University Nursing: Translation Action Plan Report

This report presents a comprehensive Translation Action Plan designed to address the prevalent issue of unnecessary urinary catheter usage within hospital settings. The report begins by outlining the problem: the frequent prescription of urinary catheters without proper indications, leading to increased risk of catheter-associated urinary tract infections (CAUTIs). The scope of the problem is detailed, highlighting its impact on nurses, patients, healthcare providers, and the hospital itself, encompassing concerns related to infection, funding, and patient satisfaction. The report employs the PICO framework to define the problem, intervention, comparison, and outcomes. It then explores whether the issue requires changes in practice, education, referral to a quality team, and adjustments to procedure manuals and documentation. The report provides substantial evidence and research to support the problem identification, citing statistics from the CDC and the American Urological Association. An action plan with a timeline, responsible parties, and outcome metrics for each step is included. Finally, a follow-up and evaluation plan is outlined to assess the effectiveness of the proposed changes, focusing on reducing CAUTI cases and improving adherence to new guidelines.

Running head: TRASLATION ACTION PLAN 1
Translation Action Plan
(Author’s name)
(Institutional Affiliation)

TRASLATION ACTION PLAN 2
Translation Action Plan
Statement of problem/issue:
In current clinical practices, there have been many instances where patients are
prescribed with urinary catheters without any proper indication (Averch, 2014). Although there is
always an order for all clinical practice from a medical doctor or a qualified senior staff,
sometimes the decisions are decided without any rigid necessity (Averch, 2014). This problem
aims to examine the aspects of urinary catheter administration in a hospital setting and its
possible contraindications and necessities.
The scope of the problem/issue
The problem with urinary catheter affects nurses, patients; health care providers and the
hospital institution meaning the extent of the problem include the whole health sector and related
fields (Ching, 2015). Various concerns such as urinary catheter infections, services funding,
multiple modes of practices and patients satisfaction have made health care workers and
researchers to understand the scope of the problem (Ching, 2015). Such concerns have led to
many hospitals and healthcare providers to minimize urinary catheter insertions and only use
them when the patients are in practical and actual needs.
What are the PICO Components?

TRASLATION ACTION PLAN 3
P-(Patient, Population or Problem) –An increase in urinary tract infections associated with Foley
catheters.
I- (Intervention) – Use sterile techniques when inserting urinary catheters and only use them
when required. Ensuring the urinary catheters are only produced by supervisors for usage (Saint
et al., 2013).
C-(Comparison with other treatments)-Use other methods of relieving urine like the use of male
condoms catheters and helping the patients to empty urine in and urinary dish (Saint et al., 2013).
O-(Outcome(s-Decrease urinary catheter infections, understanding of proper indications for
Foley catheter insertion (Saint et al., 2013).
T- (Timeframe)- Three to six months to determine and evaluate whether the action plan has
worked.
Does the problem/issue require?
X Change in Practice?
In most cases, the urinary catheters are always placed in areas where all healthcare providers
can easily access (Kennedy, Greene & Saint, 2013). This has led to the insertion of Foley
catheters to patients who do not necessarily need them (Kennedy, Greene & Saint, 2013). In

TRASLATION ACTION PLAN 4
addition, many nurses and healthcare workers often use urinary catheters in patients who have
not been prescribed to mostly in the emergency units. Therefore, Foley catheters should be kept
in areas where only supervisors access them. Also, sterile techniques should be observed all the
time during the procedure of insertion.
X Education?
A continue medical education and follow up concerning the change should be introduced
to all healthcare workers leaders. In addition, a review of the sterile procedure of insertion
should be conducted to ensure all healthcare workers are qualified (Ching, 2015). Other than
that, all hospitals should be given flow charts that easily elaborate the standards to be used
when dealing with Foley catheters.
X Referral to Quality Team?
The problem should be referred to infections and control unit in order to receive advises on
standard infection control when it comes to the use of urinary catheters (Ching, 2015).
X Addition/Change to Procedure Manual?
The procedure manuals should be updated and reevaluated to make sure all updates
concerning the standards of use are incorporated (Kennedy, Greene & Saint, 2013).
X Addition/Change to Documentation?
All documentation of Foley catheters should be well recorded. This includes a proper

TRASLATION ACTION PLAN 5
electronic database that shows the time the urinary catheter was used, the reason for ordering and
the supervisor who released it.
What is the evidence/research that supports problem identification?
In the US, hospitalized associated infections are generally costly, deadly and common.
According to the Center for Deceases Control in 2017 catheter-associated urinary tract infections
(CAUTI) accounts for 75% of all urinary tract infections (UTI) acquired in the hospital. Around 15-25%
of the patients receive the urinary catheters during their stay in hospital of which 10% of these patients
do not require them. The most risk factor of developing CAUTI is prolonged use of urinary catheters
(CDC, 2017). In addition, poorly indicated catheters inserted using wrong procedures are the
aggravating factors. Another report by the CDC showed that there is an estimate of over 2 million
hospital-acquired infection every year due to poor handling of patients equipment (CDC, 2017). Out of
those, about 99,000 patients die every year due to CAUTI. According to the American Urological
Association in 2014, there were 3.8 million cases of CAUTI between 2001 and 2010 in 70.4 million
catheterized adults (Averch, 2014). The association showed that prevention of CAUTI primary depends
on the selection of appropriate patients and mode of insertion (Averch, 2014). Therefore, Urinary
catheters should only be used for proper indications and should be removed as soon as when the patient
no longer need them.

TRASLATION ACTION PLAN 6
Action Plan
Timeline and
persons
responsible
Change in
Practice
Education
needed
Changes to
documentation
Outcome
All healthcare
professionals
including nurses
and doctor
Timeframe; one
month
Urinary catheters
should be
inserted only for
appropriate
indications
(CDC, 2017).
Review and
educate all
healthcare
professionals the
needs time to
insert Foley
catheters
including
appropriate
types and sizes
All inserted
catheters should
be electronically
documented
showing the
exact indications
for insertion,
nurses, and
doctors who
inserted and
expected a time
of change
Reduction in the
CAUTI cases
should be
experienced in the
targeted time
frame.
In addition, by the
end of one month,
all health workers
should demonstrate
the ability to insert
catheters only in
appropriate
patients, document
all procedures and
cases and show
responsibilities of
care when it comes

TRASLATION ACTION PLAN 7
to urinary catheter
insertion (Averch,
2014)
Healthcare
supervisors
Timeframe: one
month
Healthcare
supervisors
should take the
responsibility of
releasing the
Foley catheters
for insertion
(CDC, 2017).
All supervisors
should be
educated on
updated
procedures of
Foley Catheter
insertion
Supervisors and
health
management
team should
change the
practice of
documenting all
the urinary
catheters
released for
insertion
Reduced non
indicated catheter
insertion and the
cost of buying
more supplies than
needed(CDC,2017)
All health care
professionals
including
doctors and
nurses
Nurses and other
healthcare
professionals
should embrace
other alternatives
to urinary
catheterization.
This includes
use of male
Healthcare
professionals
should be
educated on
other
alternatives to
catheterization
and the
procedure and
Reduced CAUTI
infections should
be demonstrated
since most of the
alternatives of
urinary
catheterization like
male condoms
catheter have

TRASLATION ACTION PLAN 8
condom
catheters and
assisting the
patients to pass
urine in hospital
latrines.
modes of use shown minimize
chances of
contracting urinary
infections (Averch,
2014).
CDC and other
infection control
units
Time frame:
three to six
months
The CDC and
other Infection
Control Units
should update
review the
current
guidelines to
make sure Foley
catheters are
only inserted
when indicated,
proper
documentation is
followed, only
supervisors
should release
the catheters,
All updated
information by
the CDC and
other control
units should be
provided to all
hospitals and
healthcare
providers as
printed
handbooks and
flowcharts
guidelines
Healthcare
providers should
demonstrate the
effectiveness of
using the updated
information by the
national
guidelines.

TRASLATION ACTION PLAN 9
and sterile
procedure for
insertion
including the
flowcharts are
up to date.
Follow-Up and Evaluation Plan
Medical leaders and manager should perform a routine follow up checking whether the
healthcare workers comply with the new changes (Chesla, 2008). This should include checking
whether the patients catheterized were appropriately indicated, reviewing documentation of all
procedure and continuous monitoring of all catheters released from the store. The new changes
should be evaluated after six months to change whether the CAUTI infections have reduced and
if the health care providers have implemented the new proposed guidelines (Mulnard, 2011).
Also, the new proposed guidelines should be evaluated whether they are effective or not.

TRASLATION ACTION PLAN 10
References
Averch, T. (2014). Cather-Associated Urinary Tract Infections: Definitions and Significance in
the Urologic Patient. Retrieved from http://www.auanet.org/guidelines/catheter-associated-
urinary-tract-infections
CDC,(2017) Catheter-associated Urinary Tract Infections (CAUTI).. Retrieved from
https://www.cdc.gov/hai/ca_uti/uti.html
Chesla, C. A. (2008). Translational research: Essential contributions from interpretive nursing
science. Research in Nursing & Health, 31(4), 381–390. doi:10.1002/nur.20267
Ching, P. (2015). Prevention of Catheter-Associated Urinary Tract Infection (CAUTI) through a
bundle of care approach. Journal Of Microbiology, Immunology, And Infection, 48(2), S26.
doi: 10.1016/j.jmii.2015.02.200
Kennedy, E., Greene, M., & Saint, S. (2013). Estimating hospital costs of catheter-associated
urinary tract infection. Journal Of Hospital Medicine, 8(9), 519-522. doi: 10.1002/jhm.2079
Mulnard, R. A. (2011). Translational research: Connecting evidence to clinical practice. Japan
Journal of NursingScience, 8(1), 1-6. doi:10.1111/j.1742-7924.2011.00184.x
Saint, S., Greene, M., Kowalski, C., Watson, S., Hofer, T., & Krein, S. (2013). Preventing
Catheter-Associated Urinary Tract Infection in the United States. JAMA Internal
Medicine, 173(10), 874. doi: 10.1001/jamainternmed.2013.101