Implementation plan in CAUTI Prevention
In this section, the recommendations considered essential for prevention of catheter-associated urinary tract infections are organized, and criteria for evaluating success or failure of the plan is given. The high priority recommendations were chosen by the group based on the strength and applicability in the hospital care system. The implementation plan for prevention of CAUTI requires cooperation from several departments (Gould et al 2017). The management will be involved in the process to give permission for the implementation process and keep a watch on the research process. The nurses and the doctors form the team that will implement the recommendations discussed and also will be part of the evaluation team after implementation is completed. The overall criterion for evaluation of the process is a reduction in the number of cases for CAUTI in the facility within three months.
The first step to be taken in the facility is choosing of a skilled team that will be doing catheter insertion (Gould et al 2017). This step is crucial in the implementation of the study because the expected outcome depends on the use of qualified personnel. The managers will help in this step because they are aware of the best nurses and doctors in the facility who have relevant skills on catheter insertion. The criteria for evaluating this step will be a report from the nurse managers in the ward. The timeline for its evaluation is immediate because the other steps depend on the selected team. A period three days is enough for collecting information as to whom the catheter insertion team will be.
The second implementation step falls under appropriateness of urinary catheter use. It is evident from the research that complications of CAUTI resulted from the use of the catheters in patients who were not indicated. The selected team is to assess the patient for insertion and the indication recorded down for reference. Urinary catheterization for operative patients is to be done when necessary and not routinely as before. For the operative patients requiring catheterization, removal is to be done within 24 hrs unless appropriate conditions for continuation are available. The last step in this implementation process is the minimization of catheter insertion in high-risk groups for CAUTI like the elderly and those with low immunity (Agarwal et al 2009). The results will be evaluated by looking at the total number of catheterized patients within the three months, and comparison from the past should be made. Also, the cases of catheterized patients post surgery are to be evaluated. Minimal figures are expected.
Implementation of proper catheterization technique use will ensure that CAUTIs are minimized from the time of insertion. This process will depend on the qualified person doing the insertion (Munten et al 2010). As reinforcement to the implementation, sterile gloves and antiseptics will be provided. The problem with this step is that there is no information regarding antiseptic or saline use in cleaning the perineum before catheterization. The criterion for evaluating this process is the availability of sterile gloves and antiseptics in the facility. Documentation on the equipment used during catheterization must be recorded for reference.
The last part of the implementation process is monitoring and removal of catheters within the stipulated time frame. A closed drainage system is to be provided for emptying of the full urine bags. The catheter should be kept free from kinking and obstruction. Observation of leakage time for removal is to be done by the nursing team. The criterion for evaluating the outcome is a reduction in the number of CAUTI cases within the three months period.
References
Agarwal, R. K., Gould, C. V., Kuntz, G., Pegues, D. A., Umscheid, C. A., Centers for Disease Control and Prevention (U.S.), & Healthcare Infection Control Practices Advisory Committee (U.S.). (2009). Guideline for prevention of catheter-associated urinary tract infections 2009. Atlanta, GA: Centers for Disease Control and Prevention.
Gould, D., Gaze, S., Drey, N., & Cooper, T. (January 01, 2017). Implementing clinical guidelines to prevent catheter-associated urinary tract infections and improve catheter care in nursing homes: Systematic review. American Journal of Infection Control, 45, 5, 471-476.
Munten, G., Bogaard, J. V. D., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review. Worldviews on Evidence-Based Nursing,7(3), 135–157. https://doi.org/10.1111/J.1741-6787.2009.00168.X
Clarke, K., Tong, D., Pan, Y., Easley, K. A., Norrick, B., Ko, C., … Stein, J. (2013). Reduction in catheter-associated urinary tract infections by bundling interventions. International Journal for Quality in Health Care, 25(1), 43-49. doi:10.1093/intqhc/mzs077
