Preventing catheter-associated UTIs: Survey report

doi: 10.1097/01.NURSE.0000390666.44956.1f
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INSTRUCTIONS Preventing catheter related UTIs: Survey report


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GENERAL PURPOSE To provide nurses with evidence-based practice guidelines to prevent catheter-associated urinary tract infections (CAUTI). LEARNING OBJECTIVES After reading this article and taking the test, you should be able to: 1. Discuss the results of this survey. 2. Identify best practices related to CAUTI prevention. 3. Discuss the rationale for best practices.

1. What kind of sample did this survey use?

a. simple random

b. convenience

c. stratified random

d. cluster

2. In this survey, results were normally distributed

a. with a slight negative skew.

b. with a slight positive skew.

c. in a perfect bell-shaped curve.

d. with a significant tail to the right.

3. In this survey, nurses with the lowest scores worked in

a. EDs.

b. home healthcare.

c. intensive care.

d. long-term-care facilities.

4. On average, CAUTI increases a patient's length of stay by

a. 1 day.

b. 2 days.

c. 5 days.

d. 1 week.

5. Which is the most common HAI?

a. ventilator-associated pneumonia


c. central catheter-associated bloodstream infection

d. surgical site infection

6. For each day an acute care patient has an indwelling urinary catheter, CAUTI risk increases by

a. 3% to 7%.

b. 10% to 12%.

c. 13% to 17%.

d. 18% to 20%.

7. When a urinary catheter remains indwelling for a month, the risk of bacteriuria is

a. 25%.

b. 60%.

c. 90%.

d. 100%.

8. What percentage of patients with bacteriuria develops signs and symptoms of infection?

a. 3%.

b. 7%.

c. 10% to 24%.

d. 25% to 50%.

9. Mortality from hospital-acquired bacteremias from a urinary source is

a. 3%.

b. 10%.

c. 17%.

d. 25%.

10. Research suggests that silver alloy-coated indwelling urinary catheters

a. have no benefit.

b. may benefit long-term-care patients.

c. may benefit acute-care patients.

d. probably benefit both long-term- and acute-care patients.

11. Antibiotic-impregnated catheters have been found to be effective in reducing CAUTI incidence for

a. 72 hours.

b. 7 days.

c. 2 weeks.

d. 1 month.

12. Biofilm develops

a. on every indwelling medical device.

b. only on indwelling urinary catheters.

c. primarily on antibiotic-impregnated urinary catheters.

d. primarily on venous access devices.

13. Which statement is correct about biofilm?

a. It enhances bactericidal activity.

b. It's composed primarily of cellular material.

c. It's initially composed of several species of microorganisms.

d. Removing the catheter is the best way to eradicate biofilm.

14. Which is a CDC criterion for CAUTI diagnosis?

a. temperature of at least 37°C

b. indwelling catheter removed less than 72 hours before specimen collection

c. more than two species of organisms in a urine culture

d. costovertebral angle tenderness

15. Some evidence exists that CAUTI can be reduced by

a. routine meatal care with soap and water.

b. routine meatal care with an antiseptic periwash.

c. routine catheter irrigation with 0.9% sodium chloride solution.

d. application of antibacterial ointment to the meatus.

16. Which statement about CAUTI in pediatric patients younger than 1 year is true?

a. Indwelling urinary catheters rarely cause CAUTI.

b. CAUTI is always asymptomatic.

c. CAUTI isn't considered a never event.

d. CAUTI may be associated with hypothermia.

17. Best practice recommendations include changing long-term drainage bags

a. every 14 days.

b. every month.

c. every 6 weeks.

d. only as necessary based on clinical indications.

18. According to the CDC, an indwelling catheter may be appropriate if the patient

a. is incontinent.

b. is nearing death.

c. has pain upon movement.

d. prefers indwelling to intermittent catheterization.

19. Sterile technique is not required for inserting

a. antibiotic-impregnated catheters.

b. silver alloy-covered catheters.

c. intermittent catheters in the home setting.

d. urinary catheters with an expected dwell time of 1 day or less.

20. Securing a catheter after insertion helps in all of the following except

a. promoting patient comfort.

b. preventing urethral traction.

c. slowing bacterial colonization.

d. decreasing urethral lining damage.

21. Which type of evidence supports choosing a smaller-diameter catheter?

a. case studies

b. expert opinion

c. nonrandomized studies

d. randomized controlled trials

22. Evidence that using antiseptic solutions for catheter care inhibits CAUTI is

a. very strong.

b. strong.

c. weak.

d. lacking.

23. The number one predictor of CAUTI is

a. break in sterile technique during insertion.

b. failure to use a reminder system.

c. failure to use securement devices routinely.

d. prolonged catheter dwell time.

24. Catheter reminder systems to reduce CAUTI are

a. an evidence-based strategy.

b. usually ineffective.

c. expensive to implement.

d. not supported by the evidence.

25. Most nurses surveyed reported that

a. their facilities don't track CAUTI rates.

b. they don't know the CAUTI rate at their facilities.

c. the CAUTI rate at their facilities was below benchmarks.

d. the CAUTI rate at their facilities was above benchmarks.

26. The authors recommend each of the following except

a. providing information to all staff about CAUTI rates.

b. posting graphs of CAUTI rates on staff bulletin boards.

c. establishing a team of nurse managers to address CAUTIs.

d. establishing an interdisciplinary team and bedside champions.

27. Implementation of the CAUTI care bundle

a. is mandated by the CDC.

b. must include all elements to achieve improved outcomes.

c. doesn't improve outcomes.

d. provides a menu of recommended interventions from which to choose.

28. Which of the following is a CAUTI bundle strategy?

a. Maintain a closed drainage system.

b. Use antibiotic-impregnated catheters.

c. Wash the meatus with soap and water following bowel movements.

d. Administer prophylactic antibiotics for duration of catheter placement.

29. Category IB evidence is defined as a strong recommendation supported by

a. expert opinion.

b. low-quality evidence.

c. moderate-quality evidence.

d. high-quality evidence.

30. The authors conclude that CAUTI prevention

a. isn't amenable to interdisciplinary research.

b. is a multidisciplinary indicator.

c. is a nurse-sensitive indicator.

d. is currently an unattainable goal.

31. Organisms that most often cause CAUTI are

a. Escherichia coli and Candida.

b. Escherichia coli and Pseudomonas aeruginosa.

c. Enterococcus and Klebsiella pneumonia.

d. Enterococcus and Enterobacter.

32. For bladder emptying dysfunction, the CDC recommends

a. catheter irrigation.

b. external catheters.

c. indwelling catheters.

d. intermittent catheterization.

33. The CDC recommends ultrasound bladder scanners to

a. reduce unnecessary catheter insertions.

b. reduce unnecessary catheter irrigations.

c. prevent premature catheter removal.

d. identify the need for catheter removal.

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