THE GENITOURINARY SYSTEM
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What is/is the relevance of Care Bundles?
The care bundles are three to five evidence-based practices applied in tandem to generate better health outcomes than if a particular procedure is conducted individually. The care bundles are also applied as audit tools and, at the same time, encourage review of evidence and alteration of clinical care guidelines (Lavallée et al., 2017). Some of the benefits of establishing care bundles in a clinical setting include:
- The patient benefits because they are quickly relieved from the complication
- The patient experience less intensive care unit stay in the ward.
- Minimized financial impact to the patient
- Enhanced resource utilization from the hospital perspective because fewer resources in terms of the workforce get allocated towards specific patients, and also patients stand to benefit beyond particular care bundles
Incidence, cost, and health impact of urinary catheter-related infection to date
The catheters are mainly used for individuals unable to drain the urine through the normal procedure, or rather the patients unable to empty their bladder normally. The implication of using the catheter is that it may enable bacteria to enter the person’s body leading to an infection to the urethra, bladder, and sometimes the kidney. Such urinary tract infections (UTIs) are common, especially when the catheter is left idling somewhere for extended periods. The catheters are very costly because they are inserted by trained health personnel, the procedure must be done in a government-approved facility, and the catheter devices are also expensive and can only be afforded by people from the middle-class and above (Parker et al., 2017). There are also side effects, and they include:
- Bladder spasms whereby the patient experiences some stomach cramps, especially when the patient’s bladder attempts to squeeze out the balloon from the device
- The catheters also leak due to bladder spasms.
- Blood or any other debris may pile up on the catheter tube, especially if the device gets blocked.
- Injuring the urethra or narrowing it due to scar tissue arising from continuous usage of the device
- Injury to the bladder arising from the poor insertion of the device
- Bladder stones that tend to emerge after prolonged usage
The CAUTI Care Bundle Components
A CAUTI is a urinary tract infection in patients having undergone catheterization in the last 48 hours. It mainly led to increased hospital bills due to specialized attention and increased admission days (Soundaram et al., 2020). Some of the Common CAUTI care bundle components include:
- Appropriate usage: they can be used, and it is recommended that alternative technique should also be considered like nappies, intermittent catheterization, and condom catheters
- Aseptic technique for insertions and maintenance through the usage of strong hospital-specific policies in line with the nursing profession
- Early removal and hand hygiene can be achieved by monitoring the urine output and assisting in perennial wound care.
The relevance of CAUTI Care Bundle to nursing practice
The CAUTI Care Bundles are very important in resource-constrained hospital environments because they prevent the transmission of infectious diseases, which may be challenging for a particular medical institution to handle considering the shortage of resources like a properly trained workforce, facilities, and the overall cost of the treatment. The CAUTI Care Bundles also indicates some level of professionalism because, in a clinical setting, the careless transmission of infectious diseases may force the regulators to close down the facility or impose fines, which is also costly for a medical setup not mentioning the loss of its reputation (Zaiton, Relloso & Medinah, 2019).
References
Lavallée, J. F., Gray, T. A., Dumville, J., Russell, W., & Cullum, N. (2017). The effects of care bundles on patient outcomes: a systematic review and meta-analysis. Implementation Science, 12(1), 142.
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.
Soundaram, G. V., Sundaramurthy, R., Jeyashree, K., Ganesan, V., Arunagiri, R., & Charles, J. (2020). Impact of Care Bundle Implementation on Incidence of Catheter-associated Urinary Tract Infection: A Comparative Study in intensive care Units of a Tertiary Care Teaching Hospital in South India. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 24(7), 544.
Zaiton, H. I., Relloso, J. T., & Medinah, J. M. (2019). Evaluating the Impact of Utilizing Urinary Catheter Care Bundle on Minimizing the Incidence of Catheter-associated Urinary Tract Infection (CAUTI) among Intensive Care Patients. American Journal of Nursing Research, 7(5), 836-845.