Preventive Strategies for Lowering Catheter Associated UTI Risks

Running head: NURSING
Quantitative Research Critique
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Author Note

NURSING1
Introduction- Urinary tract infection (UTI) refers to an infection that occurs in a
segment of the urinary tract, predominantly due to infestation by Escherichia coli bacteria.
The common signs and symptoms of this condition encompass burning sensation at the time
of micturition, vaginal discharge, pain, pyelonephritis, nausea and vomiting (Gratzke et al.,
2015). Time and again it has been found that urinary catheters increase the likelihood of
suffering from UTI and the risk of bacteriuria, or presence of bacteria in urine does not
decrease with the administration of prophylactic antibiotics (Flores-Mireles, Walker, Caparon
& Hultgren, 2015). However, on using aseptic techniques for catheter insertion, risks of
catheter associated UTI (CAUTI) can be reduced. This essay will critically appraise two
quantitative articles that are based on preventive strategies for lowering CAUTI risks.
Background- The article by Yasuda (2017) was based on the problem of intravascular
catheter colonization, and aimed to compare the efficacy of three antiseptic solutions [10%
aqueous povidone-iodine (PVI) and 0.5%, and 1.0% alcohol/chlorhexidine gluconate (CHG)]
for preventing it. The purpose was significant to nursing since use of intravascular catheter is
imperative in contemporary clinical practice, predominantly in ICUs (Daubenspeck & Kacha,
2019). Nonetheless, use of central venous catheters contribute to catheter-related infections.
However, the purpose of the quasi-experimental study by Menegueti (2019) was to assess the
effect of executing a healthcare workers (HCWs) informative program and a day-to-day list
for indwelling urinary catheter signs. Its purpose is accredited to the fact that indwelling
catheter is generally in ICU patients, for collection of urine.
Support to nursing practice- The two articles will prove beneficial in providing
answers to the PICOT question owing to the fact that the question focused on identifying
strategies like appropriate catheter insertion and removal, training and education, and
antiseptic technique application that will help in lowering the incidence rate of CAUTI
among adult hospitalized patients, within a time frame of six months. Time and again it has

NURSING2
been found that yeast and bacteria, particularly those that are naturally present in the human
biome have the capacity to grow long urinary catheter surface, thus resulting in bladder
infection (Tiwari, Hui & Rai, 2015). According to Khan, Baig and Mehboob (2017) CAUTI
has been associated to several health complications such as, epididymitis,
prostatitis, and orchitis among males, and pyelonephritis, cystitis, gram-
negative bacteremia, endocarditis and septic arthritis. Records from the United States suggest
that roughly 449,334 CAUTI events occur each year and each event is related with a medical
expenditure of $758 (CMS Hospital Compare, 2018). This calls for the need of identifying
strategies that can help in preventing the onset of CAUTI, and/or its management, in order to
reduce the chances of related health complications. The intervention in the RCT were three
types of antiseptic solutions namely, 0.5%, and 1.0% alcohol/chlorhexidine gluconate (CHG),
and 10% aqueous PVI (Yasuda 2017). This was in contrast to healthcare routine training
intervention in the quasi-experimental study (Menegueti 2019). Both of these are relevant to
the PICOT question since the RCT was based on antiseptic intervention, and the latter was
based on educational program.
Methodology- Both the articles selected for critical analysis were based on
quantitative research design, thereby highlighting that the researchers tried to quantify the
issue of CAUTI, and used statistical or numerical data for assessing the defined variables
(incidence of CAUTI). The article by Yasuda (2017) was a RCT, thus suggesting that the
subjects were randomly allocated to one of the three treatment groups, in order to determine
the antiseptic technique that was most effective. Following randomization procedure helped
in the removal of selection bias between the three groups of patients, thus preventing the
allocation results from getting compromised. This is in contrast to the research by Menegueti
(2019) was a quasi-experimental one that generally encompasses the modification of an
independent variable, which is not accompanied by random allocation of study participants to