Chlorhexidine In Nursing Practice

Since the original plan for SNF stay was 21 days, which is the total number of the days paid by Medicare Part A 100%, there was going to be no out of pocket pay from the patient’s side if there would have not been a UTI acquired. Objective findings show that the UTI was due to poorly performed evidence-based protocol process in the urinary catheter maintenance and fitting. This cost the patient to start paying money ($144.50/day x 14 days as explained before) out of her pocket for cause that was not inevitable. Not only did the patient have to suffer being weak, having and infection and missing on her rehabilitation program, but she had to also pay for each extra day that she had to stay there for a fault that was not hers. It is clearly not only a failure of the SNF’s operational system, quality of care and healthcare professionals’ performance, but also of the governmental support which directly penalizes the patient for

treatment of Mrs. Zwick’s UTI will need to be absorbed by the facility. The facility is not

Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.

According to the Centers for Disease Control and Prevention [CDC] (2017), “Urinary tract infections (UTIs) are the fourth most common type of healthcare-associated infection, with an estimated 93,300 UTIs in acute care hospitals in 2011. UTIs additionally account for more than 12% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract” (p. 7-1).

Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection

The hospital acquired urinary tract infection that Mrs. Zwick developed during her hospital stay is not covered by Medicare. Research of an article in Medical News Today states:

Nursing research offers the scientific foundation for the practice of the profession. “In order for nursing to be at the forefront of knowledge generation and address societal issues and health care, nursing research must be relevant to health and illness situations, scientifically rigorous, and readily translatable into practice and health policy”(Potempa & Tilden, 2004). Catheter associated urinary tract infections (CA-UTIs), accounts for almost 40% of all nosocomial infections, which result in increased morbidity, mortality, and costs and, it is one of the most common health care- associated infections in acute care area. The study existed in this paper discourses the influence of the 2008 nonpayment policy of the Centers for Medicare and Medicaid Services (CMS) on catheter-associated urinary tract infections (CAUTIs) from the viewpoint of infection preventionists.

Urinary tract infections are the most common type of healthcare infection, and CAUTI is the 2nd most common cause of nosocomial bloodstream infection in the healthcare setting. ("Catheter Associated Urinary Tract," 2011). The goal of our facility is to reduce CAUTIs by 50% by the end of the year, measured by the quality department on a monthly basis, and implemented through performance improvement factors including the interdisciplinary team through a strong focus on the nursing leadership team.

In 2013, a magnet recognized hospital, Baptist Health Lexington, reduced CAUTI rates in ICU patients by 60% (Roser, Piercy & Altpeter, 2014). The study included six interventions that were followed by the staff in the effort to reduce CAUTI. The six interventions included: “communication of CAUTI data to interdisciplinary teams, a nurse-driven, physician approved protocol, problem analysis using Lean principles, daily unit-based surveillance rounds, silver alloy urinary catheters, and an antimicrobial bundle comprised of two cleansing products for patients with an indwelling urinary catheter” (Roser, Piercy & Altpeter, 2014). The nurse-physician protocol allowed for nurses to assess whether the catheter was still necessary and if found not to be, the nurse could discontinue it. This resulted in a 58% decrease in the number of catheters used (Roser, Piercy & Altpeter, 2014). An education session was implemented by nurses using principles from the Lean system that checked the capability of nurses to understand just how dangerous CAUTI can be. It was found that no single intervention alone could reduce the occurrence of CAUTI development. Nurses must integrate several interventions to have an effective result at lowering the rates. However, this particular study found that after the use of the antimicrobial bundle, rates of CAUTI did decline. Roser et al. (2014) emphasized that education and awareness of

Over the past seven years as a clinical nurse on the McKeen Pavilion (the medical-surgical amenities unit at New York Presbyterian/Columbia Medical Center), I have committed to excelling in a clinical bedside capacity, as well as a member of the NYP community. This combination has allowed me to be a true advocate for my patients, their families, and my colleagues. The unit has afforded me a tremendous amount of hands on nursing experience, as

Highlighted in the Keogh Review, and the Francis Report - Avoidable harm was inflicted by HCAI - Hand hygiene not routine amoung staff (REF). - Patients were not encouraged or assisted with hand hygiene, leading to risk of infection, staff lack awareness. - Further training needed - Staff and visitors need to comply with guidelines.

In addition to following policies and procedures, nurses are constantly looking to improve best practices and reduce the amount of people affected by a certain illness or infection. Chlorhexidine bathing can be seen in critical care settings, surgical floors, and other medical floors. However, it’s not a practice that is implemented in all health care settings or hospitals. By studying

This article does not provide the search strategy including a number of databases and other resources which identify key published and unpublished research. In this article, both the primary sources and the theoretical literatures are collected and appraised in order to generate the research question and to conduct knowledge-based research. In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. “Catheter-associated urinary tract infections in surgical patients: A controlled study on the excess morbidity and costs” is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, “Clinical and economic consequences of nosocomial catheter-related bacteriuria” is a review of a literature article which is the secondary source. Although many studies state that patient safety is a top priority and CAUTI can be controlled by the caution of health care providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care

1) Summary of Article: Indwelling catheter use is common, but so are infections associated with them. About 80 percent of all urinary tract infections in hospitals are caused by catheters, and about 20 percent of all hospital infections total are UTIs. Evidence-based practice should be used for insertion, maintenance, and removal. Catheters should not be left in longer than they need to be. Unfortunately, this research shows poor administrative efforts are to blame for

Using what she coined as the IPH model, she researched on problems associated with care in the critical care unit with a focus on bathing, incontinence, and mobility. Data suggests 63% of preventable errors in nursing are related to problems within the scope of practice such as interventional hygiene which includes prevention of skin injury, post-operative respiratory complications and failure to rescue (Vollman, 2013). Referencing Carr & Bennoit’s ( 2009) study on evidence-based bathing and incontinence care; and their effects on incidents of hospital-acquired pressure ulcers and impaired skin integrity. Vollman wrote that after a 4month intervention period in which licensed and unlicensed staff within a hospital were educated on the IPH model which incorporates evidence-based incontinence management, and comprehensive bathing, a decrease of pressure ulcer from 7.14% to 0% was noted at the end of the study. This shows that nurse sensitive care practice can influence patient outcome