Journal of Krishna Institute of Medical Sciences University (Jan 2018)
Effectiveness of Clinical Practice Guidelines on Prevention of Catheter-associated Urinary Tract Infections in Selected Hospitals
Abstract
Background: Urinary Tract Infection (UTI) accounts for forty to fifty percentage of hospital acquired infections. Catheter Associated Urinary Tract Infections (CAUTI) are the majority of health care associated infections. The urinary catheter leads to bacterial colonization, recurrent and chronic infections, bladder stones, septicemia, damage to the kidneys, bladder and urethra and development of antibiotic resistance. CAUTI mainly occurs due to the non sterile techniques followed by the nurses during the insertion and maintenance of indwelling catheter. Aim and Objectives: To assess the insertion practice of indwelling catheter and assess the maintenance practice of indwelling catheter as measured by structured observation check list and evaluate the effectiveness of clinical practice guidelines. Material and Methods: This was a quasi experimental non- equivalent control group pre test and post test design used over a period of one year. Demographic data were collected from nurses and patients. The insertion and maintenance practice of indwelling catheter data were gathered by using observational check list and urine culture and sensitivity analysis. Seven days interval was kept between pre test and post test after the implementation of clinical practice guidelines. Institutional Ethics Committee clearance was obtained and CTRI registration was done. Results: Data were collected from 70 participants (experimental – 35 and control –35). The results of the study showed that the implementation of clinical practice guidelines in indwelling catheter insertion and maintenance was effective as the p value was 0.001. The urine culture and analysis reported that, there were three cases which showed the growth of micro organisms in the experimental group, where as in control group two at the time of pre test. After implementing the clinical practice guidelines on CAUTI, the growth of organisms was not reported. Conclusion: Clinical practice guidelines strongly recommend that reporting and monitoring for infection control practices is a critical component of CAUTI prevention. It also emphasized the education and training of nurses regarding infection control measures and periodic assessment of the practice among them has also been shown to reduce the incidence of CAUTI. Thus the study creates an opportunity to develop and implement clinical practice guidelines and it helps to improve nurses practice in infection control and reduce the incidence of CAUTI in the hospitals.
