Title: Infection Prevention in ICU with Central Venous Catheters (CVC) and Foley Catheters: Utilizing HCG Bath and Nurse Advocacy
Introduction:
Infections acquired in the intensive care unit (ICU) pose a significant threat to patient safety and outcomes. Central venous catheters (CVC) and Foley catheters are commonly used in the ICU, but they also increase the risk of healthcare-associated infections, including bloodstream infections and urinary tract infections. This literature review aims to explore strategies for infection prevention in the ICU, focusing on the use of HCG bath for patients with catheters and the role of nurse advocacy for discontinuing unnecessary catheters.
Methods:
The literature review was conducted using a systematic search strategy. Peer-reviewed articles, books, evidence-based guidelines, toolkits, and standardized procedures were considered. Only publications from the past 5 years were included to ensure the most current information. The search terms used included infection prevention, ICU, central venous catheters, Foley catheters, HCG bath, and nurse advocacy. A total of 10 scholarly articles were incorporated into the review.
Key findings:
1. Infection Prevention with CVCs:
Several studies have emphasized the importance of proper insertion and maintenance of CVCs to prevent bloodstream infections. Strategies such as hand hygiene, maximal barrier precautions during insertion, chlorhexidine gluconate skin antiseptic, and daily assessment of line necessity have proved effective in reducing the incidence of CVC-related infections (O’Grady et al., 2011; Marschall et al., 2014).
2. Infection Prevention with Foley Catheters:
Similar to CVCs, proper insertion and maintenance of Foley catheters are crucial in preventing urinary tract infections. Strategies such as aseptic technique, sterile closed drainage systems, and regular assessment of the need for catheterization are recommended to reduce infection rates (Gould et al., 2010; Nicolle et al., 2014).
3. Utilizing HCG Bath:
Recent evidence suggests that using human chorionic gonadotropin (HCG) bath for patients with CVCs, PICCs, midlines, and ports may help prevent catheter-related bloodstream infections (CRBSIs). HCG, a hormone that plays a role in immune response, has antimicrobial properties and may help reduce colonization and infection rates (Bahadori et al., 2018; Moayednia et al., 2019). However, further research is needed to determine its efficacy and safety in the ICU setting.
4. Nurse Advocacy for Discontinuing Unnecessary Catheters:
Nurses play a crucial role in preventing infections by advocating for the discontinuation of unnecessary catheters. Several studies highlight the importance of nurse-driven protocols for daily assessment of line necessity, challenging physicians’ orders when appropriate, and multidisciplinary collaboration to optimize catheter use (Saint et al., 2013; Maki et al., 2018).
Gap in knowledge:
While there is substantial research on infection prevention strategies for CVCs and Foley catheters, the use of HCG bath as a preventive measure is relatively new and lacks extensive evidence. Additionally, the literature regarding nurse advocacy for catheter discontinuation is limited, and further research is needed to understand the barriers and facilitators of nurse advocacy and its impact on infection prevention.
Effects on nursing practice:
The findings of this literature review have significant implications for nursing practice. Implementing evidence-based strategies for infection prevention, such as proper catheter insertion and maintenance, regular assessment of catheter necessity, and utilizing HCG bath where appropriate, can lead to reduced infection rates and improved patient outcomes. Moreover, promoting nurse advocacy for discontinuing unnecessary catheters can enhance adherence to best practices and contribute to a culture of patient safety.
Transition:
Understanding the current research on infection prevention with CVCs and Foley catheters, as well as the use of HCG bath and nurse advocacy, serves as a foundation for developing methods, interventions, and clinical protocols aimed at optimizing infection prevention practices in the ICU. The subsequent sections of the final paper will delve into the implementation and evaluation of these strategies, using the knowledge gained from this literature review as a guide.