Rough Draft Qualitative Research Critique and Ethical Considerations
CATHETER ACQUIRED URINARY TRACT INFECTION ABSTRACT According to the nursing staff of a rehab center, it was concluded that, there is a connection between incontinent of urine and undiagnosed urinary tract infection (UTI). It is also part of their findings that urinary tract infections are better improved or healed through the administration of prescribed antibiotics on patients. The nursing staff also discovered that most of their patients with the infection are the ones that were transferred to them from one type of surgery or the other. For example, orthopedic surgery. These patients had indwelling urinary catheter inserted into them before surgery and are still left in place for some days after surgery which eventually leads to the onset of the infection. This lead to a need to carry out a study to draw a conclusion between the identified variables. The following research critique is about an eleven to twelve months study inquiry that was carried out from 2010 to 2011by Eleanor H., Alan B., Shuan, M., Renee M., Trish S., (2013) to justify or contradict the above study. Problem Statement UTI otherwise known as Urinary Tract Infection is popularly known to be hospital acquired infection. Several patients were recognized to have develop this infection while they were in the hospital as inpatients. Few or more of these patients were incontinent of urine hence the need for them to have indwelling urinary catheter inserted to prevent them from soiling their body or clothes and to prevent them from having sores on their skin because urine on the skin after a while can potentially cause skin breakdown. Also, the use of indwelling urinary catheter on patients after orthopedic surgery were suspected to be the reason for these patients to have acquire the urinary tract infection. Nonetheless, most of these infections were eliminated through the administration of certain antibiotics to the patients. “More than 15% of the infections are reported by healthcare institutions and the most common healthcare associated infection caused using indwelling urinary catheter is the urinary tract infection which have been recognized to create or cause epididymitis, pyelonephritis, orchitis, prostatitis, septic arthritis, meningitis to mention but a few among others. Urinary tract infection is also the origin of about 13,0000 deaths per year in the USA” (CDC reports). Purpose and Research Questions The goal of the research is to reveal or discover the number of patient admitted into the rehabilitation with undiagnosed UTI within 12 months period and to reveal the risk factor associated with the infection. The study or relevant questions includes: • What are the link between urinary incontinent and urinary tract infections? • Does the use of urinary indwelling catheter boost the acquisition of urinary tract infection? • After treatment with antibiotics, did urinary tract infection or incontinent improve? The purpose of the theory is to know if there is increase of undiagnosed UTI recognized among patients transferred to a rehabilitation center or unit. Literature Review Methods: Information for the research is generated from patients that has been admitted into a rehab for over a period of 12 months. Most of these patients have been through surgery (Orthopedic surgery) and they range between age 60 and 65. To detect the infection, normal mid-stream urine specimen was collected during their admission and sent to the laboratory for an analysis for culture and sensitivity. The physician used the results obtained from the lab to order treatments for the patients. Sampling Research was carried out on patients that were admitted into the rehab from 2009-2010 (Twelve months). Ages of the patients were from 20-75 years. Process/Procedure Data which includes symptoms or evidences related to UTI were collected from patient’s charts. Physician’s documentation and lab/pathology results were used to conclude that the infection either exist, vanished or are improving in patient diagnosed. Weekly, patient care was organized via case management seminars. At the seminar, the research helped in gathering information related to bowel and bladder incontinence plus presence and duration of indwelling urinary catheter. No control group required for this research. Results At the end of the research, it was revealed that 35 out of 145 in patient in the rehab center were undiagnosed with the infection that were related to the use of indwelling urinary catheter-UTI before they were admitted. After the treatment with antibiotic based on the report from the culture and sensitivity, there was an outstanding improvement recorded. As documented, some of the symptoms disclosed by the patient during the process of experiencing the infection include, burning and stinging sensation feelings during urination. Ethical Consideration Because there was no individual patient interviewed and no name was mentioned for this research but information was gathered through the lab result and documentation about feelings of patient via signs and symptoms while experiencing the infection process. Hence, there were no ethical issue necessary or involved in the research. Theoretical Plan/ Conceptual framework This research revealed an association between the identified variables: previous existence of an indwelling catheter as being linked with undiagnosed UTI during admission to the rehab center. Notwithstanding, it was observed that not all the patient having the indwelling catheter was affected or infected with the urinary tract infection. The research furthermore established that, there is an association between the acquisition of UTI and incontinence as evidenced by the resolve of the infection using the recommended or prescribed antibiotics. Due to the lapses in the nurses’ documentation, it was tough to know the extent of time that the patient was with the indwelling catheters. Conclusion Personally, my opinion to this research is that nurses and all healthcare givers must be informed about the danger involved in keeping indwelling catheter in patient for more than necessary periods. Questions should always arise if benefit really outweighs all the risks involved. Question or investigations needed to be carried out for the duration of the catheter and plans to remove it on time must be put in place. Healthcare providers must also arrive at other means of controlling incontinence different from the use of the indwelling catheter and proper following or supervision must be made towards the removal of the catheter when their use is no longer needed. Although the result from this study revealed that there is feasibility of the existence of a clinical challenge- Urinary Tract Infection. It was carried out to investigate the concern of a rehabilitation center about the infection among her patients. The result only suggests that the presence of the infection in that single facility. Wider study of other rehab centers will be very beneficial in arriving into a clearer conclusion. The author did not indicate other topic of research organized on the same issue neither was any literature from other origin specified or incorporated to reinforce the research. References CDC: http://www.cdc.gov/nhsn/PDFs/pscManual/7pscCAUTIcurrent.pdf Shuan, M., Alan B., Renee M., Trish S., Eleanor H., 92013). Prevalence of undiagnosed urinary Tract infections on admission to a rehabilitation unit. Journal of Australasian Rehabilitation Nurse Association 16(3) 7-10.