Catheter-Acquired Urinary Tract Infections (CAUTIs) in Alabama

Introduction

The urinary tract infections (UTI) can be described as infections that can involve any of the urinary systems, which include but not limited to the ureters, urethra, kidney, and bladder. As per the National Health Safety Network (NHSN), UTIs are the most common form of the infections associated with health-care. The Catheter Acquired UTI (CAUTI) is a type of UTI associated with the device which results from the urethral CatheterCatheter with dwells within the urethra. Some of the primary risk factors for the development of the CAUTI is the long term usage of the Urinary Catheter. It is therefore highly recommended for the CatheterCatheter to be used in the most appropriate manner, which includes their removal when not needed. The CAUTI is usually reported in the cases where the patient has had an indwelling catheter for at least 48 hours before the start of the UTI. In this case, the patient may either be asymptomatic or symptomatic.

The CatheterCatheter is usually inserted through the urethra to the bladder for the drainage of urine. In Alabama, the incidents of the CAUTI is highly associated with the medical words of the floor, the surgical wards, and well the medical-surgical floors. In the hospitals where such places are not present, the mixed-age wards are reported to contribute to CAUTI highly. In 2016, at least ninety two hospitals across Alabama reported cases of CAUTI amounting to 403. This number of CAUTIs was associated with 452,404 days of CatheterCatheter. This number was lower than that reported in 2015. That was an indication of improvement. More notably, Alabama performed better than the overall national performance. This study focuses on the incidents of CAUTI, Alabama.

Problem Statement

The CAUTI is a severe Health care Associated Infections (HAI) that is affecting the State of Alabama and in need of urgent mitigation. Any form of the UTI usually develops as a result of the neglect of the nursing home where the patient is admitted. The development of the CAUTI on older women and men in caring homes may develop as a result of poor hygiene as well as unfavorable sanitary conditions within the care homes. In any case, there is a greater need for mitigation procedures to take care of the adverse effects of the CAUTI. Usually, when the CAUTI is an extreme case, it might develop into sepsis, which is a health condition that might have a potential failure of the organs infected and might finally lead to death.

A s a result of the indwelling CatheterCatheter during the hospitalizations, between 21 to 50 % of the patients are put under the risk of developing various complications based on these devices. As per *** there are higher chances of development of more complications on the patients put on the catheter therapy as compared to those on the antibiotics. The most common complication on the patients was the CAUTIs. The usage of the catheters as a therapeutic procedure is coming with much harm to the individual’s life.

The population to be examined in this study are the patients who have recovered from various illnesses through catheterization and those who are on the therapy. The community is significant as it helps us understand the magnitude of the CAUTIs as a result of catheterization. Knowing the extent of the adverse impacts of the usage of catheters can help in coming up with the best mitigation procedures for the CAUTIs.

Significance of the study to Nursing

The subject of the CAUTIs is not too old in the nursing fraternity, and there are dynamic changes that take place towards the prevention of such illness. Usually, the best practice towards mitigation and hence the prevention of such ailments. Although the best way to prevent patients against UTIs associated with catheters would be to stop the usage of the catheters in the medical procedures, that is a costly move as the therapeutic process has proven to be effective in a medical procedure. Therefore, this research is aimed at reducing the incidents of the CatheterCatheter associated UTIs.

Although there have been advances in the prevention of the CAUTIs, the cases are still very much and have remained problematic. It is hence clear that some procedures can be taken to help to reduce the incidents alongside continued usage of the catheters. For instance, the reduction of bacterial colonization within the urethral area as well as near the meatal may be a very effective method. However, there is conflict over the best antiseptic to be used in such a case, which generally conflicts with the earlier recommendation. Therefore the study will be of help to nursing as it is expected to reduce the conflict of recommendation as it pertains to this reduction of the CAUTIs. Some of the mitigation procedures used in the cleansing of the bacteria colonization around that area are the usage of the chlorhexidine before the insertion of the catheters. Whoever, the method does not seem to be cost-effective enough, and its effectiveness has not yet been reviewed, which prompts a need for this study in nursing.

Literature Review and Synthesis

Studies have already reviewed that the incidents of the CAUTIs can be reduced. However, although there has been advanced in the medical industry towards the reduction of infections, the CAUTIs have remained a problem. This is despite the fact of studies showing that reducing the bacterial colonization around the urethral can reduce the risks of the CAUTIs.

As a result of the increased limit of the geriatricians in the Alabama state, most of the hospitalists are responsible for the management of the nursing homes within the state. As a result of the inappropriate handling of the antibiotics for the prevention of bacterial infections, the patients end up with indwelling urinary catheters. In this case, up 10% of the patients in such hospitals end up with the catheters. However, 50% of the patients on the urinary catheters have been known to end up with UTIs. Although the Catheters are not commonly used in nursing homes as they are in hospitals, the data indicates that more impact is on the patients in nursing homes. This has been attributed to the prolonged usage of the catheters even when they no longer needed by the patient. Therefore, when the utilization of the catheters is more prolonged, but there is prolonged usage, the intervention that might be put in place to mitigate its effects are not helpful.

According to ## the individuals who need the indwelling CatheterCatheter are usually exposed to the risks of developing CAUTIs as a result of the indwelling catheter devices and the pathogenic organisms, which are multidrug-resistant within the nursing homes. Although the feared threat of this infection is thought to be caused by opportunistic nosocomial multidrug-resistant trains, many cases of the CAUTIs are caused by the presence of the bacteria within the urine, which is purely asymptomatic. 70% of the case of the CAUTIs in Alabama has been proven to be asymptomatic, which means they are as a result of the urinary bacterium.

The indwelling catheters seep to be in favor of the colonization of the pathogen’s development as they provide a surface over which the attachment of the cells on the host takes place. In this case, the Catheters provide a receptor over which the bacteria adhesion takes place. This is basically because the CatheterCatheter typically damages the uroepithelia, which is the protective layer. Its damage provides a new site for the binding of the adhesive bacteria. Additionally, the presence of the indwelling CatheterCatheter usually damages the person’s defense mechanism against urinary tract infections. This causes the distension of the bladder as well as an incomplete voiding, which offers residual urine a chance for the microbial growth. Therefore, any embryonic development towards the mitigation of the effects of the CAUTIs, thus reducing the incidents of such loopholes must be sought first.

The pathogens, which cause the UTIs during the process of catheterization, use similar approaches to launching the infection just like any other organism causing the less complicated UTIs. However, as a result of the introduced foreign body, the organization gets favored as the service for their binding has been provided for them. This makes it easier for the pathogens in CAUTIs to colonize the whole urinary tract quickly and easily make the infection more adverse. More also, the prevalence of the catheters alone does not favor the development and the production of the pathogens; the conditions within the nursing homes also play a part in such growths. One of the most notable factors is the prolonged usage of such catheters even though there is underutilization. This provides an excellent environment as well as protracted time for the pathogens to develop.

While only 21% of patients in hospitals who are under catheterization have suffered the CAUTIs, 50% of those who are in the nursing homes under catheterization suffer from the CAUTIs. This is a clear indication that the factors in nursing homes are promoting the development of CAUTIs. This data is despite the fact the catheter utilization in the hospitals is higher than in the nursing homes. The risk factor here is prolonged usage of the catheters even when they are no longer needed.

Purpose

The purpose of the study is to examine the factors the lead to the high prevalence of the CAUTIs on the patients within the state of Alabama. The survey takes into account the patients who have recovered from the CAUTIs, those who are nursing the CAUTI, and those who are at risk of the CAUTIs.

Hypothesis

The poor sanitation in nursing homes is the reason for the high incidents of CAUTIs in nursing homes.

Theoretical or Conceptual Framework