Recurrent Urinary Tract Infection

Introduction to Mr. Clifford Stone Case Study

Mr. Clifford Stone, 81 years old, admitted to the Dementia memory support unit with symptoms of delirium. Later, he was also diagnosed with urinary tract infection which consequently subsides with antibiotics although, dementia progressed and fall into moderate severity. Age is an important risk factor associated with dementia leading to loss of memory and changing social behavior that leads the patient to loss of social engagement and loss of engagement with hobbies. Recurrent urinary treat infections made the patient vulnerable and dependable for everyday activities (WHO, 2020). The patient clinical illness is overwhelming not only for himself but for his family members and caregivers as well and the impact of bacterial infection at a larger scale can be social, physiological, economic, and physical. Nurses play an important role to improve the patient by providing effective interventions which provide a protective effect on mental health and these interventions aim to minimize the associated pain and stress to improve patient outcome.

Impact of Recurrent Urinary Tract Infection

Urinary tract infection is defined as the inflammation of the urethral systems in which inflammation is often characterized by pain while urination. The disease is majorly caused by the pathogenic bacteria, colonizing the bladder and the urethral lining, causing either the minor or the major illness (Sobel & Kaye.,2015). The infection is typically associated with pain and discomfort where the infection when reaches to upper urinary tract lead to acute and recurrent infections. The recurrent illness will hamper everyday work and reduce the quality of life. It has been observed that certain antigens are active on the urethral cells that bind with the specific bacterial pathogen and trigger the infection. However, the older population with age more than 65 years are more prone to infections owing to prostatic conditions (Sobel & Kaye.,2015). Also, immunocompromised elder patients on drugs are at increased risk of infections. Researchers have observed the improper hand hygiene will aid the spread of infection and thus, proper hand sanitization is a useful way to control the spread of infection (Nicolle,2015). The common clinical symptoms in urinary tract infection include fever, pain in the abdomen, nausea, and vomiting.

The clinical illness impairs memory owing to associated pain including verbal communication and executive function. The psychological risk factors associate with the disease include low socioeconomic status, longer hospital stays, and low education levels Moreover, recurrent infections are related to psychotic symptoms and include incontinence, aggression, delirium, and weight loss (Nicolle,2015). However, cognitive behavior therapy, social networks, and physical activities act as protective factors against associated pain. Behavioral changes are often associated with delirium which changes throughout the day and a normal and eventually, the person loses social behavior and interest in everyday activities (Sobel & Kaye.,2015). The nurse must engage the patient in social workshops which might help to reduce the associated pain and confusion with the recurrent infections.

Infection Control

Recurrent urinary tract infections are usually caused by similar bacterial pathogens as identified earlier and deteriorate the conditions in patients. Relapse of the urinary tract infections represents a risk for increasing infection or dysuria. The bacterial infection is the major cause of hospital-acquired infections when not controlled properly. Healthcare professionals including doctors and nurses form the essential component for safe and effective healthcare and these adverse infections add pain for patients and their family members as well(Mitchell et al.,2017). Moreover, these events can prolong the hospital stays, increasing the cost of treatment for patients. WHO has recommended self-hygiene, the primary mode for reducing hospital-acquired infection (HAI), and promoting a healthier care environment (McLaws et l.,2015). Adopting best hand hygiene practices can minimize the risk of infection transmission in patients. The National Safety and Quality Health Service Standards have proposed guidelines for infection prevention and control. These standards are based on evidence-based practices effective for infection control in healthcare systems (ACQHS,2020). Nurses should follow hand hygiene practices guided by hand hygiene initiative for creating safe and quality medication (Mitchell et al.,2017). A quality assurance team will evaluate and address compliance and non-compliance regarding hand hygiene practice

Micro-organisms are found everywhere and a large proportion is associated with hands. The process of infection transmission involves a susceptible host and a reservoir (Mitchell et al.,2017).` For example, in hospitals, patients are immunocompromised and therefore, infection transmits easily while handling patients. If the person is already having a bacterial infection (urinary tract infection), nurses must adopt the hand hygiene practice before handling another patient, which will help to minimize the spread of infection in hospitals. (McLaws et l.,2015). World Health Organization has pre-set a guideline describing 5 hand movements for effective hand hygiene (WHO, 2020). This evidence-based approach is easy to understand and must be followed by every healthcare setting. It forms the primary evident-based standards for controlling infection transmission in healthcare settings. Healthcare workers must clean their hands before touching a patient, before cleaning the work areas like patient beds, bed-sheets, etc., after exposure to infectious body fluids, after touching the patient, and surrounding (Mitchell et al.,2017). Moreover, hands must be cleaned before wearing gloves and after removing them as well (ACSQH,2019). Appropriate use of hand sanitizers during patient handling reduces the exposure of pathogenic agents to patients. Safe and tactical handling of patients following all the practices will reduce the spread of infections and create a safe and healthier work environment. Healthcare workers along with family members play a fundamental role in reducing infection spread for defective patient outcome

Pain Management Interventions

The recurrent urinary tract infections are often associated with pain when ye infection is limited to the bladder. The patient may feel a strong urge to urinate which triggers a burning sensation. Urinary tract bacterial infection can damage the urethral lining, which is a factor responsible for the pain during urination (Thomas et al.,2015). The continuous multiplication of the pathogenic bacteria leads to inflammation of the urethral cells which might be related to the associated with the pelvic pain. The pathogenic bacteria remain adhered to the urethral lining for a longer duration which will. The pain will consequently affect the mental wellbeing of the patient and the person restricts social behavior and turns aggressive (Thomas et al.,2015). The nurse-patient relationship can be defined as sharing bonds on family member grounds guarded with emotional, sentimental, regard, communication, and certainty. The relationship is more or less demanding care and aiding a bond where the nurse is aware of patient whereabouts as part of their practice (Rebecca et al.,2020). Nurses treat them not just as patients and tend to self-motivating and growing. The fundamental trust in a patient-nurse relationship is a key factor for considering their proficiency in form of providing care and safety. The empathic behavior filled with care is considered satisfying by both the patients and their family members which helps to help to manage the pain associated with the illness (So,2019). The consistent meetings will improve patient care and uncover the fundamental thought of effective quality care and treatments. Nurses will involve the patients in social discussions and introduce certain non-drug therapies which will improve the mental status of the patient and consequently help to manage the pain.

 The non-drug therapies will include the sense of healing touch, therapeutic touch, music therapy which will distract the patient and help to manage the pain. Nurses can engage the patient in their hobbies like playing games and gardening which will impart a sense of relaxation (Turley et al.,2018). These non-drug therapies will act as a vehicle to build a strong therapeutic relationship for effective care and increase patient output. These non-drug interventions will improve the quality of care and reduce the cost of care. Communication strategy is an essential medical skill required to be developed by every nursing practioner. Effective communication aims to establish a strong therapeutic relationship that achieves the goal of improved patient output, perk up life quality of patients, and their family members as well (Fite et al.,2019). The skilled nursing staff aims to improve patient outcomes by providing physical, mental, and emotional care as well. . Effective communication is essential and bridges the gap between nurses and patients in the hospital settings and home care setting as well. The social and cultural barrier demands extended listening, questioning, cultural support, and projection of clear instructions. Less expression of thoughts creates a void in ineffective communication (Fite et al.,2019). Skilled nurses participate, review, and summarize the thoughts and behavioral expressions of the patient. Nursing staff incorporates empathic behavior to understand hidden patient thoughts for an effective patient-nurse relationship (Turley et al.,2018). Questioning is another mode of personal communication for drafting an effective thought transfer. Nurses provide communication assistance to patients for understanding their needs and support. Nurses will implement the knowledge of individual hygiene to the patient to understand the role of hygiene in managing illness. Moreover, nurses will provide timely medication to patients for effective care.

Conclusion on Mr. Clifford Stone Case Study

Relapse of the urinary tract infections represents a risk for chronic infection or dysuria. The bacterial infection is the major cause of hospital-acquired infections and must be controlled properly to spread infection in healthcare systems. Nurses must adopt hand hygiene practices before handling another patient, which will help to minimize the spread of infection in hospitals. The recurrent urinary tract infections pain will consequently affect the mental wellbeing which consequently restricts the social engagement of the patient. Nurses will involve the patients in social discussions and implement non-drug therapies to improve the mental status of the patient which consequently helps to manage the pain associate with the infection. Nursing staff incorporates empathic behavior to understand hidden patient thoughts for an effective therapeutic relationship, encouraging care.

References for Mr. Clifford Stone Case Study

ACSQH. (2019). National Hand Hygiene Initiative Manual. Retrieved from https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/national-hand-hygiene-initiative-nhhi/national-hand-hygiene-initiative-manual

Fite, R. O., Assefa, M., Demissie, A., & Belachew, T. (2019). Predictors of therapeutic communication between nurses and hospitalized patients. Heliyon, 5(10), 1-6.

McLaws, M.L. (2015). The relationship between hand hygiene and healthcare-associated infection: It's complicated. Infection of Drug Resistance, 8, 7-18.

Mitchell, B.G., Shaban, R.Z., MacBeth, D., Wood, C., &Russo, P.L. (2017). The burden of healthcare-associated infection in Australian hospitals: A systematic review of the literature. Infection, Disease & Health, 22(3), 117-128.

Nicolle, L.E.S. (2015). Long-term-care-committee. Urinary tract infections in long-term-care facilities. Infect Control Hosp Epidemiol, 22(3), 167–175.

Pinel, J. P. J. & Barnes, S. J. (2014). Introduction to Biopsychology. London: Pearson Education Limited

Rebecca, F., Tiffany, C., Eva, J., Åsa, M.A., Maria, B., Jenny, P., Karin, B., &Alison, K.(2018). Towards a standardized definition for fundamental care: A modified Delphi study. Journal of Clinical Nursing, 27(12), 2285-2299.

So, H.M. (2019). The world of critical care nursing. Nursing and Midwifery Board, 13(2), 102-106.

Sobel, J.D., Kaye, D. (2015) Urinary tract infections. Principles and practice of infectious disease. Elsevier, 26(9), 1-14.

Thomas, W.E., Trintchina, E., Forero, M., Vogel, V., &Sokurenko, E.V. (2015). Bacterial adhesion to target cells enhanced by shear force. HHS Public Access, 109(7), 913–923.

Turley, J., Vanek, J., Johnston, S., &Archibald, D. (2018). Nursing role in well-child care. Official Publication Of the College of Family Physicians of Canada, 64(4), 169-180.

WHO. (2020) Clean care is safer care. Retrieved fromhttps://www.who.int/gpsc/tools/faqs/abhr1/en/

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