Barriers to Implementation of a Urinary Catheter Care Bundle for Critically Ill Patients with Cerebrovascular Stroke

Abstract

Background: Catheter-associated urinary tract infections (CAUTIs) are the most prevalent healthcare-associated infection in the ICU. Patients with indwelling urinary catheters are more prone to CAUTIs due to the increased risk of post-stroke infections brought on by stroke-induced immunosuppression. Therefore, it is imperative to focus on the barriers related to knowledge deficit, health care organization and nursing practice to overcome bad consequences of developing CAUTIs. Objective: to identify barriers to implementation of a urinary catheter care bundle for critically ill patients with cerebrovascular stroke. Setting: the study was carried out in five ICUs of Health Affairs Directorate hospitals in Alexandria governorate. Subjects: A convenient samples of 130 nurses of both genders who are assigned in the direct care of the newly admitted patients with cerebrovascular stroke in the previously mentioned units. Tools: two tools were used. Tool one: "Urinary catheter care bundle barriers questionnaire tool ". Tool two: "Nurses' knowledge about urinary catheter care bundle for critically ill patients with cerebrovascular stroke questionnaire". Results: The study showed that there was a significant relationship between socio-demographic data and mean score of UCCB implementation overall barriers regarding gender, age, education level and years of experience (P=0.011, P=0.001, P=0.001 and P=0.001 respectively). Furthermore, the study groups exhibited significant relationship between socio-demographic data and percent score of knowledge level about UCCB of studied CCNs regarding gender, age, education level and years of experience (P=0.114, P=0.004, P=0.001 and P=0.002 consequently). Conclusion: the implementation of urinary catheter care bundle was highly effective as it reduced CAUTI rate for critically ill patients with cerebrovascular stroke. Recommendations: critical care nurses should implement a UCCB approach that is tailored to the critically ill patients with cerebrovascular stroke. Hospital administration should establish educational program and workshops about the UCCB approach for critically ill patients with cerebrovascular stroke to critical care nurses.

Evaluation of the impact of bundled nursing strategies on the prevention of venous thromboembolism in patients with cerebral hemorrhage

“…[9] The bundled nursing strategy is a method that integrates multiple prevention and treatment measures, and improves nursing effectiveness by coordinating and optimizing various nursing methods. [10] In the prevention of VTE in nonsurgical patients with cerebral hemorrhage, this strategy usually includes multiple aspects such as drug therapy, physical therapy, nursing interventions, and lifestyle adjustments. Drug therapy mainly involves the use of anticoagulants to reduce blood clotting, while physical therapy includes wearing elastic socks and regularly engaging in lower limb activities.…”