Make a follow-up of a student’s weekly discussion and respond with your opinion regarding to her post
——You don’t have to post this in APA format necessarily, it’s just giving feedback to the student .
Review the PICOT questions of two of your peers. Provide substantive feedback and suggestions for improvement.
Diana Stelma
Dr. M and class,
PICOT Question:
In the adult ICU setting, what is the effect of the implementation of a CAUTI prevention task force team versus not implementing a CAUTI prevention task force team in decreasing the incidence of CAUTIs within one year?
Article:
A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit
to an external site.
Article Appraisal:
Description of the purpose: The purpose of this article is to decrease CAUTI rates in ICU by implementing a prevention task force team. Establishing a CAUTI task force team involves developing initiatives in quality improvement using nursing practice-related and educational interventions (American Association of Critical-Care Nurses [AACN], 2021). A multifaceted approach such as this can quickly decrease CAUTI rates with implementation and long-term effectiveness (AACN, 2021). The education part consists of the participation of all ICU nurses in a module-based educational training (AACN, 2021). This is then followed by competency sessions and hands-on skills that addresses every component of indwelling catheters (AACN, 2021). Another element involves orders and documentation, including a checklist that must be completed daily and a nurse-driven protocol removal in the discontinuation of catheters (AACN, 2021). The protocols are adapted from current recommended guidelines and practices (AACN, 2021). This type of approach has been shown to significantly reduce CAUTI events in the ICU (AACN, 2021).
Explanation of research design: This article represents a quantitative research design because measurable data was used to form facts. Data was analyzed by utilizing mixed statistics which included Fischer exact testing and independent samples (
t tests) (Shadle et al., 2021).
Discussion of sample: The UPMC Williamsport in Pennsylvania is a rural hospital that has 224 beds (AACN, 2021). The hospital in 2018, reported a total of 13 CAUTI events, which exceeded its standards of 4 or less CAUTIs annually (AACN, 2021). Unfortunately, 6 of these CAUTI events occurred in the intensive care unit (AACN, 2021). To address this issue, the ICU implemented a CAUTI prevention task force team in hopes of decreasing CAUTI rates. Interventions implemented include staff education, daily checklists, and protocols for removal that are nurse-driven (Shadle et al., 2021).
Description of data collection methods: The study was done over a period of four months in the ICU. The population targeted is patients admitted to the ICU who are 18-years of age or older (Shadle et al., 2021). The ICU implemented a CAUTI reduction task force team which was shown to quickly decrease the rate of CAUTIs and this also led to applying this intervention hospital-wide creating long-term positive outcomes (AACN, 2021).
Summary of findings: In this study during the intervention period of four-months, the ICU reported zero CAUTI events, in comparison to two CAUTIs that occurred prior to the intervention stage (AACN, 2021). Additionally, the rate of CAUTIs “decreased by 1.33 per 1,000 catheter days” (AACN, 2021, para. 6). Compliance with documentation also significantly increased from 50.0% to 83.3% following the intervention (Shadle et al., 2021).
Strengths of the study: Strengths in this study include that the intervention was successful and CAUTIs were reduced in the ICU setting following the intervention. The intervention went so well that the intervention was implemented hospital-wide.
Limitations of the study: The study was done over a four-month period only. I feel that the study should’ve been a bit longer, perhaps over a 6-month period at least.
Recommendations regarding potential application for future practice that are insightful and appropriate: The implementation of a CAUTI prevention task force team is proven to be successful from this article. This type of intervention using a prevention task force team could be used for other serious HAIs in the ICU setting such as CLABSI and VAP.
References:
American Association of Critical-Care Nurses. (2021).
Nurse-driven initiative cuts CAUTI rates in the ICU.
Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit.
Critical Care Nurse,
41(2), 62–71.