Nursing Evidence Based Practice

Running head: NURSING EVIDENCE BASED PRACTICE
NURSING EVIDENCE BASED PRACTICE
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1NURSING EVIDENCE BASED PRACTICE
Introduction
Urinary tract infections (UTI) imply the infiltration of pathogenic microbiological strains
via the urinary tract, either associated due to catheter usage in a healthcare facility or due to
engagement in self-care hygiene tasks within insanitary conditions (Flores-Mireles et al., 2015).
The following paper will focus and evaluate on evidence based practice guidelines recommended
for elderly UTI patients, taking the case of an 87 year old Caucasian female patient suffering
from UTI, pelvic inflammatory disease, hematuria and overactive bladder, with no living familial
relations apart from her single daughter. While the patient presents no underlying physiological
complications, she has presented complaints concerning food intake and swallowing as per the
SOAP handover details.
Discussion
Evidence based Practice
An electronic search strategy aided in obtaining two scholarly, peer reviewed articles
which discussed on the evidence based practice (EBP) guidelines on UTI management were
obtained. The first article, that is, systematic review by Meddings et al., (2017) aims to explore a
range of clinical interventions for the purpose of reducing UTI in residents of a nursing home, of
which, procedures like adherence to adequate hand hygiene practices, encourage of patient
hydration and fluid intake, consumption of vitamin and cranberry based products as prophylaxis,
implementation of infection prevention and control frameworks and administration of
educational and policy frameworks on hygienic management of catheters may prove to be useful.
Additionally, the second article by Saint et al., (2016), aimed to explore the effectiveness of the

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Comprehensive Unit Based Safety Program on the reduction of catheter associated UTI
(CAUTI), comprising which, interventions like assessment of the need of indwelling catheter
usage, evaluation of alternative methods of urine collection and provision of feedback as well as
education and training to health professionals on standards of catheter usage have been proven to
be useful. A key similarity underlying UTI management recommendations by both articles is
their common objective on prevention of UTI and the importance of an educational training
program on management of the same. However, a key difference lies in the first article
(Meddings et al., 2017) primarily addressing patient centered approaches for management of UTI
using hydration and prophylaxis techniques while the second article (Saint et al., 2016), aims to
address preventive procedures of catheter assessment and alternative urine collecting methods to
avoid emergence of CAUTI.
Topic Rationale
The topic of evidence based practice and nursing case management for this paper is
prioritization and mitigation of UTI symptoms. Inadequate management of UTI results in
difficulties underlying basic functioning of self care and hygiene practices further leading to loss
of self-control, performance of activities of daily living and negative psychological outcomes of
embarrassment, agitation, distress and preference towards social isolation (Gágyor et al., 2015).
Further, lack of timely prevention and symptom management of UTI or CAUTI by patients as
well by the healthcare organization personnel may result in aggravation of symptoms such as
progression of pathogenic strains to surrounding organ systems leading to life threatening
conditions such as urosepsis. Hence, achievement of positive patient outcomes in terms of
empowerment and conductance of self care practices underlying self care and hygiene and
prevention of disease aggravation form the underlying rationale behind selection of UTI for EBP

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exploration (Schaeffer & Nicolle, 2016). Hence, incorporation of EBP in UTI management will
aid the patient in the alleviation of her pelvic inflammation and urination symptoms along with
assisting her in inculcating values of hygienic self care practice engagement (Tandogdu &
Wagenlehner, 2016).
Evaluate Key points
Microbial transmission and healthcare associated prevention of the same form the
underlying key points pertaining to UTI management. UTI symptoms emerge due to the
inadequate and insanitary usage of invasive urinary assistance procedures like catheters as well
as personal engagement of hygiene practices in unhygienic conditions of inadequate wiping after
urination resulting in microbial infestation (Grabe et al., 2015). Hence, for prevention of the
same, patients as well as health professionals must consider adherence to hygienic procedures
during urination and catheter usage coupled with hand hygiene procedures. Further, considering
the microbial nature of the disease condition, administration of antibiotics dictates underlying
key points of treatment (Williams & Craig, 2019).
Multiple Viewpoints
The prevention and management of UTI symptoms have underlying multiple guidelines
and recommendations from multiple sources – of which, minor controversial and conflicting
evidence has been observed in terms of UTI and CAUTI mitigation. The American College of
Clinical Pharmacy (ACCP), recommends administration of antibiotics such as trometamol,
nitrofurantoin, oral beta-lactam agents and fluuroquinolones for UTI management (American
College of Clinical Pharmacy, 2019). Alternatively for CAUTI prevention and management, the
World Health Organization (WHO) recommends health professionals’ adherence to standards of
hand hygiene and administration of a care bundle which assesses the need and monitoring of