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Catheter-Associated Urinary Tract Infection in Nursing Homes


Geriatric patients residing in assisted living facilities require a lot of medical attention and care from the nursing staff. As many such residents have serious chronic conditions, they are susceptible to various healthcare-associated infections (HAIs), including catheter-associated urinary tract infection (CAUTI). This essay will discuss two qualitative research studies focusing on examining barriers to preventing CAUTI and other HAIs and the implementation of a program for their reduction in nursing home patients.

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Two articles were selected for this paper. The first study by Krein et al. (2017) focuses on assessing the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Long-term Care, designed to promote the reduction of CAUTI (Krein et al., 2017). The purpose of the research in question is to identify whether the program implementation was successful, with the specific objectives of understanding the staff’s experiences. The article allows establishes how the nursing home personnel adapt to implementing a new program for reducing the incidence of CAUTI.

The second paper discusses the existing barriers to the prevention of HAIs. Thus, Travers et al. (2015) examine what factors contribute to the staff failing to control the development of various infections in the patients residing in assisted living facilities. Specifically, the authors aim to recognize the barriers to recognizing and reporting infections in older adults and how the transmission is impacted by nursing practitioners (Travers et al., 2015). The study was selected for this essay as it examines the obstacles existing to the identification and treatment of CAUTI and strategies used by the medical staff to overcome those barriers.

Nurse Practice Issue

Both chosen articles support the selected nurse practice issue of CAUTI in geriatric patients. They will be used to describe the existing difficulties in preventing CAUTI in residents of nursing homes as compared to those in other clinical settings. The selected papers do not include comparison groups, with only Krein et al. (2017) research evaluating the AHRQ Safety Program intervention. Therefore, the studies will be used for the background information, examining the barriers to reducing CAUTIs in geriatric residents of assisted living establishments.

Research Methods

The articles in question applied similar methods to achieve the set objectives and answer their research questions. Thus, Krein et al. (2017) employed semi-structured telephone interviews with sixteen organizational and faculty leaders who oversaw the AHRQ program’s implementation. Similarly, Travers et al. (2015) utilized semi-structured in-person interviews with certified nursing assistants (CNAs) working in care homes. The main benefit of employing the interview method for qualitative research is that it allows examining the participants’ thoughts and feelings without bias. They can also be tailored to each participant and their personal experiences to explore the addressed topic in more detail. However, the data collected through open-ended questions is difficult to encode, compare, and analyze. It can also be argued that the information collected via interviews is not always reliable as it is difficult to establish whether the interviewees answer truthfully. Furthermore, Travers et al. (2015) note that communication can be impeded if English is not the participants’ first language, leading to a misunderstanding of questions and skewed results. Nevertheless, a semi-structured interview is an effective method of collecting qualitative data.

Study Results

Both studies were able to achieve their primary purpose and objectives. Krein et al. (2017) established that the AHRQ program could be successfully implemented to prevent infection transmission. Specifically, the researchers discovered that the program resulted in nursing staff is more knowledgeable about CAUTI (Krein et al., 2017). In addition, it encouraged conversation about the necessity of using catheters and regularly ordering urine cultures (Krein et al., 2017). However, the interviews also showed that the program was time-consuming, and high staff turn-over resulted in the need for continuous re-education of new employees (Krein et al., 2017). It can be concluded that the program was successful and resulted in the staff of the establishments where it was implemented learning more about CAUTI and other HAIs.

Similarly, five barriers to preventing infection in nursing homes were discovered in the second study. They include the language barrier, lack of knowledge and training, irregular work schedules, workload, and lack of accountability (Travers et al., 2015). Travers et al. (2015) also discovered several strategies to overcome the identified barriers, including clarifying the patient’s condition to the CNAs. Overall, it can be asserted that both Krein et al. (2017) and Travers et al. (2015) discovered a key theme in their respective papers: the lack of education of nursing home staff on HAIs, including CAUTI. Thus, the two studies’ primary implication is the necessity of education on HAIs for practitioners working in assisted living facilities.

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Ethical Considerations

Any medical study concerning human subjects must comply with ethical standards. For instance, researchers must obtain informed consent from the participants and ensure their anonymity and confidentiality (Sanjari, Bahramnezhad, Fomani, Shoghi, & Cheraghi, 2014). It can be asserted that both articles followed the last requirement as they do not disclose participants’ personal information. Travers et al. (2015) note that informed consent was acquired from the interviewed CNAs in compliance with the first obligation. Overall, both research teams accounted for ethical consideration in their studies.


The selected qualitative articles discuss CAUTI and its prevention in geriatric patients residing in nursing homes. Despite different stakeholders being interviewed and varying focuses of the research, both studies conclude there is a concerning lack of education on HAIs, including CAUTI, among the staff. The chosen papers add to the existing body of literature on the topic of urinary tract infections and imply there is a need for continuous education on HAIs for the nursing practitioners working in assisted living facilities.


Krein, S. L., Harrod, M., Collier, S., Davis, K. K., Rolle, A. J., Karen E. Fowler, K. E., & Mody, L. (2017). A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: A qualitative assessment. American Journal of Infection Control, 45(12), 1342–1348. Web.

Sanjari, M., Bahramnezhad, F., Fomani, F. K., Shoghi, M., & Cheraghi, M. A. (2014). Ethical challenges of researchers in qualitative studies: The necessity to develop a specific guideline. Journal of Medical Ethics and History of Medicine, 7(14), 1–6.

Travers, J., Herzig, C. T., Pogorzelska-Maziarz, M., Carter, E., Cohen, C. C., Semeraro, P. K., … Stone, P. W. (2015). Perceived barriers to infection prevention and control for nursing home certified nursing assistants: A qualitative study. Geriatric Nursing, 36(5), 355–360. Web.

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