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Preventing catheter-associated urinary tract infections Editors note The following is adapted from HCPros new book Preventing Catheter-Associated Urinary Tract Infections Build an Evidence-Based Program to Improve Patient Outcomes. For more discipline on this book or any other in our library, visit www. hcmarketplace. com. Catheter-associated urinary tract infections (CAUTIs) argon the most common of all infirmary-acquired conditions (HACs).Eighty percent of urinary tract infections (UTIs) result from indwelling urinary catheters, and 12%16% of uncomplainings admitted to acute c ar hospitals may have indwelling urinary catheters at some record during their stay. One of the best ways to reduce the risk of CAUTI is to reduce the use of catheters. So as the presidency begins its journey, it moldiness decide which longanimouss truly carry indwelling urinary catheters. Which patient populations with which diagnoses or conditions meet criteria for origination? How can the organizati on reduce the use of catheters?Are both male and female urinals readily in stock(predicate) for patients with urinary incontinence? Does the organization have the capability to perform noninvasive bladder scanning to treasure post-void residuals? Are there patients who are candidates for intermittent catheterization to manage urinary retention and bladder drainage? These types of questions inquire to be considered when decisions are made to insert an indwelling urinary catheter to provide bladder drainage. The most effective method for eliminating hospital-acquired CAUTIs is prevention as a result of decreasing the use of indwelling urinary catheters (Robinson et al. 2007). The beside best method to reduce infections in patients who meet the conditions for catheter placement is to limit catheter days by evaluating the reasons for proceed the catheter on a daily basis and removing the catheter at the moment patients no longer meet criteria (Saint et al. , 2000 Munasinghe et al. , 2001). machinate a prevention plan When patients do require indwelling urinary catheters, constantly evaluate the engage for use and identify other methods for managing bladder drainage whenever possible.Developing a prevention plan for your organization allow for outline steps for physicians and nurses to use in making these important clinical decisions. The prevention plan must include tools to guide clinicians decision-making regarding the insertion, care, and continuation of indwelling urinary catheters to ensure prevention of CAUTIs in patients admitted for inpatient care. An physical exertion of these essential tools is an algorithm for making decisions regarding the insertion, continuation, and removal of urinary catheters and a means of routinely assessing and documenting continued need for the catheter on a daily basis.In addition, evidence-based care must be provided to patients requiring continued catheter use, so a CAUTI wrap up is in any case an essential CAUTI prevention tool for clinicians. Assess patients at gateway As patients enter your organization, assessments and detach actions should be taken regarding patients who are symptomatic for UTIs. Having the appropriate tests completed to be able to document that the patients UTI was present on admission (POA) helps save the organization from being held accountable for a CAUTI in cases where the patient presents with a catheter in place or requires catheter placement shortly after admission.Detailed assessments of patients by their nurses during the admission process must be carefully partnered with, and supported by, physician documentation to determine whether a patients UTI preceded placement of the urinary catheter and was POA or whether the infection was acquired as a result of the hospital admission and is then considered an HAC. POA conditions are determined with the following criteria There must be wee differentiation in the presence of diagnosis/condition at time of admissi on or festering of the problem after admission. Physician documentation of the condition must exist in the patients medical record.If POA, it must be documented concurrently with the physicians admission orders. Primary responsibleness for complete and accurate documentation lies with the physician/licensed independent practitioner. Any incomplete documentation requires supplier clarification. Identify risk factors Physicians and nurses must work closely as a team to identify patients at high risk for CAUTI and carefully and accurately document findings in patients medical records. These intraprofessional team members must also share the opinion that the best means of preventing CAUTIs is to reduce catheter use whenever possible.Starting with comprehensive patient histories on stretch is essential to identify patients risk factors for developing a CAUTI or to determine whether they already have a UTI on admission. According to current findings in the literature and a record r eview of patients with CAUTI, the following are risk factors (Lo et al. , 2008) Gender (e. g. , women are more likely to have UTIs than men) Advanced age History of urinary tract problems (e. g. , enlarged prostate or urologic s urge onry) Neurologic conditions (e. g. , spinal cord injury) causing neurogenic bladder problems Previous UTIs Previous and/or current abnormal voiding patterns Current catheter history Incontinence Comorbid conditions much(prenominal) as diabetes Immunosuppression In addition, patient assessments must include documentation of any signs and symptoms of UTIs, including A frequent urge to urinate A painful, burning feeling in the area of the bladder or urethra while urinating A fullness in the rectum (in men) Suprapubic tenderness Passing only a small amount of urine muddied or reddish-colored urine Fever greater than 100. 3? F (38? C) with or without chills Incontinence Pain in the back or sideClinicians should remember that not everyone with a UTI develops signs and symptoms. It is important to distinguish between symptomatic and symptomless bacteriuria in these hospitalized patients (Tambyah & Maki, 2000). References Lo, E. , Nicolle, L. , Classen, D. , Arias, K. M. , et al. (2008). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infection go through and hospital Epidemiology 29 S41S50. Munasinghe, R. L. , Yazdani, H. , Siddique, M. , & Hafeez, W. (2001). Appropriateness of use of indwelling urinary catheters in patients admitted o the medical service. Infection Control and Hospital Epidemiology 22 647649. Robinson, S. , Allen, L. , Barnes, M. R. , et al. (2007). Development of an evidence-based protocol for reduction of indwelling urinary catheter usage. MedSurg Nursing 16(3) 157161. Saint, S. , Weise, J. , Armory, J. K. , et al. (2000). Are physicians mindful of which of their patients have indwelling urinary catheters? American Journal of Medicine 109 476480. Tambyah, P. A. , & Maki, D. G. (2000). Catheter-associated urinary tract infection is rarely symptomatic. Archives of Internal Medicine 160 678687.