Posted: March 16th, 2022

Project On Catheter Associated Infection. BENCHMARK- CAPSTONE PROJECT CHANGE PROPOSAL

Project On Catheter Associated Infection. BENCHMARK- CAPSTONE PROJECT CHANGE PROPOSAL 2

BENCHMARK- CAPSTONE PROJECT CHANGE PROPOSAL 13
The Catheter Associated Infection Research Project. PROPOSAL FOR CHANGE IN THE BENCHMARK-CAPSTONE PROJECT 2

PROPOSAL FOR CHANGE IN THE BENCHMARK-CAPSTONE PROJECT 13

BENCHMARK-CAPSTONE PROJECT CHANGE PROPOSAL 1 is the heading for this proposal.

How to Prevent Urinary Tract Infections Associated with Catheters

In spite of the fact that the United States of America is renowned for its cutting-edge medical techniques and equipment, hospital-associated infections (HAIs) have a significant negative influence on the healthcare system. Healthy People 2020 states that healthcare-associated infections (HAIs) are connected with an increase in the expense of health care in the United States, along with an increase in death and morbidity. These kinds of illnesses are entirely avoidable. Urinary tract infections caused by indwelling catheters account for approximately 80% of all cases (CDC, 2013). Healthcare workers, guided by the principle of nonmaleficence, are expected to take steps to develop solutions that reduce the likelihood of patients being harmed. Patient assessment for indwelling catheter insertion, maintenance, and care necessitates the collaboration of the entire interdisciplinary team in order to provide the best possible outcome. In accordance with evidence-based practices (EBPs), there is a link between the use of chlorhexidine (CHG) wipes and the reduction of CAUTI. The goal of this project is to provide safe, patient-centered care in the prevention of CAUTI through the use of the CAUTI Surveillance Bundle and the implementation of new interventions such as daily Chlorhexidine Gluconate (CHG) bathing for patients with Foley catheters, among others. A thorough investigation into the underlying problem, discussion of the implementation of CHG wipes instead of regular wipes for perineal care in order to prevent CAUTI, as well as evidence-based research reviews that support the project and potential barriers to success, will be provided by the author of this project proposal.

Background

Despite the fact that many healthcare organizations prioritize steps to reduce the occurrence of HAIs, acute care facilities in the United States reported 54,500 cases of CAUTIs in 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap, a 3 percent increase over the previous year (Knudson, para. 1, 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Inappropriate use of indwelling catheters, as well as improper insertion procedures, as well as inadequate and poor catheter management, are all factors associated with the occurrence of CAUTIs (Strouse, 2015 – Research Paper Writing Help Service). The use of CHG wipes for perineal care has been shown to be useful in preventing CAUTI from occurring. By utilizing CHG wipes for perineal care, it is possible to prevent bacterial colonization from occurring. One of the most common causes of CAUTI is an overgrowth of bacteria that has infiltrated the lower urinary tract. When used as directed, CHG wipes contain an antimicrobial agent that prevents bacteria from multiplying in the body (Flores-Mireles, Walker, Caparon, & Hultgren, 2015 – Research Paper Writing Help Service). Integrating best practices, involving patients in the prevention process, and providing ongoing education and training for nursing and medical personnel in CAUTI prevention are all critical.

Statement of the Problem

Although indwell-catheter care packages have been implemented in this author’s facility, they have shown little success in lowering the rate of urinary tract infections (UTIs). The most prevalent and most expensive healthcare-associated infection that increases the length of stay

Catheter-associated urinary tract infections (CAUTI) are a comorbidity that requires a hospital admission (CAUTI). It is also, in addition,

a condition that has been removed off the list by the Centers for Medicaid and Medicare Services (CMS).

It pays for the additional treatment costs incurred if a patient develops it while in the hospital (CMS, 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap).

Regardless of how much effort numerous organizations put forth to minimize CAUTIs, the United States Department of Health and Human Services

According to the Department of Health and Human Services, the rate of CAUTI has grown by 9 percent between 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer and 2015 – Research Paper Writing Help Service.

According to the AHRQ (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers), the year 2013 is a leap year. With all of the penalties imposed by CMS and the ongoing efforts of hospitals to comply,

Put into effect the best procedures to prevent CAUTIs, Foley catheter use, and catheter-associated infections.

Continually increasing numbers of Urinary Tract Infections (CDC, 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). The improvement of adherence to healthcare policies and procedures in order to aid in the prevention of CAUTI requires more adjustment (see Appendix A). In response to the clinical question regarding the usage of CHG wipes in comparison to conventional wipes to reduce bacterial colonization in the external catheter and, as a result, reduce the incidence of CAUTI, an evidence-based proposal was developed to address this issue. One of the Joint Commission’s safety objectives is to reduce the occurrence of CAUTI (Child Abuse Urinary Tract Infection) (The Joint Commission, 2015 – Research Paper Writing Help Service).

The Proposal’s Purpose

One of the objectives of the study is to raise public awareness of the potentially life-threatening health consequences of CAUTI. In order to limit the occurrence of CAUTI, this project is being implemented in phases. The first phase begins when the patient is admitted with orders to insert a urinary catheter, and the second phase concludes with removal of the urine catheter. We intend to accomplish the following results as a result of our efforts on the process:

Catheter-associated urinary tract infections (CAUTI) should be avoided or reduced.

Reduce the number of days spent with an indwelling catheter.

Improve the outcome, the quality of care, and the safety of patients.

Reduce the risk of CAUTI and urosepsis.

Reduce the amount of MDROs and C. diff that are produced as a result of antibiotic treatment

Reduce the length of stay (LOS) and the number of readmissions.

Reduce the cost of doing business

Patient satisfaction should be improved.

CAUTI is a serious infection that should not be taken lightly. It is critical to continue working on this project because every day counts.

Every patient has the right to get high-quality care that is safe, cost-effective, and evidence-based in nature.

Following a review of various research articles relevant to CAUTI prevention, it was discovered that the use of CHG wipes can help lower the incidence of CAUTI. According to the American Association of Critical-Care Nurses’ Evidence-Based Practice Guidelines (AACN, 2017), the use of CHG wipes can help reduce bacterial colonization and the spread of multidrug-resistant pathogens in the hospital setting. Finally, one of the primary goals of this evidence-based suggestion for practice is to enhance patient outcomes while also increasing the number of lives saved.

Is It A PICOT Question?

This study was motivated by the goal of reducing CAUTIs by using CHG wipes instead of conventional wipes for perineal care during a patient’s hospitalization, as previously described. When developing the plan, it was important to take into account the surrounding surroundings as well as the nursing staff’s engagement, attitude, and culture. Following this author’s conclusion on the EBP idea, a thorough investigation was carried out to determine whether the independent and dependent variables could be measured and achieved in practice. Patient care will be improved through the implementation of the project as a quality improvement initiative, according to the project’s objectives (U.S. Department of Health and Human Services, n.d.). The following components were recognized as being important in reducing the prevalence of CAUTI: How does the use of chlorhexidine-impregnated wipes for perineal cleansing (I) compared to ordinary wipes (C) affect/reduce the incidence of catheter-associated urinary tract infections rates (O) in adult hospitalized patients with indwelling urinary catheters (P) during the length of hospitalization? (T).

Strategy for Conducting Literature Research

This implementation is being conducted at a time when hospitals are seeking ways to reduce the incidence of CAUTI. The aim of this implementation is to evaluate whether employing CHG wipes for perineal care will result in a reduction in the incidence of CAUTI. Several search engines were used to gather evidence to support the change request, which was ultimately successful. Searches were made in databases such as PudMed, Ovid, CINAHL full, and recognized nursing publications, among other sources. Filters were used to ensure that peer review articles were up to date and accredited, which was important. Search terms such as CAUTI, chlorhexidine wipes, CAUTI prevention, infection control methods, and hospital-acquired infections were used to locate information that was relevant to the topic under discussion. On the other hand, the AACN website was visited in order to look for the most recent and up-to-date guidelines relevant to the SICU region. The supporting evidence was assessed through the use of a literature review table, which assisted in the comparison, evaluation, and differentiation across different study techniques, settings, and sample sizes studied. Additionally, information about CMS guidelines and the Healthy People 2020 objectives was discovered through a Google search.

Evaluation of the Literature

The literature review provided a detailed comparison of research issues and sample populations relevant to the project that was useful for the project’s planning. The evidence acquired from peer-reviewed studies unquestionably supports the application of the usage of CHG wipes for perineal care in the prevention of CAUTI infections. A reduction in the occurrence of HAI was seen when CHG wipes were used for patient washing. According to Cassir et al. (2015 – Research Paper Writing Help Service), daily use of CHG wipes was associated with lower rates of HAI caused by gram-negative bacteria, highlighting the importance of transient gram-negative bacteria in skin colonization in the pathogenesis of HAI. Another study conducted by Cassir et al. (2015 – Research Paper Writing Help Service) found that daily use of CHG wipes was associated with lower rates of HAI caused by gram-negative bacteria. It will take the involvement of nursing staff and infection control nurses as well as risk management and physicians to reduce CAUTI. This is true of any EBP deployment. Despite the fact that research supports the use of CHG wipes for CAUTI prevention, this does not negate the importance of maintaining excellent hand hygiene as a fundamental component of health. In 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay, Martnez-Reséndez et al. stated that “hand hygiene (HH) is an affordable and practicable approach, and it is the cornerstone of nosocomial infection (NI) control.”

Theories of Change

In order to be successful in implementing change in the healthcare industry, a solid foundation must be established. The author believes that the Kurt Lewin three stage change model is applicable for the proposed CAUTI prevention strategy, which includes the use of CHG wipes for perineal care. It is comprised of three stages: unfreezing, moving, and refreezing, according to Kurt Lewin’s change model. The unfreezing stage is concerned with establishing a rationale for change, the moving stage is concerned with delivering information about the necessity of change, and the refreezing stage is concerned with putting the process of change into action or reinforcing it (Rainio, 2009). The nursing staff can be divided into the following categories based on this model: It is anticipated that the unfreezing stage will include an introduction to EBP research and a rationale for using CHG wipes for perineal care; the moving stage will focus on nurses implementing the new implementation for perineal care; it is also anticipated that barriers will be addressed; and the refreeze stage will be an evaluation of the EBP proposal success with the goal of reducing CAUTI by utilizing the CHG wipes (Rainio, 2009). Regardless of the strategy chosen, communication and consistency will be essential in teaching nurses about the benefits of CHG wipes, particularly in the area of patient harm prevention and safety.

Implementation and outcome measures are proposed in this document.

The idea for the use of CHG wipes for perineal care in order to avoid CAUTI and overall HAI was addressed with the Director of Surgical Services, who agreed with the concept. The discussion raised several critical concerns, including the relationship between CAUTI scores and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, as well as the influence of reimbursement from the Centers for Medicare and Medicaid Services (CMS). For example, according to Galiczewski (2016: 2024 – Do my homework – Help write my assignment online), he states that “CAUTIs are considered avoidable, and their occurrence has reached about two million cases per year.” CAUTI has been classified as a “never occurrence” in the United States, which means that government-funded compensation is limited (para. 3). Another proposed implementation strategy for the success of this author’s EBP approach includes continued in-service nursing education and training, as well as a comprehensive CAUTI prevention bundle with a strong focus on quality improvement (see Appendix B for CAUTI bundle). In order to achieve compliance with indwell catheter care bundles and CHG wipes for perineal care, it is projected that bacteria will colonize less and CAUTI will be less likely to occur. The final stage in determining whether or not the EBP plan was effective and successful is to evaluate the proposal and measure the outcomes of the implementation. A variety of methodologies, including data collecting and recording on CAUTI incidences in the hospital, assessment of post-intervention CAUTI rates in the facility, and a readiness inventory instrument to assess the nurse’s confidence level, could be used to measure outcomes (Stevens, Puga & Low, 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Charge nurses will be expected to evaluate the nurses’ catheter insertion skills as well as their compliance with catheter management requirements. Surveillance will be used to evaluate the patient’s comfort and care delivered during perineal care with the use of CHG wipes, which will be the final and most crucial phase. The survey will also assess the patient’s understanding of the use of CHG wipes for CAUTI prevention, as well as whether or not the nursing staff gave education to the patient regarding the reasons for, care for, and complications associated with indwell catheters.

Potential Implementation Roadblocks and Possible Solutions

The transmission of catheter-associated urinary tract infections is preventable, and they should be treated with the severity that they merit. However, the evidence-based research provided this author with an understanding of some of the potential barriers that could arise during the EBP implementation process, which was useful. Catheter removal protocols that are driven by nurses are lacking, as is staff engagement and adherence to rules and procedures. There is also a need to increase nursing staff awareness regarding catheter use, insertion techniques, maintenance, and care.

The following are some possible solutions in the event that the implementation becomes muddled: amendment of the plan proposal, re-training of personnel on proper use and aseptic insertion techniques, and instructions on the use of CHG wipes for perineal care, among others (see Appendix C). Additional consultations will be held with leadership and risk management professionals, and the designation of CAUTI prevention champions will be approved. It will also be measured how well the implementation is going based on the comments received from the staff.

Conclusion

Basic nursing care and patient advocacy can result in a beneficial shift in patient outcomes over time if done correctly. Reviewing institutional policy and procedures, as well as current evidence-based research, aided in the development of a tool that guides and reminds nurses of basic patient care processes.

Catheters for urinary retention have several indications and require little care. Developing and implementing training and education programs

Nursing and ancillary personnel are instructed on the proper care and maintenance of urinary catheters and CHG washing.

supports a cost-effective adjustment for this particular project Lewin’s Change Model, as well as the Plan-Do-Study-Act cycle

The Plan, Do, Study, Act (PDSA) Improvement Model was used as theoretical frameworks for implementation.

This project will benefit from reinforcing and preserving modifications. As a CNL student, I have gained a tremendous deal of knowledge.

take something away from this experience I’ve discovered that this is a difficult journey that must be shared.

Accountability exists between the leadership team, clinicians, nurses, and other auxiliary personnel, among other things. In addition, I’ve

learned:

A culture change is required for CAUTI prevention, and this requires continual attention.

The ability to be fearless in the face of process refinement

It is important not to give up

Continuing to consult with front-line personnel about difficulties and ways to overcome them

It is important to constantly talking about patients and WHY we are doing this work!

To maintain a constant focus on patient safety.

To involve all service providers in educational programs

Communication that is respectful is a must!

The outcome of this initiative is not only CAUTI prevention, but also cost savings, decreased duration of stay, and improved patient outcomes.

Fall prevention and delirium prevention are two important aspects of this program. The provision of continuing nursing education and training will enable nurses to advance their careers and practice within their organization’s legal and ethical boundaries. In every encounter, the nursing staff is prepared to assist Americans in living a healthy lifestyle and increasing patient satisfaction.

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