Urinary tract infections are a disease that is widespread among hospital patients. The reason for the spread is incorrect nursing practices. The United States is one of the world leaders in innovation and quality control of the medical services provided. This image is maintained through constant monitoring of the quality of services and the introduction of evidence-based nursing practices. This paper aims to propose a quality improvement initiative on the use of catheters.
Purpose of the Quality Improvement Initiative
Urinary tract infection or UTI is a disease that affects the urinary system. Infections are often caused by misuse of catheters in hospitals, and the infection is then called a catheter-associated urinary tract infection (CAUTI). In particular, inadequate catheter replacement practices lead to an increase in “morbidity, mortality, length of stay, and reimbursement” (Kaur, 2021, p. 1235). Intervention practices have proven effective and are widely accepted by scientists. In particular, Reynolds et al. (2021) proved that “during the 4-year post-intervention period, we observed reductions in urine culture rates, catheter utilization, and CAUTI incidence rates from 1.7 to 0.8 per 1,000 patient days” (p. 1). UTIs require immediate treatment and lead to increased hospitalization time for patients, which is associated with an increase in time and cost. Therefore, the goal of the quality improvement initiative on the use of catheters is to ensure patient safety, improve the quality of care, and optimize the delivery of medical services.
Catheterization is a common procedure among many patients treated for more severe illnesses that often require surgery, which prevents the patients from getting out of bed. Remarkably, about a quarter of all patients undergo a catheterization procedure, and almost a quarter of them receive a UTI. Children and women 25-64 are the most vulnerable populations to develop UTIs due to improper catheterization procedures (Youngerman et al., 2019). Every year in the US, 560,000 people get CAUTI infections, requiring an immediate quality improvement initiative (Youngerman et al., 2019). The initiative will affect both patients and professionals providing medical services. Nursing teams will be tasked with developing an implementation strategy using the guidelines provided by the CDC.
Benefits of the Initiative
The benefits of the initiative will include reduced morbidity, mortality, length of stay, and time and cost savings. Equally important, the health facility implementing the initiative will meet the general requirements of quality control organizations. The quality improvement initiative will combine the basic requirements and rules from the relevant guidelines. The implementation of the initiative will be carried out following the innovation implementation model by the innovation dissemination group (Wolak et al., 2020). A responsible group of nurses will conduct a pilot practice of the initiative in a test mode, based on which a subsequent evaluation of the practice will be carried out. The initiative will make use of simple changes, such as a more careful approach to catheter replacement among patients.
Interprofessional Cooperation for the Implementation of the Initiative
The interprofessional collaboration will focus on collaboration between nurses in different departments who will work together to implement the initiative. Notably, interprofessional collaboration at the national level is expressed through cooperation between the US Department of Health and Human Services, the American Nurses Association, and the Centers for Disease Control. These organizations regulate the implementation of initiatives to improve the quality of nursing practice. Notably, quality improvement initiatives are an important element of national programs. Recently, due to the increase in the number of patients who have CAUTI, prevention initiatives have become popular in many hospitals and have shown good results in reducing the incidence.
Funding for the initiative will be associated with additional salaries for nurses who will implement the initiative in the initial stages. Subsequently, the initiative will save a significant amount of resources, including time and financial costs. In particular, taking into account the current evidence, after the introduction of the initiative, the incidence of diseases will decrease by at least two times, which means a similar decrease in the cost of extended hospital stays.
The Plan-Do-Learn-Act (PDSA) cycle will be used to evaluate the quality improvement initiative. After 30-60 days of the implementation cycle, the project will be temporarily suspended to evaluate the results (Wolak et al., 2020). Evaluation will be based on the nurses’ experiences, the actual errors, and the potential for improvement. The innovation implementation team will produce a report after the first implementation cycle of the initiative, and this report will be used in the next cycles. Theoretically, repetition to improve the quality of implementation is possible within two or three cycles.
Thus, the quality improvement initiative on the use of catheters was proposed. The initiative was discussed in terms of its purpose, target groups of impact, benefits, inter-professional cooperation, and evaluation. Improving patient catheterization practices is critical today as the prevalence of CAUTI is on the rise, while the application of practices to improve catheter use is dramatically reducing the rate of infections. Infections that affect the genitourinary system are painful and more common in women and children, and these infections can lead to further health complications for patients. Implementation of the initiative requires sensible additional funding and will halve the cost of associated extended hospital stays.
Kaur, D. (2021). The impact of nurse-led initiative interventions on CAUTI. Master’s Projects and Capstones, 1235.
Letica-Kriegel, A. S., Salmasian, H., Vawdrey, D. K., Youngerman, B. E., Green, R. A., Furuya, E. Y., & Perotte, R. (2019). Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals. BMJ Open, 9(2), 1-13. doi: 10.1136/bmjopen-2018-022137.
Reynolds, S. S., Sova, C. D., Lewis, S. S., Smith, B. A., Wrenn, R. H., Turner, N. A., & Advani, S. D. (2021). Sustained reduction in catheter-associated urinary tract infections using multi-faceted strategies led by champions: A quality improvement initiative. Infection Control & Hospital Epidemiology, 1(2), 1-5. doi: 10.1017/ice.2021.135.
Wolak, E., Overman, A., Willis, B., Hedges, C., & Spivak, G. F. (2020). Maximizing the benefit of quality improvement activities: A spread of innovations model. Journal of Nursing Care Quality, 35(3), 199-205. doi: 10.1097/NCQ.0000000000000438.