Need a reply for each paragraph:

A: With the increase of catheter associated urinary tract infections by 20% in the last two quarters, its important to look into why the prevalence of CAUTIS has increased. Catheters are among a common device used in practice to assist with proper documentation of output, keeping an incontinent patient clean and dry to prevent sacral wounds, or even post-op from surgery. Although these devices are extremely useful in practice, improper sterile technique, improper daily cleaning, or prolonged duration of the catheter are all high risks for infection. The clinical question that would guide my quality improvement project would be; “In hospitalized patients requiring urinary catheterization, does implementation of infection prevention strategies which include criteria-based catheter use, review of catheter necessity, and staff education, result in a significant reduction in the incidence of CAUTIs compared to traditional practices?”. This is a common issue in many healthcare facilities as issues like improper education and short staffing may impact proper sterile procedures and techniques. The CDC uses an administrative infrastructure to enhance the prevention of CAUTIs in healthcare facilities. Their recommendations include five different categories on how to manage an increase in CAUTIs. Beginning with the provision of guidelines that address catheter use, insertion, and maintenance. Education and training to ensure that healthcare staff and others who take care of catheters are given periodic training on techniques regarding urinary catheter insertion, daily cleaning, and removal. Using proper supplies necessary for aseptic technique, and using a proper system of documentation with exact date and times when inserted. Lastly, if surveillance for CAUTI is performed, ensuring that there are sufficiently trained staff to support patient outcomes for catheter use (Recommendations: Guideline for Prevention of Catheter-Associated Urinary Tract Infections (2009) 2015). With the prevention of catheter-associated urinary tract infections on this unit, implementation of a a comprehensive strategy that includes clear criteria for catheter use, daily patient reviews of necessity, infection prevention measures such as daily cleaning and proper sterile technique education will assist in the decrease of CAUTI’s. Continuous surveillance, data collection, and unit collaboration are essential for the ongoing success of such prevention efforts which will ultimately lead to increased patient safety, satisfaction, and enhancing high quality care.

B: The Quality Improvement (QI) committee is aimed at improving the healthcare place with changes that can be measured using specific methods. These methods, as stated in the Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice e-book, explains that these methods include, conducting an assessment, setting in place specific goals for improvement, identifying ideas for changing current practice, how these improvements will be measured, testing the changes, measuring improvements in care, and implementing the changes as the new standard of care. As a member of the QI committee my clinical question for improving catheter associated urinary tract infections (CAUTI’s) in my hospital would be, how to improve the sterile technique when inserting a catheter. A catheter for many patients is the last resort to getting fluid out that the body cannot expel on it’s own, whether that be excess urine in the bladder or fluid in a body cavity. In this specific case we are talking about catheters that are inserted into the bladder. With the increase in CAUTI’s in the hospital by 20%, major changes need to be made in order to prevent any future complications associated with the use or insertion of a catheter. These changes do not happen in a single day, as specific measurements and goals need to be made to improve a technique. The measurements and goals come from many different outlets in the hospital. Collaborating with colleagues from different specialties is essential to developing an action plan. The action plan starts at looking at the manufactures of the catheter’s. Inspecting them to make sure there is no contamination during the packaging and shipping process. The next course of action would be considering if transporting patient’s to sterile rooms for catheter insertion would be beneficial to decreasing CAUTI’s. By researching articles that use evidence-based-practice, the best clinical evidence in improving patient care can be applied.

C: In healthcare settings, catheter-associated urinary tract infections (CAUTIs) have adverse side effects on patient care, such as increased patient morbidity, healthcare costs, and hospital-acquired infection rates (Rubi et al., 2019). Over the last two quarters, our hospital unit has reported a 20% increase in CAUTIs, which is alarming necessitating imp for an implementation of an effective interprofessional action plan. Our clinical question for our QI research is: “What evidence-based interventions can be implemented to reduce CAUTI rates in our hospital unit?”. The latter question fits our research question because it will allow us to understand the root causes of CAUTIs, evidence-based interventions to treat the infections, and an interdisciplinary contribution to solving the problem from a broader perspective.

Interprofessional Action Pan

To achieve the expected goal of reducing CAUTI rates in our hospital unit, the QI committee will include various medical experts such as nurses, pharmacists, doctors, infection control experts, and patient advocates; this is because experts in each academic field have their own set of skills and understanding that can be used to combat CAUTIs. Here is a proposed action plan: 

Data Collection

The committee will critically analyze CAUTI rates, patient demographics, catheter use, and microbiological profiles, which will help reveal infection patterns and high-risk populations.

Root Cause Analysis 

After analyzing the data collected, the committee will do a background check and analysis of the leading causes of the infections, the prevalence, side effects, and the vulnerable population.

Scientific Review 

We will examine the current literature and CAUTI treatment guidelines to determine effective therapies. This step is the most important in the action plan as it will portray empirical evidence for interventions geared towards reducing and preventing the high rates of CAUTI in our hospital unit. It will require much research from peer-reviewed journals and books.

Implementation

The committee will work together to develop solutions and test their effectiveness in patients to ensure that all of the unit’s needs are met. From the testing results, the committee will approve the implementation of the interventions in patients in our unit.

Evaluation Of interventions

The prevalence of CAUTIs and the success of preventative measures will be monitored constantly through questionnaires and patient feedback. The committee will have frequent meetings to review the status of its initiatives and make any necessary revisions. This stage will also involve frequent patient education on preventing infections and nurse training to avoid infections.

D: The rising trend of CAUTIs in our healthcare setting warrants immediate, well-coordinated action through a Quality Improvement (QI) plan (White & Latimer, 2019). A multi-faceted team is essential, comprised of members from nursing, infection control, medical practice, and quality assurance departments. Our first step is leveraging tools from the National Healthcare Safety Network (NHSN) to gather initial data on the existing rates of CAUTIs and their contributing factors. This will help us pinpoint specific conditions and contexts where CAUTIs are most likely to occur, thus allowing for more focused interventions (Dhar et al., 2021).  Based on suggestions from the Agency for Healthcare Research and Quality (AHRQ), we will next launch a thorough instructional program for the department. CAUTI prevention training will include fundamentals like hand cleanliness and aseptic catheter placement and the most recent advances and results in the field. (White & Latimer, 2019). Dhar et al. (2021) propose instituting a CAUTI-prevention checklist as an integral component of catheter placement and upkeep. The entire medical staff will be accountable for following this checklist and upholding industry standards.

Engaging Patients and Families:

As part of our all-encompassing plan, we will educate patients and their loved ones. Educating patients and their families about CAUTIs requires the production of pamphlets and possibly even short video presentations that can be shown in the waiting room (Dhar et al., 2021).

Monitoring and Feedback Loop:

Key Performance Indicators (KPIs) will be used to assess the effectiveness of our action plan regularly. Metrics will encompass CAUTI rates, staff adherence to guidelines, patient satisfaction, and even the time taken for catheter removal when no longer medically necessary. An interprofessional forum will be established to discuss ongoing results, share insights, and adjust strategies as needed (Dhar et al., 2021). By executing this elaborated, multidisciplinary approach, our goal is to significantly reduce the incidence of CAUTIs, thereby improving patient outcomes and making healthcare delivery more cost-effective.