Research Paper Sample on Catheter-Associated UTIs

A urinary tract infection (UTI) is an infection that includes one or more parts of the urinary system, that is, ureters, bladder, kidney, and urethra. UTIs are the most familiar kind of healthcare-associated infections outlined to the national healthcare safety network (NHSN). Around three-quarters of UTI acquired from the nursing homes are related to a urinary catheter. Most of the patients get urinary catheters in the course of their time in the hospital. The major imperative risk factor for receiving a catheter-associated UTI (CAUTI) is the use of a catheter for a prolonged period of time. It is therefore crucial that catheters be used only when it is suitable and should be pulled out as soon as they complete their work. The purpose of this paper is to evaluate a clinical intervention, ask background questions to narrow down researchable questions related to clinical intervention and identify relevant nursing practice, develop a picot question. Additionally, the paper will also summarize and synthesize literature finding to articles and lastly critique peer-reviewed journal articles.

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Purpose Statement

Catheter-associated urinary tract infection (CAUTI) is a regular problem in hospitalized patients. According to Oman et al, (2012) Urinary tract disease (UTI) is a standout amongst the most widely recognized hospital procured infections; 70 percent- 80percent of these infections are owing to an indwelling urethral catheter. The weight of CAUTI in pediatric patients isn't well defined. Twelve percent to sixteen percent of adult's clinic inpatients will be given a urinary catheter sooner or later amid hospitalization. The regular danger of obtaining of bacteriuria shifts from 3 percent to 7per cent when an indwelling urethral catheter stays in the original place it was inserted (Oman et al., 2012). It, therefore, raise questions on the cause that lead or contribute to these infections; is there a relationship between the routine uses of urine catheters? Or does the health workers hard washing reduce the contracting of the infection? Or does using catheters for a less time reduce the infections?

Overview of Research Question Selected (PICOT)

The health workers are also recommended to consider the use of external catheters as a substitute for the internal catheters in those males who cooperate and are without urinary retention. The use of intermittent catheterization is advisable for men with bladder emptying problems and in kids with the neurogenic bladder to decrease the risk of CAUTI (Chen et al., 2015). The health workers have also learned on the proper methods for catheter insertion. The workers should wash their hands before and after insertion using a sterile glove. The collection bag should always be at a lower level than the level of the bladder. There have been quality improvement programs (QI) that enhance the necessary use of internal catheters and to lower the risk of CAULI on the basis of facility risk appraisal (Oman et al., 2012). The QI programs objectives should be: to ensure the necessary use of catheters, identification, and removal of catheters that are no longer required, lastly ensuring adherence to hand cleanliness and good catheters care.

PICOT

Does not routinely using a urine catheter in patients reduce CAUTI?

Example

(P) Problem

Hospital-acquired infection

Invention

Not using catheter routinely

(C) Comparison

(O) Outcome of interest

Using catheter routinely

Reduced infection

Relevance/Significance to Nursing Practice

There have been ways and methods designed to help nurses reduce the contracting of CAUTI, some of the nurses directed interventions are as follows first and foremost nurses are required to use urinary catheter appropriately. This is by inserting catheters for only the suitable indications and should be pulled out immediately they are not needed (Chen et al., 2015). Nurses also have minimized the catheters use and the time frame of use in all their patients, in particular, the most vulnerable for CAUTI or mortality from the use of catheters such groups as women, patients with impaired immunity and the elderly. The health workers are advised not to use urinary catheters in patients who are nursing homes residents and are unable to control over their urination. According to Chen et al., (2015) further research is required on the periodically using of condom catheters or external catheters in incontinent residents of patients and using catheters in attempt to prevent skin breakdown. Nurses have been directed not to use catheters regularly but only in the operative patients. The catheter should be removed from operative patients immediately after the operation, this should be done within 24hrs unless there is need to continue using it.

Summary and Synthesis of Literature Findings

Study 1

According to a study by Johnson et al. 2018, 78% of people seeking conventional cancer treatment (surgery, radiotherapy, chemotherapy, or hormone treatments) survived, compared a mere 55% of those seeking alternative treatment alone. Most significant difference was observed for breast cancer, where patients who sought alternative therapies had higher chances of dying within 5 years than those who decided to opt conventional treatments. Factors that might have affected people's survival chances were not accounted for though treatment choice seems to be the most likely explanation. Results showed that 86.6% of people who chose conventional treatment for breast cancer lived at least five years, 58.1% of people who wanted alternative therapies for breast cancer lived at least five years while people were 5.68 times more likely to live at least five years if they had conventional treatment for breast cancer.

The inconsistency in this research was the observational study which had a deviation since the data was generalized. It provides an analysis of cancer patients and not specific to breast cancer patients. It also neither focus much on the side effects of chemotherapy nor a conclusion to the preferred treatment method amongst the cancer treatment methods.

Study 2

Following research conducted by Smith et al. 2017, their findings indicated that around 40,610 women die due to breast cancer, and about 9% lie between 40-49 years. Breast cancer survival varies by stage at diagnosis. The overall relative survival rate for 5 years is 27 % for the distant-stage disease, 85% for the regional syndrome and 99% for the localized disease. Survival within each stage varies by tumor size while factors associated with lower breast cancer survival were poor education, lack of health insurance as well as poverty. Factors that may lead to breast cancer include family history, obesity, postmenopausal drugs, hormonal birth control, environmental and other risk factors. People get varieties of suggestions of the type of treatment depending on the woman's age. For women at high risk, mammography and magnetic resonance imaging are included. Chemotherapy is dependent on a number of factors. They including the number of lymph nodes involved, the size of the tumor, etc. Other treatment methods used include; surgery, hormonal therapy, systemic therapy, radiation therapy and targeted therapy to treat chemotherapy. The researchers are on the front line in mitigation of breast cancer where early detection, treatment, and prevention are their crucial role.

The inconsistency of the research does not discuss the variance in effects of breast cancer treatments by other methods stated. In this way, it is not easy to tell which treatment method is preferable.

Articles Critique

In the article of prevention of urinary infection; the following information can be obtained from them, first, the journal clearly states it objectively which is basically the ways in which the article can be helpful to people with the urinary infection. On the other hand, the article of the BMC Geriatrics tries to find out away in which the persons with the mental problem can regain his or her normal social live hood. Secondly, the article of prevention measure of urinary infection gives the findings of 256 patients that were examined in a hospital under the nurse's care and the result tabulated on page 3154. On the other hand, BMC Geriatrics stated their findings and elaborated them, for example, the finding of the physical need oriented logics, the renouncement logics among other elaborated. The articles are therefore useful for their targeted group it is only that the one giving preventive measure is very precise to the points. The Journal of Nursing gives a brief explanation on the abstract cover page concerning the prevention measure of urinary infections. The BMC Geriatrics articles gives a brief explanation of the ways in which other researchers have attempted to re-stabilize the social live hood of dementia persons. The explanation is on the abstract page. In the journal of nursing, the framework is one year that is from 2015 to 2016, whereas that of BMC Geriatrics used a descriptive design from other published works. In the BMC Geriatrics, the research sampled 24 health cares and it was through interviews. For the case of Nursing Journals, 129 randomly selected patients were examined. Both methods of data collection were done by trained personnel's so that the participants care is upheld. In the Journal of Nursing the research was a model of the previous research studies, while in the BMC Geriatrics the research was designed from other articles and books with related ideas.

In the Journal of Nursing, the researchers used the computers to analyze the data in excel sheet format. On the other hand, the recorders were to store information that was later transcribed. The rationale of the research, relevancy of the research, collection of data, instruments used purpose of the research and other relevant disciplines to the research. (Stockhausen & Conrick 2002). In the case of the Journal of Nursing group of nurses moved from one federal district hospital to the other sampling the patients' urine. On the other hand, the data collection was done through a semi-focused group that did interviews. The data analysis was as follows, BMC used systematic text condensing and Nursing journals used excel spreadsheet to analyze the findings. The data analyses of the Journal warrant reliability since they were given in tabular form. While that of mainly in text form and therefore lacks authenticity. The data were analyzed in both cases and the objectives of the two types of research were met. The Journal of Nursing gave their findings and the prevention measures outline similarly the BMC journal gave the approaches to redeeming mental retardations. Both types of research are vague on the limitations of the researchers these imply that for further understanding of the limitations one must excavate deeply into the work. The implications of the research are not conspicuous. This means that the hypotheses are not affirmed in all of them. In the Journal of Nursing, the recommendations are not clearly drowned. This is one of the major setbacks of this research while for the case of BMC the recommendations for further research are stipulated which is a plus on the journal. The two types of research are very useful for my nursing training since they build on the general studies involving nursing.

Conclusion

In conclusion, evaluating a clinical intervention to curb the spread of CAUTI is an important step. This has been done through asking background questions to narrow down researchable question related to clinical intervention and identifying relevance nursing practice. Through the implementation of the recommended clinical intervention such as the use of catheter appropriately, nurses will have taken a milestone in curbing spread of the CAUTI.