Introduction
Nursing home residents are highly susceptible to various healthcare-related infections (HAIs). Their transmission can lead to the quality of life of such patients substantially declining and the necessity for hospitalization. Catheter-associated urinary tract infection (CAUTI) is among the most prevalent infections in assisted living facilities and requires effective prevention strategies. This essay will examine two quantitative articles focused on the discussion of different intervention programs for CAUTI in geriatric patients living in nursing homes.
Background
CAUTI is one of the most common HAIs developed by patients residing in assisted living facilities. In their research, Smith et al. (2017) focused on examining the correlation between nursing home safety culture and CAUTI rates. The researchers’ objective was to measure the relationship of the facility-level reports on safety culture and the rates of CAUTI before and after the implementation of technical and socio-adaptive prevention strategies (Smith et al., 2017). Thus, the article explores how safety culture is linked to the incidence of CAUTI and other HAIs in geriatric patients and whether prevention interventions can effectively reduce their rate.
In the second article, the reduction of the unnecessary use of indwelling urinary catheters (IDC) is considered. The study’s primary purpose is to decrease the duration of IDC use in patients and decrease the frequency of inappropriate catheterization by introducing bundled catheter care (Parker et al., 2017). In addition, the researchers set several objectives, including identifying the rate and incidence of CAUTI before and after the intervention, the barriers to the implementation, effectiveness, and cost benefits of the strategy (Parker et al., 2017). Overall, the article in question aims to investigate how a more comprehensive approach to catheterization and education can reduce CAUTI rates and incidence.
Nurse Practice Issue
The selected works significantly add to the existing body of literature on CAUTI in residents of nursing homes and effective prevention strategies. The intervention groups in the discussed studies correspond to the one proposed for future research on the existing nurse practice issue. Specifically, the control group is geriatric patients living full-time in nursing homes. Smith et al. (2017) included establishments not practicing the proposed strategies as a comparison group. Parker et al. (2017) intend to include adults undergoing usual urinary catheterization as a comparison demographic, whereas, in the proposed study, residents in assisted living facilities will be compared to older adults in other clinical settings. The chosen articles will provide information on the effectiveness of various interventions and the role of safety culture on the rate and incidence of CAUTI in patients.
Research Methods
Different methods are implemented for the selected works. Thus, Smith et al. (2017) employed a prospective cohort study to determine whether nursing home intervention strategies effectively reduce CAUTI and other HAIs. Meanwhile, Parker et al. (2017, p. 316) plan to utilize “a multiple pre-post control intervention design using a phased mixed-method approach.” The selected methods are somewhat similar, with both cohort and pre-post studies requiring the collection of baseline information before the beginning of the strategy and after its conclusion. However, multiple pre-post research requires at least two phases, with data collected before and after each stage. The reviewed methods used in the chosen articles have certain advantages and disadvantages. Thus, both methods are highly time-consuming, with Smith et al. (2017) demanding a minimum of 12 months, whereas Parker et al. (2017) will require 16 months for their research. A prospective cohort study’s main advantage is collecting specific data at given intervals, preventing recall bias. In addition, although the pre-post design is easy to implement and is cost-effective, it may be challenging to determine whether the observed changes occur due to the examined intervention.
Study Results
Overall, the outcomes of one article can be assessed, while the second one includes a discussion of future results. Smith et al. (2017) discovered that applying technical and socio-adaptive prevention strategies can lead to a 52% decrease in CAUTI incidence in nursing home patients. Moreover, the implementation of the described schemes led to the overall improvement in the safety culture of the participating assisted living facilities (Smith et al., 2017). Parker et al. (2017) predict that their study will help determine the existing barriers to implementing effective CAUTI reduction strategies. The selected studies will outline the obstacles to providing high-quality care in nursing homes and determine whether technical, socio-adaptive, and educational strategies can help reduce CAUTI rates among the residents.
Outcomes Comparison
The proposed research’s anticipated primary outcome is as follows: CAUTI incidence in assisted living facilities is higher than in patients in other clinical settings. Furthermore, educational intervention strategies for the staff and residents can help decrease the rate of infection. The expected results compare to those of the reviewed articles, as Smith et al. (2017) discovered a significant decrease of CAUTI rate. The proposed study will confirm specific barriers to prevention strategies, including lack of knowledge on the use of urinary catheters and infections addressed by Krein et al. (2017) and Travers et al. (2015). Overall, the predicted results will be comparable to the outcomes of the discussed research studies.
Conclusion
CAUTI and other HAIs are a major concern for nursing homes as they significantly affect the residents’ health and well-being. The articles discussed in this paper examine the effect of various prevention strategies on CAUIT rate and incidence in geriatric patients residing in assisted living facilities. Thus, Smith et al. (2017) discovered that technical and socio-adaptive interventions could effectively reduce infection transmission. Further research will compare patients diagnosed with CAUTI in different clinical settings and the effectiveness of strategies implemented in them.
References
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.
Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): A pre-post control intervention study. BMC Health Services Research, 17(1), 314–325. Web.
Smith, S. N., Greene, M. T., Mody, L., Banaszak-Holl, J., Petersen, L. D., & Meddings, J. (2017). Evaluation of the association between nursing home survey on patient safety culture (NHSOPS) measures and catheter-associated urinary tract infections: Results of a national collaborative. BMJ Quality & Safety, 27(6), 464–473. Web.
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.