Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation with Permalink

Meddings, J., Manojlovich, M., Ameling, J. M., Olmsted, R. N., Rolle, A. J., Greene, M. T., ... & Saint, S. (2019). Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract Infection: A Pre–Post Observational Study. Annals of Internal Medicine, 171(7_Supplement), S38-S44. Retrieved from https://annals.org/aim/fullarticle/2752410

Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC health services research, 17(1), 314. Retrieved from https://link.springer.com/article/10.1186/s12913-017-2268-2

Huis, A., Schouten, J., Lescure, D., Krein, S., Ratz, D., Saint, S., ... & Greene, M. T. (2020). Infection prevention practices in the Netherlands: results from a National Survey. Antimicrobial Resistance & Infection Control, 9(1), 1-7. Retrieved from https://aricjournal.biomedcentral.com/articles/10.1186/s13756-019-0667-3

How Does the Article Relate to the PICOT Question?

This article analyzes the effect of a multimodal initiative on CAUTI in hospitals with high burden of health care–associated infection (HAI)

This article analyzes ways in which IDC usage rates can be reduced by reducing inappropriate urinary catheterization and duration of catheterization.

This study aimed to examine the extent to which acute care hospitals have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI).

Quantitative, Qualitative (How do you know?)

This is a quantitative study because data is collected using structured research instruments and is presented in form of numbers.

This is a quantitative study as it uses randomized controlled trial as the research design.

This is a quantitative study because data is presented in form of numbers and researchers compare various variables to determine the outcome.

Purpose Statement

To investigate the effect of a multimodal initiative on CAUTI in hospitals with high burden of health care–associated infection (HAI)

To reduce IDC usage rates by reducing inappropriate urinary catheterization and duration of catheterization.

To examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI).

Research Question

What are the effects of a multimodal initiative on CAUTI in hospitals with high burden of health care–associated infection (HAI)?

How can IDC usage rates be reduced by reducing inappropriate urinary catheterization and duration of catheterization?

What is the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI)?

Outcome

The combination of web based program and psychotherapy was more effective than psychotherapy alone after three months.

A sample size calculation has indicated that 500 patients per Health District would be sufficient to detect a 40% fall (15 to 9%) in relative IDC insertion rates with a power of 0.8 and alpha 0.05

Surveillance systems for monitoring CAUTI, CLABSI, VAP, and CDI were present in 17.8, 95.4, 26.2, and 77.3% of hospitals, respectively

Setting

(Where did the study take place?)

Acute care, long-term acute care, and critical access hospitals,

Hospitals in NSW, Australia 

Acute care hospitals in the Netherlands

Sample

387hospitals

4- four acute care hospitals

47 hospitals

Method

Prospective, national, nonrandomized, clustered, externally facilitated, pre–post observational quality improvement initiative

multiple pre-post control intervention design using a phased mixed method approach

Written interview

Key Findings of the Study

This multimodal intervention yielded no substantial improvements in CAUTI or urinary catheter utilization.

Hospital-wide and multi-hospital interventions help to reduce urinary catheter use and the development of CAUTI.

Most Dutch hospitals report regular use of recommended practices for preventing CLABSI and CDI. 

Recommendations of the Researcher

Future studies should focus on how to improve the prevention of CAUTI.

 More studies need to be conducted on the topic to provide ways in which integrated approaches can be used to prevent CAUTI.

Future studies should focus on the importance of using integrated approaches to the prevention of CAUTI

Criteria

Article 4

Article 5

Article 6

APA-Formatted Article Citation with Permalink

Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). Emergency department catheter-associated urinary tract infection prevention: multisite qualitative study of perceived risks and implemented strategies. infection control & hospital epidemiology, 37(2), 156-162. Retrieved from https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/emergency-department-catheterassociated-urinary-tract-infection-prevention-multisite-qualitative-study-of-perceived-risks-and-implemented-strategies/8A6263415F32FB876EEED70C7E269654

Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). A qualitative study of factors facilitating clinical nurse engagement in emergency department catheter-associated urinary tract infection prevention. JONA: The Journal of Nursing Administration, 46(10), 495-500. Retrieved from https://journals.lww.com/jonajournal/Abstract/2016/10000/A_Qualitative_Study_of_Factors_Facilitating.4.aspx

Fletcher, K. E., Tyszka, J. T., Harrod, M., Fowler, K. E., Saint, S., & Krein, S. L. (2016). Qualitative validation of the CAUTI Guide to Patient Safety assessment tool. American journal of infection control, 44(10), 1102-1109. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0196655316302930

How Does the Article Relate to the PICOT Question?

This study explores various strategies for reducing the risk of CAUTIs in the healthcare setting.

This article explores the actions of nurse leaders that facilitated clinical nurses' active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs.

This article explores the need for CAUTI guide to patient safety (GPS) to prevent CAUTI

Quantitative, Qualitative (How do you know?)

This is a qualitative study because semi structured interviews were used to collect data.

This is a qualitative study because semi structured interviews were used to collect data.

This is a qualitative study because semi structured interviews were used to collect data.

Purpose Statement

To describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs.

To explore the actions of nurse leaders that facilitated clinical nurses' active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs.

To qualitatively validate The CAUTI guide to patient safety (GPS)

Research Question

Does early-adopting emergency departments (ED) redesigned workflows minimizes catheter use and ensure proper insertion technique?

What are the actions of nurse leaders that facilitated clinical nurses' active involvement in emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention programs?

What is the effectiveness of CAUTI guide to patient safety (GPS) in preventing CAUTI?

Outcome

ED CAUTI prevention was perceived to differ from CAUTI prevention in the inpatient setting.

Clinical nurses are best positioned to examine urinary catheter insertion workflow and to suggest improvements in avoiding use and improving placement and maintenance.

Nurse managers found the GPS helpful and complete. There was higher agreement between nurse managers and unit nurses than with physicians. 

Setting

(Where did the study take place?)

Six diverse hospitals

6 emergency departments

 4 medical intensive care units and 4 medical-surgical units 

Sample

52 participants

52 participants

49 participants

Method

Semi structured interviews

Semi structured interviews

Semi structured interviews

Key Findings of the Study

Early-adopting EDs redesigned workflow to minimize catheter use and ensure proper insertion technique

The prevention of CAUTI is an important opportunity for nurse leaders to engage clinical nurses in meaningful improvement efforts

 GPS is comprehensive and may be best used to stimulate discussions between stakeholders to address key issues.

Recommendations of the Researcher

Assessment of ED workflow is necessary to identify and modify local practices that may increase CAUTI risk.

The researchers suggest nurse leaders should focus on how urinary catheters expose patients to potential harm to engage clinical nurses in CAUTI prevention,

The current healthcare structures need to be changed to accommodate GPS.