Assignment: Unnecessary Urinary Catheterization

The topic that I am planning to use for my clinical practice experience is prevention of catheter associated urinary tract infections (CAUTIs). In geriatric patients with indwelling urinary catheters (P), does provider education and daily reminders use (I) compared to standard guidelines on catheter insertion (C), reduce the over use of urinary catheters and catheter-associated urinary tract infections rates (O) during the period of hospitalization (T)

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P (Population) – Geriatric patients with indwelling urinary catheters. Older adults are susceptible to CAUTIs since they usually use indwelling urinary catheters due to prolonged catheter use and unnecessary urinary catheterization.

I (Intervention) – Nurse training, education and reminder systems use. Educating the nurses on proper catheter insertion and maintenance will reduce unnecessary catheterization and prolonged use. The use of daily reminder systems will ensure that the urinary catheters are removed immediately they are no longer needed.

C (Comparison) – Standard guidelines on catheter insertion. Routine care and guidelines in the clinical settings have been used in catheter management but incidence of CAUTIs are still being reported.

O (Outcome) – Reduce the over use of urinary catheters and catheter-associated urinary tract infections rates

T (Time) – During the period of hospitalization

Being one of the hospital-acquired infections, CAUTI has a negative impact on burdening both the patient and the healthcare system. CAUTI compromises the quality of care and puts patient safety at risk as it increases the hospitalization period and complications (Theobald et al., 2017). The major risk factors of CAUT include prolonged use of catheters, poor maintenance of urinary catheters, unnecessary insertion of catheters, and lack of skills for catheter insertion (Meddings et al., 2019). Evidence-based practices are critical for the nurses; hence they should be educated and trained on the strategies so that they are skilled in insertion and maintenance of catheters, including removal.

QD2 Tatiana

Discuss the purpose of the literature review, and which topics are you going to search for your topic?

The literature review is essential. For example, it describes the relationship of each idea or works to the rest or others that are under discussion or consideration. Hence, it provides a better understanding of the existing relationships between the ideas or work. Secondly, it places each work in a particular context of its contribution to providing a good understanding of the research problem that is being studied (The literature review, 2021). In this manner, many studies can be effectively reviewed separately to deliver different kinds of information associated with the research topic under study. Thirdly, it focuses on identifying ways to interpret prior research; this will help the reader to have a better idea of what the research under study is all about. Assignment 13: Unnecessary urinary catheterization.

The fourth function is that it resolves conflicts that exist among the previous studies that seem contradictory. For that reason, it will ensure that the past ideas are updated to meet the circumstances and demands of the changing world (The literature review, 2021). Last but not least, the literature review locates your research within the existing literature’s context. For that reason, the reader of the researcher will gain a better understanding of the existing research and the available debates that relate to the topic under study. The topics that I am going to search for include catheter associated urinary tract infections (CAUTIs), indwelling urinary catheters, daily reminder systems, nurse training on catheter maintenance, urinary tract infections, urinary catheterization, routine catheter care.

Discuss also what are the challenges that nurses are facing today when they have to do a literature review?

Literature review in nursing provides an analysis and summary of research published on a specific nursing or health topic. However, there are challenges, which the nurses face when doing a literature review. For instance, it is a challenge to concentrate on the desired details of the text. When reading an extended article, an individual may notice that it is increasingly hard to concentrate when reading a whole book.

Secondly, when doing a Google search, it may not show the relevant results (Opollo et al., 2014). Even though everything can be found on the internet, when doing a nursing literature review, it is not particularly accurate. Besides, the information can be excessive, hence challenging to find some relevant references and results. Managing a proper balance is another challenge. In this case, when doing a literature review, it is compulsory to ensure that the literature review contains both provocative, modern, and fundamental ones (Konwar & Kalita, 2018). In this manner, the balance between the actual studies and the most prominent past researchers should be maintained to ensure effective literature review.

Pathophysiology

QD1 Erich

1. When the mother arrives to the ER, she is perplexed at how she was able to move the seat. She tells you she can barely lift 50 lb at home. She asks you how it was possible for her to move such a tremendous amount. How would you respond?

In regards to the case presented, I would explain to the mother that she was able to move that amount of weight could be due to pure adrenaline rush in the moment (Cafasso, 2018). It also could be to a concept called hysterical strength. It could also be seen that the mother is stronger than she believes herself to be. Assignment 13: Unnecessary urinary catheterization.

1. The woman asks you how to further explain to her “how all levels of the brain work together to perform such a complex movement”?

In regards to the case presented, I would explain that the amygdala reacted as that is where adrenaline is formed. The amygdala is also the area of the brain that associates fear. Adrenaline is a stress hormone that is also known as epinephrine, that can provide extra strength or energy (Norris, 2019). This is a way our brain and body can work together through fear or panic. This can also take place in a flight or fight response. our brains are able to respond quickly in times of despair (Cafasso,2018).

QD2 Erich

Fifty-four–year-old Fred is complaining of a headache that started about 2 weeks ago. For the past 2 days, the headache has increased in severity, and he is photophobic and has uncial rigidity and projectile vomiting. CT scan results show an arteriovenous malformation in the basal artery and a small hemorrhagic bleed in the middle meningeal artery

1.How is the concept “disorders of brain function” related to Fred’s presenting symptoms?

Brain injuries can be categorized as traumatic or nontraumatic. The concept of “disorders of brain function” applies to Fred’s symptoms because he is presenting headaches which is considered a disruption to the normal function of the brain. His photophobia and unusual rigidity are also symptoms that can be associated with neurological disorders and deteriorating brain function (Norris, 2019). Assignment 13: Unnecessary urinary catheterization.

2.What aspects of cerebral circulation would come into play in Fred’s case?

The circulation of blood is supplied from the two internal carotid arteries. Fred’s case presents that he has arteriovenous malformations and the circulation of blood is affected in this process. The high levels of pressure make them pre disposable to rupture or hemorrhage and since blood is being diverted from the tissue it can cause perfusion (Shaligram, et al., 2019).

Also the bleed in the meningeal artery can also affect the cerebral circulation. Because most of the arterial blood in the internal carotid arteries is distributed through the anterior and middle cerebral arteries. The type of bleed in the middle meningeal artery can cause strokes (Norris, 2019).

Assignment: Unnecessary Urinary Catheterization