CATHETER ASSOCIATED URINARY TRACT INFECTION

Changing indwelling catheters to silver alloy coated foley in order to reduce catheter associated urinary tract Infection

Changing indwelling catheters to silver alloy coated foley in order to reduce catheter associated urinary tract Infection

Introduction

Catheter -associated urinary tract infections (CAUTIs) account for approximately 40% of all hospital-acquired infections. Approximately 25% of patients admitted to hospital will require urethral catheterization?(Liedberg 2005) and there are similar numbers of patients in residential homes with long-term indwelling catheters. Up to half of the patients requiring an indwelling urethral catheter for five days or more will develop bacteriuria or funguria.

A CAUTI is defined as the new appearance of bacteriuria or funguria with a count of greater than 103 colony-forming units per millilitre (cfu/mL). (Sagripanti 2005)

Discussion

Many methods have been used in an attempt to decrease the incidence of CAUTIs. Bacteria have been shown to colonize and form a biofilm along the internal and/or external surfaces of indwelling catheters and? therefore? hydrophilic substances? antibiotics? heparin? silver oxide and silver alloy have all been applied to the catheter surface as a preventative measure. (Darouiche 2007)

According to Lewin, the first step in the method of change is to unfreeze the living position or rank quo. The rank quo is advised the equilibrium state. Unfreezing can be accomplished by the use of three methods. First, boost the going by car force that directs the change away from the living rank quo. This study displayed that most of the persons supplying care highly ranked the change which will help propel change from the rank quo. Secondly, you have to decline holding back forces that contrary sway the action from the living equilibrium. In alignment to change the rank quo you have to address these anxieties and double-check that their points will be advised in the designing process. Third, find a blend of the two methods.

Hydrogel coating alone reduces the risk of developing bacteriuria compared with standard latex urethral (Foley) catheters. Antimicrobial-impregnated catheters coated with minocycline and rifampicin has been reported to decrease the incidence of Gram-positive bacteriuria from 38% with standard non- coated catheters to 7%.(Stark 2006) Due to the systemic use of these antibiotics? the use of these catheters is limited by the theoretical risk of resistance developing.

Since CAUTIs are the leading cause of nosocomial infection and are associated with increased morbidity and mortality? any intervention that reduces the incidence of CAUTIs is potentially important. (Patel 2008) Silver-coated hydrogel catheters are showing promise in the prevention of catheter colonization and CAUTIs. Silver has a broad-spectrum antimicrobial effect against Gram-positive and Gram-negative aerobic and anaerobic bacteria.

The use of two types of silver-coated urethral catheters has been reported in the literature: silver oxide and silver alloy with hydrogel. The silver coating can be applied to either the internal or external catheter surface or to both. Silver alloy with hydrogel appears to be more effective at reducing CAUTIs than does silver oxide. (Warren 2005)

Lewin's second step is changing or implementation. In this step, it is essential to move the ...