Research Paper Example on Catheter-Associated Urinary Tract Infection (CAUTI)

Catheter-Associated Urinary Tract Infection (CAUTI) is a hospital acquired infection which is caused by various bacteria acquired through a catheter inserted into immobile hospitalized patients. Through the use of catheters, the bacteria gain access to the urinary tract thus causing an infection. The purpose of this paper is to address this problem through a review of studies that have been carried out on CAUTI prevention and management. The paper will analyze two studies one qualitative and the other study will be quantitative. Studies have been completed on CAUTI regarding its occurrence and prevention, but this case remains a hospital concern whereby its incidence and management still stands out as a big problem.

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Critical analysis of a qualitative study

A qualitative study was conducted on indwelling urinary catheter management and catheter associated urinary tract infection prevention practices in nurses improving care for healthsystem Elders hospitals, Fink et al., (2012). Indwelling urinary catheters are preferably used in hospitalized patients and most cases elders (Fink, et al., 2012).

Problem statement

CAUTI cases are approximately 345% of the hospital associated infections in the United States and impact the healthcare management cost Fink, et al., (2012). The gap being filled by this study is that the CAUTI prevention practices had not been well described. Understanding the measures used to prevent the occurrence of CAUTI is of great significance in management and prevention of this healthcare acquired infection. According to CAUTI cases are approximately 345% of the hospital associated infections and impacts the healthcare management cost Regina, et al., (2012) the significance of this study was to cut the cost of CAUTI management in the healthcare system.

Purpose and research question

The purpose of this study was to examine the degree to which the nurses' adherence to the CDC guidelines and recommendations for CAUTI prevention techniques that are specific to nurses' practice (Fink, et al., 2012). These recommendations included indications for catheter insertion, catheter materials, management of obstruction and specimen collection (Fink, et al., 2012). The purpose of the study has an excellent correlation with the problem of the study. The study did not identify a research question. The purpose of a study question is to guide the reader on the full expectation of the study findings. According to the study findings, the research question could have been; what is the effect of adhering to CAUTI prevention guidelines and recommendations according to CDC. From the results and the study findings, both the purpose and research question are well answered. The study findings on Nurses Improving the Care of Healthsystem Elders (NICHE) addressed the reasons why there was a high incidence of CAUTI in the healthcare setups. The study also applied qualitative method whereby a descriptive design was applied to survey NICHE application in hospitals. NICHE is a national program from Hartford Institute for Geriatric Nursing which enables nurses to apply the evidence-based practice (Fink, et al., 2012).

Literature review

The literature review of this study used both quantitative and qualitative studies that were relevant to the study focus. The limitations of these studies are that they are more than five years old which is a requirement of a qualitative study. The study literature review was also based on CDC guidelines and the national survey of infection control practitioners (Saint, et al., 2008). On the evaluation of the previous studies, the author stated that CAUTI had not been a priority of hospital infection control activities ((Fink, et al., 2012), et al., 2012). From the literature review, it is justifiable that research is needed to evaluate measures used in prevention and management of CAUTI. For example, according to the author, the application of evidence-based prevention practices as illustrated by CDC 2010 would result in 20-70% decrease in CAUTI cases.

Conceptual/theoretical framework

The study did not rely on any conceptual or theoretical framework. The purpose of using a theoretical framework is to ground the study based on a certain theory or concept. In this study, the only applicable concept of the study was evidence-based practice application and its effectiveness in prevention of critical care cases.

Critical analysis of a quantitative study

A quantitative study was done to test prevention bundle for catheter-associated urinary tract infections Blanck, et al., (2014). The station of the study was Danbury Hospital. The purpose of this study was to test the use of bundled approach of catheter care practices for the duration of three months to reduce the occurrence of Catheter- associated urinary tract infections (CAUTIs) in adult critical care patients who had indwelling urinary catheters (Blanck, et al., 2014). The study applied a quasi-experimental design with the results providing a 50% reduction in CAUTI incidence.

Protection of human participants

From the study, the participants benefited from the reduction of CAUTI incidence and then through the follow-up in the study, it was a beneficiary study to the participants. No risk of participation was involved in the study. Regarding the informed consent, all the participants were assured of their confidentiality and anonymity whereby their names and identifications were not collected. From the informed consent, it is justifiable that all participants of the study did it voluntarily. Prior conducting the study, an ethical consideration was applied where the study was approved by the hospital institutional review board (IRB).

Data collection

In the data collection, the study design used a comparison group of two groups that were used for the study. The two comparisons were used as the study variables where the independent variable was all participants who admitted to the (CCU) with CAUTI, and the dependent group was the group participants with indwelling catheters without a UTI (Blanck, et al., 2014). Through the application of these variables, the results were reliable regarding the prevention of CAUTI. On the data collection method, an observation method was used to check the catheter days and incidence of urinary tract infection. The observed data was recorded in the comparison charts (Blanck, et al., 2014). The rationale behind the use of the method to collect data is that accuracy and report integrity was maintained. Additionally, this approach was easier to audit the data by the surveillance and research control coordinators. The data collection period of this study was three months from October 1, 2012, through December 31, 2012. The three months of the study were enough to compare the two variables of the study. The data collection applied a sequence of events whereby; the participants were observed on a daily basis on their catheter condition regarding UTI infection. The sequence also involved close monitoring of UTI development since the insertion of the catheter.

Data Management and Analysis

The data management and analysis of this study applied a good data layout to justify the comparison. From the two groups of study which are CCU admission with CAUTI and those without CAUTI, data was collected daily to monitor the development incidence (Blanck, et al., 2014). From the data layout and presentation, it is justifiable that the collected data for this study applied to draw a conclusion from the finding. Another effort put forward in the management of data was that a systematic presentation was used which included a daily observation and recording plus a monthly analysis and recording for three months from Oct through December. The applied data analysis involved a pre-intervention outcome of the CAUTI cases and the intervention period. The incidence rate of CAUTI for the purpose of analysis used a unique formula:

Incidence Rate = number of CAUTIs number of catheter days 100.

Concerning the data management and analysis, the author has not provided enough critical analysis that was made during the data analysis. One of the shortcomings involved in data analysis is a failure to apply statistical software to analyze data and maintain the accuracy of the results obtained. From the study, the results were not statistically correct, but they were clinically significant. Concerning the data analysis biases, the author did not provide a clear logic on how data bias was mitigated. From the analysis of this study, the results appear to be statistically wrong, but according to the stepwise analysis of the presented data, the results are clinically acceptable since there were no measures put in place to minimize the research bias.

Findings/interpretation of findings: Implications for practice and future research

The researcher's interpretation of findings states that there is little literature that supports the specific nursing care strategies to prevent the occurrence of CAUTIs for hospitalized patients with indwelling catheters. Additionally, through the application of the bundled research, the gap has been filled which supported the clinically available approach in the reduction of CAUTI incidence (Blanck, et al., 2014). According to the researcher's findings, they are accurate and reliable concerning the management of CAUTI. I have the confidence to present these results of research to prevent CAUTI incidence.

The only identified limitation of the study by the researchers was that inadequate literature was available concerning the measures put in place towards prevention of CAUTI incidence. From the above limitation, it was difficult to criticize the study findings. The coherent logic to the presentation of study findings is that all the findings of the study were clinically applicable to prevent the occurrence of CAUTI and again, according to the 50% reduction of CAUTI incidence from the bundle prevention approach, it is acceptable according to practice change acceptable limits of change. The implication of the study findings is that they are applicable in the nursing practice. The nurse approach and intervention on some critical care unit cases is a strategic measure to mitigate the occurrence of these cases as well as their management. From the above study, the suggestions made for future studies indicated that additional research should be done to find out the efficacy of applying CAUTI prevention bundle in other clinical care units and other healthcare settings.

Conclusion

The importance of the thesis statement of this paper was to reflect what is required of the reader as they go through the paper. From the thesis statement, it is clear that not much information is available regarding the prevention and management of CAUTI from the previous studies. From the two studies, prevention of CAUTI remains a big problem in the healthcare whereby a strict evidence-based practice is needed to address this issue. The involvement of nurses' intervention is a measure that can change the healthcare outcome on CAUTI outcomes. From the findings, failure to use the CDC guidelines on prevention and management of patients with indwelling catheters is the shortcoming associated with CAUTI cases ("CDC - 2009 CAUTI Guideline:TOC - HICPAC", 2017). Nurses' intervention with an evidence-based practice on prevention of CAUTI and management of patients with indwelling catheters, plus patient education on urinary tract infection are measured applicable in managing CAUTI occurrence.

PICOT statement

In hospitalized patients with indwelling catheters (P), what is the effect of nurses' intervention (I) on the occurrence of catheter-associated urinary tract infection (O) compared with non-intervention of nurses(C) within a given duration o...