Article Summary
The impact of CAUTI remains a major threat to the safety of the patient and accounts for about 40% of hospital-acquired infection. The main culprit associated with the occurrence of CAUTI is having an indwelling catheter during a hospital stay. According to the Centers for Medicare and Medicaid Services, CAUTI’s are well thought-out to be an avoidable barrier of hospitalization, hence no extra payment is afforded for this treatment.
Therefore, the expected practice using the American Association of Critical-Care Nurses (AACN) Levels of Evidence is to assess the patient’s need for an indwelling catheter and other options prior to placement. When absolutely necessary, adherence to aseptic technique is essential for placement,
Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.
During my clinical preceptorship at New York Presbyterian Hospital, many patients that came into the hospital with urinary retention a catheter was inserted to determine the amount of urine in their bladder or post-void residual (PVR). Many patients later developed pain and a urinary tract infection or Community Acquired Infection secondary to frequent cauterization. Therefore, the gap identified was related to a knowledge deficit of the current practice that inserting a
Her medical diagnosis of ARDS from overdosing and pneumonia are the cause of her deteriorating condition. Then, it moves on to the first two primary nursing diagnoses of impaired gas exchange and risk for infection, followed by the lower ranked ones of impaired tissue integrity, anxiety, and finally decrease cardiac output. The case study then explored her expected outcomes, the interventions used for her primary two nursing diagnoses with literature reviews, and finally an evaluation of the plan of care. The learning from this patient is that it is not our place as nurses and medical personnel to judge, but to treat with fairness and compassion. It is easy to look down on this patient for her chronic illnesses that affect her long-term health, but she needs help, and now may never be back to her pre-hospitalized state.
Patients that are admitted to the hospital frequently require intravenous (IV) fluids. Many hospital policies require IV sites to be changed every 72-96 hours to reduce the risk of complications caused by the IV catheter. There is increasing evidence supporting that routine IV site replacement is ineffective (Rickard, McCann, Munnings, & McGrail, 2010, p. 2). Working in the labor and delivery department, we rarely have patients that require an IV site for more than 24-48 hours.
Central line associated bloodstream infections (CLABSIs) in 2009 were amongst 23,000 infections in the inpatient population of US hospitals. (Sweet, Cumpston, Briggs, Craig, & Hamadani, 2012) These infections increase morbidity of patients, mortality, and increase cost. Those that are at risk are the population with central venous catheters. This infection is commonly due to improper hub care and consequently provides the direct introduction of the bacteria into the blood stream. A fairly new intervention to prevent this morbid infection is the implementation of alcohol impregnated protective caps, otherwise known as the brand name Curos caps in addition to others.
Working in a renal/urology medical-surgical unit, it is a challenge for both the nursing staff and nursing administration to have readmissions due to fluid and electrolyte imbalance from patients with ESRD and CHF. In my own experience, patients who have been in and out of the hospital for the past six months to a year are at a higher risk of acquiring nosocomial infections resulting in a weaker immune system to an already compromised one, as well as longer hospital stay. Readmissions from these patients pose as a physical, emotional and financial strain to both patients and/or their families. Additionally, readmissions within 30 days for patients with CHF poses as an additional cost for hospitals as there is reduced Medicare payments for Inpatient
TACT consulted with Dr. Gentry and it was recommended to refer for inpatient hospitalization for safety and stabilization. TACT assisted the ED doctor in completing IVC paperwork. TACT will search for appropriate
The incidence of pacemaker infection in our institution has increased from 4.92% in 2012 to 17.86% in second quarter of 2013. This number is comparable to the data retrieved from National Inpatient Sample reported that there was a 224% increase in the pacemaker infection rate from 1193 to 2008 while the Implantable Cardioverter Defibrillator (ICD) remained constant.5 According to Patel J, incident of infection increases among patients with diabetes, heart failure, renal failure and respiratory failure. However, our study found that patients’ presenting illness prior to pacemaker implantation
In my facility, the safety of our patients is our top priority. We use a set of interventions using clinical indications to ensure the safety of patients with indwelling catheters. These indications are strict intake and output (I&O), patients monitored for acute renal insufficiency or failure, sedated patients with critical illness, and neurological patients monitored for syndrome of inappropriate antidiuretic hormone (SIADH) or diabetes insipidus. Patients suffering from acute urinary retention, or bladder outlet obstruction with the inability to void, as well as select surgical patients, are also indicated.
Lots of health care services, including certain procedures, are now performed in an outpatient setting, such as ambulatory surgical centers, which increases the risk of acquiring an infection, as the outpatient setting usually have a much less oversight and infection control compared to a hospital
The CIWA evaluation tool is sometimes replaced with the Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method (CAM) assessment tools when patients reside in the ICU.24 These are well validated tools that evaluate the level of a patient’s agitation versus sedation and presence or absence of
Part 1 Explain why it is important for nurses to use credible and relevant evidence to underpin their clinical practice. (Justify and support answers with credible and relevant evidence whilst adhering to UWS referencing guidance). The role of nurse changes as new research emerges and finds new and improved ways of helping patients to be restored to health. As Aveyard and Sharp (2016) suggested, evidence based practice requires that the approach is clear but also up to date and it based on the best type of evidence available at the point in time. The Nursing and Midwifery Council Code (2015) is to always provide the best possible service related to the best available evidence that is also in line with the patient’s preferences.
(REF must not be thrown away) .I place an Inco - pad on the chest of the patient for the anaesthetist to put the removed tube, for cleanliness and to prevent infection (REF). Prior to the extubation of the patient, the Anaesthetist checked the patient’s response to verbal command and recalled after
Discuss the population at increased risk for CAUTI and identify evidence-based practice in maintaining a Foley. 4. Identify the appropriate anatomical location for catheter insertion and demonstrate suitable inches for catheter insertion for male versus female. 5. Demonstrate the correct technique in cleaning a catheter using water and soap. 6.
The circulating nurse also initiated the time-out. During the time-out, the circulating nurse said the patient’s name, the surgery that the patient was getting, and the limb in which the surgery was being performed on. The other health care professionals agreed that it was the right patient, right site, and right procedure. Throughout the surgery the circulating nurse continued to ensure the safety of the patient by watching the surgical staff and making sure that the sterile field was not contaminated. This nurse’s role also included gathering materials for the surgeon, throwing away trash, and keeping the environment comfortable for the staff.