Clinical Prediction Rule for Catheter Associated Urinary Tract Infections in ICU Patients

Evidence Based Nursing Research
Student University
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Definition of clinical prediction rule:
The research methodology was conducted using the Clinical Prediction Rule. The study
based on patients in the medical intensive care unit with indwelling urinary catheters. Infections
from indwelling urinary catheters lead to increased patient morbidity and mortality in all medical
centers worldwide Hooton et al (2010). The variable of the study was catheter associated urinary
tract infections. The outcome of the study was a course of action in utilizing the direct
observation over the standard procedure of catheter insertion. The outcome, if positive, is
important and clinically rational in preventing CAUTI, because of its high morbidity and
mortality factor in ICU patients in hospitals.
Sample population and spectrum of the population.
The study population was ICU patients with indwelling urinary catheters. This is a good
spectrum of patients to conduct the study on because bacterial infections or candidiasis is almost
inevitable in more than 60% of the patients who require an indwelling urinary catheter for more
than 5 days. These patients, due to the surroundings that they are in, are at a high risk of
developing infections especially bacteria that are part of the patient's colon or perineum, or
derived from the hands of medical and paramedical personnel during insertion of indwelling
catheters or improper handling of the collection system such as stomas or chest tubes ,Nicolle, L.
E. (2010).
Validation of direct observation of urinary catheter insertion
The direct observation procedure was not validated on a different set of patients. It’s not
sufficient that the rule had an outstanding outcome on the ICU patients only. The direct

observation of urinary catheter insertion should have been validated in other hospitalized
patients.
The predictor variables and the outcome.
The independent variable of the study was urinary catheter insertion using the standard
hospital procedure. The outcome of the study was to evaluate the rates of catheter associated
urinary tract infections in ICU patients with indwelling catheters.
Evaluation of the predictor variable and outcome in sample population
The independent variables and outcomes were evaluated in the whole population sample.
There were no drop outs. The outcome was measured by determining the total number of
diagnosed cases of urinary tract infection associated with the indwelling catheter in all the ICU
patients.
Statistical methods and positivity criterion
The variables and outcome of the study were included in the statistical method. The
positivity criterion is well explained. The study was conducted in two phases. Through phase I, a
backdated data review was conducted on utilization and urinary catheter infection rates when
practitioners followed the hospital's standard insertion procedure.in this phase, the total number
of catheters inserted was plotted against the total number of cases of urinary tract infections in
patients with indwelling catheters. During phase II, the predictor variable, standard procedure of
catheter insertion, was manipulated. Direct observation supplemented the standard insertion
procedure. Random observations for catheter insertion were performed revealing wide variances