Indwelling Catheter-Associated Urinary Tract Infection
In the article, Poudel, Baniya and Pokhrel (2009) conduct a prospective study to investigate the microbiological profile as well as the resistance pattern of the strains that cause urinary tract infection associated with the use of Foley’s Catheter. In the study, 100 catheterized adult patients, all above the age of 16, in a hospital participated. The patients used the indwelling Foley’s catheters for both short and long intermediate purposes. 3 ml urine samples were aseptically taken from the patients at the repeat of the catheterization and repeated on unevenly in subsequent days and weekly until the patient was discharged or the catheter was removed or the individual patient developed bacteriuria. Analysis of the antibiotic sensitivity test taken on the urine samples revealed that the most common organism that causes catheter-associated urinary tract infections was E. coli, which surfaced in 40% of the patients (Poudel et al., 2009). Upon further isolated study of the E. coli, it was found out that the strain can be suppressed by Imepenem, unlike other antibiotics which it is resistant to.
The study focused on a methodological model in which urine samples were collected during the catheter insertion and in its use and using sterilized sample collection methods and conducting tests within a short time (1 hour) to avoid any cases of other organisms or substances affecting the quality of the samples. Another important element in the study was the defined sample collection methods and routine, particularly in regard to the use of fairly concentrated urine samples (10ml) and strict application of the aseptic technique and following the closed drainage system. These aspects reflect the credibility and confirmability of the study as that provided assurance of properly collected and interpreted data thus findings reflect the aspect studied.
In the sample testing, the authors used the Kirby-Bauer disk diffusion technique and the use of the Chi-square in the analysis of the variables served to ensure the objectivity in the study. The authors also compare the result of the study to a similar study conducted by M. Sharifi and highlight the significant differences and the common ground as well. In the comparison, it was identified that E. coli is associated with the urinary tract infections, even though it was in the third rank after K. pneumonia and E. cloacae in Sharifi’s study (Poudel et al., 2009; Sharifi, 1999). This aspect relates to the consistency in findings and is reflective of data thus affirming the dependability and transferability of the study.
Indwelling Urinary Catheter Management and Catheter-Associated Urinary Tract Infection Prevention Practices in Nurses Improving Care for Healthsystem Elders Hospitals
In this article Fink et al. (2012) conduct a study that involves an electronic survey to investigate indwelling urinary catheters care practices aimed at preventing CAUTI in relation to equipment, insertion and maintenance, personnel and training, and documentation and removal reminders. The study was conducted at 75 hospitals and findings indicated that routing CAUTI surveillance and IUC documentation practices varied widely with practices, including the use of gloves, hand washing, and maintenance of a sterile barrier being the most common practices and use of catheter securing device being the least common practice followed.
The study focuses on persistent observation and triangulation to bring together various data sources. Information was gathered from nurses from different units, clinical informatics staff, purchasing staff and educators through surveys. The survey was also analyzed by an expert panel of nurse researchers and infection scientists and later reviewed by physicians (Fink et al., 2012). This helps to obtain rich information and a professional analysis which highlights the credibility of the study. The findings of the study were also found to resonate with previous studies which investigated CAUTI prevention strategies highlighting the limited use of catheter securing devices owing to their prices in different hospitals. The resonance in findings brings out the confirmability of the study. The research process also features a clear methodological approach that uses survey technologies such as Survey Monkey and the consideration of the IUC placement procedures of different hospitals. This means that the results of the study can be transferred to other settings since diverse settings are investigated. These aspects increase the dependability and transferability of the study.
The study presents a detailed definition of the endpoint interest in relation to indwelling urinary catheters care practices aimed at preventing CAUTI with specific emphasis on aspects such as costs and availability of the options. Specifically, the study indicates that catheter securing devices are expensive and thus most hospital rely on personal hygiene practices and training (Fink et al., 2012). Cost factors in healthcare are major elements that affect many hospitals and care practices and thus the study findings can be applicable to the general population. It highlights what seems to be common in the prevention of CAUTI, the personnel, and hygiene matters because they are less expensive and effective in the long-run.
References
Fink, R., Gilmartin, H., Richard, A., Capezuti, E., Boltz, M., & Wald, H. (2012). Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals. American Journal of Infection Control, 40(8), 715-720.
Poudel, C. M., Baniya, G., & Pokhrel, B. M. (2009). Indwelling catheter associated urinary tract infection. Journal of Institute of Medicine, 30(3), 2-7.
Sharifi, M. (1999). Bacteriuria in Catheterized Patients of Gynecology Ward. Archives of Iranian Medicine, 2(4).
