advanced medical practices and equipment, however, hospital-associated infections (HAIs) have a tremendous impact to the healthcare system. According to Healthy People 2020, Healthcare-associated Infections (HAIs) are related to increasing cost of health care in the United States as well as mortality and morbidity. These types of infections are preventable. Indwelling catheters count for about 80% of urinary tract infections (CDC, 2013). As healthcare professionals and adhering to the principle of nonmaleficence, we are obligated to make efforts to implement strategies to avoid any risks to harm patients. Proper assessment of patients regarding indwelling catheter insertion need, maintenance and care requires the collaboration of the entire interdisciplinary team. Evidenced-based practices (EBPs) have found a relationship between chlorhexidine (CHG) wipes usage and CAUTI reduction. This project’s goal is to provide safe-centered patient care in prevention of CAUTI through utilizing CAUTI Surveillance Bundle and implementing new interventions such as daily Chlorohexidine Gluconate (CHG) bathing for patients with Foley catheter. The author of this proposal will be providing an in-depth investigation into the background problem, discussion of the implementation of CHG wipes instead of regular wipes for perineal care for CAUTI prevention, as well as presenting evidence-based research reviews that support the project and potential barriers to success.
Even though, measures to decrease the incidence of HAIs is the priority of many healthcare organizations, acute care facilities reported 54,500 cases of CAUTIs in the U.S in 2012, which represents a 3 percent fold increase from 2009 (Knudson, para. 1, 2014). Factors associated with the prevalence of CAUTIs is the inappropriate use of indwelling catheters, in addition to improper insertion techniques, and inadequate and poor catheter maintenance (Strouse, 2015). Preventing CAUTI by employing CHG wipes for perineal care has been proven to be effective. By using CHG wipes for perineal care the colonization of bacterial could be eliminated. One key reason for CAUTI is the overgrowth of bacteria that invade the lower urinary tract. CHG wipes have an antiseptic component that inhibits the growth of bacteria in the body (Flores-Mireles, Walker, Caparon, & Hultgren, 2015). The integration of best practices, patient involvement, and ongoing education and training for the nursing and medical staff in CAUTI prevention is imperative.
The problem at hand is the difficulty that this author’s facility is experiencing in reducing the rates of urinary tract infections (UTIs) despite the implementation of indwell-catheter care bundles. The most common and costly healthcare related infection that prolongs the length of
stay and comorbidity is catheter-associated urinary tract infections (CAUTI). Furthermore, it is
one of those conditions that the Center for Medicaid and Medicare Service (CMS) no longer
reimburses the extra cost of treatment if a patient develops it during hospitalization (CMS, 2012).
Regardless of how hard many organizations put energy to reduce CAUTIs; the U.S. Department
of Health and Human Services indicates CAUTIs rate has increased by 9% between 2010 and
2013 (AHRQ’s, 2008). With all the penalties from CMS and continued effort from hospitals to
implement the best practices to reduce CAUTIs, Foley catheter use and Catheter-associated
Urinary Tract Infections continue to grow (CDC, 2010). Improving the adherence to healthcare policies and procedures in order to help prevent CAUTI needs further revision (see Appendix A). The evidence-based proposal arose from the clinical question in relation to the use of CHG wipes in comparison to regular wipes to decrease bacterial colonization in the external catheter and thereby reducing the incidence of CAUTI. One of safety goals set forth by the Joint Commission, is the reduction in the incidence of CAUTI (The Joint Commission, 2015).