PICOT Question and Literature Research on CAUTI Prevention Strategies

This report focuses on catheter-associated urinary tract infection (CAUTI) prevention strategies in a hospital environment. It begins with a summary of CAUTIs, highlighting their prevalence, risk factors, and mortality rates, emphasizing the importance of prevention. The report then presents a PICOT question to guide the research, focusing on interventions to reduce CAUTI incidence among hospitalized adults. The interventions include accessing risk factors, practicing proper catheter insertion and removal, increasing nurse knowledge, and using antiseptic techniques. The report includes a literature review table summarizing six articles related to CAUTI prevention, covering their purpose, research questions, outcomes, settings, samples, methods, key findings, and recommendations. The articles explore topics such as hand hygiene, catheter reminder systems, hospital environment, clinician education, and antiseptic solutions, offering insights into various aspects of CAUTI prevention. The report aims to demonstrate the preventive strategies that can be used to reduce CAUTIs and promote patient safety.

Running head: PICOT Question and Literature Research 1
What are the Commonly used Catheter Associated Urinary Infection Prevention Strategies in a
Hospital Environment?
(Author’s name)
(Institutional Affiliation)

PICOT QUESTION AND LITERATURE RESEARCH 2
Summary
According to the Center of Disease Control (CDC) Catheter Associated Urinary Tract
Infections(CAUTI) is among the major health care related infections as reported by the National
Healthcare Safety Network(NHSN)(CDC, 2015) .In the United States, catheter related urinary
tract infections accounts for about 75% of all urinary tract infections(UTIs) and 40% of all
hospital infections. Catheter associated urinary tract infection accounts for approximately 13,000
deaths per day in the United States only(CDC,2015). Around 25% of all hospitalized patients
receive an indwelling catheter during their hospital stay.(CDC,2015) One of the most crucial risk
factor for the developing catheter associated urinary tract infections is the prolonged use of the
indwelling catheters(Saint et al., 2015). Due to that reason, it is recommended to use the urinary
catheters with appropriate indications only. In addition, the urinary catheters should be removed
immediately when their uses are no longer needed.
The catheter associated urinary tract infection can be prevented. According to the
Department of Health and Human Resources guidelines of 2009, about 69% of all CAUTIs can
be prevented y targeting the risk factors(Fasugba et al., 2018). Most common strategies that can
be used to prevent catheter associated tract infections in hospitals is by avoiding unnecessary
cauterization, use of antiseptic techniques during insertion and removal, reducing the duration of
cathetirisations and use of hydrophilic coated catheters(Yasuda et al., 2017). In addition, use of
technological techniques like urinary catheter reminders have proved to be among the best
prevention strategies of catheter associated urinary tract infections. Therefore, it is the
responsibility of nurses and heath care workers to assess the risk factors, use proper catheter
insertion and remove techniques and always practice aseptic techniques during patient care to
control and prevent CAUTIs(Joshi et al., 2018)

PICOT QUESTION AND LITERATURE RESEARCH 3
However, most of the nurses fail to adhere to the prevention techniques due to various
reasons. Some of these reasons include patients overload and under staffing, long working hours
and lack of enough knowledge and skills(Menegueti et al., 2019). Developing policies that
ensure adequate staffing can enhance CAUTIs prevention especially in intensive care units and
other prominent wards. Other than that, nurses needs frequent training and remainders on the
proper strategies and prevention techniques necessary to promote quality and safe care(Atif,
Lorcy, & Dubé, 2019). In addition, there is need of developing maintenance systems as a key
step forward in initiating immediate removal of catheters as many nurses may be unaware of
their existence. This study aim to demonstrate various preventive strategies that can be used to
prevent CAUTIs and thus promoting patients quality and safe care.
PICOT QUESTION.
Patient population- The patients in the research question will include all hospitalized adults,
male or females receiving a urinary catheter or already with urinary catheter.
Interventions- Accessing risk factors, practicing proper insertion and removal of urinary
catheters, increasing knowledge and skills to nurses, and proper use of antiseptic techniques.
Comparison interventions- Direct treatment of the catheter associated diseases.
Outcomes- Reduced incidences of catheter associated infections among hospitalized adults
patients.
Time – Six months.

PICOT QUESTION AND LITERATURE RESEARCH 4
Articles
Atif, S., Lorcy, A., & Dubé, E. (2019). Healthcare workers’ attitudes toward hand hygiene
practices: Results of a multicentre qualitative study in Quebec. Canadian Journal of
Infection Control.http://eds.a.ebscohost.com/abstract?
site=eds&scope=site&jrnl=11835702&AN=137298600&h=YtEw6D8Cs8QTDiAVxmSPE
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%2blKkmUlPWErOzpz5FwNrdA%3d
%3d&crl=c&resultLocal=ErrCrlNoResults&resultNs=Ehost&crlhashurl=login.aspx
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%3d11835702%26AN%3d137298600
Fasugba, O., Cheng, A. C., Russo, P. L., Northcote, M., Rosebrock, H., & Mitchell, B. G.
(2018). Reducing urinary catheter use: A protocol for a mixed methods evaluation of an
electronic reminder system in hospitalised patients in Australia. BMJ Open.
https://doi.org/10.1136/bmjopen-2017-020469
Joshi, S. C., Diwan, V., Joshi, R., Sharma, M., Pathak, A., Shah, H., … Stålsby Lundborg, C.
(2018). “How can the patients remain safe, if we are not safe and protected from the
infections”? A qualitative exploration among health-care workers about challenges of
maintaining hospital cleanliness in a resource limited tertiary setting in rural india.
International Journal of Environmental Research and Public Health.
https://doi.org/10.3390/ijerph15091942
Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G.
G., Canini, S. R. M. da S., … Laus, A. M. (2019). Long-term prevention of catheter-
associated urinary tract infections among critically ill patients through the implementation
of an educational program and a daily checklist for maintenance of indwelling urinary
catheters: A quasi-experimental study. Medicine.
https://doi.org/10.1097/MD.0000000000014417
Saint, S., Fowler, K. E., Sermak, K., Gaies, E., Harrod, M., Holland, P., … Krein, S. L. (2015).
Introducing the no preventable harms campaign: Creating the safest health care system in
the world, starting with catheter-associated urinary tract infection prevention. American
Journal of Infection Control. https://doi.org/10.1016/j.ajic.2014.11.016
Yasuda, H., Sanui, M., Abe, T., Shime, N., Komuro, T., Hatakeyama, J., … Lefor, A. K. (2017).
Comparison of the efficacy of three topical antiseptic solutions for the prevention of
catheter colonization: A multicenter randomized controlled study. Critical Care.

PICOT QUESTION AND LITERATURE RESEARCH 5
https://doi.org/10.1186/s13054-017-1890-z
Reference
CDC, (2015). Catheter-associated Urinary Tract Infections (CAUTI). Retrieved from
https://www.cdc.gov/hai/ca_uti/uti.html
Literature review table of the above six Articles in Order.
Article 1 Article 2 Article 3 Article 4 Article 5 Article 6
Purpose
statement
To
determine
barriers and
enablers of
hand
hygiene
among
healthcare
workers
To
determine
the
effectivenes
s of catheter
reminder
systems
To
understand
various
aspect of
hospital
environment
and
infection
control as
related to
CAUTI and
other
infections
To
investigate
the impact
of educating
the
clinicians on
changing
the urinary
catheters
To reduce
safety
problems as
related to
CAUTI
To compare
the efficacy
of three
antiseptic
solutions in
prevention
of CAUTI
Research
Questions
How
effective are
the catheter
reminder
systems in
preventing
CAUTI
What are
various
aspect of
hospital
environment
and
infections
control
methods
What are the
impacts of
educating
clinicians on
changing
the
indwelling
catheters
How no
harms
preventable
problems
can be
applied to
reduce
CAUTI
Which
antiseptic
solution
work best in
prevention
of CAUTI

PICOT QUESTION AND LITERATURE RESEARCH 6
Outcome Reduced
CAUTI
Increased
efficiency in
catheter
removal and
insertions
Reduce
hospital
related
infection
Reduced
CAUTI
Reduced
CAUTI
Reduced
CAUTI
Setting Nine
Hospitals in
Qubec
Hospital in
Austrlalia
Hospital in
India
Hospital Hospital Hospital
Sample 65
interviews
and 18
observations
100 5 doctors
and 10 focus
group
discussions
12 years of
study
7 hospitals 16 ICU
Methods Qualitative
and semi
structure
interviews
quantitative Qualitative
group
discussions
Qualitative quantitative Quatitative
Key
Findings
Factors
promoting
compliance
to hand
hygiene
were
categorized
into
environment
al factors,
organization
al and
communicat
ion factors.
Reminder
systems
increased
the level and
time
patients are
removed
catheters
Improve
hospital
cleanliness
will reduce
associated
infections
Decreased
CAUTI for
a period of
12 years
A
significant
reduction of
CAUTI
rates
No
significant
difference
was
observed in
all solutions
Recommend
ation of the
researcher
The three
strategies
could be
employed to
prevent
CAUTI
Reminder
systems
should be
used
Improve
surveillance
and
decontamina
tion
Educational
programs
help in
CAUTI
control
Regional
collaboratio
n can help
to reduce
CAUTI
Both 0.5%
and 1.0%
alcohol
CHG are
superior to
10%
aqueous
PVI in
prevention
of CAUTI

PICOT QUESTION AND LITERATURE RESEARCH 7