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Putting it into practice

All posts from: July 2011

Why is catheter-associated urinary tract infection still a challenge?

25 July, 2011 Posted by: -

Key points

  • Patients with urinary catheters are at high risk of infection.
  • Catheters reduce the body’s natural ability to cleanse the urinary tract of micro organisms.
  • Bacteria can be free floating or can colonise into biofilms that attach to the catheter surface and may cause catheter blockage.
  • Biofilms can develop a resistance to antibiotics.
  • Silver alloy urinary catheters can reduce biofilm formation and colonisation by releasing silver ions into the urinary tract.

Let’s discuss

  • Why does catheter-associated urinary tract infection (CAUTI) remain a persistent challenge in healthcare?
  • What strategies have you found to be effective in reducing CAUTI?
  • Looking at the evidence in this article, do you think silver alloy catheters should be used routinely in clinical practice?

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Comments (2)

Why are fluid balance charts notoriously difficult to maintain accurately?

18 July, 2011 Posted by: -

Every week we’ll choose a practice article and pose a few questions for debate, post your questions or answers below …

Key points

  • Fluid balance is a term used to describe the balance of the input and output of fluids in the body to allow metabolic processes to function;
  • To make a competent assessment of fluid balance, nurses need to understand the fluid compartments within the body and how fluid moves between these compartments;
  • Dehydration is defined as a 1% or greater loss of body mass as a result of fluid loss. Physical symptoms of dehydration include impaired cognitive function, headaches, fatigue and dry skin. Severe dehydration can lead to hypovolaemic shock, organ failure and death;
  • The three elements to assessing fluid balance and hydration status are clinical assessment, including vital signs, body weight and urine output, review of fluid balance charts, and review of blood chemistry;
  • Fluid balance recording is often inadequately or inaccurately completed. Reasons identified for inappropriate completion of fluid balance charts include staff shortages, lack of training, and lack of time.

Let’s discuss

  • Why are fluid balance charts notoriously difficult to maintain accurately?
  • What role should healthcare assistants play in fluid balance monitoring and assessing patients’ hydration needs?
  • In the clinical situation are signs of dehydration and fluid overload easy to identify? When do you find it challenging?

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Comments (8)

How could you adapt intentional rounding for use on your ward or unit?

12 July, 2011 Posted by: -

Every week we’ll choose a practice article and pose a few questions for debate, post your questions or answers below …

Key points …

  1. Concerns about essential nursing care have refocused attention on the need to ensure fundamental aspects of care are delivered reliably
  2. Intentional rounding involves health professionals carrying out regular checks with individual patients at set intervals
  3. The approach helps nurses focus on clear, measurable aims for undertaking the round
  4. It also helps frontline teams to organise workload on the ward
  5. Rounding can reduce adverse incidents, offer patients greater comfort, and ease their anxiety

Let’s discuss …

  • How could you adapt intentional rounding for use on your ward or unit?
  • The authors suggest “It may be possible that rounding might prove challenging for staff, because it leads them to encounter directly and personally some individuals’ painful circumstances via immediate, regular contact with patients as people”. What do you think?
  • How can intentional rounding be used to improve the organisation of, and quality of, care?
  • What are the benefits and potential pitfalls of implementing this approach in your place of work? How could the pitfalls be addressed?

Comments (9)

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