The facility’s name is Shady Grove Medical Center (COVID ICU UNIT) 

 enlarged the infographic using the attached info  

Running head:

THE USE OF FEMALE EXTERNAL CATHETERS TO REDUCE UTIS

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THE USE OF FEMALE EXTERNAL CATHETERS TO REDUCE UTIS

PURE WICK CATHETERIZATION

This project is aimed at the process of using the female external catheter (purewick) instead of the use of an indwelling catheter to reduce urinary Tract Infection (UTIs). Purewick is an external female catheter, which facilitates simple and non-invasive management of urine output in female patients. It makes use of a low-pressure wall suction to send urine into a collection canister. The use of this external catheter can enhance the care of female patients by eradicating the problems they face when they use internal catheters. The population affected in this project mainly is the female patients in Covid ICU unit at the Shady Grove Medical Center. This project is very important because it will help in the reduction and prevention of UTIs and can help lower the risk of kidney infection. Even though Covid-19 is the current healthcare pandemic are other secondary infections within the intensive care unit (ICU) COVID unit.

Urinary tract infections (UTI) are among the secondary complications that worsen the already established healthcare issues that are brought by the pandemic of covid-19. Several prevention approaches are being proposed with others being implemented to help in the reduction in the reported incidences of UTI at the ICU COVID Unit (Zavodnick et al., 2020). Therefore, the discussion of this paper is focused on changing the use of the female external catheter (purewick) from the Indwelling catheter at Shady Grove Medical Centre Information collected and gathered from a personnel at the ICU covid unit in Shady Grove Hospital showed that there was 61.7% reduction in CAUTIs after the introduction of the device. Additionally, the use of indwelling catheter utilization for females within the same period reduced from 15.7% to 9.7%, and the Standardized Infection Ratio (SIR) decreased from 1.319 to 0.865, which according to the personnel was below the CDC’s National Healthcare Safety Network goal.This data was between August and November 2020.

Catheter-associated urinary tract infections (CAUTIs) can be fatal and are considered to be the source of preventable medical costs for the patients and healthcare facilities. Prolonged catheterization is considered to be causing an increase in the risk of infection, therefore; the avoidance of the catheters is crucial for infection prevention. The indwelling urinary catheters (IUC) are commonly used in healthcare facilities, however, there has been an increase in the number of potential complications like CAUTIs. This leads to an increase in mortality, extended hospital stays, and medication costs for both healthcare facilities and patients. The longer use of IUC increases the risks of urinary tract infections, therefore, avoidance of the IUCs is an important approach towards the prevention of this type of infection (Beeson & Davis, 2018).

Despite the benefits they have on an individual, the insertion process is quite difficult and uncomfortable, and for this reason, there is a need to use anesthesia. At the same time, careless insertion can also lead to significant side effects as the patient may end up suffering from infections. In this assignment, we will focus on how to change from internal to external catheters.

The Pure wick female external catheter is the most reliable form of the noninvasive external catheter for women. In the medical setup, a great percentage of people usually have an indwelling catheter, which generally increases the possibility of contracting infections. In this case, the medics have established that the only way to change the narrative is by using alternative methods, which have been explained earlier, in order to reduce the overall infection rate (Beeson, & Davis, 2018). Essentially, both the internal and external catheters are meant to manage and control urinary incontinence in acute care patients, as they are usually unable to do that for themselves. At the moment, there aren’t any other alternatives to the catheters and in this case, catheters have remained to be the most reliable option.

Below is the process of changing from the use of internal to external catheters in women;

· The first major step is to begin by removing the indwelling catheter, which begins by emptying the urine bag. Afterward, the nurse should then wash the hands to avoid contaminating the patient.

· After the hands have been washed, the nurse should then gather the supplies, including the towels, wastebaskets, and syringes.

· The syringe should then be pushed into the catheter’s balloon port and then water should gradually push out from the balloon. Once the balloon is completely empty, the catheter should be pulled out gently to avoid hurting the patient, and then a towel is used to wipe the leakage or spilled urine. After the removal process is complete, the next step is to insert the external one.

As highlighted, the pure wick is an external catheter which is generally much safer as the rate of infections is reduced.

The major steps include the following;

· Plugging power and correctly placing the collection canister.

· Attaching the pump to the pure wick system. After the system has been set up, the nurse should then assess the skin integrity, and at the same time prepare the perineal area. The legs should then be spread, extending towards the gluteus muscles and then palpating the pubic bone.

· The soft gauze should face the patient, after which the distal end is aligned.

· Lastly, the soft side should be tucked between the already separated labia ad gluteus.

The process is quite sensitive and should be done slowly and carefully to ensure that the patient doesn’t get hurt.

At the same time, an individual should refrain from using the pure wick system if the surface is too hard as this could lead to the onset of pressure ulcers. Additionally, the system should be changed after every eight to twelve hours, or if the system gets too soiled. Essentially, the goal is to ensure that the patient doesn’t ultimately suffer from any form of infections and subsequent secondary side effects as a result of the system use.

The main reason for this test of change is to reduce the overall rate of infections. As mentioned earlier, about five percent of acute care patients ended up suffering from infections as a result of the use of internal catheters (Beeson, & Davis, 2018). This is mainly because they are invasive and, in this case, irresponsible use or collection of dirt and bacteria before insertion leads to the occurrence of infection. Additionally, the internal catheters are usually very uncomfortable to insert for the patients, and this leads to the use of anesthesia or pain management mechanisms.

At the end of the project, there is proof that the rate of infections significantly reduces after the pure wick system has been used. This ensures that the patients are able to empty their urine without struggle and uncomfortability.

The overall outcomes of the project were that female external catheters were helpful in reducing the number of UTIs, cost of medication and treatment of CAUTIs, prevention of the risk of kidney infection from prolonged use of indwelling catheter, management of female urinary incontinence and the reduction of skin breakdown. Patients in the ICU especially in the ICU COVID units are highly exposed to the UTI as a result of using the indwelling catheters. However, the use of the female external urine collection device is considered to be a feasible alternative to this issue. It helps in the reduction of exposure to skin breakdown and UTI among female patients. At the end of the project, there is proof that the rate of infections significantly reduces after the pure wick system has been used. This ensures that the patients are able to empty their urine without struggle and comfortability.

References

Holman, H., Williams, D., Johnson, J., Sommer, S., Ball, B., & Lemon, T.

Nursing leadership and management (7th ed., p. 12). 2019 Assessment technology institute.

Critical Care | Maryland | Adventist HealthCare. (2021). Retrieved 6 March 2021, from

https://www.adventisthealthcare.com/services/critical-care/

Beeson, T., & Davis, C. (2018). Urinary management with an external female collection device. Journal of Wound, Ostomy, and Continence Nursing, 45(2), 187.

Beeson, T., & Davis, C. (2018). Urinary Management With an External Female Collection Device. Journal of Wound, Ostomy and Continence Nursing, 45(2), 187-189. doi:10.1097/WON.0000000000000417

Bliss, D. Z., Bland, P., & Wiltzen, K. (2017). Incontinence briefs containing spiral-shaped fiber acidify skin pH of older nursing home residents at risk for incontinence-associated dermatitis. J Wound Ostomy Continence Nurs, 44(5), 475-480. doi:10.1097/WON.0000000000000362

Zavodnick, J., Harley, C., Zabriskie, K., & Brahmbhatt, Y. (2020). Effect of a Female External Urinary Catheter on Incidence of Catheter-Associated Urinary Tract Infection. Cureus, 12(10), e11113. doi:10.7759/cureus.11113

Improving Urinary
Catheterization

Introduction.
Urinary catheters collect urine in a drainage bag from the bladder.

Problem statement
Urinary catheters are posing a high risk to patients due to high rate of infections

Aim statement
To reduce the infection rate f catheters from current 10% to about 2%.

Measures.
A drop in the infection rates, the current expenditure used to
treat complications due to infections and
an increase in patient satisfaction

Selecting and making changes
Use of the catheter.
Insertion and maintenance technique
.

Testing changes through the use of a networking model

Summary
Catheter related infections are high.
The project finds solution to the problem.
Recommendations include appropriate use of catheters, having administrative infrastructure in place.