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

Recurrent urinary tract infections (UTIs) represent a significant clinical problem in a patient undergoing intermittent catheterization, particularly in patients with neurogenic lower urinary tract dysfunction. Traditional approaches to UTI management tend to be more treatment-oriented than preventive-oriented, which has contributed to unnecessarily taking antibiotics and later antimicrobial resistance. Research indicates that a majority of first UTIs are associated with bacteria resistant to at least one antibiotic, and with every infection, the resistance is enhanced, with the first infection showing resistance to one or more antibiotic classes, and the second and subsequent infections showing resistance to three or more antibiotic classes (Center for Infectious Disease Research and Policy, 2024).

The dynamic nature of the nursing practice has made evidence-based practice (EBP) one of the key considerations in guiding clinical decision-making that can result in patient safety, high-quality care, and enhanced patient outcomes in the long term. The current paper follows the process of the recurring UTI diagnosis performed among intermittent catheter users and applies an evidence-based practice model to explore and put into practice the sound evidence to improve nursing assessment and management practices.

Role of Evidence-Based Practice in Treatment Selection

Recurrent UTIs in intermittent catheter patients are a complex diagnosis, which is contingent on behavioral, physiological, and procedural factors. Recent statistics indicate UTIs are very prevalent amongst individuals with neurogenic bladder when taking intermittent catheterization, and according to statistics, about 70 percent of individuals who practice clean intermittent catheterization (CIC) develop at least 1 UTI, and 79 percent who have an indwelling catheter develop a UTI during the follow-up. It emphasizes that the risk of the infection is highly related to the means of managing the bladder and is not defeated by CIC (Elliott et al., 2025). Neurogenic bladder dysfunction leads to loss of sensation, incomplete bladder emptying, bowel malfunction, and patients with neurogenic bladder dysfunction cannot maintain consistent catheters. They fail to adhere to the same technique of catheterization.

These challenges put one at risk of infection and, in most cases, lead to a sequence of antibiotic prescriptions, in which the clinical manifestations are not known. This tendency not only places patients at risk of the adverse effects of the drugs but also leads to the emergence of antibiotic resistance and the reduction of the effectiveness of treatment in the long term (Lauridsen et al., 2022). This is among the reasons why the EBP approach is particularly helpful in the given case setting since it enables nurses to critically analyze available studies on the issue of UTI prevention, effective assessment, and a patient-centered approach to managing the disease. Thus, the application of the EBP model means that the recommendations on the UTIs treatment are presented on the basis of the best quality of the studies to provide the patients with the most efficient and personalized treatment.

Application of the Evidence-Based Practice Model

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model has been selected as the best model to be implemented in addressing the recurrence of UTIs among the intermittent catheter users. This model is also common in nursing practice owing to its simplicity, practicability, and good predisposition to evidence translation to clinical practice. The JHNEBP Model may be broken down into three broad steps, one of which is the Practice question step, another is the Evidence step, and the last one is the Translation into practice step (Tsistinas, 2020).

The first step of the model, articulating the clinical problem, i.e., defining how evidence-based nursing assessment and preventive interventions may reduce the number of UTI recurrences, as well as, at the same time, unnecessary antibiotic use. This is needed to ensure that the overall focus is on patient safety, nursing-based assessment, and preventive care rather than focusing solely on the treatment method, especially where the population is characterized by complicated and repetitive kinds of conditions. The second one, Evidence, is the step at which the corresponding research studies, clinical rules, and specialists’ recommendations are precisely stated and critically analyzed to determine the intensity and usage of the existing evidence on intermittent catheterization and UTI prevention. 

The final step of the JHNEBP model is translation, which is supposed to bring the latest evidence into the clinical environment through the development of nursing suggestions, patient education plans, and outcomes assessment. It is needed to ensure that the evidence-based outcomes can be implemented and sustained in practice, particularly to avoid frequent infections based on frequent evaluation and contact with the patient (Lauridsen et al., 2022). The JHNEBP model can be applied in this diagnosis because effective management of recurrent UTIs requires evidence-based decision-making that should consider patient behaviors, clinically related risks, and the feasibility of the nursing interventions.

This systematic course of action will assist the nurses to make sound decisions as they will enhance accuracy in evaluation, preventive health, and patient outcomes. This model of incorporating the factors of evidence-based practice will guarantee a uniform approach to nursing care and patient-centered care, and reduce the variability of practice and the possible formation of complications connected with the infections.

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

A systematic search was completed using the JHNEBP Model to find the high-quality evidence on the recurrent UTI among individuals in intermittent catheterization. Practice Question was done, and this centered on the clinical issue of improving nursing evaluation and preventive practices in order to reduce the incidence of UTI without necessarily using inappropriate antibiotics. This was done by identifying evidence that would address not only the practice of nursing assessment but also the aspects of patients that would influence the risk of being infected.

At the Evidence stage, the peer-reviewed databases were searched to locate the studies on intermittent catheterization, UTI assessment, prevention instruments, and patient-centered care. It was decided to choose the article by Lauridsen et al. (2022) as one of the key sources because it concerned the nursing and user vision of the UTI assessment, and the emphasis was placed on the structured examination and prevention-based treatment.

A narrowing down of the search was then done to review the literature on infection prevention and antimicrobial stewardship in patients with neurogenic bladder. The diagnosis and stewardship-based decision-making were proven as the only possible ways of limiting the unnecessary exposure to antibiotics, as the required evidence according to Abbott et al. (2022), and the prevention method, including technique consistency of catheterization, hydration, and bowel management, was the focus of the study conducted by Pannek (2020).

The Translation stage was carried out by integrating the results of these studies to determine their implications in the nursing practice, particularly to improve the quality of assessment and patient education. Another challenge of this step was the way to integrate behavioral and clinical evidence into a single nursing approach. However, the JHNEBP model ensured that the evidence used was clinically useful and could be applied to improve patient outcomes.

Using the JHNEBP Model to Guide Evidence Search

In the process of conducting an evidence search through informing a JHNEBP model in the event of recurrent UTIs, a number of challenges were also faced. The most significant difficulty in the practice question phase was formulating a developed clinical inquiry, one that would concentrate on both the physiological mechanisms of infections and behavioural factors associated with the use of intermittent catheters.

UTIs among neurogenic bladder patients were of a multifactorial nature; this implied that the matter must be treated with care to ensure that the query reflected on nursing evaluation, prevention, and patient participation. The issues that were to be addressed during the Evidence stage were that the quality of the study had to be determined, the relevance of the study to the adult neurological population, and its relevance to the nursing practice, as some studies were primarily medical management as opposed to nursing interventions.

The other challenge was in the distinction of evidence on symptomatic UTIs and the studies that focused on asymptomatic bacteriuria, in which case inappropriate treatment of the former can result in antibiotic resistance. Whereas Lauridsen et al. (2022) paid attention to user-reported symptoms and structured assessment, other sources had to be evaluated with caution to determine their relevance to the nursing practice. At the synthesis phase, it was necessary to balance clinical usefulness and patient safety to combine qualitative and quantitative evidence. The above difficulties were overcome by the systematic and dependable analysis of evidence that resulted in the nursing care due to the structured nature of the JHNEBP model.

Credibility and Relevance of Evidence

The credibility and relevance of each of the chosen resources were critically assessed to provide the answer to the recurrent urinary tract infections among intermittent catheter users. The article by Lauridsen et al. (2022), which is published in Biomed Central (BMC) Nursing, was fairly credible, as it is a peer-reviewed study with a clear methodology, with both patient and nurse-based perspectives, which is why it is very applicable in nursing practice. Its attention to evaluation and treatment was very much in line with the diagnosis and the nursing role in the management of UTI. Abbott et al. (2022) is published in a well-known infectious disease journal, i.e., Clinical Microbiology and Infection, which is why the text is considered up-to-date and reliable regarding its information about antimicrobial stewardship and provides further support to the primary concern of the correct diagnosis and informed choice of treatment.

On the same note, the Pannek (2020) review provided useful information on preventive measures in neurogenic bladder groups, which enhanced its feasibility for intermittent catheter patients. In comparison to anecdotal or old sources, such studies gave detailed evidence-based views that were backed by recent studies. They were more appropriate to discuss the multifaceted nature of recurrent UTIs compared to single-focused studies or studies that were not centered on nurses.

Conclusion

An evidence-based practice model is necessary when attending to patients with recurring urinary tract infections. JHNEBP Model offered a systematic model to find, test, and implement plausible evidence to enhance the accuracy of assessment and preventive care plans. Despite the still existing issues (symptoms variability, diagnostic uncertainty, etc.), the combination of high-quality evidence and clinical intuition leads to safer, more effective, and patient-centered care. The given approach also emphasizes that evidence-based practice may be essential to improve the decision-making of nurses, minimize the needless usage of antibiotics, and achieve better long-term outcomes among individuals with neurogenic bladder dysfunction.

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