EVIDENCE BASED NURSING CARE ASSESSMENT 1

1.Using the APA style of referencing ,state the full title of journal article you intend to review.(3 marks) Reviewed full title of the journal articleis“A NEW APPROACH TO IMPROVE HAND HYGIENE PRACTICE IN INNER CITY ACUTE HOSPITAL IN AUSTRALIA”.
2. Briefly described at least three important reasons why this journal article could be considered as evidence based nursing practice. (5 marks)
The three important reasons of this journal article is * Gives the guidelines for indwelling urinary catheter management * Hospital wide strategies including policy and product improvements * Multifaceted nursing - driven approach

Multifaceted nursing-driven approach
Based on the review of evidence, the University of Colorado Hospital’s CAUTI interdisciplinary Quality Intervention Team initiated a quality improvement project that provided a multifaceted nursing-driven approach to reduce CAUTIs.The purpose of this quality improvement process study was to develop and implement evidence –based,multifaceted,nurse-driven interventions to improve urine elimination management in hospitalized patients and to measure the impact of these interventions on the duration of indwelling urinary catheterization (dwell time) and the CAUTI incidence among patients on the target inpatient units.
Hospital wide strategies Strategies are updated to reduce CAUTI risk and reviewed the approaches. There are ample guidelines regarding strategies to prevent CAUTI and unit specific strategies that focus on the review of current evidence to guide practice.

Guidelines for indwelling catheter management
CAUTI is the single largest source of bacteraemia in hospitalised patients, commonly leading to unnecessary antimicrobial use, prolonged hospitalisations and increased health care costs. The indwelling urinary catheter (IUC) is associated with the majority of these infections.
3.State the processes you intend to review the journal article? (5 marks)
Background: Catheter-associated urinary tract infections (CAUTIs) are common, morbid, and costly. Nearly 25% of hospitalised patients are catheterized yearly, and 10% develop urinary tract infections. Evidence based guidelines exist for indwelling urinary catheter management but are not consistently followed.
Methods: Evidence -based practice guidelines derived from valid, current research and other evidence sources can successfully improve patient outcomes and quality care. Simply disseminating evidence is often ineffective in changing clinical practice. This is highly important to promote high quality and safe care. To facilitate effectively, the translation of best evidence into practice, processes, enhancing practice change must be embraced by the health care provider. A pre/post intervention design was used in this quality improvement project to test the impact of nurse-driven interventions based on the current evidence to reduce CAUTIs in hospitalized patients on 2 medical/surgical units. Interventions consisted of hospital-wide strategies including policy and product improvements and unit strategies that focussed on a review of current evidence to guide practice. The framework used in this research includes * Recruit a multidisciplinary team * Examine the evidence * Identify and understand product use, availability, and costs. Refine the product use based on the best evidence and cost analysis. * Measure the outcomes * Work with infection control and clinical informatics staff to audit and measure outcomes * Provide feedback to staff

Results:
The number of catheter days decreased from 3.01 to 2.2 on the surgery unit and from 3.53 to 2.7 on the medical unit .CAUTI rates were too low to achieve significant reduction. Product cost savings were estimated at $52,000/year.
Intervention uptake * Healthstream module compliance * Competency based IUC insertion training * Intervention unit in services and