Please do a paragraph about this post with this instruction .

post most have 4 or more sentences .

you also have to have a high quality post from a content perspective. This means it also needs to do more than agree with or praise a class mate. If you agree with a classmate, explain why, give an example, share what you learned in the reading

My chosen practice change is to develop and impliment a nurse-driven Foley catheter removal protocol for the Surgical ICU at a VA Medical Center.

Article 1: Buras, B. (2013). Ready, set, implement! Prevention Strategist, 6, 34-37. Retrieved from https://www.apic.org/Resource_/TinyMceFileManager/… CAUTI_PS1304-Winter-FINAL-2.pdf

Summary: This article provides an in-depth description of the development and implementation of a nurse-driven Foley catheter protocol, aimed at reducing CAUTIs. One of the focuses of the article was the education that was done with the nurses prior to the protocol being implemented.

Strength: Article gives a step by step walk through of the process from idea conception to evaluation. Could be modified and used as a guide through to EBP process with in the any healthcare system.

Weakness: Article does not contain much scientific data or results from their implementation.

Article 2: Daurat, A., Choquet, O. Bringuier, S. Charbit, J., Egan, M., Capdevila, X. (2015). Diagnosis of postoperative urinary retention using a simplified ultrasound bladder measurement.

Anesthesia and Analgesia, 120 (5), 1033-1038. doi: 10.1213/ANE.0000000000000595

Summary: This article discusses the problem of post-operative urinary retention (POUR) which is the reason catheters are placed, reinserted and retained in virtually all patients in the Surgical ICU. It gives scientific statistical data proving that bladder ultrasound can be utilized to diagnosis both POUR and any urinary retention.

Strength: This article describes the most frequent complication associated with early catheter removal, POUR. It also gives insight into the efficacy of utilizing a bladder ultrasound technique to diagnose POUR. Bladder scanning is proven in this article to be a tool that can be utilized as part of a Foley catheter removal protocol.

Weakness: This article is not specifically about CAUTI or a nurse-driven catheter protocol.

Article 3: Meddings, J., Rogers, M. A., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2013). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrated review. British Medical Journal of Quality and Safety, 23(4), 277-289. doi: 10.1136/bmjqs-2012-001774

Summary: This article is a summary of interventions commonly used to decrease the use of Foley catheters and the occurrences of CAUTI. It is a copulation of data from 30 different studies.

Strength: This article gives a detailed description of implementation and sustainability strategies that proved to be successful. It also backs up its suggestions with statistic data that demonstrates the levels of effectiveness.

Weakness: This article was not focused specifically on surgical or ICU patients or units.

Article 4: Purvis, S., Gion, T., Kennedy, G., Rees, S., Safdar, N., VanDenBergh, S., & Weber, J.

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. doi: 10.1097/NCQ.0000000000000037

Summary: This article describes an initiative at a VAMC to reduce CAUTIs. This process utilized current national standards and included surgical patients.

Strength: The process described in the article was carried out at a VA, which makes their process requirements similar to those in the facility of interest. It also describes the standardization of a protocol that includes epidurals and utilizes a multi-disciplinary approach.

Weakness: The initiative described in this article does not include ICU data specifically.

Article 5: Tsambarlis, P., Sherer, B., Godlewski, K., Deal, R. & Deane, L. (2016). Quantification of risk factors in 500 consecutive patients with postoperative urinary retention (POUR). The Journal of Urology, 195(4S), 973. Retrieved from http://www.jurology.com/article/S0022-5347(16)0199…

Summary: This article describes a scientific study that was performed on surgical patients. It identifies the most common risk factors for developing POUR, a common problem and reason for prolonged urinary catheterization within the SICU.

Strength: This article identifies which post-op surgical risks for POUR can be changed and modified with proper treatment and which are not.

Weakness: This article is not focused on CAUTI or a nurse-driven Foley removal protocol.

Article 6: Yatim, J., Wong, K. S., Ling, M. L., Tan, S. B., Tan, K. Y., & Hockenberry, M. (2016). A nurse-driven process for timely removal of urinary catheters. International Journal of Urological Nursing, 10(3), 113–177. doi: 10.1111/ijun.12113

Summary: This article describes the implementation of a nurse-driven Foley removal protocol. It includes details of the process used and their resulting CAUTI rate improvements.

Strength: This article focuses on Foley catheter removal and gives specific details about Foley removal exclusion criteria utilizing the mnemonic HOUDINI.

Weakness: While this article does discuss a Foley removal protocol it is not focused on the Surgical ICU or specifically discuss post-Anesthesia issues.