Students Will Develop A 1,250-1,500 Word Paper That Includes The Following Information As It Applies To The Problem, Issue, Suggestion, Initiative, Or Educational Need Profiled In The Capstone Change Proposal:

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Problem statement
Purpose of the change proposal
Literature search strategy employed
Evaluation of the literature
Applicable change or nursing theory utilized
Proposed implementation plan with outcome measures
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.



Literature Review

Atsede Iyasu

NRS-490- 0500- Professional Capstone and Practicum

Grand Canyon University


Analysis of Literature Review


Catheter-associated urinary tract infection (CAUTI) more so in the ICU seems to be an issue that is challenging hospitals and health care centers. Nurses are the healthcare staffs who are responsible for ensuring that patients do not acquire CAUTI in their stay in the ICU (Mody et al., 2015). There are proven techniques and methods identified to be effective at preventing the catheter associated urinary tract infection. One technique that is highly mentioned in the prevention of CAUTI is strict aseptic technique and hand hygiene. The technique can significantly help nurses reduce CAUTI in intensive care units and lessen the health burden of patients in the intensive care unit (Bradley et al., 2018).

In order to confirm whether the above-mentioned technique is effective at preventing CAUTI, a literature review was carried out. The review touched on these method as well as other known methods or techniques for preventing CAUTI. A total of eight studies were reviewed. All the reviewed studies were on publications made between 2014 and 2018. It is important that the studies reviewed are not over five years old. The above was important as it ensured only relevant and up-to-date information established from the review. Comment by Shanna Foley: Great introduction. Be sure your thesis discusses the purpose of the current paper, not the purpose of your change proposal.

A comparison of the research questions

There were three main research questions that were identified in the studies reviewed. The first main research question identified was whether there was an effective scientific method of preventing CAUTI (Purvis et al., 2014). Five of the studies reviewed were interested in answering whether there is a well-known and established medical interventions or scientific interventions that can effectively prevent CAUTI. All the five studies are driven by the hypothesis that CAUTI can be prevented and treated by given medication and it is for the above reason that all the five studies were seeking to confirm whether medical interventions can effectively prevent the infection.

The second main research question was what is the role of hospitals or health centers in the acquiring of CAUTI? According to a publication done in 2017 by Theobald and his colleagues, Hospital conditions are the primary reasons that patients acquire CAUTI. The conditions being mentioned above include; general hospital cleanliness practices and the handling of patients. The third main research question identified was whether the method of administering and removing the catheter was the main reason that patients were acquiring CAUTI. Three of the studies reviewed seemed to run on the hypothesis that the main reason that CAUTIs are acquired is that the techniques of inserting and removing the catheters are not safe and are the loopholes that bacteria utilize to cause CAUTI (Trautner et al., 2015). Comment by Shanna Foley: Very good!

Comparison of the sample populations in the study

All the studies reviewed carried out their studies on large sample populations. Of all the eight studies the lowest population studied was 205 patients and it was on a study published in 2015 (Kwaan et al., 2015). The largest study population was 1500 patients and it was on a study published in 2014. The sample populations used in the study incorporated diverse populations as people from different ethnic backgrounds and ethnicities were part of the studies. One of the studies concentrated on hospital statistics on CAUTI whereas there was another study that concentrated on the number of bed days that patients suffering from CAUTIs took up in the treatment of the infection. Comment by Shanna Foley: Doing so helps with validity! Good. Comment by Shanna Foley: My only critique here is that you need to follow up the sentences that say… One of the studies, or In five of the studies… you need to place the in-text citation with all of the journals. You will just put the multiple citations. (author(s), date) (author, date) (author, date)

A comparison of the limitations of the studies

There were two main limitations of the studies that were analysed. The limitations seemed to cut across all the eight publications. The first limitation of the studies was that they overlooked other aspects or factors that could influence the development of CAUTI (Sabir et al., 2017). Each study had a particular factor or attribute leading to CAUTI that was being investigated. The above statement implies that the concentration on what was being investigated made other factors crucial to the development and prevention of CAUTI. The second main limitation of the eight studies was that none of the eight studies gave a concrete solution to the CAUTI challenge. None of the conclusions made from the studied gave a definite answer on how to prevent the disease. Six out of the eight studies concentrated on dealing with CAUTI as opposed to preventing it in the first place. A minor limitation of the studies that were analyzed was that little behavioral study of the causation of CAUTI was carried out (Babich et al., 2017). Comment by Shanna Foley: Very good!


According to the study findings as well as the limitations identified, it is very clear that there is a need for further research to be carried out on CAUTI. Based on the literature review, the prevention of CAUTI is possible through mixed methods; through the use of medical interventions and through the practice of health hygiene by the nursing staff. All the articles reviewed stated that unhealthy nursing practices such as the wrong technique of administering the catheter were the primary reason as to why CAUTI is a challenge in the health sector more so in intensive care units. In conclusion, according to the literature review, the controlling healthcare-acquired infections is directly related to the urinary tract infections related to the catheter; by controlling health acquired infections, hospitals and health centers would reduce the likelihood of CAUTI by almost 35% (Theobald et al., 2017 ). Comment by Shanna Foley: Very good job!

References Comment by Shanna Foley: Make sure this is at the top of the next page.

Babich, T., Zusman, O., Elbaz, M., Ben-Zvi, H., Paul, M., Leibovici, L., & Avni, T. (2017). Empirical antibiotic treatment does not improve outcomes in catheter-associated urinary tract infection: prospective cohort study. Clinical Infectious Diseases, 65(11), 1799-1805.

Bradley, C. W., Flavell, H., Raybould, L., McCoy, H., Dempster, L., Holden, E., & Garvey, M. I. (2018). Reducing Escherichia coli bacteremia associated with catheter-associated urinary tract infections in the secondary care setting. Journal of Hospital Infection, 98(3), 236-237.

Kwaan, M. R., Lee, J. T., Rothenberger, D. A., Melton, G. B., & Madoff, R. D. (2015). Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Diseases of the Colon & Rectum, 58(4), 401-405.

Mody, L., Meddings, J., Edson, B. S., McNamara, S. E., Trautner, B. W., Stone, N. D., … & Saint, S. (2015). Nurses Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes. Clinical Infectious Diseases, 61(1), 86-94.

Purvis, S., Gion, T., Kennedy, G., Rees, S., Safdar, N., VanDenBergh, S., & Weber, J. (2014). Catheter-associated urinary tract infection: a successful prevention effort employing a multipronged initiative at an academic medical center. Journal of nursing care quality, 29(2), 141-148.

Sabir, N., Ikram, A., Zaman, G., Satti, L., Gardezi, A., Ahmed, A., & Ahmed, P. (2017). Bacterial biofilm-based catheter-associated urinary tract infections: causative pathogens and antibiotic resistance. American journal of infection control, 45(10), 1101-1105.

Theobald, C. N., Resnick, M. J., Spain, T., Dittus, R. S., & Roumie, C. L. (2017). A multifaceted quality improvement strategy reduces the risk of catheter-associated urinary tract infection. International Journal for Quality in Health Care, 29(4), 564-570.

Trautner, B. W., Grigoryan, L., Petersen, N. J., Hysong, S., Cadena, J., Patterson, J. E., & Naik, A. D. (2015). Effectiveness of an antimicrobial stewardship approach for urinary catheter-associated asymptomatic bacteriuria. JAMA internal medicine, 175(7), 1120-1127.

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