NURS FPX 4025 Assessment 2 Role of Evidence-Based Practice in Recurrent Urinary Tract Infections

Role of Evidence-Based Practice in Recurrent

Urinary Tract Infections

Student name

Capella University

NURS-FPX4025

Professor’s Name

Submission Date

Introduction

The most significant clinical issue in patients undergoing intermittent catheterization, such as neurogenic lower urinary tract dysfunction, is recurrent urinary tract infections (UTIs). The traditional approaches to managing UTI have tended to focus more on the treatment than the prevention of the same, resulting in the unnecessary use of antibiotics and hence antimicrobial resistance. Research indicates that more than half of original UTIs are related to one or more antibiotic-resistant bacteria and that the resistance increases with each subsequent infection, to 65 percent for a single or multiple antibiotic group, and 20 percent for three or more groups, in repeat infections ( Center for Infectious Disease Research and Policy, 2024).

As the nursing practice continues to vary, evidence-based practice (EBP) has turned out to be a very important aspect of guiding clinical judgments that may result in patient safety, quality care, and better long-term patient outcomes. The current paper follows the recurrent UTI diagnosis implementation in intermittent catheter users and applies the evidence-based practice model to explore and apply the valid evidence to improve nursing assessment and management strategies.

Role of Evidence-Based Practice in Treatment Selection

UTIs (recurrence) in intermittent catheter patients are a complex diagnosis that relies upon behavioral, physiological, and procedural factors. UTIs are so prevalent in the population with neurogenic bladder undergoing intermittent catheterization that recent statistics indicate that about 70% of people who undergo clean intermittent catheterization (CIC) have a UTI, and 79% of people who have indwelling catheters also develop a UTI within the scope of the follow-up. It emphasizes the fact that the risk of infection is directly related to the approach to bladder management and cannot be eradicated by CIC only (Elliott et al., 2025). Neurogenic bladder dysfunction patients are also expected to lose their sensation, experience incomplete bladder emptying, bowel impairment, and inconsistent catheterization.

They are unable to keep the same approach to catheterization. These hardships predispose to the infection and most frequently end up in a cyclic course of antibiotics, with the clinical symptoms not being clear. Not only does this trend expose patients to the adverse impact of the drugs, but it also leads to the development of antibiotic resistance and loss of treatment efficacy over time (Lauridsen et al., 2022). This is a part of the reasons why an EBP approach is particularly effective in the given situation because it enables nurses to critically assess available literature on the subject of UTI prevention, effective assessment, and patient-centered care of managing the disease. Consequently, the adoption of the EBP model means that the recommendations made in terms of the UTIs treatment are guided by the best quality of studies to make sure that the patients receive more effective and individual treatment.

Application of the Evidence-Based Practice Model

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model was selected as the most appropriate model to be implemented to address the recurrent UTIs among the intermittent catheter users. The model is also widely used in nursing practice because it is simple, practical, and highly interested in evidence-based clinical practice. JHNEBP Model may be split into three significant stages, one of whichis the Practice question phase, the next step is the Evidence phase, and the final step is the Translation into practice (Tsistinas, 2020). The first step of the model is the Practice Question, which is to define the clinical issue, in other words, how the evidence-based nursing assessment and preventive measures can be used to reduce the UTI recurrence and, simultaneously, to stop the irrelevant use of antibiotics.

This needs to be done to ensure that the significant focus is placed on patient safety, nursing-based assessment, and preventive care rather than the treatment method only, especially when dealing with a population that has complex and recurring forms of disease. The second step, Evidence, is the step in which the pertinent research studies, clinical guidelines, and high expert recommendations are distinctly determined and critically reviewed to determine the strength and applicability of presented evidence on intermittent catheterization and UTI prevention.

The final step of the JHNEBP model is translation, which entails the latest evidence into the clinical environment via developing nursing recommendations, patient education, and outcomes assessment. It is needed to ensure that the results obtained through evidence-based methods will be correctly implemented and supported in practice, particularly to avoid the frequent occurrence of infections owing to regular assessments and contact with patients (Lauridsen et al., 2022). The JHNEBP model can be applied in this diagnosis because the effective management of recurrent UTIs requires the use of the evidence-based decision-making process that considers the behaviors of the patients, the clinical risk factors, and the feasibility or infeasibility of the nursing interventions.

This type of systematic action will assist the nurses in making prudent decisions, which will result in the enhancement of accuracy in assessing, preventive health, and patient outcomes. The approach to the integration of evidence-based practice factors into this model will provide the assurance of uniformity in nursing care and patient-centred care and reduce the inconsistency of practice and the possible emergence of complications linked to infection.

Application of the Evidence-Based Practice Model to Urinary Tract Infections

A systematic search was conducted in the JHNEBP Model to find out the high-quality evidence regarding the recurrent UTI in individuals under intermittent catheterization. The Practice Question was carried out and centered around the clinical issue of the improvement of nursing assessment and prevention approaches to reduce the incidence of UTI recurrence without resorting to the use of inappropriate antibiotics. In this step, they needed to identify evidence that would encompass the practice of nursing assessment and the aspects of patients that would influence the risk of infection.

The search of peer-reviewed databases was completed during the Evidence stage to identify the studies related to intermittent catheterization, UTI assessment, prevention tools, and patient-centered care. It was decided to select the article by Lauridsen et al. (2022) as one of the key sources since it concentrated on the nursing and user experience of the UTI assessment, paying attention to the structured assessment and prevention-oriented care.

This search was then limited to review literature on infection prevention and antimicrobial stewardship in neurogenic bladder patients. The diagnosis and stewardship-based approach to decision-making was confirmed as the sole way to limit unnecessary exposure to antibiotics, and the prevention approach, such as the technique consistency of catheterization, hydration, and bowel management, was the focus of the study by Pannek (2020). In the Translation stage, the findings of these studies were combined to determine what they portended to the nursing practice, particularly to improve the quality of assessment and patient education. An additional challenge in this step that was one of the most crucial, was integrating behavioral and clinical evidence into a single nursing plan. However, the JHNEBP model ensured that the evidence chosen was clinically useful and could be applied in order to improve patient outcomes.

Using the JHNEBP Model to Guide Evidence Search

Several challenges were experienced when an evidence search was conducted through the JHNEBP model when it was applied in the case of recurrent UTIs. The big task with the practice question was to develop a formulated clinical inquiry that would involve both the physiological mechanism of infections and behavioral issues associated with the use of an intermittent catheter. UTIs of neurogenic bladder patients had a high multifactorial nature; this indicated that the problem had to be taken seriously to ensure that the question reflected on nursing evaluation, prevention, and the patient. The quality of the study, its applicability to the adult neurological population, and to nursing practice had to be determined during the stage of Evidence as not all studies were based on nursing interventions.

The other challenge was the distinction between evidence on symptomatic UTIs and those studies on the subject that focused on asymptomatic bacteriuria, in which inadequate management of the latter can result in resistance to antibiotics. Compared to Lauridsen et al. (2022), who concentrated on the user-reported symptoms and structured assessment, other sources had to be evaluated thoroughly to determine how they can be applied to the nursing practice. This stage of synthesis required striking a balance between clinical applicability and patient safety in the process of integrating qualitative and quantitative evidence. The JHNEBP model provides a structured approach that supports the systematic and reliable analysis of evidence on which the nursing care is based, despite the challenges indicated above.

Credibility and Relevance of Evidence

The credibility and relevance of each of the chosen sources in the context of the study of recurrent urinary tract infections in intermittent catheter users were critically appraised. The article of Lauridsen et al. (2022) in Biomed Central (BMC) Nursing exhibited high credibility because of its peer-reviewed design, well-defined methodology, and taking into account both patient and nurse perspectives, which highly contributed to nursing practice. Its emphasis on evaluation and prevention fitted well with diagnosis and nursing intervention in the treatment of UTI. The article by Abbott et al. (2022) is a reliable source of information on antimicrobial stewardship as it appears in a reputable journal in the field of infectious diseases, i.e., Clinical Microbiology and Infection, supporting the need to diagnose a person precisely and make decisions on the basis of evidence.

Likewise, the Pannek (2020) review provided useful information on neurogenic bladder population preventive measures, which makes it more applicable to intermittent catheter users. These studies offered broad, evidence-based views as compared to anecdotal or outdated sources, with recent research backing them. They were in a better position to face the complexity of recurring UTIs since they were peer-reviewed and applicable to both clinical and nursing practice, as compared to single-focus or non-nursing-centered research.

Conclusion

An evidence-based practice model should be used in the nursing care of patients with recurrent urinary tract infections. JHNEBP Model offered a systematic format in the detection, analysis, and utilization of reliable evidence to enhance accuracy in assessment and preventive care measures. Despite the presence of challenges: variability of symptoms and uncertainty in diagnosis, collecting high-quality evidence in combination with clinical expertise facilitates safer, more effective, and patient-centered care. The given approach indicates that evidence-based practice has a significant role in increasing the quality of nursing decision-making and decreasing the rate of unnecessary antibiotic administration and the long-term outcomes of people with neurogenic bladder dysfunction.

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