Made available in DSpace on 2014-12-17T14:46:39Z (GMT). No. of bitstreams: 1 ParticiaCBF_DISSERT.pdf: 926078 bytes, checksum: 9ea88765b5e731681c2629ed4e7288ec (MD5) Previous issue date: 2009-09-29 / A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection. / Estudo descritivo, de abordagem quantitativa e observacional n?o participante, que teve como objetivo geral analisar a associa??o do conhecimento e conduta de inser??o e manuten??o da sonda vesical de demora pelos profissionais de enfermagem na ocorr?ncia de infec??o do trato urin?rio, realizado na UTI do Hospital Universit?rio Onofre Lopes em Natal/RN. A amostra pesquisada foi composta por 42 profissionais da equipe de enfermagem, sendo cinco (5) enfermeiros e 37 t?cnicos de enfermagem, deles 27 eram terceirizados (FUNPEC e bolsistas do IEL) e 10 servidores da UFRN. A coleta de dados foi realizada atrav?s de dois instrumentos, o primeiro utilizado na observa??o procedimentos de inser??o e de manipula??o da Sonda Vesical de Demora (SVD) e o segundo, com a aplica??o de um question?rio que abordou dados de caracteriza??o dos pesquisados, conhecimentos e conduta na inser??o e manipula??o da SVD. Os resultados foram tabulados no Excel e analisados atrav?s do programa estat?stico SPSS, vers?o 15.0. Encontramos a predomin?ncia de funcion?rios com v?nculo institucional terceirizado IEL e FUNPEC - (64,3%), do sexo feminino (69,0%), na faixa et?ria de 21 a 35 anos (59,5%) e com n?vel m?dio de escolaridade (88,1%). Quanto aos conhecimentos, verificamos que os enfermeiros apresentaram n?vel de bom a ?timo e os t?cnicos de enfermagem, de regular a ruim. Os enfermeiros erraram mais na escolha da SVD (40,0%) e na lavagem das m?os (30,0%) e os t?cnicos, na lavagem das m?os (74,4%) e no conte?do da bandeja (34,7%). Em rela??o ?s condutas de inser??o da SVD, os enfermeiros erraram mais na escolha da SVD (66,7%) e na lavagem das m?os (57,1%). Em rela??o ? manipula??o da SVD/sistema de drenagem, os t?cnicos erraram mais ao lavar as m?os (56,0%). Ao analisarmos as condutas inadequadas com a categoriza??o do conhecimento, vimos que os t?cnicos de enfermagem que erraram mais apresentaram conhecimentos inadequados (ρ = 0,001). Ao final, vimos que o risco de um paciente adquirir ITU est? maior em duas vezes e meia quando ocorre um n?mero grande de inadequa??es, paciente passa mais tempo usando a SVD e internado na UTI. Quanto ?s hip?teses do estudo, aceitamos a Hip?tese alternativa e rejeitamos a hip?tese nula proposta no in?cio desta pesquisa, onde a quantidade de inadequa??es no conhecimento e conduta aumenta a ocorr?ncia de infec??o do trato urin?rio.

The passing of the act on non-physician medical professions and the decree on activities of healthcare workers has brought numerous changes that are also linked to changes of nurse competences. Aim 1: To find out whether nurses with ARIC specialization perform male urethral catheterization. Aim 2: To find out whether nurses with ARIC specialization are interested in improvement of their knowledge of male urethral catheterization. Aim 3: To find out whether nurses with ARIC specialization have sufficient practical skills in male urethral catheterization. Aim 1: To find out what opinion physicians have on male urethral catheterization performed by a nurse specialized in ARIC. Aim 2: To find out whether physicians let nurses specialized in ARIC perform male urethral catheterization. The research part of the thesis was based on quantitative and qualitative research. The research results will be provided to head nurses in the hospital where the research was performed. The results might be useful for preparation of a specialization course focused on male urethral catheterization not only for nurses specialized in ARIC, but also for nurses that are interested in performing the procedure in the future, particularly as it is known that no such a course exists in the South Bohemia. The results might also be used as an input to further research.

Background: Catheter-associated urinary tract infections (CAUTIs) are a major source of avoidable hospital-acquired infections. The scientific evidence supports utilization of nurse-driven protocols to reduce CAUTIs. Purpose: The purpose of this quality improvement project was to update and implement an evidence-based CAUTI prevention protocol for the nursing staff on a medical-surgical unit in an adult acute care hospital to decrease the utilization of indwelling urinary catheters and CAUTIs. Theoretical Framework: Donabedian’s structures, processes, and outcomes (SPO) model was utilized as the framework for this project. Donabedian’s SPO model focuses on strong healthcare structures and processes to improve nurse, patient, and organizational outcomes. Methods: This project utilized a quantitative design. A convenience sample of 28 nurses from the medical-surgical unit of a South Florida hospital participated in the project. An educational intervention was delivered on CAUTI prevention based on guidelines from regulatory agencies, and the hospital existing protocol was updated and revised to reflect the guidelines. The sample was administered a short demographic survey, and 10-item pretests and posttests on CAUTI prevention before and after implementation of the standardized evidence-based protocol. To determine possible differences in nurses’ knowledge and perceptions of indwelling urinary catheters before and after the implementation, paired t tests were conducted. To determine if the proportions of days with urinary catheters were statistically significantly different 30 days before and after implementation of the standardized evidence-based guideline, a 2-proportion z-test was conducted. Results: On analysis of the pretests and posttests, a statistically significant difference was found in 6 of the 10 questions, indicating that nurses’ knowledge and perceptions of CAUTIs improved after the intervention (p < .001 to p < .043). After the intervention, urinary catheter days relative to patient days also decreased significantly (z = 5.562, p < 0.001). Conclusion: Implementation of an evidence-based nurse-driven protocol in a hospital in South Florida improved nurses’ knowledge and perceptions of CAUTI prevention. Nursing practice and healthcare delivery can benefit from development of such guidelines and educational interventions to empower nurses to better manage patients’ indwelling urinary catheters, and decrease the incidence of CAUTIs in hospitals.