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