Evaluation of the Utilization of Catheter Associated Urinary Tract Infection Bundle Among Critical Care Nurses - Kenyatta National Hospital
American Journal of Nursing Science
Volume 5, Issue 5, October 2016, Pages: 201-212
Received: Sep. 2, 2016; Accepted: Sep. 18, 2016; Published: Oct. 19, 2016
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Authors
Assanga P. A., School of Nursing Sciences, University of Nairobi, Nairobi, Kenya; Social Services League Hospital, Critical Care Unit, Nairobi, Kenya
Omondi A. L., School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
Inyama H. K., School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
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Abstract
Majority if not all patients admitted to the Critical Care Units (CCUs) have indwelling urinary catheters predisposing them to Catheter Associated Urinary Tract Infections (CAUTI). CAUTI bundle was introduced to reduce the infections whose prevalence had been high. Utilization of this bundle is considered standard gold and should be utilized completely by nurses while providing care to the patients. The aim of this study was to determine the utilization of the CAUTI bundle among critical care nurses at Kenyatta National Hospital’s (KNH’s). The study applied a cross-sectional descriptive design with cluster sampling and simple random sampling for each cluster. Ninety five critical care nurses were selected from a total of 136 nurses using Cochran’s formulae. A structured questionnaire and an observation checklist were used to collect data which was analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0. Descriptive statistics was used to summarize the data and inferential statistics (Chi-square test, odds ratio and Pearsons’ correlation) was used to establish relationships between variables. Nurses working at KNH’s CCUs utilized and adhered (49.5%; P >0.005) to the bundle. There was a weak correlation between the observed and reported bundle utilization [r = 0.043; 95% CI 0.16 – 0.24; P = 0.678].
Keywords
Catheter Associated Urinary Tract Infection (CAUTI), Critical Care Units (CCUs), Kenyatta National Hospital (KNH), Critical Care Nurses, Centre of Disease Control (CDC)
To cite this article
Assanga P. A., Omondi A. L., Inyama H. K., Evaluation of the Utilization of Catheter Associated Urinary Tract Infection Bundle Among Critical Care Nurses - Kenyatta National Hospital, American Journal of Nursing Science. Vol. 5, No. 5, 2016, pp. 201-212. doi: 10.11648/j.ajns.20160505.15
Copyright
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
CDC. "Centre of Disease Control Catheter-associated Urinary Tract Infection Guideline Fast Facts." 2015. https://www.cdc.gov/HAI/ca_uti/uti.html. [Accesed on 20/03/2016].
[2]
Weber D. J, Sickbert-Bennet E E., Gould C. V, Brown V. M, Huslage K, Rutula W. A., ''Incidence of catheter-associated urinary tract infections in a healthcare system''. Infect control hosp Epidemiol., 2011; 32 (8): 822-823.
[3]
CDC, ''Diagnosis, Prevention and Treatment of Catheter-Associated Urinary Tract Infection in Adults''. 2009 International Clinical Practice Guidelines from Infectious Diseases Society of America. 2009. https://www.google.com/webhp?sourceid=chromeinstant&ion=1&espv=2&ie=UTF8#q=Diagnosis%2C+Prevention+and+Treatment+of+Catheter-Associated+Urinary+Tract+Infection+in+Adults. [Accessed on 10/03/2016].
[4]
Saint S, Olmstead R. N, Fakih M. G, Watson S. R, Sales A. E & Krein S. L, ''Translating health care-associated urinary tract infection research into practice via bladder bundle''. Joint commission Qual Patient Saf, 2009; 35 (9): 449-455.
[5]
Reser R, Griffin F. A, Haraden C & Nolan T. W, ''Using care bundles to improve health care quality. IHI Innovation series white paper.'' http://www.ihi.org/resources/pages/ihiwhitepapers/usingcarebundles.aspx [Accessed on 01/01/2016].
[6]
Horner K. L, ''Closing the Quality Gap: Prevention of Healthcare Associated Infections.'' http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=738 [Accessed on 10/04/2016].
[7]
Leblebicioglu H., Ersoz G, Rosenthal D. V, Nevzat-Yalcin A, Akan A. O, Sirmatel K. A et al, ''Impact of a multidimensional infection control approach on Catheter Associated Urinary Tract Infection rates in adult Intensive Care Units in 10 cities of Turkey." Am J Infect Cont, 2013; 41 (10): 853–891.
[8]
Gould C. V, Ulmscheid C. A, Agarwal R. K, Kuntz G and Pegues D. A, ''Guideline for prevention of Catheter-Associated Urinary Tract Infections,'' Infect Contr Hosp Epidemiol, 2010; 31 (4): 391-326.
[9]
Clarke K, Tong D, Pan Y, Easley K. A, Norrick B, Ko C, Wang A et al, ''Reduction in Catheter-Associated Urinary Tract Infections by bundling interventions''. Int J Qual Health Care, 2013; 25 (1): 43-49.
[10]
Maturi P. M., ''The prevalence of Nosocomial Urinary Tract Infections in patients with indweling urinary catheters at Kenyatta National Hospital''. UoN Digital Repository. 2010. http://hdl.handle.net/11295/25007. [Accessed on 3/03/2016].
[11]
Inyama H. K, Revathi G, Musandu J and Odero T, ''The incidence of Nosocomial Urinary Tract Infections: Kenyatta National Hospital Intensive Care Unit''. BIRJ, 2011; 1 (2): 12-21.
[12]
Gould C. V, Ulmscheid C. A, Agarwal R. K et al., ''Guideline for prevention of Catheter Associated Urinary Tract Infections 2009'', HICPAC. 2010. https://www.cdc.gov/hicpac/cauti/001_cauti.html [Accessed on 3/3/2016].
[13]
Ulmscheid C. A, M.itchel M. D, Doshi J. A, Agarwal R, Brennan P. J and Williams K, ''Estimating the proportion of Healthcare Associated Infections thatt are reasonably preventable and the related mortality and costs.'' Infect Contr Hosp Epidem, 2011; 32 (2): 101-104.
[14]
Meddings J, Krein S. L, Fikah M. G, Olmsted R. N, Saint S, ''Reducing Unnecessary Urinary Catheter Use and other Strategies to Prevent Catheter Associated Urinary Tract Infection: Intergrative Review.'' BMJ Qual Saf, 2013; 1 (1): 1-5.
[15]
IHI ''How-to-Guide: Prevent Catheter Associated Urinary Tract Infections. Institute for Healthcare Improvement..'' http://www.ihi.org/resources/pages/tools/howtoguidepreventcatheterassociatedurinarytractinfection.aspx [Accessed on 14/03/2016].
[16]
Drenkoja D. M, Kuskowski M. A & Johnson J. R, ''Internet survey of foley catheter practices and knowledge among Minessota nurses.'' Am J Infect Contr, 2010; 38 (1): 31-37.
[17]
Brunett K. P, Erickson D, Hunt A, Beaulieu L, Bobo P & Shute P, ''Strategies to prevent urinary tract infections from urinary catheter insertion in the emergency department.'' J Emerg Nurs, 2010; 36 (6): 546-550.
[18]
Dingwall L & Mc.Lafferty E, ''Nurses' Perception of Indwelling Urinary Catheters in Older People.'' Nurs Stand, 2010; 21 (16): 35-42.
[19]
APIC. ''Association for Proffessionals in Infection Control and Epidemiology.'' 2008. http://www.apic.org [Accessed on 20/02/2016].
[20]
Ribby K. J, ''Decreasing urinary tract infections through staff development, outcomes, and nursing process.'' J Nurs Care Qual, 2006; 21(3): 272-276. www.ncbi.nlm.nih.gov [Accesd on 20/02/2016].
[21]
Blanck A.W, Donahue M., Brenhinger L, Stinger D. K & Polito C, ''A quasi-experimental study to test a prevention bundle for Catheter-Associated Urinary Tract Infections.'' J Hosp Admin. 2014; 3(4): 101-108. www.sciedu.caljha [Accessed on 20/02/2016].
[22]
CDC, ''Appendices of guideline for prevention of Catheter Associated Urinary Tract Infections." CDC. 2009. https://www.cdc.gov/hicpac/cauti/001_cauti.html [Accessed on 20/02/2016].
[23]
Amine A. E, Bakr W. M & Helal M. O. ''Evaluation of an intervention program to prevent Hospital-Acquired Catheter-Associated Urinary Tract Infections in an Intensive Care Unit in a rural Egypt hospital." GMS Hyg Infect Control, 2014; 9 (2): 15. http://www.ncbi.nlm.nih.gov/pubmed/25152860 [Accessed on 22/12/2015].
[24]
WHO. ''World Health Organization's Patient Safety: WHO Guidelines on Hand Hygiene in Healthcare.'' First Global Patient Challenge Clean is Safer Care. Geneva. 2009. Available: http://www.who.int. [Accessed on 20/12/2015].
[25]
Gould.C. V, Ulmscheid C. A, Agarwal R. K andKuntz G, ''Guideline for prevention of Catheter Associated Urinary Tract Infections 2009.'' Healthcare Infection Control Practices Advisory Comittee. https://www.cdc.gov/hicpac/pdf/CAUTI/CAUTIguideline2009final.pdf [Accessed on 10/03/2016].
[26]
Maki D. G and Tambyah P. A, ''Engineering out the risk for infection with urinary catheters.'' Emerg Infect Dis, 2001; 7 (2): 324 - 327.
[27]
Titsworth W. L, Hester J, Correia T, Reed R, Williams M et al., ''Reduction of Catheter-Associated Urinary Tract Infections among patients in a neurosurgical Intensive Care Unit: a single institution’s success.'' J Nurs. 2012; 116 (4): 911 - 920.
[28]
CDC, ''Centre of Disease Control: Catheter Associated Urinary Tract Infection Guideline.'' Fast facts. 2015. https://www.cdc.gov/HAI/ca_uti/cauti_faqs.html. [Accessed on 30/03/2016.].
[29]
Hanchett M, ''Techniques for Stabilizing Urinary Catheters.'' Am J Nurs. 2002; 102 (3): 44-48.
[30]
Crouzet J, Bertrand X., Venier A. B, Badoz M, Husson L & Talm D, ''Control of the duration of Urinary Catheterization: Impact on Catheter Associated Urinary Tract Infections.'' J Hosp Infect, 2007; 67 (3): 253-257.
[31]
CDC, ''Appendices of guideline for prevention of catheter-associated urinary tract infections.'' 2009. Available: http://www.cdc.com. [Accessed on 05/02/2016.].
[32]
Gould C. V, Ulmscheid C. A, Agarwal M. D, Kuntz G and Pengues D. A, ''Guideline for prevention of Catheter Associated Urinary Tract Infections.'' Healthcare Infection control Practices Advisory Committee. Infct Contr Hosp Epid., 2010; 31 (4): 319-326.
[33]
Dimick G, ''Quality Check: An overview of Quality Measures and their Uses.'' J AHIMA, 2010; 81 (8): 34-38. http://library.ahima.org/doc?oid=101998.[Accessed on 21/01/2016].
[34]
Thompson D, Chairez D, Nimmo V & Scott K, ''Point Prevalence Surveillance of foley catheter maintenance and utilization.'' Foley Catheter Observation Survey. 2016; 2 (3): 12-18.
[35]
Siegel T. J, ''Do Registered nurses perceive the anchoring of indwelling Urinary catheters as a necessary aspect of nursing care? A pilot study.'' J Wound Ostomy Continence Nurs, 2006; 33 (2): 140-144.
[36]
Appah Y, Hunter K. F & Moore K. N, ''Securement of the Indwelling Urinary Catheter: A Prevalence Study.'' J Wound Ostomy Continence Nurs, 2016; 43 (2): 173-177. 2016.
[37]
Clarke K., Tong D, Pan Y, Easley K. A, Norrick B, Ko C and Wang A. ''Reduction in Catheter-Associated Urinary Tract Infections by bundling interventions.'' Int J Qual Health Care, 2013; 25 (1): 43-49.
[38]
Mangnall J & Watterson L, ''Principles of Aseptic Tecchnique in Urinary Catheterization.'' Nurs Stand, 2006; 21 (1): 49-56.
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