A nurse has to be fully aware of the entire catheterization process because bacteria can enter the bladder during or after the catheterization is complete. First, if any part of the inside or outside of the catheter is contaminated during the catheterization it would provide a direct link for the bacteria to access the bladder. Also, it is possible for bacteria to enter through the outlet tube of the drainage bag, the catheter to urethral surface, or where the catheter attaches to the plastic tubing. Finally, nurses need to account for the time period of the catheter in use because the risk of infection increases about 5% with each day it is remains in the patient. (Maki & Tambyah, 2001).
Significance
Urinary tract infections are the most common nosocomial infection in the United States, they account for at least 40% of all in-hospital infections (Orenstein & Wong, 1999). With that high of a percentage that number concludes to be around 1 million cases per year where patients suffer from a UTI secondary to just being in the hospital. Urinary tract infections develop in the hospital because of contaminated catheters and tend to be more serious than the UTI occurring in the community because hospital related infections can be more resistant to drug treatment and the patients are often poor in health. Orenstein and Wong (1999) cite that the estimated total cost to the United States healthcare system solely due to urinary tract infections is approximately 1 billion dollars annually. Saint (2001) reports that the average cost of urinary tract infections to be from $675 dollars for the antibiotic treatment, but if the bacteria happens to reach the blood and cause bacteremia the additional cost can easily jump to about $2800 dollars.
With the short staffing of nurses and the traffic amongst hospitals it is also unfortunate that the average stay for a patient increases an average of 1-4 days depending on the severity of the UTI (Jarvis, 1996). The goal of the asepsis catheterization program is to reduce hospital-acquired urinary tract infections ultimately leading to lower spending for the patients and the hospital.
Purpose Statement
The purpose of this study is to investigate the effectiveness of an asepsis catheterization program for the prevention of urinary tract infections for patients in a hospital setting.
Hypothesis or Study Question
The first hypothesis for this study is: There will be a decrease in the incidence of urinary tract infections following the initiation of an asepsis catheterization program as compared to prior to the asepsis catheterization program.
The second hypothesis for this study is: There will be a decreased average cost for patients in a hospital setting following the initiation of the asepsis catheterization compared to prior to the infection control program.
Variables
Independent Variable: Asepsis catheterization program
Dependent Variables: 1) Incidence of urinary tract infections
2) Decreased average cost of patients in a hospitalized setting
Extraneous Variables: Underlying diseases, duration of patient stay, differences in medication, environment, immunological state, age, gender
References
Jarvis, W. R. (1996, August 17). Selected aspects of the socioeconomic impact of nosocomial infections: morbidity, mortality, cost, and prevention. Infection Control and Hospital Epidemiology, 17(8), 552-557. Abstract retrieved February 2, 2006, from PubMed database: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed
Maki, D. G., & Tambyah, P. A. (2001, March/April). Engineering out the risk for infection with urinary catheters. Emerging Infectious Diseases, 7(2), 342-347. Retrieved February 1, 2006, from Academic Search Premier database: http://search.epnet.com. ezproxy1. lib.asu.edu/login.aspx?direct=true&db=aph&an=4440472
Orenstein, R., & Wong, E. S. (1999, March 1). Urinary tract infections in adults. American Family Physician, 59(5), 1225-1234. Retrieved February 2, 2006, from Academic Search Premier database: =aph&an=1674064
Saint, S. (2001, July). Prevention of nosocomial tract infections. In A. J. Markowitz (Ed.), Making health care safer: a critical analysis of patient safety practices (chap. 15). Rockville, MD: AHRQ. Retrieved February 3, 2006, from http://www.ahrq.gov/clinic/ptsafety/chap15a.htm
