NR 451 Week 6 Assignment: Evidence Based Practice Change
Process 100% Updated Summer
Star Point 1: Discovery (Identify topic and practice
... [Show More] issue)
Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing
practice issue.)
The topic is hospital acquired infections. The nursing practice issue is catheter associated urinary tract
infections and the high incidence on an acute rehabilitation unit.
Briefly describe your rationale for your topic selection. Include the scope of the issue/problem.
The nursing practice issue I would like to investigate is healthcare associated infections (HAI),
particularly catheter associated urinary tract infection (CAUTI). CAUTI is very important to
investigate because I believe HAI’s can be decreased, if not prevented. Being that nurses are
educated on the possible causes or symptoms of HAI’s, we can be more proactive in our
treatment plans. If a patient falls, that can be an unpredictable event but HAI’s are more so
predictable. With CAUTI, making sure that the perineal area is cleaned on a regular, consistent
basis is important. Providing proper interventions to not keep an indwelling catheter in longer
than necessary is also important.
Urinary tract infections are one of the most common hospital acquired infections. At least 80% of
urinary tract infections an be attributed to an indwelling urinary catheter. There are
approximately 13,000 annual deaths associated with catheter associated urinary tract infections
(CAUTI). CAUTIs can lengthen hospital stays, increase morbidity and mortality, and raise
healthcare costs.
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NR 451 Evidence Based Practice Change Process
PICOT question- In (P) patients with an indwelling catheter on an acute rehabilitation unit, does
(I) cleansing the perineal area every eight-hour period compared to (C) routine daily cleansing of the
perineal area (O) decrease the catheter associated urinary tract infection with patients over a (T) six month
period?
List the systematic review chosen from the Cochrane Database of Systematic Reviews from the
Chamberlain library. Type the complete APA reference for the systematic review selected.
Interventions to improve professional adherence to guidelines for prevention of device‐ related infections.
Reference
Flodgren G, Conterno LO, Mayhew A, Omar O, Pereira CR, Shepperd S. Interventions to improve
professional adherence to guidelines for prevention of device ‐ related infections. Cochrane Database
of Systematic Reviews 2013, Issue 3. Art. No.: CD006559. DOI: 10.1002/14651858.CD006559.pub2.
List and briefly describe other sources used for data and information. List any other optional
scholarly source used as a supplement to the systematic review in APA format.
In my search for evidence, I found an article about nurse-driven CAUTI prevention. This evidence is
relevant to my PICOT because I would like to find a way to decrease or eliminate the instances of CAUTI
in a hospital setting. The article gives a history of prevalence of CAUTI then goes into costs related to
CAUTI. The article also mentions ways of preventing CAUTI. The article also discusses an algorithm
used to decrease the prevalence of CAUTI.
I also found an article about the causes of CAUTI and how to properly clean the perineal area as an
educational tool.
Reference
Russell, J. A., Leming-Lee, T. ‘Susie,’ & Watters, R. (2019). Implementation of a Nurse-Driven CAUTI
Prevention Algorithm. Nursing Clinics of North America, 54(1), 81–96. https://doiorg.chamberlainuniversity.idm.oclc.org/10.1016/j.cnur.2018.11.001
Memorial Sloan Kettering Cancer Center (2018). Caring for Your Urinary (Foley®) Catheter. Retrieved
from https://www.mskcc.org/cancer-care/patient-education/caring-your-urinary-foley-catheter
Briefly summarize the main findings (in your own words) from the systematic review and the
strength of the evidence.
The main findings from the systemic review were that there weren’t sufficient evidence to properly
corroborate the research. The trials were too small and there was inadequate reporting of information.
Because the findings were too small, it was difficult to determine which intervention would be optimal in
CAUTI care. The strength of the evidence was weak for the change process.
Outline one or two evidence-based solutions you will consider for the trial project. [Show Less]