Write a paper (1,500-2,000 words) in which you analyze and appraise each of the (15) articles identified , Pay particular attention to evidence that supports the

problem, issue, or deficit, and your proposed solution.

Hint: The Topic 2 readings provide appraisal questions that will assist you to efficiently and effectively analyze each article.

“About Catheter-Associated Urinary Tract Infection” (2013). Center for Disease and Control
Retrieved from http://www.cdc.gov/hai/pdfs/uti/ca-uti_tagged.pdf
Summary of Article:

The author breaks down aspects of catheter-associated urinary tract infections. The authors specifically examine silver oxide-coated catheters.

Research Elements: Design, Methods, Population, Strengths, Limitations:

The authors provide an evidence-based synopsis of preventative approaches for both urinary and central line-related infections.  The purpose is to contemplate the

evidences supporting particular prophylactic techniques.

Outcome(s): Research Results:

These results reveal that numerous variables affected the occurrence of CAUTI’s and that the silver impregnated catheter seemed to have helped to prevent CAUTI’s

amongst women not getting antibiotics.

Foxman, B. (2002). Epidemiology of Urinary Tract Infections: Incidence, Morbidity, and Economic Costs. The American Journal of Medicine 113(1): 5-13.
Summary of Article:

The author breaks down aspects of CAUTI’s including its prevention, pathogenesis and epidemiology.  This is performed through a qualitative research process by

examining research from previous sources.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Both qualitative and quantitative methods were operated to understand all areas including epidemiology, pathogenesis, and prevention. They wanted to determine that

inability to stratify patients by main risk influences, particularly catheter duration, sex, and antibiotic exposure, makes analysis of several tests incomprehensible.

Outcome(s): Research Results:

Further research of pioneering catheter system design, targeted antimicrobial prophylaxis, and bacterial-host epithelial cell relations, seem like the most probable

methods to managing UTI’s yet to come.

Goetz, A.M., and S. Kedzuf (1999) Feedback to Nursing Staff as an Intervention to ReduceCatheter-associated Urinary Tract Infections American Journal of Infection

Control 27(5): 402-404
Summary of Article:

Researchers Goetz and Kedzuf (1999) decided to try a new form of intervention in order to reduce rates of catheter-causing urinary tract infection.  The authors

provided nurses with detailed feedback about the rates at the hospital to see if it would improve the outcome.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Nursing staff associates were given quarterly reports with CAUTI occurrences shown by graphs on each unit. Within the 18 months following this intervention, the

average UTI frequency diminished to 17.4/1000 catheter-patient-days (95% CI, 14.6-20.6, P = .002)

Outcome(s): Research Results:

The authors concluded that feedback of each unit to each unit of nosocomial CAUTI rates to nursing staff is an extremely beneficial approach of decreasing infection

occurrences and cutting expenses related to nosocomial UTI’s.

Jain, P., J.P. Parada, and A. David (2005) Overuse of the Indwelling Urinary Tract Catheter inHospitalized Medical Patients Arch Med. 155(13): 1425-1429.
Summary of Article:

Researcher Jain examines intervention to reduce catheter-causing infections—specifically the overemployment of indwelling urinary tract catheters of hospital patients.

Research Elements: Design, Methods, Population, Strengths, Limitations:

As stated by the researcher, the method was the following: “This prospective study involved 202 patients admitted to either the medical intensive care unit (n=135) or

the medical floors (n=67) of a tertiary care university hospital who were catheterized during the hospital admission. An independent observer assessed the indication

of initial catheterization by chart review and interview with the patient and the nurse. “

Outcome(s): Research Results:

The IUTCs are considerably over utilized in l patients and vigilant notice to this facet of patient care might decrease catheter-related difficulties through primary

prevention.
Johnson, J.R., Roberts P.L, and R.J. Olsen (2009).Prevention of Catheter-Associated Urinary Tract Infection with a Silver Oxide-Coated Urinary Catheter: Clinical and

Microbiologic Correlates. The Journal of Infectious Diseases 162(5): 1145-1150.
Summary of Article:

Johnson examines a general overview of how to prevent catheter-related bacteria including urinary tract infection. Specific attention was provided for the silver

oxide-coated urinary catheter.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Johnson utilized a study that observed patients from similar demographics. The participants provided their consent to be observed.  The author was able to determine

possible causes as well as implications of the outcomes of patients that were at risk for UTI’s.

Outcome(s): Research Results:

Johnson concluded that additional research of advanced catheter system design is necessary to improve catheter insertion and bacteria resistance.

Karchmer, T.B., and E.T. Giannetta (2000). A Randomized Crossover Study of Silver-Coated Urinary Catheters in Hospitalized Patients Arch Intern Med. 160(21): 3294-

3298.
Summary of Article:

The author’s objective was to measure the efficiency of silver-impregnated urinary catheters for the avoidance of nosocomial CAUTIs.

Research Elements: Design, Methods, Population, Strengths, Limitations:

The Author’s approach was a 12-month randomized crossover trial-compared occurrences of CAUTI’s in patients with silver-impregnated vs. non silver impregnated

catheters. A cost examination was organized.

Outcome(s): Research Results:

The author concluded that the chance of infection deteriorated by 21% amongst random patients, who received silver-impregnated catheters and by 32% amongst patients in

which silver-impregnated catheters were operated on the units.  The utilization of the more costly silver-coated catheters seemed to present expense reserves by

avoiding additional expenditures from CAUTI’s.

Nazarko, L. (2013). Recurrent Urinary Tract Infection in Older Women: an Evidence-Based Approach”. British Journal of Community Nursing. 18(8): 407-412
Summary of Article:

Author L. Nazarko (2013) inspects an evidence-based method in recurring UTI’s amongst older women in her research piece—particularly, why age is such a significant

issue in women with the infection. Aging, according to Nazarko, enlarges the risk of women acquiring the ailment. Additional connected ideas are investigated in her

editorial counting improper use of antibiotics when doctors misdiagnose older women.  “Antibiotic therapy has costs as well as benefits and can lead to changes in gut

and vaginal flora that further predispose women to UTI” (Pg. 407).

Research Elements: Design, Methods, Population, Strengths, Limitations:

The author tackles these stages in an evidence-based way with the use of research.  Her qualitative method permits her to operate current studies done on the matter to

derive terminations about UTIs amongst the elderly.

Outcome(s): Research Results:

Nazarko’s evidence based approach to UTIs among elderly women educates us that evidence based practice is an incredibly valuable function in a nursing setting.  We

should use EBP in every-day actions such as a UTI’s because it has the ability to run into bigger problems.

Nicolle, L.E. (2005). Catheter-Related Urinary Tract Infection Drugs and Aging 22(8): 627-639.
Summary of Article:

Nicolle explores features of CAUTI including epidemiology, acquirement of infection, antimicrobial treatment, diagnosis, prevention and infection, and complications.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Qualitative researched utilized several studies that involved previous hospital records from the last ten years.  Events of catheter-related urinary tract infections

were examined to understand their possible causes and complications.

Outcome(s): Research Results:

The author concluded the following: “Complications of infection may be prevented by giving antibacterials immediately prior to any invasive urological procedure, and

by avoiding catheter blockage, twisting or trauma.”

Richards, M.J., Edwards, J.R., and D.H. Culver. (2009). Nosocomial Infections in Pediatric Intensive Care Units in the United States. Pediatrics. 103(4): 39-52.
Summary of Article:

The authors’ objectives were to define the occurrence of CAUTI’s in pediatric intensive care units (ICUs) in America.

Research Elements: Design, Methods, Population, Strengths, Limitations:

The Methods used in the study were the following: Info was gathered from January 1992 till December 1997 from 61 pediatric ICUs in the USA, by means of the regular

inspection procedures and nosocomial infection site delineations of the National Nosocomial Infections Surveillance System’s ICU surveillance component.

Outcome(s): Research Results:

The authors concluded that blood infections were the greatest widespread nosocomial infection. The spreading of infection sites and bacteria fluctuated with age and

from that registered from adult ICUs.

Saint, S. (2000). Clinical and Economic Consequences of Nosocomial Catheter-Related Bacteria. American Journal of Infection Control. 28(1): 68-75.
Summary of Article:

Saint reviews the clinical and economic consequences of catheter-causing urinary tract infections.  His research is based on qualitative study of various forms of

data.
Research Elements: Design, Methods, Population, Strengths, Limitations:

Utilizing quantitative research, Saint observed patients with indwelling catheters for 2 to 10 days. He then gathered data on those patients to determine who obtained

a urinary tract infection and the possible causes. Specific focus was on the economic impact and consequences of these infections placed on hospitals.

Outcome(s): Research Results:

The author concluded the following: “Each episode of symptomatic urinary tract infection is expected to cost an additional $676, and catheter-related bacteremia is

likely to cost at least $2836.”

Saint, S., S.H. Savel, and M.A. Matthay. (2002). Enhancing the Safety of Critically Ill Patients by Reducing Urinary and Central Venous Catheter-Related Infections.

American Journal     of Respiratory and Critical Care Medicine. 165(2): 1475-1479.
Summary of Article:

The authors state that augmenting the protection of seriously sick patients necessitates that intensive care experts be cognizant of the developed techniques for

avoiding CAUTI’s and CLAB’s
Research Elements: Design, Methods, Population, Strengths, Limitations:

The authors provide an evidence-based synopsis of preventative approaches for CAUTI’s and CLAB’s..  The object is to contemplate the evidences supporting particular

preventive techniques, and paying more notice to interventions that may be controversial.

Outcome(s): Research Results:

“Infections due to CVCs are common among the critically ill and lead to substantial morbidity and healthcare costs. Several new methods will likely reduce the

incidence of this common patient safety problem, including the use of: (1) maximum sterile barriers during catheter insertion; (2) CVCs coated with an antimicrobial

agent; and (3) CHG at the insertion site.”
Saint, S., and B.A. Lipsky. (1999). Preventing Catheter-Related Bacteriuria. Arch Intern Med.  159(8): 800-808
Summary of Article:

Saint examines a general overview of how to prevent catheter-related bacteria including urinary tract infection. The author utilized a study that observed over 10

hospitals with patients ranging from ages 30-50.

Research Elements: Design, Methods, Population, Strengths, Limitations:

As mentioned above, Saint utilized a study that observed patients from similar demographics. The participants provided their consent to be observed.  The author was

able to determine possible causes as well as implications of the outcomes of patients who were at risk for a urinary tract infection.

Outcome(s): Research Results:

Saint concluded that additional research in the areas of groundbreaking catheter system design is essential to improve catheter insertion and bacteria resistance.

Stamm, W. E. (1991). Catheter-Associated Urinary Tract Infections: Epidemiology, Pathogenesis, and Prevention. The American Journal of Medicine. 91(3): S65-S71.
Summary of Article:

The author breaks down aspects of CAUTI’s including its prevention, epidemiology, and pathogenesis.  This is performed through a qualitative research process by

examining research from previous sources.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Both qualitative and quantitative methods were utilized to understand all areas including epidemiology, pathogenesis, and prevention. They wanted to determine that

failure to stratify patients by major risk factors, particularly catheter duration, sex and antibiotic exposure, and makes perception of numerous tests

incomprehensible.

Outcome(s): Research Results:

Additional research of a new catheter system design, targeted antimicrobial prophylaxis, and bacterial-host epithelial cell interaction, seem the most probable methods

to governing UTI’sc in the future.

Trautner, B.W., and R.O. Darouiche. (2004). Catheter-Associated Infections. Arch Intern Med. 164(8): 842-850.
Summary of Article:

Trautner explores aspects of catheter-related urinary tract infection including epidemiology, acquisition of infection, diagnosis, antimicrobial treatment, prevention

and infection, and complications.

Research Elements: Design, Methods, Population, Strengths, Limitations:

Qualitative researched utilized several studies that involved previous hospital records from the last ten years.  Events of catheter-related urinary tract infections

were examined to understand their possible causes and complications.

Outcome(s): Research Results:

The author decided that further research is necessary to prevent UTIs including possible alternatives to catheters.

Warren, J. W. (2001). Catheter-Associated Urinary Tract Infections. International Journal of Antimicrobial Agents. 17(4): 299-303.
Summary of Article:

Warren examines a specific urinary tract infection known as the nosocomial UTI, which is the most widespread type. The author points out that instance of catheter-

related UTIs have decreased, but more research is needed to improve this.

Research Elements: Design, Methods, Population, Strengths, Limitations:

The author utilized a qualitative research technique. He examined external sources to understand the best procedures for eliminating catheter-induced urinary tract

infection.

Outcome(s): Research Results:

Warren’s conclusions were: “Once a catheter is put in place, the clinician must keep two concepts in mind: keep the catheter system closed in order to postpone the

onset of bacteriuria, and remove the catheter as soon as possible. If the catheter can be removed before bacteriuria develops, postponement becomes prevention.”

Topic 2: Checklist
Review of Literature and Incorporating Theory

Instructions:

This checklist is designed to help students organize the weekly exercises/assignments to be completed as preparation for the final capstone project proposal. This

checklist will also serve as a communication tool between students and faculty. Comments, feedback, and grading for modules 1-4 will be documented using this

checklist.

Topic     Task    Completed    Comments / Feedback    Points
Review of Literature
•    Analyze and appraise each of the 15 articles identified in module 1.  (15 articles).            _____ / 90
•    Analysis organized using the sample provided in “Sample Format for Review of Literature.”
_____ / 10
Total    _____/100

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