Statistical Information Paper

Statistical Information Paper

University of Phoenix

BSN0510-HCS438

Ellen Aebig

Elizabeth Ball

Marie Deitz

Michele Wilson

November 13, 2006

The particular study that Team "C" has decided to review is a study done at a VNA home care. This particular study looks at an increase of urinary tract infections associated with indwelling catheters. The study includes 36 patients, 13 females and 23 males. The average age of the patient is 78.31 years old. The total number of days that the device was used was 828 days. The total number of urinary infections found in this group of patients was seven.

According to an article called, Guideline for Prevention of Catheter-associated Urinary Tract Infections, by Edward S. Wong, MD., "The urinary tract is the most common site of nosocomial infection, accounting for more than 40% of the total number reported by acute-care hospitals and affecting an estimated 600,000 patients per year. Most of these infections--66% to 86%--follow instrumentation of the urinary tract, mainly urinary catheterization."(2005).

In the study that team "C" reviewed, 19.4% of the patients acquired urinary tract infections. The team will discuss the data observed and the data that was not included in this study. The purpose of this paper is to show how a study can be misinterpreted and the advantages and disadvantages of this study in making decisions on health care...

The information collected was related to urinary tract infections on patients in our home care agency (Holyoke Visiting Nurse Association, HVNA), that is inclusive of adult home health patients and hospice patients. The criteria for data collection was patients that had an indwelling catheter i.e. bladder or suprapubic and data was analyzed every 60 days which equals the amt of time that a patient requires review per Medicare regulations. I will choose the dates of July through September 2006 and inclusive of the VNA patients and hospice patients. The type of data collected was the date of the urinary tract infection (UTI), the date identified, date resolved, the number of infections, the sex of the patient ,the number of days that the patient had the device, if there were days that were interrupted, and frequency of catheter change. The one consistent missing piece of data was the date resolved. The total number of patients was 36 which totaled 828 device days. There were seven infections with one patient having acquired two infections. All the patients had indwelling bladder catheters.

This particular study should have included the admitting diagnosis of the patient because certain disease processes may be more prone to developing an UTI. A patient who is near end-of-life will likely be more susceptible to developing an UTI, due to a weakened condition where as a person who may require the catheter for a short time. For example, post surgery and is in a normal healthy state. Some other considerations that may be included are that of mobility concerns, cognitive status, if they are alone or live with a support person. These factors are important for the appropriateness of ability to care for the device i.e. cleansing procedures, emptying procedures and just general care of device.

The advantages of the study on infections of patients with indwelling catheters is important in interpreting or improve on decisions in the health care setting by putting in place guidelines for care, reasons for assessment, include both staff and management, the become reminders for patient specific care and provides areas for continuing education or training (Recommendations for implementation, audits, surveillance, and research, chapter 7). The use of cultures and studies will help determine causes of UTI's and how to prevent them. The study can be helpful in determining how effective the treatment is or is not. Culture and sensitivity reports are vital in the treatment of these infections. The reports show what the bacteria are resistant and sensitive to. These stats help to set apart bacteria from other forms and how well they perform under attack of different drug use. In addition to the treatment of bacteria the report will determine what medications not to use in the treatment. At times it has been recommended the infection run its course and not be treated with medication if the culture shows a slight problem.

Urine should be collected at first sign of symptoms to prevent a serious more difficult problem occurring. Removing the source of the problem can be more effective in the future of the patient. The studies can be helpful in the why of UTI's and what to do to prevent them. Sometimes the symptoms of patients are from other causes than UTI's. The symptoms can be because of STD's or PID...but unless the culture is completed or a pelvic exam done a true diagnosis can not be made. The stats show what medications are effective in the treatment of men vs. women, elderly, and children, are food products safer and as effective in the treatment, discuss personal hygiene with patients such as toileting practices, and how will the treatment affect the patient's lifestyle or what are their feelings about the situation (Recommendations, implementations chapter 7).

The use of studies to determine causes of certain infections seen more frequently than others is beneficial to all patients. These can help define the problem with procedures that might cause bacterial infections. One infection that comes to mind is a nosocomial. Unfortunately this occurs within the walls of the institution where the chance of a procedure going wrong is the cause. The problem can be these strain of bacteria can be resistant to many treatments and difficult to eradicate. These stats are helpful in putting together educational training course for staff and doctors in the prevention of the nosocomial