WZT 1 Task 2
WZT 1 Task 2 WGU
Sally Perez
WZT 1 Task 2 Procedure Until recently it was not uncommon for patients admitted to an acute care facility to have an indwelling catheter anchored for unnecessary reasons. Patients that came in thru the emergency department typically were sent to the units with unnecessary indwelling catheters in place and it was not unusual for a surgery patient to have an indwelling catheter anchored before or during a procedure. Once a patient was admitted and was transported to the units nursing would also anchor indwelling catheters for multiple unnecessary reasons. These Catheters could be anchored for many unnecessary days and in some cases until discharge.
In 2008 the Centers for Medicare and Medicaid Services (CMS) initiated a policy change to no longer reimburse hospitals for additional cost that were incurred due to catheter associated urinary tract infections or in another term CAUT’Is (Palmer, 2013). The CMS recognized that CAUTI’s are the most common type of hospital acquired infection. The CMS also determined that when evidence based practices are initiated and followed they can be highly preventable, leading to a change in practice.
Current Practice Up until 2012 there were no policies pertaining to the anchoring or removal of indwelling catheters in the facility I work for. Nursing would complete their assessment of the patients and per their discretion they would determine if an indwelling catheter by their standards is appropriate. An indwelling catheter could be deemed appropriate according to nursing for multiple reasons including; urinary incontinence, retention, convenience, pressure ulcers, strict output recordings and in some cases per patient request. The nurse was required to obtain an order from the physician in order to anchor a catheter and most cases the physician would comply.
Sally Perez
WZT 1 Task 2 Procedure Until recently it was not uncommon for patients admitted to an acute care facility to have an indwelling catheter anchored for unnecessary reasons. Patients that came in thru the emergency department typically were sent to the units with unnecessary indwelling catheters in place and it was not unusual for a surgery patient to have an indwelling catheter anchored before or during a procedure. Once a patient was admitted and was transported to the units nursing would also anchor indwelling catheters for multiple unnecessary reasons. These Catheters could be anchored for many unnecessary days and in some cases until discharge.
In 2008 the Centers for Medicare and Medicaid Services (CMS) initiated a policy change to no longer reimburse hospitals for additional cost that were incurred due to catheter associated urinary tract infections or in another term CAUT’Is (Palmer, 2013). The CMS recognized that CAUTI’s are the most common type of hospital acquired infection. The CMS also determined that when evidence based practices are initiated and followed they can be highly preventable, leading to a change in practice.
Current Practice Up until 2012 there were no policies pertaining to the anchoring or removal of indwelling catheters in the facility I work for. Nursing would complete their assessment of the patients and per their discretion they would determine if an indwelling catheter by their standards is appropriate. An indwelling catheter could be deemed appropriate according to nursing for multiple reasons including; urinary incontinence, retention, convenience, pressure ulcers, strict output recordings and in some cases per patient request. The nurse was required to obtain an order from the physician in order to anchor a catheter and most cases the physician would comply.
References: Bernard, Michael S, Hunter, Kathleen F, Moore, Katherine N. (2012). A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence Carter, Nina M, Reitmeier, Laura, Goodloe, Lauren R. (2014). An Evidence-Based Approach To the Prevention of Catheter-Associated Urinary Tract Infection Gray, M. (2010). Reducing catheter associated urinary tract infection in the critical care unit. Hooton, T., Bradley, S., Cardenas, D., Colgan, R., Geerlings, S., Rice, J., Nicolle, L. (2010). Diagnosis, prevention, and treatment of catheter-associated urinary track infection in adults: Mori, C. (2014). A-Voiding Catastrophe: Implementing a Nurse-Driven Protocol. MedSurg Nursing