Nursing theories are the support of nursing practice nowadays. Application of nursing theory into practice has significant impact on improving quality of patient care and overall healthcare outcomes. In particular, a practice theory called Plan-Do-Study-Act cycle (PDSA), developed by W. Edwards Deming, can be applied to improve processes in healthcare settings. According to Varkey, Relle, & Resar (2007), this theory “involves trial-and-learning approach in which a hypothesis or suggested solution for improvement is made and testing is carried out on a small scale before any changes are made to the whole system” (p. 736). Healthcare processes need to be constantly evaluated based on evidenced-based-practice for quality improvement and better patient outcomes. Nursing leaders have significant impact on quality management and empowering employees to seek process improvement.
In my paper, I will discuss application of PDSA cycle in quality improvement to decrease catheter-associated-urinary-tract-infections (CAUTIs) among elderly patients. Gained knowledge will help with identification of strategy to reduce the number of CAUTIs in acute care settings. Furthermore, staff will be empowered to improve the delivery of care to this population and management will revise existing policies and procedures to provide standards for improved practice. Overall, reduction in the occurrence of CAUTIs will result in higher quality management and better patient outcomes.
During hospitalization for other conditions within ones health, healthcare-associated-infections (HAIs) develop. According to Stone (2009), they are the fifth leading cause of death in United States acute-care facilities. Most common infection that accounts for 32% of the total HAI estimate is CAUTI and eighty percent of them are caused by the use of indwelling catheter (Buchmann & Stinnett, 2011). The most important factor in the development of CAUTI is the length of time of catheterization. Other risk factors include: patient age, sex, comorbidities, and elevated serum creatinine level (Sedor & Mulholland, 1999). Furthermore, CAUTI is one of the leading causes of change in mental status among elderly patients. The signs and symptoms associated with UTI among elderly include “lethargy, disorientation, increased or new onset of confusion, and delirium” (Sundvall, Ulleryd, & Gunnarsson, 2011, p. 2). A urinary tract infection develops due to an attack of disease causing organisms that reproduce in the host. Most common microorganism that is responsible for development of CAUTI is Escherichia coli (E-coli) and most common treatment is an antibiotic (Buchmann & Stinnett, 2011).
One of the goals of Healthy People 2020 is prevention, reduction, and eventually elimination of HAIs ("Healthcare-associated infections," 2013). Center for Disease Control and Prevention specifies appropriate indication for the use of indwelling catheter among patients...