NRS 493 Topic 6 DQ 2 Catheter Associated Urinary Tract Infection

Sample Answer for NRS 493 Topic 6 DQ 2 Catheter Associated Urinary Tract Infection Included After Question

Topic 6 DQ 2

Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?

A Sample Answer For the Assignment: NRS 493 Topic 6 DQ 2 Catheter Associated Urinary Tract Infection

Title: NRS 493 Topic 6 DQ 2 Catheter Associated Urinary Tract Infection

My initial capstone topic started out as CAUTI (Catheter Associated Urinary Tract Infection) associated with foley utilization rates. Although there are several evidence-based practices that have been shown to reduce CAUTI including reducing the use of urinary catheters, incorporating interventions to help avoid the use of urinary catheters when they are not indicated including nurse-driven protocols for the removal of urinary catheters as soon as no longer required (Centers for Disease Control and Prevention, 2019).

This is quite different than the current focus of my change proposal. I decided to shift to a more narrowed focus that is a direct reflection of a current need at the rehabilitation hospital. One influential moment for the change came when I was asked by a staff nurse, “Do I really have to change the foley out before I get a specimen?” I thought that she was just joking, considering her experience and longevity with the company. Either way I assumed that she would know the proper procedure to collect from a catheterized patient. After going over the policy of urine specimen collection in catheterized patients, it dawned on me that perhaps she actually didn’t know, which may result in improper collection and false positive readings. After discussing this situation with my preceptor, she shared with me that that hospital just got their second CAUTI of the year, due to urine cultures being ordered without proper clinical indication. After considering these factors, my focus shifted to urine culture collection and how they can increase CAUTI rates.

My capstone change proposal project involves the initiation of a Urine culture stewardship initiative focused on addressing the issue of increased rates in CUATI associated with improper testing of urine cultures for reason that do not indicate the need for culture testing, as well as addresses the significance of proper specimen collection practices and in reducing the overtreatment with antibiotics and other associated treatment costs. Specific studies have shown that urine culture stewardship initiatives aimed at reducing UC overutilization and were correlated with a decrease in CAUTIs, and the addition of urine-culture stewardship to standard best practices could reduce CAUTI in various care settings (Al-Bizri, Vahia, Rizvi, Bardossy, Robinson, et al., 2021).

Reference

Al-Bizri, L., Vahia, A., Rizvi, K., Bardossy, A., Robinson, P., Shelters, R., Alangaden, G. (2021). Effect of a urine culture stewardship initiative on urine culture utilization and catheter-associated urinary tract infections in intensive care units. Infection Control & Hospital Epidemiology, 1-4. doi:10.1017/ice.2021.273

CDC (Centers for Disease Control and Prevention). (2019). Survey Practices and Outcomes. Urine Culture Stewardship. HAI. https://www.cdc.gov/hai/prevent/cauti/indwelling/survey.html

A Sample Answer 2 For the Assignment: NRS 493 Topic 6 DQ 2 Catheter Associated Urinary Tract Infection

Title: NRS 493 Topic 6 DQ 2 Catheter Associated Urinary Tract Infection

Thank you for sharing your project with the class. In addition to what you elaborated on the interventions that are mostly carried out by health professionals to prevent CAUTI are external catheters such as condom catheters for male patients and pure wick for females. These external catheters are used in my unit a lot on patients on incontinent patients with impaired movement and also on patients who are on diuretics and on strict intake and output.

Thank you for responding to my post. The alternatives to foley catheters are many, but I agree are greatly under utilized. Evidence-based alternatives to indwelling catheterization include intermittent catheterization, bedside bladder ultrasound, external condom catheters, and suprapubic catheters. In addition, adherence to general infection control principles is important (eg, hand hygiene, surveillance and feedback, aseptic insertion, proper maintenance, education). Other CAUTI prevention strategies include aseptic insertion, catheter maintenance, antimicrobial UCs, and bladder bundle implementation (Meddings, Rogers, Krein, Fakih, Olmsted, & Saint, 2014).

Reference

Meddings, J., Rogers, M. A. M., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2014). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual. Saf., 23(4), 277–289. doi: 10.1136/bmjqs-2012-001774

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Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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