I am creating a research project about catheter associated UTIs related to post-surgical
patients. For this part of my project, I am needing to answer the questions below related to
Who are the key stakeholders who will need to be engaged in order to get support to move
What are specific persuasive arguments that you would use with each constituency and
Where do you anticipate blockages and what strategies will you employ?
- Reference organizational theory, systems theory, change theory.
Urinary tract infection (UTI) related to perioperative urinary catheterization is a poorly
researched area. Only a countable number of studies, most of them orthopedic studies done by
small single institutions, shed light in this field (Iorio et al, 2005). Despite absence of massive
documented evidence, many authors on this subject have proposed decatheterization not later
than 2 days post operatively. An analysis of data from the National Surgical Infection Prevention
Project revealed that 86% of patients who had undergone major surgical intervention had had
peri-operative urinary catheter inserted. 50% of these stayed with the catheters for more than 2
days (Wald, Ma, Bratzler & Kramer, 2008). This translates to the same being exposed to a 50%
chance of getting perioperative catheter related UTI. Apart from UTIs, it has been shown that
such prolongation with catheter in-situ is associated with nosocomial infections, increased in-
hospital stay and death (Wald, Ma, Bratzler & Kramer, 2008).
Of Stakeholders in the research
A number of personalities will have to be involved for the research to take off successfully the
following will need to be engaged: local research ethics committee’s approval will have to be
won, the go- ahead by the hospitals/ facilities in which the research will be conducted, sponsors,
co-operation by the medical team involved in the care of patients for study (nurses, surgeons and
general physician) and informed consent by the patients/ their significant others (for those who
are not legible to give consent of their own, such as minors or mentally the incapacitated).
Arguments for the Research support by the stakeholders
The research and ethics committee has the mandate to assess regulate potential research projects.
They have standards and expectations. The role of the researcher is to sufficiently prove the
necessity, science base, benefit & practicality of the research to be conducted. As it is, there is a
good standing to conduct this research; being so far a poorly researched on field. This study will
substantially contribute toward covering the gap in the body of knowledge on reducing UTIs
secondary to prolonged catheterization perioperatively.
The hospital administration will be approached bearing in mind the organizational theory. The
organizational theory suggests that understanding the way an organization operates is important
in order to know how to introduce change. It is the hospital’s administration that has the overall
picture of how its components work and influences their operations. The argument toward the
organization management for supporting the study will be based on making the facility be more
efficient in service delivery; be more productive. This is because there is a potential to reduce
UTIs and infections related to prolonged catheterization, reduced hospital stay, and reduced
mortalities. Hence, more man-hours will be saved for other conditions and less money spent on
treating infections and managing complications related to long stay of indwelling catheterization.
This will also be a basis for upgrading its operational guideline for better outcome.
Approaching the potential sponsors to this project is crucial for the purpose of funding. Ptential
donor organizations (such as the National Institute of Health) or individuals need to be convinced
of the magnitude of impact the study will have. Depending on the scale of my study, it can be
shown that the contribution toward science based evidence will be enriched, such as to influence
future trending perioperative catheter use.
Approaching the medical practicing staff, patients to participate in the study will be on the basis
of the principles in systems theory. The entire medical team is part of the system, so is the
patient. Individually, they are subsystems within the whole. Yet, their activities are interrelated,
in that they affect the outcome of whether the whole system meets its primary goal: wellness of
the patient (Hazzard, 1971). It will be good for the medical team to co operate as better outcome
of their patient result in better patient prognosis and less hours per patient in the long run. The co
operation of the patient will see to it that not only will he have a chance to benefit by potential
better outcome due to the intervention, it’s a chance to better the lives of others is a situation like
theirs in future.
Change theory by Lewin states that resistance will come toward any move to alter the status quo.
First, there would be the challenge of convincing some health facilities in charges to participate
in the study. That will be solved by thorough literature review and sound justification for the
study. The other will be reluctance to participate in the study by healthcare workers due to being
used to “work as usual” practice. This is a new idea, which may take time for them to adjust to
(Roussel & Swansburg, 2008). What will be done is first conducting a number of education
sessions with the staff to be involved, and having research assistants monitoring the
implementation of the catheter care as per the study plan alongside the staff.
Progress in the medical field will only be realized through progressive research, education and
implementation of the acquired knowledge thus generated. Once gaps have been realized, it takes
the nurse as the change agent to rise up and do something about it. Conducting this research will
bring in new perspectives that will better practice in catheter use for perioperative patients.
Challenges may be faced, but the earnest interest to better patient care will prevail.
Douglas Hawk. 2013. Organizational theory in nursing.