BHA4010_u301_MSzymanski
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Feb 20, 2024
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Catheter-Associated Urinary Tract Infections: Patients in ICUs
Michelle Szymanski
BHA4010: Intro to Health Care Research
Instructor: Jason Roberts
July 30, 2023
1
Table of Contents
Background and Evidence
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3
Problem Statement
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4
Purpose Statement
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4
References
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5
2
Background and Evidence
According to the Centers for Medicare & Medicaid Services (CMS), hospital-acquired conditions (HACs) are identified as high cost or high volume or a combination of both, “result in
the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis” and within reason, could have been prevented through “application of evidence-based
guidelines” (Retrieved on July 30, 2023, from https://www.cms.gov/Medicare/Medicare-Fee-for-
Service-Payment/HospitalAcqCond). This research paper will focus on the prolonged use of catheters and the correlation to catheter-associated UTIs (CAUTIs). A catheter-associated UTI (CAUTI) is a urinary tract infection. It is the most common type of HACs, accounting for one million cases per year in the United States, according to research from Werneburg (2022). Their study also found that the associated costs are estimated to range from $115 million to $1.82 billion per year and that for patients in the intensive care unit (ICU), the “incidence of CAUTI is 7.78 per 1000 catheter days” and that these infections are attributed to increased lengths of stay, increased expenditure within health care and overuse of antibiotics (Werneburg, G., 2022). In addition to the costs, CAUTIs can lead to further medical complications and sometimes death as the research found by
Dias et al. (2022), “its [CAUTI] use is precursor to more than 75% of cases of hospital urinary infections, and responsible for up to 40% of nosocomial infections showing a mortality rate of 2.3%”. As part of one particular study that tracked CAUTI rates across 47,926 patients hospitalized between 2012 and 2016 in an urban academic health system comprising two medical centers, two community hospitals, and a pediatric hospital, the root cause analysis found
that CAUTI primary contributing factor was the length of time the catheter remained in the patient and that both clinical and infection control persons agreed that the catheter could have 3
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been removed sooner (Letica-Kriegel, A.S. et al., 2019). In another study conducted in Minneapolis, researchers were able to link a reduction of percent of the time with catheter insertion and an overall decrease in reported CAUTI as a result of training or re-training of clinical staff and daily evaluation of the need to continue the use of the urinary catheter specifically those patients in the ICU (
Menegueti, M.G. et al., 2019).
Problem Statement
CAUTI can be avoided by reducing the length of time the urinary catheter remains in a patient during their ICU stay, as cited in the research conducted by researchers including Leticia-
Kriegel et al., Werneburg, G. and Menegueti, M.G. et al
.
Purpose Statement
The research into CAUTI and the efforts to reduce the occurrence of this type of HAC, specifically for patients in the ICU, will provide evidence proving that the shorter period the urinary catheter is in place, there is reduction in the likelihood that a CAUTI will develop. 4
References
Centers for Medicare and Medicaid Services.
(2020, February 11).
Hospital-acquired conditions.
Links to an external site.
http://www.cms.gov/medicare/medicare-fee-for-
service-payment/hospitalacqcond/hospital-acquired_conditions.html
Dias, L. D., Duarte, L. S., Naves, P. L. F., Napolitano, H. B., & Bagnato, V. S. (2022). Self-
disinfecting urethral catheter to overcome urinary infections: from antimicrobial photodynamic action to antibacterial biochemical entities.
Microorganisms
,
10
(12), 2484.
https://doi.org/10.3390/microorganisms10122484 Letica-Kriegel A.S., Salmasian H., Vawdrey D.K., Youngerman B.E., Green R.A., Furuya E.Y., Calfee D.P., Perotte R. Identifying the risk factors for catheter-associated urinary tract infections: A large cross-sectional study of six hospitals.
BMJ Open.
2019;
9
:022137. doi:
10.1136/bmjopen-2018-022137 Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., Canini, S. R. M. D. S., Basile-Filho, A., & Laus, A. M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patients through implementing an educational program and a daily checklist for maintenance of indwelling urinary catheters: A quasi-experimental study.
Medicine
,
98
(8), e14417. https://doi.org/10.1097/MD.0000000000014417 Werneburg G. T. (2022). Catheter-associated urinary tract infections: current challenges and future prospects.
Research and reports in urology
,
14
, 109–133. https://doi.org/10.2147/RRU.S273663
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