1. URINARY TRACT INFECTIONS IN RELATION TO HAI Group Assignment #1 Laura Jones, Cathleen Cieply, Sotheavy Birgisson BIOL – 330 Infection & Disease Dr. Marsha Stock September 2014

2. What is a Urinary Tract Infection? An inflammatory condition of the lower urinary tract or the upper urinary tract caused by an infectious organism. (Casey, 2014)

3. Types of UTI’s Lower Urinary Tract Urethra (Urethritis) Bladder (Cystitis) Upper Urinary Tract Ureters (Ureteritis) Kidneys (Pyelonephritis)

4. Causes Catheterization Personal anatomy Urinary retention or incomplete empting of the bladder Compromised immune system Hygiene History of UTIs Age

5. Catheterization (Casey, 2014)

6. Infection causing Organisms Gram Negative Bacterial – Escherichia Coli ( E.Coli)- most common – Staphylococcus saprophyticus5-15% of UTI’s – Klebsiella, Enterococci bacteria and Proteus mirabilis (Mulryan, 2011)

7. CDC Statistics On UTI's UTI's account for 40% of HAI's 54,500 UTI cases are catheter associated urinary tract infections (CAUTI) CAUTI leads to increased morbidity, mortality, hospital costs, and length of stay

8. Treatments During hospitalization Urinary Tract Infections are treated with antibiotics early to prevent a serious complications which can delay healing time. Start full course of Cipro 500mg orally every 12 hours for outpatients Start full course of Cipro 400mg intravenously every 12 hours for hospitalized patients

9. Untreated UTI’s If a UTI goes unnoticed in a health care setting or the wrong medications are prescribed a urinary tract infection can develop into something more severe. – Pyelonephritis – Sepsis – Preterm labor and other pregnancy complications

10. CAUTI Prevention Guidelines Appropiate urinary catheter use -insert catheters only for appropiate indications and leave in place only as long as needed Proper techniques for urinary catheter insertion -perform hand hygiene immediately before and after insertion or any manipuation

11. CAUTI Prevention Guidelines Proper techniques for urinary catheter maintenance -following aseptic insertion of the urinary catheter, maintain a closed drainage system Quality improvement programs -implement quality improvement programs or strategies to enhance appropiate use of indwelling catheters and to reduce CAUTI risk

12. CAUTI Prevention Guidelines Administrative infrastructure -provision of guidelines, education and training, maintaining supplies needed, and having a system for documentation Surveillance -identify the patient groups or units on which to conduct surveillance based on frequency of catheter use and potential CAUTI risk

13. Preventative measures Sterile techniques in catheterization and only used when necessary Implement CAUTI prevention guidelines as recommended for hospitals Pregnant woman should be screened and treated Menopausal woman prescribed estrogen therapy

14. Preventive Measures Wiping front to back Stay hydrated; drink water Feminine products such as douching Cotton crotch panties.

15. References Casey, G. (2014). Understanding urinary tract infections. Kai Tiaki Nursing New Zealand, 20(5), 20-23. Center for Disease Control (CDC), (2014). Catheter-associated Urinary Tract Infections (CAUTI). Retrieved from http://www.cdc.gov/HAI/ca_uti/uti.html Daily, S. (2011). Prevention of indwelling catheter-associated urinary tract infections. Nursing Older People, 23(2), 14-19. Mulryan, C. (2011). Urinary tract infections: causes and management. British Journal Of Healthcare Assistants, 5(8), 392-396. Saint et al., (2008). Preventing hospital‐acquired urinary tract infection in the United States: A national study. Clinical Infectious Diseases, 46, 243-250.

16. References (continued)