Handwashing and the Impact on Catheter Associated Infections

Handwashing and the Impact on Catheter Associated Infections

Melissa Bolle

Chamberlain College of Nursing

NR451 RN Capstone Course

May 2016

Handwashing and the Impact on Catheter Associated Infections

Catheter associated infections remain an issue within healthcare today. Yates (2016) shows that almost 80% of hospital acquired infections are catheter associated urinary tract infections or CAUTI’s. Fox et al (2015) reports that there are over 2.5 million hospital acquired infections (HAI’s) reported yearly and those can mostly be attributed to poor hand hygiene practices. In response to the overwhelming amount of HAI’s Medicare announced in 2008 that they would no longer reimburse for infections acquired in the hospital. This paper will focus on the impact of hand hygiene related to CAUTI’s in a 24 bed emergency department. There are on average 1275 urinary catheters placed monthly and their current rate of CAUTI’s is at an astounding 8.4%. While hand hygiene is talked about widely and often within the health care arena somewhere the practice is still falling short. Re-training and continuing education are necessary to ensure that healthcare workers are practicing proper hand hygiene at all times but need to especially be vigilant when dealing with urinary catheters.  For the purpose of this discussion hand washing and hand hygiene are interchangeable.

Change Model Overview

According to Dearholt & Dang (2012), the John Hopkins Nursing Evidence-Based Practice Process is an 18 step process that takes 3 phases to complete and can be simply described as the practice question, evidence, and translation or PET. The process always begins with the identification of an issue. This is the most important step as it is what drives the remaining steps of the process. The practice question is derived from the problem statement. From there a search for evidence is conducted. After the evidence collection phase is completed the evidence must be evaluated and determine if it fits criteria to be included in the process. It also has to show that it will improve or impact the practice in question. If there is enough data to support the proposed practice change then the final step of translation begins. In this step practice change is planned, implemented, and evaluated. In the final step of the translation phase the information is disseminated to patients, families, hospital board and the community, if necessary.

Practice Question

Step 1: Recruit Interprofessional Team

The team leader will by the writer of this paper. The remaining team will consist of the emergency department nurse educator, four charge nurses, infection control representative, and a staff nurse from the emergency department.

Step 2: Develop and Refine the EBP Question

Is handwashing linked to urinary catheter associated infections? P-lack of proper hand hygiene prior to inserting a urinary catheter. I- education on how to properly perform hand hygiene. C-hand hygiene not being performed properly, or not at all. O- 50% reduction of catheter associated urinary tract infections for patients that had a urinary catheter placed in the emergency department and were admitted over a 6 month trial period.