The article “Interventions to minimize the initial use of indwelling urinary catheters in acute care: A systematic review” focuses on the issue of Catheter-Associated Urinary Tract Infections (CAUTIs). Murphy, Fader, and Prieto (2014) argue that “CAUTIs and healthcare-associated infections have been on the rise in the recent past” (p. 5). Healthcare workers use indwelling urinary catheters (ICUs) to support the needs of many inpatients (Nicolle, 2014). However, such ICUs present numerous health problems to different patients. ICUs can various cause urinary tract infections (UTIs). Such infections have the potential to cause death. CAUTIs are usually managed and treated using various antibiotics. The biggest challenge is that such microbes have become resistant. Gram-negative microbes and organisms have also become resistant thus reducing the effectiveness of different antibiotics (Nicolle, 2014). The purpose of the study was “to examine the effectiveness of various interventions towards minimizing the initial placement of ICUs in acute care settings” (Murphy et al., 2014, p. 4). This essay gives a detailed analysis of the key elements of the article. The discussion will also examine the article’s potential implications on clinical practice.
The researchers observed the use of indwelling urinary catheters (ICUs) led to a wide range of urinary tract infections. Past researches had focused on the best approaches that can reduce the use of these ICUs in every acute care setting (Murphy et al., 2014). Past studies have encouraged medical practitioners to reduce and remove every placed catheter. However, very few studies have managed to explore how the initial placement or use of ICUs can be reduced.
The main objective was to examine “the existing evidence of the appropriateness of the interventions used to reduce the initial placement of ICUs in acute care” (Murphy et al., 2014, p. 4).
A systematic review was used by the authors to present the most appropriate discussions. To begin with, the researchers selected many articles that focused on the use of indwelling urinary catheters (ICUs). Most of the targeted articles described various strategies that could be used to reduce the use and place of ICUs in different acute care environments (Murphy et al., 2014). The authors selected articles targeting patients aged over 18 years to come up with the best analyses. The scholars also incorporated various articles detailing the incidents of IUC placement (Murphy et al., 2014).
The researchers used “the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMA) model or checklist to support the review” (Murphy et al., 2014, p. 4). Most of the targeted articles were obtained from revered databases such as EMBASE, Medline, Cochrane Library, and CINAHL. These medical databases provide evidence-based and peer-reviewed articles that can be used to transform the nature of the medical practice. The systematic approach made it easier for the authors to synthesize information on the best measures towards minimizing the placement of ICUs in different acute care environments (Murphy et al., 2014).
The systematic review presented powerful insights that can transform the future of acute care delivery. The eight research articles reported various interventions that can decrease or increase the initial placement of IUCs (Murphy et al., 2014). However, most of the studies supported the use of ICUs in an attempt to provide appropriate care to the targeted patients. Each article identified some acceptable indications for the use of ICUs. Seven articles explained why new post-intervention measures were needed. The authors observed that “past studies had failed to present useful conclusions regarding the initial placement of IUCs” (Murphy et al., 2014, p. 12).
The researchers explained why there is a need to undertake more studies. Such research can establish when ICUs can be used or not. The important objective is to ensure the initial placement of such devices is minimized. New studies will encourage more practitioners to minimize the use of such ICUs (Murphy et al., 2014). The studies will also present powerful interventions and methods that can minimize the initial use and placement of indwelling urinary catheters in different healthcare settings.
The Article’s Potential Impact on Clinical Practice
Nicolle (2014) argues that “healthcare practice is an ever-changing field that is informed by new findings and studies” (p. 3). That being the case, new research findings should be embraced to transform and improve the nature of medical care. This article offers evidence-based ideas that can empower different health researchers and practitioners. The important goal is to ensure various urinary tract infections have been reduced in the future (Hooton et al., 2010). The use of ICUs has been associated with various urinary tract infections. The current interventions used to reduce the use of such ICUs are ineffective. Modern studies have also failed to promote the best healthcare practices that can address the challenges associated with these ICUs.
Future studies should “examine the appropriateness of various quality improvement (QI) interventions that can minimize the initial use of ICUs in different healthcare settings” (Murphy et al., 2014, p. 12). Different pre-intervention methods should also be designed to support the health needs of many patients (Nicolle, 2014). Recent studies have also failed “to analyze the major causes of IUC overuse” (Murphy et al., 2014, p. 12). The authors, therefore, encourage educational researchers and healthcare practitioners to come up with new strategies that can support the use of these ICUs. The gathered evidence will encourage caregivers to minimize the use of such devices (David et al., 2014). They will also focus on the best practices that can reduce the overuse of these ICUs (Oman et al., 2011).
It will also be appropriate to analyze various gaps and problems that make it impossible for different healthcare facilities to minimize the use of catheters. Numerous studies will be needed to understand when the initial placement of an IUC should be done. Such studies will also define what will constitute an overuse of IUCs (Meddings, Rogers, Macy, & Saint, 2010). These studies will present evidence-based and consistent ideas that can be used to support the effective use of ICUs in various acute care settings (Murphy et al., 2014). The authors encourage future researchers to focus on the decision-making processes embraced by different clinicians (Oman et al., 2011). The approach will eventually present powerful insights that can transform the nature of healthcare.
This article presents powerful ideas that can revolutionize the future of the clinical practice. It will be appropriate for researchers to examine the issues associated with the continued use of indwelling urinary catheters (Meddings et al., 2010). Such studies will also examine the opportunities and challenges associated with such IUCs (David et al., 2014). These evidence-based ideas will be used to design powerful interventions that can reduce the initial placement of ICUs. The process will support the changing health expectations of many patients in every acute care setting.
David, K., Colebaugh, A., Eithun, B., Klieger, S., Meredith, D., Platcher, N.,…Coffin, S. (2014). Reducing Catheter-Associated Urinary Tract Infections: A Quality-Improvement Initiative. Pediatrics, 134(3), 1-12.
Hooton, T., Bradley, S., Cardenas, D., Colgan, R., Geerlings, S., Rice, J.,…Nicolle, L. (2010). Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. IDSA Guidelines, 50(1), 625-663.
Meddings, J., Rogers, M., Macy, M., & Saint, S. (2010). Systematic Review and Meta-Analysis: Reminder Systems to Reduce Catheter-Associated Urinary Tract Infections and Urinary Catheter Use in Hospitalized Patients. Clinical Infectious Diseases, 51(5), 550-560.
Murphy, C., Fader, M., & Prieto, J. (2014). Interventions to minimize the initial use of indwelling urinary catheters in acute care: A systematic review. International Journal of Nursing Studies, 51(1), 4-13.
Nicolle, L. (2014). Catheter Associated Urinary Tract Infections. Antimicrobial Resistance and Infection Control, 3(23), 1-17.
Oman, K., Makic, M., Fink, R., Shraeder, N., Hulett, T., Keech, T.,…Wald, H. (2011). Nurse-directed interventions to reduce catheter-associated urinary tract infections. American Journal of Infection Control, 1(1), 1-6.