Abstract
There has been extensive documentation on hospital-acquired infections, and of these, catheter-associated urinary tract infections are the most common. In fact, catheter-related infections account for up to 40% of nosocomial infections. Among those with nosocomial urinary tract infections, 10-20% of patients had genitourinary or urological manipulation, while 80% had placement of a permanent urethral catheter. Despite the significant contribution of urethral catheterization, many patients are inserted with a urinary catheter upon admission to the emergency department without proper justification. The author of the paper suggests a protocol that is evidence-based and that provides evidence that supports the proper identification of patients who must undergo catheterization and limits this to those patients only.

Outline:
Introduction
Define the Problem
Critique Research: Review of Related Literature
Evidence-based Practice Plan
Bibliography

From the Paper
"Unlike the intact genitourinary system, indwelling catheters have no innate defense mechanism; hence, biofilm formation occurs. Biofilms consist of microorganisms that adhere together, along with host urinary components such as proteins, electrolytes, and other organic molecules (Trautnere and Daraouiche, 2004). More bacteria attach to this material and thrive on them. Biofilms are found within the catheter lumen and on the external surface of the catheter. Biofilms are difficult to eradicate because they are able to resist being swept away by simple shear forces, resist phagocytosis, and resist antimicrobial agents. Therefore, they continuously flourish until microorganisms reach pathologic levels. The presence of biofilms and their resistance to conventional treatment supports the fact that catheters should be avoided or removed the soonest time possible to reduce the exposure on biofilm infections (Crosby, 2005). Current recommendations for short-term catheterization make use of indwelling catheters that are made of latex rubber, siliconized latex, or plastic. However, it seems that none of these are impervious to biofilm formation. Therefore, it is only rational and supported by studies that catheters are limited only to those who need it."

Tags:infection, catheter, aseptic, antimicrobial, clorhexidine, emergency, indwelling, urinary, nosocomial, genitourinary

Abstract
This paper evaluates the effectiveness of a protocol that addresses patient, family and staff activities and competencies, as opposed to regular care. This is in an effort to reduce the use of Foley catheters in long-term care facilities and the associated higher incidence of urinary tract infections.

From the Paper
"Finally, while Smith emphasizes that sterile techniques create an optimal condition during insertion of the indwelling Foley catheter and basic urinary catheter care and maintenance exceed any commercially available Foley catheter product (Smith, 2003, p. 5), an interesting study by Dr. R. Ramirez and his colleagues at the North Broward Hospital District (NBHD) in northern Broward County, Florida concerned two acute care facilities, Coral Springs Medical Center (CSMC) and Imperial Point Medical Center (IPMC), which elected to trial a silver/hydrogel coated Foley catheter as a quality improvement project to reduce the incidence of nosocomial urinary tract infections (NUTI)."

Tags:LifeCare, hydrophilic, CDC

Abstract
This paper proposes research into the issue of the inappropriate use of urinary catheters. The paper points out that, in the past three decades, the major focus of catheter-associated urinary tract infection (CAUTI) prevention research has been evaluation of new devices or materials that will prevent CAUTI. The paper states that a common theme emerging from the literature is that not all indwelling urinary catheters are appropriate for the duration of the catheterization, which places the patient at an increased risk of CAUTI. The proposed study will be administered in a 149 bed rural for-profit hospital using a descriptive, correlation design. Objectives of the mandatory nursing staff education will be to educate all nurses on the relationship of increased catheter days to hospital-acquired urinary tract infection, and to report the findings of the survey. In conclusion, the paper suggests that catheter days be collected over the next three months to determine the effect of the study.

Outline:
Introduction
Significance
Problem Statement
Purpose
Research Question and Research Hypothesis
Definition of Terms
Conceptual Framework
Review of the Literature
Methodology
Ethical Considerations
Measurement Method
Limitations
Communication of Findings
Appendices

From the Paper
"Catheter-associated urinary tract infection (CAUTI) has been a leading cause of morbidity and mortality in hospitalized patients (Somwang & Chertsak, 2005). The Centers for Disease Control developed the first guideline for prevention of CAUTI in 1981, and CAUTI has been repsonsible for at least forty percent of healthcare-acquired infection since that time (Centers for Disease Control, 1981). More than four decades ago, Dr. Paul Beeson argued against the routine use of indwelling urinary catheters (Saint, 2002). He argued that the decision to use the devices should be made with the knowledge that they could lead to serious consequences or disease for the patient (Saint). In addition ot increased morbidity and mortality, infections associated with the use of urinary catheters lead to increased healthcare costs and patient discomfort (Saint). In 2007, Medicare decided to disallow incremental payments associated with eight secondary conditions that it sees as preventable complications of healthcare (Rosenthal M., 2007). Catheter-associated urinary tract infection, if not present at the time of admission, will no longer be taken into account in calculating payment to hospitals after October 1, 2008 (Rosenthal). After twenty-seven years, the Centers for Disease Control will issue new draft guidelines for the prevention of CAUTI in June 2008 (Brennon, 2008). Appropriate catheter placement and avoiding inappropriate catheter days will be addressed in the new guidelines (Brennon). New guidelines will assist the infection control practitioner in mitigating patient risk for CAUTI through development of process improvements designed to decrease the number of catheter days experienced by the patient."

Tags:disease, urinary, tract, infection

Abstract
The paper evaluates the importance of existing guidelines regarding catheter insertion and maintenance in promoting safe and effective techniques for nursing practice. The paper explains that it is often very difficult for nurses to improve their practices and techniques without sufficient knowledge in hand. The paper discusses how with research-based practice, there are considerations to be made for future practice.

From the Paper
"The topic that has been selected for this discussion is research related to vascular catheter infection, with a guideline title of "Guidelines for the prevention of intra-vascular catheter-related infections." The above referenced guidelines suggest the following in reducing the incidence of catheter-related infections: 1) Promoting effective training mechanisms regarding catheter use for nurses and other professionals to identify infection and other problems at catheter sites through routine monitoring and the understanding of warning signs; 2) Utilize appropriate measures of hygiene when examining or working at catheter insertion sites by regularly washing hands with antiseptic soap or other anti-bacterial options."

Tags:nursing, practice, research

Abstract
This paper offers a critique of the article "Impact of Dressing Materials on Central Venous Catheter Infection Rates." The writer discusses research into the use of such dressings at one medical facility, based on records covering several years. Further the writer examines the use of three different dressings over that time. In this article, the writer also looks at the way the report is written, how the research was conducted, how valid it may be and similar issues.

From the Paper
"Based on the fact that transparent, semipermeable, polyurethane dressings are widely accepted for dressing central venous catheter (CVC) insertion sites today, it is noted that there have been differing results with this method, meaning differences in their association with microbial growth under the dressing and with the risk of subsequent CVC-associated infection. This is the problem, and the purpose of this study is to report on the positive experience of the authors in terms of the impact of a highly permeable transparent dressing on CVC-associated infection among patients at their facility."

Tags:nursing, article, critique

Abstract
The paper relates that the occurrence of urinary tract infection (UTI) in the intensive care unit (ICU) is, according to Marklew (2004), "a nursing procedure, the importance of which is sometimes overlooked" (p. 21) with potentially catastrophic results, as a UTI in this setting increases patient mortality. The paper discusses how Sheehan and Mooka (2005) explain that bacteremia takes place in 1-3% of UTIs caused by catheterization, and that 13 percent of these cases are mortal (p. 905).

From the Paper
"The occurrence of urinary tract infection (UTI) in the intensive care unit (ICU) is, according to Marklew (2004), "a nursing procedure, the importance of which is sometimes overlooked" (p. 21) with potentially catastrophic results, as a UTI in this setting increases patient mortality. Sheehan and Mooka (2005) explain that bacteremia takes place in 1-3% of UTIs caused by catheterization, and that 13 percent of these cases are mortal (p. 905)."

Tags:uti, icu, foley

Abstract
The paper focuses on a case of an 8-month old female with gastroschisis and details her clinical situation, treatment in the hospital, the family's functional status and an assessment of the child's development and growth. The paper provides a discussion of gastroschisis, including its prevalence, external and internal factors that affect it and its pathophysiology. The paper also describes the management needs this child has and outlines current research on catheter use and sepsis.

Outline:
Introduction
The Child and her Family
Developmental Milestones
Laboratory Results
Fluids and Nutrition
Medications
Client Learning Needs
Pathophysiology of Gastroschisis
Application of a Nursing Research
Summary

From the Paper
"Gastroschisis is a congenital abdominal wall defect and is associated with a significant fetal and neonatal mortality rate of less than 10% (Vu, Nobuhara, Laurent, and Shaw, 2008). The intestines protrude through the defect and are exposed to the amniotic fluid, which has toxic substances, such as urine and small quantities of antenatally-defecated material. This may result to life-crippling complications such as bowel atresias and increased risk for sepsis. Such effects in the child's quality of life may lead to a prolonged stay in hospitals and consequent high health care cost."

Tags:intestines, bowels, liver, nutrition, medication, sepsis, catheter, feeding

Abstract
This study reviews and assesses data from previous meta-studies that compared the actions of the skin antiseptics, Chloraprep and Providone Iodine among others, with regard to sterilization prior to catheter insertion. The study reassess the available data in an attempt to understand whether the findings remain conclusive in supporting the use of chlorhexidine over Providone Iodine solution in prevention of catheter related blood stream infection (CRBSIs). The paper relates that the clinical problem statement is 'What are the most effective antiseptic techniques to use to minimize risk of infection from use of intravenous catheters". The study attempts to solve this clinical problem statement through a thorough review of the clinical trials which have been conducted globally since the introduction of chlorhexidine.

Outline:
Definitions
Introduction
Problem Statement
Description of Methodology
Presentation of Findings
Synthesis of Findings

From the Paper
"Several studies have now been completed to compare the actions of the skin antiseptics Chloraprep and Providone Iodine among others. The results of a Meta-Analysis study "found that the use of Chlorhexidine gluconate rather than Providone Iodine can reduce the risk for catheter-related blood stream infection by approximately 50% in hospitalized patients who require short-term catheterization." The study goes on to state "Given the extent of the benefit and the small incremental cost, chlorhexidine gluconate should be considered as a replacement for Providone Iodine solution, particularly in patients at high risk for catheter related blood stream infection."

Tags:maximum, effectiveness, sterilization, antiseptic, techniques

Abstract
The paper explains how our society is increasingly at risk; the number of fatalities each year from coronary artery disease continues to rise in spite of efforts to educate the populace on methods to reduce risk factors. The paper lists the steps that must be taken to identify those individuals at risk and provide them with treatment options. The paper identifies angiography as providing the best method of coronary evaluation available, and lists the three types currently in use: magnetic resonance, catheter, and computed tomography. The paper analyzes the specific benefits and limitations of each type. Of the three, the paper finds that computed tomographic angiography (CTA) provides the greatest versatility and has the least associated risks and limitations, and also provides the greatest volume of information and detail. In conclusion, the paper anticipates that the CTA will likely become the diagnostic tool of choice and ultimately supplant catheter angiography.

From the Paper
"The super-sized, rapid paced, high stress society we inhabit contributes daily to the demise of our fellow citizens. The epidemic rise of obesity and diabetes compounds the risk of America's number one killer: heart disease. The number of Americans succumbing to heart disease will nearly double from 500,000 in 2002 to 930,000 in 2005. The cost to treat cardiovascular patients in 2005 will cap at just under $400 billion (Kazerooni, 2005). Emphasis on risk reduction should be made, but it falls short of real impact. Steps must be taken to diagnose patients at risk and provide treatment options appropriate to their level of disease."

Tags:angiography, calcium, catheterization, coronary, ct, gold, heart, mesa, mra, scoring, standard

Abstract
Catheterization as a medical technique has been in practice for more than two millennia. While it first began as an experimentation with animals, it gradually became part of human treatments. The procedure of cardiac catheterization in humans was first put to clinical use more than five decades ago and has undergone many changes since then. What was once a purely experimental technique is now one of the most common invasive medical procedures in Europe and North America, with more than eighty-percent of those procedures performed to diagnose suspected heart disease. Animal cardiac catheterization was first accomplished in 1844 with a horse. The characterization of the human heart was first accomplished by a German medical student in 1929. By the 1940's, the practice had become improved and was starting to become common practice in a few hospitals in North America and Europe. By entering a catheter through an arm vein, surgeons were able to reach the atrium of the heart. Today, cardiac catheterization is accomplished with a great deal of skill and technology, but is much easier and less dangerous than when it first was being used. It is the purpose of this paper to examine the history of cardiac catheterization and its import to medicine today.