Clinical Issue
One of the most common complications of hospital care is healthcare-associated infection. There were approximately 722,000 hospital-acquired infections in 2011, with approximately 75,000 being fatal. Each year, healthcare-associated infections cost hospitals an estimated $40 billion in the United States (Loftus et al, 2018). Among the most common types of healthcare-associated infections are catheter-associated urinary tract infections. CAUTIs happen when germs enter and infect the urinary tract via the catheter. This could occur during insertion if the drainage bag is not sufficiently emptied, bacterial contamination from a bowel movement, periodic cleaning, or urine from the catheter bag flows backward into the bladder. Prolonged catheter use is the leading risk factor for CAUTI. They have been linked to increased morbidity, mortality, healthcare costs, and length of stay in hospitals.
Development of PICOT Question
PICOT question is made up of five major components. The population, or the problem, is the first component. In this case, the population is high-risk patients in the medical-surgical ward. After stating the problem, a potential intervention is considered. One possible intervention is preventive controls, such as routine screening in high-risk patients. It is essential to have a comparison factor as time goes on. The comparison factor, in this case, is the use of antiseptic silver alloy-coated silicone urinary catheters. Progressively, the outcome is the intervention’s impact on reducing catheter-associated urinary tract infections in patients. The study’s time frame should be included. Therefore, the observation will take place over 12 months.
The PICOT question is as follows: Among the high-risk patients in surgical wards (P), how does the use of preventive controls such as routine screening (I) compared to antiseptic silver alloy-coated silicone urinary catheters (C) reduce the risk of CAUTI (O) with the duration of hospital stay (T).
Database Searched
The search terminologies in this scenario entail locating the critical components of the inquiry and converting them into plain language. The PICOT question’s main topics include high-risk patients, silver-alloy coated silicone catheters and catheter-associated urinary tract infections. When these phrases were searched in the databases, several articles on the value of silver-alloy-coated silicone catheters were found. For example, one of the searches on the significance of SACC revealed that using urinary catheters made of silver alloy is one method thought to reduce CAUTI (Bonfill et al., 2017). Silver has long been used in medicine due to its broad spectrum of antibacterial properties. It reduces biofilm formation and colonization by dispersing silver ions into the urinary system (Bonfill et al., 2017). Other search terms included bacteria and antibiotic resistance.
Strengths and Level of Evidence for the Articles
Article #1
The study addresses the issue by providing specific outputs illustrating how checks are performed and actions are taken to improve the standard of care for urinary infections. It focuses on key preventive measures that nurses may overlook, such as documenting and monitoring the CAUTI indicators associated with CAUTI results (Krocová & ProkeÅ¡ová, 2022). Furthermore, the study in the article provides only the most relevant and up-to-date evidence. For instance, it states that deficiencies in observing CAUTI results and process indicators stem from a lack of catheterization documentation, exacerbating the disease’s prevalence. Furthermore, it identifies knowledge gaps and has a low bias in research.
Article #2
The study systematically addressed the issue by searching, appraising, and summarizing the available literature on how increasing awareness of the epidemiology of pathogen transmission might help increase compliance with intraoperative infection control procedures and reduce CAUTI-related issues. The researchers used randomization of study participants and a large study sample, which increased the chances of applicability to wide-population settings. The approach used to search and select the research articles minimized bias, resulting in reliable and accurate conclusions.
Level of Evidence for the Articles
Article #1
The study systematically searched, appraised, and summarized all available literature for implementing a Nurse-Driven CAUTI Prevention algorithm. Consequently, it provided only the best and most relevant evidence on the topic. The approach used to search and select the research articles minimized bias, resulting in reliable and accurate conclusions as it used a quantitative analysis. Additionally, it sums up findings from various studies, making the information easier to read and understand. Systematic reviews provide precise estimates of interventions that benefit clinical research. For instance, this review provides accurate results on implementing a Nurse-Driven CAUTI Prevention Algorithm. It found that the quality improvement projects showed an increased nursing awareness of IUCs and helped to prevent CAUTIs (Russell et al., 2019). Moreover, it reveals gaps in knowledge, which informs future research studies.
Article #2
This study systematically reviewed all available literature on the Impact of Routine Screening on the Geriatric Hip Fracture Population in Reducing CAUTI Infections. Because it used a quantities analysis, the method used to search for and select research articles minimized bias, resulting in reliable and accurate conclusions (Singh et al., 2021). Furthermore, it summarizes findings from various studies, making the information easier to read and understand.
References
Bonfill, X., Rigau, D., Esteban-Fuertes, M., Barrera-Chacón, J. M., Jáuregui-Abrisqueta, M. L., Salvador, S., & Seguel, M. (2017). Efficacy and safety of urinary catheters with silver alloy coating in patients with spinal cord injury: a multicentric pragmatic randomized controlled trial. The ESCALE trial. The Spine Journal, 17(11), 1650-1657. Web.
Krocová, J., & Prokešová, R. (2022, January). Aspects of Prevention of Urinary Tract Infections Associated with Urinary Bladder Catheterization and Their Implementation in Nursing Practice. Healthcare, 10(1), 152.
Singh, S., Angus, L. D. G., Munnangi, S., Shaikh, D., Digiacomo, J. C., Angara, V. C., Brown, A., & Akadiri, T. (2021). Reducing Catheter-Associated Urinary Tract Infection: The Impact of Routine Screening in the Geriatric Hip Fracture Population. Journal of Trauma Nursing, 28(5), 290–297. Web.
Loftus, R. W., Dexter, F., & Robinson, A. D. (2018). High-risk Staphylococcus aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. American Journal of Infection Control, 46(10), 1134-1141.
Russell, J. A., Leming-Lee, T. ‘Susie,’ & Watters, R. (2019). Implementation of a Nurse-Driven CAUTI Prevention Algorithm. Nursing Clinics of North America, 54(1), 81–96. Web.