Introduction
The focus of the capstone is on “Catheter Acquired Urinary Tract Infection Prevention in Health Care Facilities.” Catheter-acquired urinary tract infection is a common health problem, which nursing professionals attribute to the utilization of indwelling urinary catheters by individuals receiving care in hospitals. Nicolle (2014) confirmed that the bacterial infection develops on the devices depending on the length of catheterization on the patient. A substantial burden is attributed to the use of catheters that cause the infection. According to the author, approximately 20% of infection cases are witnessed in acute care facilities, and more than 50% in long-term care. Various guidelines have been published that would help in the prevention of healthcare-associated infections (HAIs), including catheter-associated urinary tract infection. One of the practical recommendations is limiting indwelling catheter use. Whenever it is necessary, it is essential to stop it as soon as it is medically feasible (Lo et al., 2014). Therefore, the proposed capstone project recommends a best practice process to prevent catheter-associated urinary tract infections.
The proposed intervention is a page-long protocol to be filled out by each nurse for each patient at the beginning of a shift. In the protocol, nurses will answer a set of questions about the patient’s need for a catheter. The questions will relate to either continue using the Foley catheter or remove it, following consultation with the doctor. The intervention is already implemented in my unit, and I propose its implementation in other departments experiencing a high rate of catheter-associated urinary tract infections. The protocol is a straightforward way of deciding whether a patient requires the catheter. By avoiding the catheter as much as possible and removing the much-needed cases as soon as possible, the initiative will help to reduce the rate of catheter-associated urinary tract infections in the hospital.
Concepts
The proposed capstone will focus on two concepts, KNOWLEDGE and COMPLIANCE. A conceptual definition of a concept is the actual meaning, while operational definition refers to the way it is measured. Conceptually, “knowledge” can either be defined as the skills, or information acquired through education or experience; the practical or theoretical understanding (Shinde & Mohite, 2014). The concept can also be defined as the awareness or familiarity acquired through the expertise of a situation or fact. Operationally, the program will be measured depending on the level of awareness of the use of the protocol in various units (Labrague, McEnroe-Petitte, van de Mortel, & Nasirudeen, 2018). Another operational definition of knowledge is based on awareness of when and why a patient would require a catheter. Thus, to measure knowledge, it is crucial to implement the protocol and collect data from nurses regarding their understanding of its use.
The second concept includes “compliance.” The conceptual definition of compliance is the act of conforming or yielding. Another explanation is conformity or accordance (Cheung et al., 2015). Operationally, the implementer of the proposed program will test the level of compliance with the new work standards. Nurses are expected to comply by filling the protocol or else the program will not be effective in reducing the prevalence of catheter-associated urinary tract infection. Data will be collected upon implementation of the new program to test compliance (Labrague, McEnroe-Petitte, van de Mortel, & Nasirudeen, 2018). Some of the data that will be collected is whether and how many times per day, nurses will be filling the protocol and responding to the questions relating the need for the catheter.
Discussion
Defining nursing concepts might appear easy, but the process can be confusing. One of the issues is determining whether the available definition relates to the concept as used in nursing or a different discipline. For instance, compliance can be used in practice standards as well as in a legal perspective. Compliance and knowledge have been studied in different scientific points of view, including nursing, medicine, psychology, and health economics. Therefore, they lack a common definition. Lack of consistency in their definitions and measurements is a major challenge for researchers in nursing and other medical disciplines. Besides, studies that have defined the two concepts in the context of the standards for preventing catheter-associated urinary tract infection are limited. Therefore, in defining the two concepts, conceptually and operationally, it is imperative to review other related studies and apply the information in the context of the capstone topic.
Summary
The proposed capstone subject entails the application of a paper-based protocol to prevent catheter-associated urinary tract infection among critically ill patients. The researcher recognizes the high prevalence of catheter-associated urinary tract infections among patients using catheters. Therefore, it is necessary to implement an intervention to reduce the use of a catheter to the most necessary cases. The paper-based protocol will promote best practice in all units within the hospital by recording information every day for each patient regarding catheter use. Two concepts, knowledge and compliance, are analyzed regarding the topic. The conceptual and operational definitions of the two terms are given. In addition, the discussion includes issues and challenges involved in defining the concepts. Regardless of the challenges, it is critical to define the terms to ensure they are used effectively in the study.