Evidence-Based Practice in Catheter Associated UTI

 
 
Evidence-Based Practice in Catheter-Associated Urinary Tract Infection 
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 College of Nursing
NR451 RN Capstone Course
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Evidence-Based Practice in Catheter-Associated Urinary Tract Infections
Description of Health Issue/Case 
In this particular case study, we have an 83-year-old male, Simon Jones, who is a retired autoworker. He has had a history of urinary retention, for which he requires a constant indwelling urinary drain/catheter. He also had an overgrowth of benign prostate tissue that was pushing against his bladder and the urethra and blocking his urine flow. For this hypertrophy, he underwent surgery six months ago. Although his follow-ups with the urologist showed considerable improvement, he still uses a catheter to avoid retention or incontinence after the surgery.
Apart from this, Mr. Jones has also suffered two myocardial infarctions in the past five years. For this, he has undergone the five-vessel coronary artery bypass surgery about two years back. On top of that, he has recently been diagnosed with congestive heart failure. His medications currently include statins, cardiac glycosides, enalapril, along with furosemide and potassium to maintain his electrolyte balance.
The patient has recently come into the hospital with a urinary tract infection (UTI) due to prolonged indwelling catheter use. Mr. Jones will see an infectious diseases consultant to devise antibiotics after the examination of his urine and bacterial culture. It is quite a baffling question, why are we not able to prevent bacteriuria even when the patient practices good hygiene? According to Parker et al. (2017), catheter-associated UTIs account for at least 53% of all UTI cases in both men and women. If patients like these that require long-term catheters repeat antibiotic regimens to treat or prevent microbial infections, they can develop antibiotic resistance. This can prevent the antibiotics from acting on the bacteria and prevent other related or unrelated infections in the body.
Evidence-Based Practice Guideline Grid
Tenke, P., Mezei, T., Bőde, I., & Köves, B. (2016, October 18). Catheter-associated urinary tract infections. European Urology Supplements. /science/article/abs/pii/S1569905616301439. 
Carolyn et al. (2019). Guideline for Prevention of Catheterassociated Urinary Tract Infections 2009. Healthcare Infection Control Practice Advisory Committee. Retrieved from /infectioncontrol/pdf/guidelines/cauti-guidelines-H.pdf

Target Population

Adults requiring long-term indwelling urinary catheter 

Purpose / Objective

To discuss different management options for both the prevention and treatment of catheter-associated urinary tract infections in efforts to reduce frequent use of antibiotics, which can lead to resistance.

Summary of Recommendations

It is recommended to implement the most effective methods of prevention of CAUTIs that include avoiding unnecessary catheterization and removal of catheters as soon as possible. It is also important to introduce optimal materials for catheters that do not become a harbor for bacterial ...