Catheter-associated urinary tract infection (CAUTI) is a major health concern among mixed gender patients in the long-term acute care setting (LTAC). Adopting an early indwelling urinary catheter treatment exposes these patients to the risks of contracting urinary infections. When compared to cases involving the adoption of external urinary collection device (EUCD), the use of indwelling catheters presents a myriad of health problems.
For instance, such medications expose patients to high rate of developing CAUTI and being hospitalized for long catheter days. The catheter management plan also exposes nurses’ failure to self-administer drainage tubes exposing patients to greater risks of developing CAUTI. As such, implementing evidence-based education is crucial in empowering nurse practitioners to discontinue an early indwelling catheter intervention with an aim of adopting external urinary collection device (EUCD) treatment. Embracing the use of EUCDs is also useful in managing the risks of LTAC patients from contracting CAUTI and reducing catheter days by a period of 8 weeks.
Reflection on Nursing Science Underpinnings and Managing Change
Reflecting on the application of EUCD as an alternative to urinary catheter care provides an opportunity for nurse improvement plans in handling LTAC patients. For instance, the implementation of EUCD programs requires clinicians’ expertise, knowledge, and skills for their autonomic decision-making contrary to their overreliance on doctors’ directions when managing the conditions of LTAC patients (Advani & Fakih, 2019). These nurses, therefore, need the education to empower them to feel assertive in following the required protocols in discontinuing an indwelling urinary catheter program without the intervention of doctors.
The ideas of transformative learning model can be used to educate nurses to gain autonomy in making decisions. Particularly, proper training on evidence-based practices will empower physicians to advocate for better care plans in improving their service provision.
Practice Problem in the Context of a Nurse MetaParadigm
CAUTI prevention is among healthcare issues that clinicians may find challenging to address. Nurses who are not well trained mostly rely on the doctor’s knowledge in making healthcare intervention decisions (Snyder et al., 2020). As such, lack of self-confidence undermines the autonomic decision making of most clinicians. Training on indwelling catheter-based challenges would, therefore, enhance their awareness to implement external urinary collection devices. The practice would help improve CAUTI rates and reduce the total catheter days to 8 weeks.
Ways of Knowing
The concept of Ways of Knowing theory illustrates the common four principles of awareness, such as propositional, presentational, practical, and experimental knowing. The model provides the basis of discontinuing an indwelling catheter program and recommends that nurse practitioners adopt an experimental intelligence in performing evidence-based medication. An example of the application of this theory is evident in the testing of medical drugs with an aim of creating medical interventions’ positive outcomes. To practice EUCD intervention, a tested positive outcome can be adopted in the subsequent procedures of medical therapy for all LTAC patients.
To illustrate the implications of adopting indwelling urinary catheter discontinuation, the adoption of Mezirow’s Transformative Learning Theory plays a key role in explaining how EUCDs’ implementation would bring a change to the current usage of an indwelling urinary catheter. The model explains the importance of discontinuing indwelling urinary catheter therapy with the aim of implementing EUCDs (Krepia et al., 2018). The theory is based on the precept that clinicians’ engagement with training influences their preexisting mindset into adopting a given course of action. Providing evidence-based nurse training on the benefits of implementing EUCD treatment would, therefore, encourages them into discontinuing the use of urinary catheters.
Development and Discussion
In my view, the emphasis of adopting evidence-based training as a refresher course to promote nurse leader service provision is a new knowledge for my learning. Previously, I regarded the use of indwelling catheters as the best treatment option presenting minimal exposure to CAUTI for LTAC patients. However, several literary works question the current use of indwelling urinary catheters (Parker, 2017). These thoughts are common with my experience during an internship program. An LTAC patient contracted CAUTI within a period of one month hospitalization. From the experience, I realized the need of discontinuing the use of indwelling catheters and embracing EUCDs in reducing patients’ exposure to CAUTI.
A number of studies have dwelt on the effeteness of considering EUCD as an alternative to the indwelling catheter usage. Gray et al. (2016) present the findings of expertise’s viewpoint of the importance of adopting external collection devices in a healthcare setting. The article provides important evidence-based recommendations on the effectiveness of adopting EUCDs as cost saving and safe healthcare programs contrary to the urinary catheters. Supporting these findings is crucial in approving the use of EUCDs to provide quality nurse care intervention. Anticipating the adoption of nurse education and evidence-based practices will also enhance professional knowledge in providing medical interventions when handling LTAC patients.
Discontinuing indwelling catheters and adopting EUCDs in the LTAC patients’ treatment plans provide a cost saving and safe approach to medical treatment. These interventions are suitable alternatives to the indwelling urinary catheter option. For effective adoption of EUCDs, clinicians need to be well trained on evidence-based nurse decision making to enhance nurse care service provision. With the early withdrawal of indwelling catheters, the LTAC population can receive better medical care. This group will project a decline in the CAUTI rates and being less subjected to long-term hospitalization as a result of the reduced catheter days. The theory of transformative learning provides an evidence-based training option crucial in enhancing medical practitioner’s understanding of their obligations to quality service delivery. Physicians, therefore, have a duty to make decisions about the adoption of EUCDs as an effective healthcare therapy.
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. Web.
Gray, M., Skinner, C., & Kaler, W. (2016). External collection devices as an alternative to the indwelling urinary catheter: Evidence-based review and expert clinical panel deliberations. Journal of Wound, Ostomy, and Continence Nursing, 4(3), 301-307. Web.
Krepia, V., Katsaragakis, S., Kaitelidou, D., & Prezerakos, P. (2018). Transformational leadership and its evolution in nursing. Progress in Health Sciences, 8(1), 18-24. Web.
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), 1-9. Web.
Snyder, M. D., Priestley, M. A., Weiss, M., Hoegg, C. L., Plachter, N., Ardire, S., & Thompson, A. (2020). Preventing catheter-associated urinary tract infections in the pediatric intensive care unit. Critical Care Nurse, 40(1), 12-17. Web.