Nursing RUA Capstone Evidence based paper NR452 Prevention of Catheter-Associated Urinary Tract Infection (CAUTI) in the ICU Utilizing a Multidisciplinary Checklist

Introduction

Healthcare-associated infections (HAIs) represent some of the most severe complications in hospitals across the United States. According to the Agency for Healthcare Research and Quality (2012), approximately 2 million hospitalized patients in the U.S. suffer from HAIs annually, leading to 99,000 deaths. Among these infections, Catheter-Associated Urinary Tract Infection (CAUTI) stands out as one of the most prevalent, particularly in adult intensive care settings. This essay explores the implementation of a multidisciplinary checklist in the adult intensive care unit (ICU) at the University Medical Center of Southern Nevada. The goal is to evaluate whether this intervention can effectively prevent CAUTIs in patients with indwelling catheters. The checklist involves contributions from nurses, physicians, respiratory therapists, pharmacists, nutritionists, and other healthcare team members, who will incorporate its use into their daily tasks. The rising number of CAUTI cases necessitates this approach, as it aligns with the health promotion and maintenance category of the NCLEX-RN exam blueprint, helping nurses prevent the occurrence of these infections and promote optimal patient health.

Importance

The prevalence of CAUTI in hospital settings, particularly in ICUs, ranges between 30% and 40%, making it one of the most common HAIs (Marra, 2011). The financial implications are significant, with each CAUTI case incurring an estimated additional cost of $1,000 (Fuchs, 2011). This translates to an annual medical cost of approximately $4.5 billion, with inflationary adjustments raising this figure to around $6.65 billion based on the consumer price index (Fuchs, 2011). Given the staggering incidence of 2 million CAUTI cases per year, the Centers for Medicare and Medicaid Services (CMS) have designated CAUTI as a “never event,” thereby limiting reimbursement to acute care hospitals (Vacca & Angelos, 2013). This designation underscores the necessity for stringent preventive measures.

The use of indwelling urinary catheters significantly increases the risk of CAUTI, as these devices provide a direct pathway for microorganisms to enter the bladder. Improper sterile technique during catheter insertion, as well as breaches in the urinary catheter drainage system at connection points, can introduce pathogens, leading to infection (Fryklund, Haeggman, & Burman, 1997). This underscores the critical need for a multidisciplinary approach to CAUTI prevention.

For additional resources on preventing healthcare-associated infections, visit https://nursingschooltutors.com/.

Multidisciplinary Approach and Checklist Implementation

The implementation of a multidisciplinary checklist is a strategic intervention aimed at reducing the incidence of CAUTI in the ICU. The checklist is designed to ensure that all aspects of catheter care are meticulously followed, thereby minimizing the risk of infection. Each member of the healthcare team plays a pivotal role in this process.

Nurses are at the forefront of this initiative, as they are responsible for the direct care of patients with indwelling catheters. Their duties include ensuring proper catheter insertion techniques, maintaining sterile conditions, and regularly monitoring catheter sites for signs of infection. Physicians contribute by evaluating the necessity of catheter use and advocating for early removal when possible, thus reducing the duration of catheterization—a key risk factor for CAUTI.

Respiratory therapists, while primarily focused on pulmonary care, can assist by maintaining a clean environment and avoiding unnecessary movement of catheters during respiratory interventions. Pharmacists play a crucial role in managing antibiotic use, ensuring that prophylactic antibiotics are used appropriately to prevent resistance and that treatment regimens are tailored to the specific pathogens involved in CAUTIs.

Nutritionists contribute by ensuring that patients receive adequate hydration, which helps maintain urinary tract health and reduces the risk of infection. Other healthcare associates are also involved, each contributing to the checklist by performing their respective tasks with a heightened awareness of CAUTI prevention.

This collaborative approach is essential for the success of the checklist. By involving multiple disciplines, the intervention covers all aspects of patient care, from the technicalities of catheter insertion to the overall health and well-being of the patient. The checklist serves as a constant reminder of the importance of infection prevention and fosters a culture of accountability within the ICU.

For expert advice on implementing multidisciplinary approaches in healthcare settings, visit Order a similar paper