CAUTI: Catheter Associated Urinary

Hospital acquired infections are a major cause of mortality and morbidity and is a challenge to all health care professionals. To prevent these infections effective hand hygiene, identifying patients at risk for infections and following standard precautions to prevent transmission must be done (Mehta et al., 2014, p. 149). Among these hospitals acquired infections(HAI) the topic that I have chosen for the class is CAUTI which means catheter associated urinary tract infection. UTIs are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network. “Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during
their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter” (Centers for Disease Control and Prevention, 2015). This paper is a four-hour class developed for registered nurses working on a medical surgical unit about the prevention and management of CAUTI. This class has two sessions which are 2 hours each. The paper provides a brief description of the class, target audience, learning objectives and expected outcomes for the class, resources of study and domains of learning for each objective.

Philosophy of The Hospital
The educational training program is sponsored by the department of education at Good Samaritan Hospital Medical Center, West Islip, New York. This hospital is a member of catholic health services of long island which comprises of a 537 bed nonprofit teaching hospital which serves the Nassau and Suffolk counties of Long Island New York. This hospital serves as a level 2 trauma center and has an open heart program. The different services provided by this hospital are cardiology, oncology, pediatrics, ambulatory surgery, Obstetrics and gynecology etc. (Good Samaritan Hospital Medical Center, n.d.). “The mission of this hospital is to continue Christ healing mission, promotes excellence in care and commits itself to those in need. The hospital affirms the sanctity of life, advocates for the poor and underserved, and serves the common good. It conducts its health care practice, business, education and innovation with justice, integrity and respect for the dignity of each person” (Good Samaritan Hospital Medical Center, n.d., p. 1).
The hospitals philosophy of promoting excellence in care goes along with the objective of the class which is to provide excellent care to the patients to avoid hospital acquired infections like CAUTI. Needs Assessment
In order to decrease the rate of hospital acquired infections an infection prevention and quality improvement committee was formed. According to their study results it was found out that the most frequently acquired infection was urinary tract infection. On the basis of these results registered nurses were asked to perform Foley catheter insertion in the simulation lab as they practiced it on the units. It was found out that the maintenance of sterile field was affected during the procedure. Due to this, the committee decided to conduct a training program for nurses explaining to them Foley insertion and its maintenance. The target audience are the registered nurses on the medical surgical unit. Description of the Class
The class focuses on catheter associated urinary tract infection(CAUTI) for registered nurse on the medical surgical unit. The duration of the class is 4 hours and is divided into two sessions. Before the class begins, nurses will be asked to read about the topic as they will have some idea regarding the class which would help in the discussions during the class. The first session of the class would include mainly theoretical aspects of the topic and the contents will be:
• Introduction
• General discussion
• Review of handouts
• Review of anatomy and physiology
• Review of pathogenesis of urinary tract infection
• Review of CAUTI bundle
• Discussion of evidence based practices on CAUTI prevention
• Differentiating the techniques practiced and the new technique that is developed. The second session is the practical in which the class will be shown step by step demonstration of the urinary catheterization procedure. Later the class will be asked to demonstrate the procedure back. This return demonstration will help the class to identify their mistakes and follow the right way, along with the demonstration the class will be able to clarify any doubts regarding the procedure. Target Audience The target audience identified for this class is the registered nurses practicing on the medical surgical units. Even though every health professional is responsible for prevention of infection nurses are the front line staff providing direct patient care. Not only this, the nurses are the ones who inserts Foley in majority cases unless there is any kind of complication associated with the patient. It has also been added to the class that two registered nurses must be present during urinary catheterization in order to maintain sterile techniques at all times. Before the class begins it is very important to identify the learning styles of the registered nurses.
Upon discussion this can be known. It has been noted that the nurses are auditory and visual learners. This information has helped a lot in the teaching process. Learning Resources The resources for the registered nurses in the class includes handouts from the educator, Anatomy and physiology text book, another nursing practice manual which is Lippincott manual of nursing practice and a CAUTI toolkit (Centers for Disease Control and Prevention, n.d.). Program Outcomes The expected outcomes for the program is as follows:
• Describe about hospital acquired infections and its effects on the organization
• Review the strategies that can be applied to prevent CAUTI.
• Review evidence based practices in the prevention of CAUTI
• Discuss the role of a registered nurse in the prevention of HAI
• Take leadership initiative in discussing the plan of
care

Learner Objectives for sessions 1 and 2 The objectives for the first session of class includes:
• Class will be able to understand the anatomy and physiology of the urinary tract system as well as the pathogenesis of urinary tract infection.
• Class will be able to recognize the importance of prevention of infections like CAUTI in hospitals.
• Will exhibit the knowledge of evidence based practice in the prevention of CAUTI. The objectives of the second session of the class includes:
• Exhibit the competency of proper usage of urinary catheterization kit.
• Demonstrate the skill of maintain aseptic technique throughout the procedure.
• Implementing the theoretical knowledge gained in providing care to patients with indwelling catheter.
• Accept the responsibility and take leadership in educating the unit from preventing infections.
The learning process and its objectives are always correlated with the domains of learning. The different domains of learning are cognitive domain, affective domain and psychomotor domain (Billings & Halstead, 2016, p. 166). Cognitive domain is the domain for the first session objectives as this emphasizes on understanding the problem, applying solution and evaluating the outcome. The objectives of the second session are affective and psychomotor domain. The learner will take responsibilities and at the same time exhibit the skills that is used in the clinical settings