CONTROL CHART FOR CATHETER-ASSOCIATED URINARY TRACT 7
ControlChart for Catheter-Associated Urinary Tract
Acontrol chart is used to indicate whether a process is in a state ofstatistical control. It is astatisticaltool. Statistical tools employ statistical methods to monitor andcontrol a process in order to ensure preserved quality at the inputto the output. The tools also ensure that the process is operating atits full potential. The primary goal of statistical methods is toidentify trends and eliminate variations. It can be used to determineanegativeor a positive trend in performance. It is used to determine when aprocess should undergo a formal examination for quantity relatedproblems. It establishes whether there is stability and whether thevariations are common to the sources that are familiar with thesystem. If the source of variationsis common to the system, no corrections or changes to the parametersof the system are required. In addition, the data on the controlchart can also be used to predict the future expected performance ofthe system. When the chart indicates that the process being monitoredis out of control, the data can is used in establishing the cause ofthe variation. The variationsoften result in reduced performance of the process. In the case ofclinical control, the control chart can be used in hospitals todetermine the trends of catheter-associated urinary tract infections(CAUTI) (Bester field, 2004).
Accordingto (Chandran, 2012), the common symptoms of urinary infection areexperienced in the process of urination. A nurse can identify withthe disease from the description given by the patient. They includepain, or the patient describes to be feeling a burn during urination.In addition, the patient experiences frequent and urgent needs tourinate. The patient describes experiencingan altered color of the urine as either bloody red or the urinecontains pus and appears cloud, accompanied byfoul or a very strong urine stench. The males experience pain orpressure while the females experience pain in the pubic bone. Thereis also the experience of passing only a small amount of urinedespite experiencing a strong urge to urinate. Other symptoms includetiredness, weakness, fever, a combination of fever and irritability.Finally, the patient experiences loose stools combined with feedingproblems. Old patients have specialsymptoms for the Urinary Tract Infection such as mental changes andconfusion
Theurinary tract infections are the most regular nonsocial infections. Asubstantial number of recorded cases reported by acute carehospitals involved 40% casesof urinary tract infections. Asubstantial80% of urinary tract infections related to an indwellingurinary catheter. Urinary tract infections related to catheter causesan increase in hospital costs. In addition, they are associated withincreased mortality.   Majority of hospitals refer to theinfections aspresenting a preventable complication that can cause hospitalization(Bagga, 2012).
Thecommon practice involves patient assessment for accepted indicationsbefore placing an indwelling urinary catheter. The nurse appliesthe aseptic technique for manipulation, placement and themaintenance of the indwelling catheters. The medics later documentthe instances for all indwelling urinary catheters such as theinsertion date, indication and the removal date (Chandran, 2012).
Accordingto (Hillier, 2012), to construct the control table, the nurse needsat least one control sample of patients. In each single batch ofpatients, the nurse can establish one control sample of patients whohad a condition that referred to as anormalurinary tract condition with normalsymptoms of the urinary tract condition. This samplewill create the mean for the control table. The X sign atthe middle of the table depicts the mean.
Thetargeted outcome wasselectedfrom research conducted by Alexander Sparker.He is from the department of health sciences research in Mayo Clinic,Rochester, Minnesota. With him was James R Cerhan from theEpidemiology departmentCollege of public health at the University of Iowa. The reason thisdata has beenselectedis due to its use in relating the history of urinary tract infectionand the risk of catheter-associated urinary tract infections. Thecases included 233 males and 133 females who wereidentifiedthrough the Iowa cancer registry controls (Bester field, 2004).
Thedata wascollectedfrom 1,497males and 751 females.They wererandomly selectedfrom the general population. The frequency of the data was designedto match age and sex. The interviewees provided exhaustiveinformation on their size, functional capacities, and nutrition andhealth history risk factors. Upon the examination of age, threatamplified for interviewees with an account ofkidney or bladderinfection detected in the past by a physician. It related to a meanof 1.9 and 0.95 standard deviation compared those without suchhistory. Smoking and sex status modified the threat ofcatheter-associated urinary tract infections (CAUTI) associated witha history of Urinary Tract Infection. The highest risk wasassociatedwith males. It related to a mean of 2.7, and 0.95 standard deviation.Current smokers had a mean of 4.3 and 0.95 standard deviation.Greater threat related to ongoing male smokers with an account ofUrinary Tract Infection, which had a mean of 9.7 and 0.95 standarddeviation. Multivariate adjustment for anthropometric, lifestyle,and dietary factors did not alter these findings. Results suggest apositive association between Urinary Tract Infection history with andthe development of catheter-associated urinary tract infections, witheminent threat remarkable for males with an account of smoking. Thestudy identified a history of Urinary Tract Infection wasdefinedas having one or more physician-diagnosed kidney or bladderinfections. Furthermore, the data suggested evidence of aninteraction of history of Urinary Tract Infection with smoking.Higher threats werereportedfor male smokers with an account of Urinary Tract Infection. Thenurses in a hospital can use the control table to identify positiveand negative trends in patients with both diagnosisand as a follow up on the healing performance of their prescriptions.Further, they can determine a patient’s risk of developing theRenal Coronary Condition from their described history of UrinaryTract infection (Bester field, 2004).
Accordingto (Bester field, 2004), UCL means the upper control limit or theupper action limit. UWL means the upperwarning limit. LWL means the lower warninglimit while LCL means the lower control limit. Whenever the controlresults fall within a distance of 2 standard deviations from themean, the disease is under control. However, control results abovethe 2standard deviations indicate that the condition is critical sincethis is the warning limit. Results falling above the 3standard deviations indicate that the disease has advanced to a muchworse condition.
Thenurse can identify critical urinary conditions, normal conditions,developing conditions and early stages of the illness by relating thedata to the control table. The level of risk associated with thesymptoms is related to the patient’s demographic, anthropometric,lifestyle, dietary and medical history risk factors conditions asdescribed bythe patientsto determine critical conditions. For example, for patients whoreport a history of physician-diagnosed kidney or bladder infectionthe standard deviation is 0.9 and a mean of 1.9 compared to those whodo not have a physician diagnosed kidney infection.Similarly, the risk for male current smokers with a history ofUrinary Tract Infection will be evaluated using a mean of 9.7, and0.95 standard deviation. The nurse can identify whether thecondition lies between 1, 2 or 3 standard deviations in eitherdirection from the mean. A condition determined to lay near 1standard deviation to the mean,isanormalUrinary Tract Infection condition, the nurse can proceed andprescribe the accredited medicine to the patient. When the conditionis 2standard deviations to the mean, it is interpreted as a warning thatthe condition is critical and quick action should result onthe patient. Further, if the diagnosis indicates a 3standard deviation, it is then a far advanced condition.The chances are that the Urinary Tract Infection has developed to acatheter-associated urinary tract infections (CAUTI). The controlchart enhances the nurse’s ability to diagnose and offer thecorrect prescription to their patients. In addition, it will improvethe monitoring of patients’ recovery process.Throughthe abilityto monitor the nurse can identify the efficiency of variousprescriptions and hence identifythe most appropriate time to remove the indwelling catheters(Hillier, 2012).
Chandran,K. B., and Stanley E. Rittgers. BiofluidMechanics: The Human Circulation. 2nded. Boca Raton: CRC, Taylor & Francis Group, 2012. Print.urinary
Bagga,Arvind. UrinaryTract Anomalies and Infections in Children – ECAB.London: Elsevier Health Sciences APAC, 2012. Print.
Parsons,Matthew, and Linda Cardozo. FemaleUrinary Incontinence in Practice.London: Royal Society of Medicine, 2004. Print.
Hillier,Frederick S. X̄Chart Control Limits Based on a Small Number of Subgroups.Stanford: Applied Mathematics and Statistics Laboratories, StanfordU,2012. Print.
Besterfield,Dale H. QualityControl.7th ed. UpperSaddle River, NJ: Pearson Prentice Hall, 2004.Print.