Iatrogenesis

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IATROGENESIS 6

PartOne

Analysisof the Clinical Outcomes

Theiatrogenic catheter-associated UTI has many clinical outcomes. First,it results in longer hospital stays for patients. The extended periodand the medication offered increase the treatment expenses of thesick people significantly. Second, it leads to various complicationsin men such as orchitis, prostatitis, and epididymitis. In the caseof women, the condition leads to various infections such asendophthalmitis, vertebral osteomyelitis, and meningitis amongothers. Fourth, individuals suffering from the infection experiencesevere discomfort that may include severe pain. Lastly, it is alsoassociated with causing deaths to some patients (CDC, 2017).

Analysisof the Financial Outcomes

Theiatrogenic catheter-associated UTI has adverse financial impacts onboth hospitals and patients. In the case of the sick individuals, theextended stays in the medical centers imply that they lose incomebecause they cannot go to work. Besides, they are forced to digdeeper into their pockets to pay for the medication and servicesoffered at the health facility. Similarly, health institutions losemoney due to iatrogenic catheter-associated UTI since the FY2017 Domain Weightingpolicy requires infirmaries to cut back the cost of clinical care byfive percent. In addition, the policy has increased the Safety DomainWeight to 20 percent. This means that the hospitals will charge thepatients 20 percent less on all the safety services offered and theclinical care by 5 percent. The reduction would result in less incomefor the facilities (CMS to improve quality of care during hospitalinpatient stays, 2014). It is worth noting that the Centers forMedicare &amp Medicaid Services do not refund health facilities forhospital acquired infections since 2008.

Rolesof a Clinical Nurse Leader

Theclinical nurse leaders (CNLs) develop evidence-based research intopractical nursing skills. They can help to improve iatrogeniccatheter-associated UTIs cases in a health facility throughconducting research on possible causes of the problem and thendeveloping a solution to solve the challenge once and for all.Besides, the professionals are highly skilled in the management. Theycan help to control widespread UTI prevalence through guiding thehealth care staff to develop effective strategies to avert newinfection cases (Kehyani, 2016).

PartTwo

DesiredNursing Outcome

TheAmerican government has an elaborate plan to enhance and improve forall the citizens. Through several benchmarks, the government aims atencouraging collaboration among stakeholders. Another desired outcomeis to make citizens make informed health decisions. It is hoped thatthe adoption of best practices for preventing CAUTI will be utilizedby all healthcare facilities. The goals are achievable throughquality improvement programs to achieve appropriate placement, care,and removal of catheters.

Comparisonof Desired Outcomes with Illinois State Standards

In2011, Illinois reported 41 percent bloodstream infections than theapproximated figures. The state requires health facilities to reportdata to the CDC on CLABSIs and CAUTIs. To attain improved outcomes,the state undertakes regular audit on medical records. It has alsoformulated and implemented the CAUTI Prevention Collaborative besidesthe involvement with antimicrobial stewardship activities (TheCenters for Disease Control and Prevention, 2017). The state ofIllinois has performed better on the desired outcomes than moststates in the US.

Comparisonof Desired Outcomes with the National Standards

Thedesired iatrogenic catheter-associated UTI outcomes are far below thenational standards. The target of the national standard is less thanten percent. Nonetheless, CDC (2017) states that 93, 300 (12%) of theadult population in acute care facilities suffered from thecondition. Given that the national standard benchmark is below 10%,the efforts of respective healthcare bodies have not yet attained thebenchmark. CAUTIs increase the length of stay of more than 80% ofgeriatric patients confined in various nursing homes (Qualitymeasures compared to achievable benchmarks, n.d). It also causesmortality rates of above 13,000 patients every year, which impliesthat the presentcontrolrate is far much below the desired outcome (Carter, Reitmeier, &ampGoodloe, 2014).

Comparisonof Desired Outcomes with Elmhurst Memorial Hospital

Accordingto Rowe and Juthani-Mehta (2013), women above 65 years have UTIincidence rate of more than 10 percent. The Illinois Department ofPublic Health (2016) report indicated that Elmhurst Memorial Hospital(Elmhurst) was compensated $26,317.34 for the treatment ofUTI-related conditions. Nonetheless, the facility reported zeroiatrogenic CAUTIs on the same year, which means that the facilityaccomplished the desired nursing outcome in the year 2016 (ElmhurstMemorial Hospital Ratings, 2017). Nonetheless, the same study arguesthat the results were not better than the national standard since thefacility had a low turnout of patients.

References

Carter,N., Reitmeier, L., &amp Goodloe, L. (2014). An evidence-basedapproach to the prevention of catheter-associated urinary tractinfections.&nbspUrologicNursing,34(5),238-245. doi:10.7257/1053-816X.2014.34.5.238

CMSto improve quality of care during hospital inpatient stays. (2014,Oct. 4). Centersfor Medicare &amp Medicaid Services.Retrieved fromhttps://www.cms.gov/newsroom/mediareleasedatabase/fact-sheets/2014-fact-sheets-items/2014-08-04-2.html

ElmhurstMemorial Hospital Ratings (2016, March 8). ConsumerReports.Retrieved fromhttp://www.consumerreports.org/health/doctors-hospitals/hospitals/hospital-ratings/elmhurst-memorial-hospital-6431620-report-card.htm

IllinoisDepartment of Public Health (2016). Median charges: Urinary tractinfections. IllinoisHospital Report Card and Consumer Guide to Health Care.

Kehyani,M. (2016). Implementing ways to reduce catheter-associated urinaryinfections (CAUTIS). Universityof San-Francisco.Retrieved fromhttp://repository.usfca.edu/cgi/viewcontent.cgi?article=1337&ampcontext=capstone

Qualitymeasures compared to achievable benchmarks. (n.d). NationalHealthcare Quality and Disparities Reports.Retrieved fromhttps://nhqrnet.ahrq.gov/inhqrdr/National/benchmark/summary/All_Measures/All_Topics

Rowe,T. A., &amp Juthani-Mehta, M. (2013). Urinary tract infection inolder adults. AgingHealth,9(5),10.2217/ahe.13.38. http://doi.org/10.2217/ahe.13.38

TheCenters for Disease Control and Prevention (CDC) (2017). Urinarytract infection (Catheter-associated tract infection [CAUTI] andnon-catheter-associated urinary tract information [UTI]) and otherurinary system infection [USI] events. DeviceAssociated Module.