599-601.
Taha, H., Raji, S. J., Khallaf, A., Hija, S. A., Mathew, R., Rashed, H., ... & Ellahham, S. (2017). Improving catheter-associated urinary tract infection rates in the medical units. BMJ Open Quality, 6(1), u209593-w7966.
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