PICOT Question and an Evidence-based Approach
Evidence-based practice is deemed as the backbone of quality service delivery in the healthcare sector. The patients entrust the health service providers with their lives and they feel safe in their hands. To live up to the expectation of the patients, healthcare professionals should display competency in their service delivery. As part of the competency-based care, nurses should utilize research and learn new ideas related to patient care. The paper builds on a quality and safety issue and develops a PICOT question whose answer offers a solution to the quality/safety issue.
The Quality/ Safety Concern
The selected health quality/safety issue is catheter-associated urinary tract infection (CAUTI). CAUTI is an example of a common hospital-acquired infection. One of the risks associated with the use of indwelling catheters is the entry of bacteria into the body. The bacteria lead to infections that affect the whole urinary system. The most affected group of patients in various healthcare facilities are those in an acute setting. Due to the infection, the patients have to spend more time within the healthcare facility. The extra amount of time spent in acute care translates to additional healthcare costs. Besides, such patients have to deal with additional pain related to the urinary tract infection alongside their acute conditions. It is thus of the essence to present evidence-based interventions that help in reducing the risk of the healthcare-acquired infection.
PICOT Question
One of the promising interventions that is supported by research is the use of low-risk indwelling catheters. Other than the standard types of catheters, silver alloy-coated catheters and antimicrobial-impregnated catheters have been associated with low risk of catheter-associated urinary tract infection. The following PICOT question can this be used to draw evidence that supports the use of alternative catheters.
In hospitalized older adults in acute care settings (P), does the use of silver alloy-coated catheter (I), compared to standard catheters (C) reduce the risk of CAUTI (O) for 2 weeks (T)?
Hospitalized older adults in an acute care setting – Population
Silver alloy-coated catheter- Intervention
Standard catheters- Comparison
CAUTI risk reduction- Outcome
Two weeks- Time
Literature Search
To better answer the question, a literature search was conducted to identify the evidence that supports the use of silver alloy-coated urinary catheters. Some of the databases that were critical in identifying relevant evidence during the search include the Cochrane Library database, CINAHL plus Full Text, MEDLINE, EMBASE, and PubMed. During the search process, the use of keywords was utilized. Some of the keywords that were critical include ‘types of low-risk catheters’ and ‘how to reduce CAUTI in hospitalized adults.’ During the search process, various filters were used to end up with recent evidence related to the related care. One of the filters that was quite relevant in the literature search was the year of publication. Evidence-based information in the nursing field is deemed to be recent if it is published within the last five years.
Analysis of Literature
Alhoji, Hassan & Gupta (2016) present evidence on the efficacy of noble metal alloy urinary catheters in the reduction of risks associated with urinary tract infection. According to the study, noble alloy catheters are safe to use among hospitalized patients who require indwelling catheters. Although the study was conducted in an intensive care unit setting the presented evidence can be applied in acute care settings. The conclusions drawn from the study are based on valid results. The researchers report close adherence to research guidelines and ethical principles. The study employed a single-blinded, randomized, single-centered study design.
Bonfil et al. (2016) present evidence on the efficacy of using silver alloy-coated catheters in patients with spinal cord injuries. The randomized control trial experiment reveals a low number of patients in the experimental group with symptomatic catheter-related urinary tract infection compared to the control group. According to the presented data, there is a significant chance that the use of silver-alloy coated catheters may reduce the risk of CAUTI among patients in acute care settings or those in intensive care units. The randomized control trial adheres to the set research guidelines draw conclusions based on the findings of the study.
From the presented results, the risk of catheter-associated urinary tract infection depends on the type of catheters used. Although other interventions such as proper hand hygiene and proper insertion of the catheter are critical, nurses should ensure that these low-risk catheters are used in hospitalized patients who need them. Additionally, the healthcare service providers should equally be updated on the standard procedures of insertion of the indwelling catheters. It is equally of the essence for the healthcare professionals to understand the importance of timely removal of the catheters. Nurses and other healthcare professionals should constantly engage in evidence-based study to know the updated interventions regarding risk reduction of catheter-associated urinary tract infections among hospitalized older adults.
References
Aljohi, A. A., Hassan, H. E., & Gupta, R. K. (2016). The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection. Urology Annals, 8(4), 423.
Bonfill, X., Rigau, D., Esteban-Fuertes, M., Barrera-Chacón, J. M., Jáuregui-Abrisqueta, M. L., Salvador, S., … & Andrade, M. J. (2017). Efficacy and safety of urinary catheters with silver alloy coating in patients with spinal cord injury: a multicentric pragmatic randomized controlled trial. The ESCALE trial. The Spine Journal, 17(11), 1650-1657.