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RESEARCH ARTICLE SUMMARY TABLE PAPER

RESEARCH ARTICLE SUMMARY TABLE PAPERRESEARCH ARTICLE SUMMARY TABLE PAPERDescribe article on Research Article Summary Table• Use bullet points for each review contentUse article attach ( content 111) and example providedUSE TEMPLATE ATTACH (PART 6) EXAMPE PROVIDEuSE ARTICLE Prevention of Catheter Associated Urinary Tract Infection (CAUTI)Analyzing Published Research Article Summary TableORDER A PLAGIARISM-FREE PAPER HEREArticles (2 pts)Authors (year) Study Purpose (2) Participants (2)NumbersInclusion & Exclusion Criteria Interventions (5)Intervention Contents & Procedures ORDescription of Procedure for Descriptive Study Data Collection with Measurement Tools (4) Participants Sociodemographic Findings) (5)Study Results/Findings (5) #1.Study Type:       *RESEARCH ARTICLE SUMMARY TABLE PAPER*      • Describe article on Research Article Summary Table• Use bullet points for each review contentPrevention of Catheter Associated Urinary Tract Infection (CAUTI)Manu Acha Roy1, Nisha Philip2, Deepa Fulwadiya2, Shruti Dhabade31HOD Paediatric Nursing, Symbiosis College of Nursing, Symbiosis International University, Pune, 2MSc Nursing 2nd Year, Symbiosis College of Nursing, Pune, 3BSc Nursing 4th Year SymbiosisCollege of Nursing, PuneABSTRACTUrinary tract infections (UTIs) are a major public health problem in terms of morbidity and incur the highest total health care cost among urological diseases, exceeding that of chronic renal failure even when renal dialysis and renal transplantation are included. This study was conducted to assess the practice of staff nurses regarding prevention of UTI in clients with indwelling catheter.RESEARCH ARTICLE SUMMARY TABLE PAPERAn evaluative approach was adopted for the study to determine the effectiveness of structured teaching program on practice among staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter. Pre -experimental, one group pre-test –post-test design was used for conducting the study. The result shows that the mean practice score in the post-test (18.56+- 3.88) was higher than the mean pre-test practice score(10.4+- 4.39),which is highly significant as p value <0.0001.This shows that the structured teaching program was effective in improving the practice of staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter.RESEARCH ARTICLE SUMMARY TABLE PAPERKeywords: Catheter associated Urinary Tract Infection (CAUTI), Effectiveness, Practice, Staff nurseINTRODUCTIONUrinary tract infection represents one of the most common diseases encountered worlwide in medical practice today with more than 150 million UTIs per annum. Although UTI occur in both men and women, clinical studies suggest that the overall prevalence of UTI is more in women. Uncomplicated urinary tract infections in healthy women have an incidence of 50/1000/year. An estimated 50% of women experience at least one episode of UTI at some point in their lifetime and 20% – 40% of women have recurrent episodes. Approximately 20% of all UTIs occur in men. Most episodes of UTI are caused by E- coli (up to 85%) and Staphylococcus saprophyticus(up to 10%)1. Catheter associated urinary tract infection (CAUTI) are a major problem in hospitals inspite considerable spending on education and prevention. About 5,60,000 CAUTI are reported by Centre of disease control and prevention (CDC)every year2. It has been estimated that more than 7 million people visits to emergency units and 100,000 hospitalization annually and accounts for 35% ofnosocomial infection3.RESEARCH ARTICLE SUMMARY TABLE PAPERUrinary catheterization is a known cause of bacterial infections, which in the worst-case scenario can be fatal. More than 5 million patients every year is been catheterized. Up to 25 % of patients who are catheterized for more than 7 days will develop catheter associated urinary tract infection. It is the most common nosocomial infection, comprising more than 40 percent of all nosocomial infections 4.To minimize the risk for introduction of microorganisms into the bladder, urinary catheters should only be inserted by well trained personnels.RESEARCH ARTICLE SUMMARY TABLE PAPERHand hygiene is the most important means of preventing infection and should be performed immediately before and after insertion of the catheter. The Investigator also felt during her clinical experience that many of the staff nurses posted in the medical surgical unit, uro-ward, and post operative wards failed to maintain proper aseptic technique while providing catheter care5.RESEARCH ARTICLE SUMMARY TABLE PAPERDOI Number: 10.5958/0976-5506.2018.00525.969 Indian Journal of Public Health Research & Development, June 2018, Vol. 9, No. 6So the investigators felt that it is necessary to assess the practice of staff nurses regarding prevention of UTI in clients with indwelling catheter. Further the investigator felt that the written material must be supplied to staff nurses working in the medical surgical wards which will help them in preventing urinary tract infection in patients with indwelling catheter.RESEARCH ARTICLE SUMMARY TABLE PAPERNEED FOR STUDYA catheter is a tube placed in the bladder that excrete urine from the urinary tract. Because this tube stays in place for a long period of time, it is called an indwelling catheter. Catheterization is commonly done in critically ill and post opeartive patients .As the critically ill patients have less immunity they are highly prone to get nosocomial infections. Many hospitalized patients get UTI due to catheterization. These infections are often caused by E- coli and Proteus mirabilis. Individuals needing an indwelling catheter are predisposed to the development of CAUTIs due to the presence of an indwelling catheter and more likely pathogenic multidrug-resistant organisms in the hospital settings. Although the imminent threat of infection from these potent opportunistic nosocomial multiresistant strains, most cases of catheter-associated bacteria or the presence of bacteria in the urine are asymptomatic. However, if an episode of CAUTI becomes symptomatic, the resulting array can range from mild (fever, urethritis, and cystitis) to severe (acute pyelonephritis, renal scarring, calculus formation, and bacteremia)6.RESEARCH ARTICLE SUMMARY TABLE PAPERA study was carried by Danbury hospital, USA to test a prevention bundle for catheter related urinary tract infections. They concluded that there are around 560,000 cases of catheter associated urinary tract infection per year. CAUTIs accounts for 23% of health care-associated infections in adult critical care units leading to complications such as cystitis, pyelonephriti, bacteremia, sepsis and increased risk of death. National rates for critical care have reached as high as 8.1 infections per 1000 catheters. Studies from around the world has shown that CAUTIs increase the costs of medical care morbidity and mortality.8RESEARCH ARTICLE SUMMARY TABLE PAPERThe Indian journal of critical care medicine carried out a study to assess the knowledge and attitude of health care providers regarding the indications for catheterization and method of preventing CAUTI. They concluded that there is a tremendous scope ofimprovement in catheterization practices in the hospital settings and education induced intervention would be the most appropriate effort towards reducing the incidence of CAUTI.7A CAUTI occurs when a patient with an indwelling urinary catheter develops 2 or more signs or symptoms of UTI such as hematuria, fever, flank pain, change in the character of urine and altered mental status.Most hospitals do not have strict guidelines for the prevention of CAUTI. Training the health care personnel and introducing the prevention of CAUTI as a high priority in hospitals is strongly associated with decreased incidence of CAUTI. Many studies have shown that single most important modifiable risk factor for decreasing the incidence of CAUTI is reducing unnecessary catheter use3.RESEARCH ARTICLE SUMMARY TABLE PAPERProblem Statement:A study to assess the effectiveness of structured teaching program on the practices of staff nurses regarding prevention of catheter associated urinary tract infection (CAUTI) among hospitalized patients in selected hospitals of Pune.OBJECTIVES OF THE STUDYTo assess the practice of nurses regarding prevention of urinary tract infection in patients with indwelling catheter.To assess the effectiveness of structured teaching program on the practices of nurses regarding prevention of urinary tract infection.To find out the association of practice among nurses with selected demographic variables.OPERATIONAL DEFINITION1) PracticesAccording to oxford dictionary practices refers to “the actual application or use of an idea, belief, or method, as opposed to theories relating to it:‘the principles and practice of teaching’‘the recommendations proved too expensive to put into practice”RESEARCH ARTICLE SUMMARY TABLE PAPERIn this study it refers to the method followed by the staff nurse in urinary catheterization.Indian Journal of Public Health Research & Development, June 2018, Vol. 9, No. 6 702) Staff nursesAccording to oxford dictionary “An experienced nurse less senior than a sister or charge nurse which helps the patient to restore to an healthy state”In this study it refers to the staff nurses working in the medical surgical wards of the selected hospital in Pune.3) Catheter associated urinary tract infection(CAUTI)“A catheter urinary tract infection (CAUTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney in a patient associated with urinary catheter”METHODOLOGYAn evaluative approach was adopted for the study to determine the effectiveness of structured teaching program on practice among staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter. The present study is aimed at assessing the effectiveness of Structured Teaching Program on practice among staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter in selected hospitals.The design selected for the present study was Pre -experimental, one group pre-test –post-test design.The setting of the present study was medical surgical wards of selected hospitals of Pune city. The population for the study was staff nurses working in the medical surgical wards of selected hospital.Non –probability purposive sampling technique was used for the present study. The sample comprised of 60 staff nurses working in medical surgical wards of the selected hospital.RESEARCH ARTICLE SUMMARY TABLE PAPERThe data collection method used for the study was observational method to assess the practice related to prevention of urinary tract infection in patients with indwelling catheter. An observation checklist has been prepared as a tool to assess the practice of staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter.The study was divided into 3 phases.PHASE 1:Pre-test i.e. assessing the existingpractice of staff nurses regarding prevention of urinary tract infection in patients with indwelling Catheter through observational checklist.PHASE 2: Structured Teaching program on practice regarding prevention of urinary tract Infection in patients with indwelling catheter.PHASE 3: Post-test i.e. assessing the practice of staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter.Development of the toolThe tool for data collection had 2 sections – Section A and BSection A: Demographic ProformaThis section consists of 5 items for the demographic proforma of the staff nurses regarding their age, gender, educational status , Years of experience and area of work.Section B: Structured Observational Checklist:-RESEARCH ARTICLE SUMMARY TABLE PAPERA structured observational checklist was used collect information regarding the practice of staff nurses on prevention of urinary tract infection in patients with indwelling catheter. This consists of 30 items. Each item was given a score of 1 and total score of the observational checklist was 30.Arbitrary scoring of prevention of urinary tract infection practicesGood 20-30Average 10-19Poor 0-9Reliability of the toolThe reliability of the tool was calculated to be 0.90 for practice aspects. The co-efficient of equivalence was used to check the observational checklist by inter-rater reliability. Thus the tool was found to be reliable.Method of data collection:The pilot study was conducted to assess the feasibility of the study. The subjects of the pilot study were from selected hospital. Sixty staff nurses were selected using non-probability purposive sampling technique.The purpose and nature of the study was71 Indian Journal of Public Health Research & Development, June 2018, Vol. 9, No. 6explained to the authority to gain cooperation. Then the consent was taken from the willing staff nurses from medical surgical wards.After obtaining the informed consent for study, on the first day, a pre-test was obtained using observational checklist.On the same day itself, a structured teaching practice was done.The practice of catheterization was after the intervention on the 2nd day.DATA ANALYSISThe data obtained was analysed by descriptive and inferential statistics on the basis of objectives of the study.To compute the data a master data sheet was prepared.RESEARCH ARTICLE SUMMARY TABLE PAPERSection :1 Demographic proformaData on demographic proforma was analysed by frequency and percentage and is presented in tables and figures.Section II: Practice on prevention of CAUTIThe practice of staff nurses regarding the practice on prevention of CAUTI ,before and after administration of intervention was analysed in terms of frequency, percentage, mean, median, mean percentage and standared deviation and is presented in the form of tables and diagram.The significant difference between mean pre-test and post -test scores are found out by t -test.Section III: Association between the practice scores and selected demographic variablesAssociation of practice scores of staff nurses regarding age, years of experience, and educational status are tested using Chi-square test.RESULTS AND INTERPRETATIONSection A: Description of the demographic Variables of samples.Table 1: Frequency and distribution of sample according to demographic variable (n=60)SNO DEMOGRAPHIC VARIABLESFREQ- UENCYPERCEN- TAGE1 Age (in years )20-30 15 2531-40 25 41.641-50 15 2551-60 5 8.42 EducationGNM 40 66.6BSC Nursing 20 33.33RESEARCH ARTICLE SUMMARY TABLE PAPERMSC Nursing nil 03 Years of experienceless than 5 20 33.305 to 10 years 10 16.610 to 20 years 20 33.320 to 30 years 10 16.6Table 1: shows that maximum percentage(41.6) of subjects were from the age group of 31-40 years wherein (8.4%) of them were in the age group of 51-60 years. Majority (66.6%) of subjects had GNM education , 33.33% had BSc/PBBSc Nursing and none of the subjects had Msc Nursing education. 33.3 % of the subjects had equal percentage of year of experience ie. less than 5 ,and 10-20 years of experience respectively. Remaining 16.6% of the subjects had 20-30 years of total experience.Section B: Level of practice of staff nurses on prevention of CAUTIPractice of 60 staff nurses was assessed by using observational checklist and analysed by descriptive statistics as presented in table 2.Table 2: Frequency and percentage Distribution of sample based on level of practiceLevel of practice Range of score Pre-test Post-testFrequency Percentage Frequency Percentage Poor 0-9 27 45 0 0 Average 10-19 29 48.33 42 70 Good 20-30 4 6.6 18 30Indian Journal of Public Health Research & Development, June 2018, Vol. 9, No. 6 72The data presented in table 2 shows that in pre-test majority (48.33%)of the the staff nurses had average practice, 45% of staff nurses had poor practice and 6.6 % had good practice on prevention of CAUTI .In post-test (70%) of staff nurses had average practice and 30% had good practice whereas none of the staff nurses had poor practice on prevention of CAUTI.RESEARCH ARTICLE SUMMARY TABLE PAPERTable 3: Mean, Median, standard Deviation and mean percentage and t’- value of pre-test and post-test practice scoresMean Standard Devi- ationMean percent- ageMean difference of pre-test and post testt test valuePre-test 10.4 4.39 34.66 8.16 12.76Post-test 18.56 3.88 61.86Data in the table 3 shows that the mean practice score in the post-test was (18.56+- 3.88) was higher that the mean pre-test practice score(10.4+- 4.39), which is highly significant as p value <0.0001.This shows that the structured teaching program was effective in improving the practice of staff nurses regarding prevention of urinary tract infection in patients with indwelling catheter.Section C: Association between pre-test practice score and demographic proformaThere were no significant difference in the pre-test knowledge score with selected demographic variables such as age, and year of experience, educational statusDISCUSSIONSIn this study the seriousness of CAUTIs in the hospitalised patients, decreasing the CAUTI rate by 50% was a tremendous leap forward in the study and this effort helped to minimize the CAUTI rate and increased the practice of staff nurses. This study also provided standardization in nursing practice when caring for patients with urinary catheters. The bedside checklist and interventions provided further consistency in care as a reminder to staff to perform all aspects of CAUTI prevention. Limitations in this study included lack of randomization for group assignments. For ethical reasons, standard catheter care could not be withheld in the patients, thus eliminating the possibility of a true control group for this study. RESEARCH ARTICLE SUMMARY TABLE PAPER. Further, it would not be feasible from a nursing work-flow perspective to effectively sort the patient assignments based on bundled versus non-bundled catheter care to form a control group. Finally, results were collected on adult patients in medical surgical units and as such, resultsare not generalizable to pediatric patients. During the pre-intervention time period, patients with indwelling cathters were cleansed daily with chlorhexidine wipes. This may have also had a positive impact in reducing CAUTIs, although the chlorhexidine wipes were never used on mucosal areas such as the perineum/meatus.RESEARCH ARTICLE SUMMARY TABLE PAPERCONCLUSIONThe findings of the study show that there is a highly significant difference between the pre-test and post-test practice scores of the group. The Structured Teaching program significantly brought out an improvement in the practice aspect among nurses working in medical surgical wards regarding prevention of urinary tract infection in patients with indwelling catheters. There is no significant association between practice scores with the selected demographic variables like age, educational status, years of experience and as p value >0.05. The study could help in increasing the practice among staff nurses regarding prevention of urinary tract infection in patients with indwelling catheters.RESEARCH ARTICLE SUMMARY TABLE PAPEREthical Clearance: It is been taken from Research Advisory Committee(RAC), Symbiosis College of Nursing.Source of Funding:- SelfConflict of Interest: NilREFERENCES1. Alyson W. Blanck, Moreen Donahue, Laurie Brentlinger, Kristy Dixon Stinger, Carol Polito. A quasi-experimental study to test a prevention bundle for catheter associated urinary tract infections. Journal of Hospital Administration. March 27, 2014.73 Indian Journal of Public Health Research & Development, June 2018, Vol. 9, No. 62. Fink, R., Gilmartin, H., Richard, A., Capezuti, E., Boltz, M., Wald, H. Indwelling urinary catheter management and catheter associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals. American Journal of Infection Control. 2012; 40(8): 715-720.3. Tsuchida, T., Makimoto, K., Ohsako, S., Fujino, M., Kaneda, M., Miyazaki, T., et al. Relationship between catheter care and catheter associated urinary tract infections at Japanese general hospitals: A prospective observational study. International Journal of Nursing Studies. 2008; 45(3): 352-361.RESEARCH ARTICLE SUMMARY TABLE PAPER4. Kazi MM, Harshe A, Sale H, Mane D, Yande M, et al. (2015) Catheter Associated Urinary Tract Infections (CAUTI) and Antibiotic Sensitivity Pattern from Confirmed Cases of CAUTI in a Tertiary Care Hospital: A Prospective Study. Clinical Microbiology 4:193. doi: 10.4172/2327- 5073.10001935. Yatim J, Wong KS, Ling ML, Tan SB, Tan KY, Hockenberry M. A nurse-driven process for timely removal of urinary catheters. International Journal of Urological Nursing. 2016 Nov 1;10(3):167-72.6. Parry MF, Grant B, Sestovic M. Successful reduction in catheter-associated urinary tract infections: focus on nurse-directed catheter removal. American journal of infection control. 2013 Dec 31;41(12):1178-81.7. Blanck AM, Donahue M, Brentlinger L, Stinger KD, Polito C. A quasi-experimental study to test a prevention bundle for catheter-associated urinary tract infections. Journal of Hospital Administration. 2014 Mar 27;3(4):p101.RESEARCH ARTICLE SUMMARY TABLE PAPER8. Lee JH, Kim SW, Yoon BI, Ha U-S, Sohn DW, Cho Y-H. Factors That Affect Nosocomial Catheter- Associated Urinary Tract Infection in Intensive Care Units: 2-Year Experience at a Single Center. Korean Journal of Urology. 2013;54(1):59-65.doi:10.4111/ kju.2013.54.1.59.Copyright of Indian Journal of Public Health Research & Development is the property of Institute of Medico-legal publications Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use. RESEARCH ARTICLE SUMMARY TABLE PAPER

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