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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000431270.01203.4b
Feature Articles

CE Test 2.4 Hours: Using Evidence-Based Practice to Reduce Catheter-Associated Urinary Tract Infections

Contrada, Emily

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Continued Education
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TEST INSTRUCTIONS

* To take the test online, go to our secure Web site at http://www.nursingcenter.com/ce/ajn .

* To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form.

* Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.

* Registration deadline is June 30, 2015.

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DISCOUNTS AND CUSTOMER SERVICE

* Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test.

* We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details.

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PROVIDER ACCREDITATION

LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC).

These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states.

The ANCC's accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.

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CE TEST QUESTIONS

GENERAL PURPOSE:

To report the details of an evidence-based practice project to reduce the incidence of catheter-associated urinary tract infection among patients in a long-term acute care hospital.

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LEARNING OBJECTIVES:

After reading this article and taking this test, you will be able to

* explain the background information helpful in understanding the need for this project.

* outline the planning process the author used in designing the project.

* summarize the implementation and results of the project to reduce the incidence of catheter-associated urinary tract infection.

1. The Centers for Disease Control and Prevention (CDC) define catheter-associated urinary tract infection (CAUTI) as clinical symptoms and laboratory evidence of urinary tract infection in a patient who has had a urethral catheter

a. inserted.

b. in place for at least 12 hours.

c. in place for at least 24 hours.

d. in place for more than 2 days.

2. CAUTI accounts for what percentage of all hospital-acquired infections?

a. 16%

b. 24%

c. 32%

d. 40%

3. In 2008, the Centers for Medicare and Medicaid Services (CMS) identified CAUTI as one of the hospital-acquired conditions they would not reimburse unless

a. identified and treated promptly.

b. documented as present on admission.

c. significant clinical risk factors existed.

d. first-line therapy did not resolve it.

4. Identifying supplemental preventive tactics such as avoiding the use of urethral catheters exemplifies which of the following steps of the evidence-based practice (EBP) protocol?

a. Cultivate a spirit of inquiry.

b. Search for the best evidence.

c. Ask relevant clinical questions.

d. Critically appraise the evidence.

5. In the author's clinical question, which component of the PICOT protocol does the phrase “affect the number of catheter-days and CAUTI rates” fulfill?

a. population

b. intervention

c. comparison

d. outcomes

6. The purpose of the rapid critical appraisal is to determine whether the literature identified in the search is valid, relevant, applicable, and

a. reliable.

b. accessible.

c. conclusive.

d. peer-reviewed.

7. Descriptive studies characterize which level of evidence?

a. I

b. III

c. V

d. VI

8. After their analysis of external and internal evidence, the team members agreed that the goal of the project was to

a. evaluate best practices.

b. design a new approach to care.

c. improve the quality of care.

d. use a nurse-driven protocol.

9. The nurses decided that the best way to promote consistent protocol use was to

a. express the protocol in algorithm form.

b. design a simpler practice change.

c. promote a culture that supports EBP.

d. gather more input from stakeholders.

10. To help reduce CAUTI incidence, the CDC recommends using bladder scanners to

a. assess for signs of infection.

b. recognize overactive bladder.

c. identify structural problems.

d. evaluate urinary retention.

11. To calculate CAUTI rates, count the number of CAUTIs over a specified period, divide that number by the number of catheter-days over that same period, and

a. multiply the quotient by 100 catheter-days.

b. multiply the quotient by 1,000 catheter-days.

c. divide the quotient by 100 catheter-days.

d. divide the quotient by 1,000 catheter-days.

12. The author recommends making ideas “sticky,” which means easy to

a. implement.

b. remember.

c. understand.

d. negotiate.

13. Simply reporting catheter-days and CAUTI rates can

a. reduce both.

b. enhance workflow.

c. replace observation of staff behavior.

d. mask the need for a protocol change.

14. A factor identified as contributing to the spike in the percentage of patients using urethral catheters after the intervention was

a. a decline in patient census.

b. a statistical error during data collection.

c. a random increase in patients actually needing catheterization.

d. the failure of new staff to receive thorough protocol instruction.

15. From before to after the intervention, CAUTI rates at the author's facility declined by

a. 10%.

b. 25%.

c. 33%.

d. 50%.

16. A lesson the author learned during this project is the importance of mentor presence until there is sufficient evidence of

a. positive outcomes.

b. enculturation.

c. staff feedback.

d. sustainability.

© 2013 Lippincott Williams & Wilkins, Inc.

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