Appendix: Synthesis And Recommendations EBP Question: Categ ✓ Solved

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Appendix : Synthesis and Recommendations EBP QUESTION: Catego

EBP QUESTION: In males with urinary inconsistencies, dementia, an overactive bladder, or even those going through alcohol withdrawal, what is the effect of condom catheterization as compared to the use of Foley catheterization on the prevention of CAUTIs, a condition referred to as Catheter-Associated Urinary Tract Infections (CAUTIs)?

Paper For Above Instructions

Catheter-associated urinary tract infections (CAUTIs) represent a significant healthcare issue, particularly among vulnerable populations such as males with urinary inconsistencies, dementia, overactive bladder, or during alcohol withdrawal. This paper synthesizes the findings from various studies evaluating the efficacy of condom catheterization compared to Foley catheterization in reducing the incidence of CAUTIs, providing an evidence-based recommendation for clinical practice.

Understanding CAUTIs

CAUTIs are among the most common hospital-acquired infections, leading to increased morbidity, prolonged hospital stays, and additional healthcare costs (Advani & Fakih, 2019). The risk factors for developing CAUTIs include prolonged catheterization, poor catheter management, and patient-specific factors such as age and underlying conditions (Li et al., 2019).

Catheterization Methods

There are two common types of urinary catheters used in clinical settings: Foley catheters, which are inserted directly into the bladder and left in place for an extended period, and condom catheters, which adhere externally to the penis. Each method has its implications for infection risk, patient comfort, and care needs.

Evidence Synthesis

Studies reviewed reveal varying degrees of evidence regarding the effectiveness of each catheter type in preventing CAUTIs. For instance, a meta-analysis by Li et al. (2019) indicated that prolonged use of catheters can significantly increase infection rates among bedridden patients. In contrast, other studies highlighted the benefits of condom catheters in decreasing the incidence of CAUTIs due to their lower risk of direct bladder contamination compared to Foley catheters (Jabbour et al., 2018; Gnade et al., 2020).

In a pilot study conducted by Hariati et al. (2019), the authors found that condom catheters provided a reduced risk of infection when compared to traditional Foley systems, particularly in populations similar to the target group of this EBP question. Furthermore, Gnade et al. (2017) emphasized the importance of proper care and maintenance as critical factors influencing the effectiveness of condom catheters.

Limitations of Existing Studies

Despite the promising benefits of condom catheterization, several limitations were identified within the studies. Many studies, such as those by Agrawal et al. (2020) and Majumder et al. (2018), reflect small sample sizes or lack comprehensive data that hinders the ability to draw definitive conclusions. Moreover, the subjective interpretation of findings can influence the perceived quality of evidence (Majumder et al., 2018).

Recommendations Based on Evidence

Based on the synthesis of findings from various studies, it can be recommended that condom catheters should be considered as the preferred method of urinary management in males with urinary inconsistencies, dementia, or undergoing alcohol withdrawal. Their lower associated risk of CAUTIs, combined with the necessity of individualized patient care and proper catheter management, may lead to better outcomes in this population.

Translation Pathway

To implement these findings in clinical practice, education and training for healthcare providers on the proper application and management of condom catheters are essential. Additionally, developing clinical guidelines that favor the use of condom catheters in specified populations could significantly reduce CAUTI rates.

Conclusion

The evidence suggests that condom catheterization might be more beneficial than Foley catheterization in preventing CAUTIs among high-risk male populations. Future research with larger sample sizes and varied settings can provide further insight into these findings and contribute to more robust clinical guidelines.

References

  • Advani, S. D., & Fakih, M. G. (2019). The evolution of catheter-associated urinary tract infection (CAUTI): is it time for more inclusive metrics? Infection Control & Hospital Epidemiology, 40(6).
  • Agrawal, M., Gite, V. A., & Sankapal, P. (2020). Penile gangrene: A rare but disastrous complication of the improper application of condom catheters. Journal of Clinical Urology.
  • Dehghanrad, F., Nobakht-e-Ghalati, Z., Zand, F., Gholamzadeh, S., Ghorbani, M., & Rosenthal, V. (2019). Effect of instruction and implementation of a preventive urinary tract infection bundle on the incidence of catheter associated urinary tract infection in intensive care unit patients. Electronic Journal of General Medicine, 16(2), 1–9.
  • Jabbour, Y., Abdoulazizi, B., Karmouni, T., El Khader, K., Koutani, A., & Iben Attya Andaloussi, A. (2018). Penile gangrene and necrosis leading to death secondary to strangulation by condom catheter. Case Reports in Urology, 2018.
  • Li, F., Song, M., Xu, L., Deng, B., Zhu, S., & Li, X. (2019). Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies. Journal of Advanced Nursing, 75(3).
  • Majumder, M. M. I., Ahmed, T., Ahmed, S., & Khan, A. R. (2018). Microbiology of catheter associated urinary tract infection. IntechOpen.
  • Hariati, H., Suza, D. E., & Tarigan, R. (2019). Risk Factors Analysis for Catheter-Associated Urinary Tract Infection in Medan, Indonesia. Open Access Macedonian Journal of Medical Sciences, 7(19), 3189.
  • Gnade, C., Storm, D., & Ten Eyck, P. (2017). MP92-02 BPA alert effect on CAUTI hospital-wide at UIHC. The Journal of Urology, 197(4S), e1226-e1226.
  • Gnade, C., Wu, C., Ten Eyck, P., Leder, L., & Storm, D. (2020). The Influence of an Electronic Medical Record Embedded Best Practice Alert on Rate of Hospital Acquired Catheter Associated Urinary Tract Infections: Do Best Practice Alerts Reduce CAUTIs? Urology, 141, 71-76.
  • Majumder, M. M. I., Ahmed, T., Ahmed, S., & Khan, A. R. (2018). Microbiology of Catheter Associated Urinary Tract Infection, in Microbiology of Urinary Tract Infections - Microbial Agents and Predisposing Factors. IntechOpen. DOI: 10.5772/intechopen.80080.

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