Theurinary tract infection is a health problem that affects the urinarytract, especially in women, due to the infection of the bladder bybacteria (Romito, 2012). When bacteria multiply in the urine, theycause infection in the bladder and the urinary tract. It occursmainly due to sexual activity, pregnancy, previous infection,catheterization, instrumentation and dehydration. This condition hassignificant impacts on the patient and the rehab unit. As a nurseworking in the rehab, I would experience a lot of challenges withpatients who suffer from this health problem.
UrinaryTract Infection (UTI) causes a lot of discomfort to the patient,causing him or her to exclude himself or herself from other people.It also increases the length of stay in the hospital and cost oftreatment. Furthermore, some cases may lead to death. Patients withUTIs have the urge of urinating frequently, and when they do, theyget a burning sensation which makes them uncomfortable. These issuesare usually caused by the complications associated with the disease,including cystitis, gram-negative bacteremia and endocarditis(Romito, 2012). Some UTIs may also cause infections of the kidney,leading to poor functioning of the kidney or kidney scars. They mayalso lead to permanent damage of the kidney.
Theinpatient rehabilitation facility unit experiences a lot ofchallenges as we provide treatment to patients infected with UTI. Inparticular, I have to endure a lot work as I test, treat and monitorthe progress of patients. Due to the discomfort and frequent urge ofpatients to urinate, I will have the challenge of surveillance on thepatients as a nurse in the rehab. Furthermore, I will be likely toface challenges of experiencing undiagnosed UTI because patients inthe rehab facility with urinary catheter may be infected through theinstrument (Romito et al, 2012). This means that I will treat a newdisease that was not expected. As a nurse, I am always involved indecisions regarding the use of catheter, which requires me to providemore surveillance when the catheter results in UTI. Lack ofinvolvement makes it difficult to address the condition.
Iwill use Quality management tools may to analyse and monit6or the UTIproblem in the rehab facility unit. There are surveillance programsin the unit used to monitor urine culture and progress of thecondition. During monitoring, I will observe the patients todetermine whether the symptoms of the disease have disappeared orstill persistent. If they are still there, the recommendation wouldbe for the patient to return to the clinic for assessment and furthertreatment. I will also recommend urinalysis to be done regularly foras long as the symptoms are seen.
Someof the qualitative improvement tools that I may use includeflowcharts, run chart, pareto chart and Gantt charts (Perry et al,2014). Specifically, I will use flowcharts and the PDCA model toanalyse and monitor patients with UTI in the rehab facility. PDCAmodel refers to a few steps used to improve the quality of a service.Such steps are: Plan-Do-Check-Act. These steps are used to implementmonitoring and analysis initiatives for UTI patients gradually asimprovements are made as required. My first step will be to “plan”,which involves the establishment of objectives required from themonitoring and analysis of patients (Perry et al, 2014). Step 2 is“Do” which refers to the implementation of the plan. The thirdstep is “Check”, whereby I will study the implemented programsand compare them with the expected results. Lastly, I will “Act”by improving on the prior standards and providing new standards asthe rehabilitation unit goes forward. The flow chart is the primaryqualitative improvement tool used in this model, as shown below.
Objectives of the monitoring and analysis process: reduce symptoms of UTI, reduce discomfort of patients, increase nurse’s participation in Catheter usage, avoid kidney infection
Urine microscopy urine analysis antibiotic treatment bacteriological cure rehab unit nurses participate in catheter usage.
Check symptoms 14 days after treatment
Test regularly after treatment to identify infection
Measure the effectiveness of catheters after the participation of rehab unit nurses.
If the actions fail and the patient experiences the symptoms:
Use other antibiotics
Refer patients to clinic for urinalysis
Increase participation of nurses from other units regarding the use of catheters
Fromthe flowchart, it is clear that the objectives include those thatwill provide solutions to the problems of patients and nurses. I willimplement these steps within the unit. Monitoring system alsoinvolves regular checking of the implemented treatment and diagnosismechanisms. Appropriate actions are provided to change the existingsystem if the symptoms of the disease continue showing even after theimplementation. These steps are implemented sequentially after asignificant period has been allowed for the symptoms to subside,preferably 3 to four weeks (Lo et al, 2014). The new standards areexpected to improve the quality of service provided to the UTIpatients.
Lo.,E. Et al (2014). Strategies to Prevent Catheter-Associated UrinaryTract Infections in Acute Care Hospitals: 2014 Update. InfectionControl and Hospital Epidemiology,35(5), 464-479.
Perry,A.G., Potter, P.A., & Ostendorf, W. (2013). Clinicalnursing skills & techniques.St. Louis, Missouri: Elsevier.
Romito,D., Beaudoin J.M. and Stein, P. (2012). Urinary tract infections inpatients admitted to rehabilitation from acute care settings: adescriptive research study. RehabilitationNursing,36(5), 216-222.