Introduction
Poor hygienic practices cause Catheter-associated infections of the urinary tract (CAUTI) among women who have undergone cesarean section delivery. Catheters used in emptying the bladder among patients with issues emptying their bladder may harbor microorganisms that cause disease. Healthcare professionals should emphasize evidence-based hand washing techniques to reduce the risk of getting infections. Viruses, fungi, and bacteria may cause urinary tract infections. Change theory principles are used in healthcare institutions to implement changes to mitigate the CAUTI menace.
Background
The root cause of CAUTI is poor sterile practices, unclean hands, or various surfaces that come in contact with the body area exposed. Problems increasing CAUTI include poor training and inadequate resources due to low funding. Few human resources limit clinicians and healthcare workers’ quality of services, resulting in infections owing to substandard practices (Atkins et al., 2020). According to Advani & Fakih (2019), handwashing is fundamental in preventing urinary tract infections, especially when handling catheters. Using soap to wash hands helps eliminate harmful pathogens that may cause diseases. To achieve the best results in a nursing facility, proper steps in handwashing should be followed.
Clinical Problem Statement
High levels of infections associated with women who have undergone cesarean section operations in the mother-baby units are the major issues in the health sector. Urinary tract infections are more associated with catheter insertion and cause alarm for the management and the patients. Poor hand washing techniques and practices are the primary cause of diseases.
Purpose of the Change
The change proposal technique will aid in the prevention of various infections. The spreading of germs will be limited, making the urinary tract safe and free of pathogens (Boswell & Cannon, 2018). There is reduced risk, dropping the chances of harmful microorganisms getting into the body. Urinary or bladder issues will thus be limited or wholly avoided (Advani & Fakih, 2019). Hygiene levels are also improved since hands are washed effectively with soap or other disinfectants.
PICOT Question
The target population is the mothers who have undergone cesarean section delivery and have had their bladder emptied using catheters. Interventions include proper handwashing techniques to improve the hygiene of nurses and other health care workers or caregivers. Other interventions to be considered include treatment of already infected mothers and adequate education for the caregivers of the patients (Advani & Fakih, 2019). The control measures include the lack of proper handwashing techniques, no treatment, or proper education to the caregivers of the patients.
The desired outcome is that there are few or no CAUTI. The time frame for the evaluation of the product is three months. This timeframe is adequate to evaluate the success of the interventions. Therefore, to curb the problem at hand, the following question was identified: in a population of mothers who have undergone cesarean section, how does the strict adherence to handwashing techniques among health workers compared to lack of handwashing affect the incidence of urinary tract infections within the hospital stay period?
Literature Search Strategy Employed
Literature search requires a strategy in which one will use to acquire the precise information needed from a database (Patel et al., 2019). Employment of specific key terms to locate literature from the databases was used. Additionally, The keywords used in this study include infection prevention, cesarean section, cesarean-associated urinary tract infections, and urinary tract infections. Examples of databases used in this study include Alt Healthwatch, PubMed, ScienceDirect, and JSTOR (Galiczewski & Shurpin, 2017). These key terms were used to search the databases and acquire essential research that has been done on Caesarean-associated Urinary tract infections. These data sources also helped to educate the strategies to be used in the study.
Evaluation of the Literature
Scholars have agreed in many works on hygiene and infections; many cases have been reported to result from poor practices in sterilizing the catheter or handling the patient. According to Atkins et al. (2020), nurses often fail to follow the recommended rules for many reasons such as nursing shortages, colossal workload, and insufficient funding hence few resources such as soaps for handwashing. Infections were reported among mothers who had their bladder emptied by catheters due to contamination by nurses.
Change Theory
Change theory has some concepts that are vital for the implementation of a strategy. The ideas include the driving forces, various restraining forces, and the equilibrium needed. The driving forces play a significant role in the implementation of the change. They generally create a positive impact on the performance of the strategies laid down. Factors that facilitate change entail these forces (Patel et al., 2017). Unfreezing is to be done to ensure that proper practices are followed in hand washing. Freezing ensures that the nurses or the management do not slide back to their old ways that caused infections in patients. Freezing ensures that a culture is created based on the new guidelines.
Proposed Implementation Plan
The plan is to ensure that the management of the mother and baby unit is aware of the importance of high levels of hygiene for the mothers who have undergone cesarean section. Funding is also to be available to avoid any barriers to the plan. The prominent proposal introduces handwashing techniques to the department to prevent urinary tract infections (Tyson et al., 2020). Nurses will be advised to perform regular handwashing before performing any procedures on patients who have undergone cesarean section. Posters will be posted on all nurses’ stations and handwashing points to facilitate adherence. The outcome is to ensure that germs or pathogens are killed and eliminated hence reducing common infections.
Evidence-Based Practice
Most of the laboratory results have shown that women with urinary tract infections have disease-causing microorganisms and could have gotten into them during catheter insertion (Damilare, 2020). The nurses who performed the procedures also reported huge workloads and failure to use soap when washing hands or had a water shortage (Tyson et al., 2020). Women who did not report any signs of infection after catheter insertion were reported to have no pathogens in their tract when tests were done on their urine
Evaluation Plan
Evaluating the interventions put in place will help ensure that the strategies’ goals have been met. It will also help identify weak areas of the strategy and set up other methods to ensure its success. Evaluation of the proposed plan is to be done monthly. Statistics on the number of new urinary tract infections following cesarean section are to be recorded. These statistics are vital in the appraisal of the success of strategies used. The statistics will help create additional strategies to reduce CAUTI. The statistics can also help guide decisions to allocate more resources to reduce CAUTI within the hospital setting. The mother and baby care unit should get adequate funding to acquire detergents and sufficient clean water. Training should be done on proper handwashing while ensuring the nurses understand the importance of hygiene for the patient’s safety.
Identification of Barriers and Solutions
The issues that may arise include inadequate funding, nursing shortages, huge workloads with few resources, and poor management. The management should be trained on the importance of planning for proper hygiene to see the essence of handwashing for patient safety. Adequate cleaning water and detergents should be available within the health care setting (Tyson et al., 2020). The motivation of nurses to follow the guidelines provided by the management is also essential.
Conclusion
In summary, hand washing is the best way to handle infections caused by poor sanitation during catheter insertions. Disinfectants are used to clean the surfaces that may contact the catheter or instruments used in performing the procedure. More education should be done to ensure that nurses follow the guidelines of proper sanitation. Barriers may be eliminated if the management can make good decisions and implement laid plans effectively. If nurses can follow guidelines, including handwashing during catheter insertion, infections of the urinary tract will be avoided and the best outcomes achieved.
References
Advani, S. D., & Fakih, M. G. (2019). The evolution of catheter-associated urinary tract infection (CAUTI): is it time for more inclusive metrics?. Infection Control & Hospital Epidemiology, 40(6), 681-685.
Atkins, L., Sallis, A., Chadborn, T., Shaw, K., Schneider, A., Hopkins, S.,… & Lorencatto, F. (2020). Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioral analysis of interventions. Implementation Science, 15(1), 1-22.
Boswell, C., & Cannon, S. (2018). Introduction to nursing research (5th ed.). Jones & Bartlett Learning.
Damilare, O. K. (2020). Hand washing: An essential infection control practice. International Journal of Caring Sciences, 13(1), 776-780. Web.
Galiczewski, J. M., & Shurpin, K. M. (2017). An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: direct observation of catheter insertion procedure. Intensive and Critical Care Nursing, 40, 26-34. Web.
Patel, P. K., Gupta, A., Vaughn, V. M., Mann, J. D., Ameling, J. M., & Meddings, J. (2017). Review strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs. Journal of hospital medicine, 13(2), 105-116.
Tyson, A. F., Campbell, E. F., Spangler, L. R., Ross, S. W., Reinke, C. E., Passaretti, C. L., & Sing, R. F. (2020). Implementation of a nurse-driven protocol for catheter removal to decrease catheter-associated urinary tract infection rate in a surgical trauma ICU. Journal of intensive care medicine, 35(8), 738-744.
Appendix section
Educational materials
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