Reducing Catheter Induced UTIs
Reducing Catheter Induced Urinary Tract Infections
Catheter induced urinary tract infections are common occurrences in any hospital-like setting. Because of this, catheters should only be used when absolutely necessary and not because it is convenient for hospital staff. Although this type of infection is very common, it is also very preventable. Such things as the type of catheter used, proper hygiene, as well as frequent replacement of the catheter can go a long way in preventing any type of infection from occurring. The prevention and reduction of urinary tract infections due to indwelling catheters is of great benefit to the patient, not only medically, but for some monetarily also. This is because Medicare and Medicaid will no longer pay for any type of hospital acquired infections and urinary tract infections resulting from an indwelling catheter fall into this category.
IMPORTANCE OF TOPIC
This project is aimed at reducing catheter induced infections in patients. The reason for this is because it will reduce the morbidity rate of patients from this type of infection as well as reduce cost for the patient and the hospital. Catheter induced urinary tract infection is a universal problem and one way to combat it is the use of non-latex catheters since many patients have found to be allergic to latex. Instead, the recommended type of catheter is the all silicone, silver lined one. This catheter has been shown to reduce the rate of urinary tract infections in patients.
This issue is of great importance to nursing education because the nurses are generally the ones that insert the catheters and are responsible for the care of the patients with the catheters. Nurses must be educated on the necessity of the catheter and should determine if other, safer methods are available. They should also be aware of such things as proper hand hygiene in order to reduce the rate of infection because according to Deutsch, as many as 1.7 million hospital acquired infections occur in the United States annually resulting in at least 99,000 deaths (2008).
Jim Thorpe Rehab is affiliated with the Integris Southwest Medical Center. Southwest Medical Center has already implemented procedures regarding Foley catheters which have cut down on the number of days the patients need to keep the catheter in. Since certain information is classified and can only be viewed by hospital personnel, Jim Thorpe Rehab does not know of the policies. As a result, Jim Thorpe Rehab must come up with their own set of policies to implement. This is necessary because the facility has a large Medicare and Medicaid patient base and cannot afford an abundance of infections that they will ultimately be responsible for financially.
It should be mentioned that the rehabilitation facility does not have a high incident of catheter induced urinary tract infection patients, but procedures need to be documented for the benefit of the hospital and the patients. Also, beginning in 2008 Medicare and Medicaid will no longer pay for hospital acquired infections so the hospital staff must have written procedures on how to cut down on the rate of infection and the Medicaid and Medicare patients need to be informed of any financial obligations.
III. LITERATURE REVIEW
With regard to the type of Foley catheter used, much has been written about the all-silicone silver Foley catheter because of its ability to repel infections. The use of this type of catheter has been proven to reduce the incidence of catheter induced urinary tract infections as well as medical costs associated with these infections (Bystrom, 2005; Caudill, 2005; Davis, 2005; Foster, 2005; Hutchins, 2006; Mack, 2005; McArdle, 2005; and Sullivan, 2005). Many hospitals and healthcare facilities have switched over to the used of the silver coated Foley catheters, and although they are better than latex in the reduction of infections, there is still a chance that the patient will get an infection if other measures are not taken.
Drekonja notes that knowledge regarding the use of Foley catheters and ways to prevent infection has increased among nurses. An internet survey was administered to several nurses in Minnesota and the majority of them agreed that the use of the silver coated catheters as well as cleaning and replacement will cut down on the incident of the patient catching a urinary tract infection (2010). Graves did a study on the correlation between the length of the hospital stay and the incident of the patient getting a catheter induced urinary tract infection. He found that the greater the length of the hospital stay, the more likely the patient was to get the infection and that this coupled with older patients increased the likelihood of getting the infection even more (2007). For this reason, nurses and other staff should not assume that the silver plated Foley is a guarantee against infections. Proper care must still be taken for the patient involved.
Given that urinary tract infections account for approximately thirty percent of hospital acquired infections in health care settings, it makes sense to find ways to reduce this number. Rothfield states that of this thirty-percent, eighty percent of these infections are catheter related and those simple measures can be taken to greatly reduce this percentage. He says that in most health care settings catheters are overused and other methods for infection reduction are readily available such as using superabsorbent diapers instead. A study was conducted at a medical facility using the superabsorbent diapers and Rothfield reports that the rate of catheter induced urinary tract infections decreased from 48 patients to just 9 patients within a short amount of time (2010). The use of a diaper may seem an embarrassment to some, but a skilled nurse can explained tactfully how wearing the diaper gives the patient more freedom than the catheter would. They can also explain how the chance of getting the catheter reduced urinary tract infection has been eliminated because there is no catheter involved.
This issue is apparently prevalent in medical facilities worldwide. In Japan, a study was done by Tsuchida, et al., on the rate of catheter induced urinary tract infections and they discovered that many nurses in several medical facilities assumed that by using the all silicone silver plated catheters meant that they could provide less care and upkeep for the patient. As a result, the rate of infection increased which meant that the nurses should have been educated on this type of catheter before using them on patients (2008). Even though this type of catheter has been shown to reduce the rate of urinary tract infections, the same care and hygiene practices used for other types of Foleys should still be administered with the newer types of catheters. If not, the same situation that happened at the medical facilities in Japan is likely to happen elsewhere.
Although the type of Foley catheter used can help to prevent urinary tract infections, other steps and measures taken by hospital personnel can also be followed in order to reduce the risk of infection. Typically, when a patient is in the Intensive Care Unit (ICU) of a hospital or healthcare facility, he does not maintain the ability to use the bathroom facilities on his own. As a result, a catheter may be used. Allen found that a major cause of infection was due to cross contamination by hospital workers. He says that something as simple as washing hands in between patients can eliminate this, but may nurses and healthcare providers fail to do this simple step (2005).
Allen’s example outlines why the need for a monitored hand washing system is necessary. A hand hygiene monitoring device was conducted at the Toronto Rehabilitation Institute in Ontario, Canada. Small monitoring devices were installed in patient rooms as well as restrooms and healthcare professionals wore a badge-like device which notified them to wash their hands upon leaving the room. The frequent washing of hands helped to reduce the spread of hospital acquired infections (Boscart, 2010).
It should be noted that washing hands with soap and water may not always be possible, so hospital should ensure that dispenser with anti-bacterial gel is easily accessible throughout the medical facility. This is due to the fact that in addition from spreading one patient’s germs to another because of lack of hand washing, a healthcare professional my touch an object in the hospital that is not as clean as it should be. This is considered environmental contamination and this coupled with lack of hand washing can definitely increase the rate of infection (Carling, 2010). Education regarding the prevention of hospital acquired infections is crucial. The appropriate staff should be educated on issues such as proper care and cleaning of the catheter, hand washing hygiene and even when to determine whether or not a catheter should be used at all (Gokula, 2007).
The push to use the all silicon, silver coated Foley catheters as well as to eliminate hospital acquired infections is important because not only does it lower the morbidity rate, it also lowers costs. Although the silver coated catheters have a higher upfront cost than latex catheters, the cost balances out because of the reduced amount of urinary tract infections which leads to a reduced need for antibiotics and other methods to eliminate the infection (Dikon, 2006). This is important because the cost of hospital acquired infections run high. The cost to care for a patient with a hospital acquired infection is almost three times the amount to care for a patient without a hospital acquired infection (Hassan et al., 2010).
Since hospital acquired infections can be attributed to the hospital, Medicare and Medicaid will no longer cover payment of these infections beginning in 2008. Medicare and Medicaid reimbursements are designed to set payment rates that are consistent with hospital costs (Malatestinic et al., 2003). An acquired hospital infection is not considered a cost to Medicare or Medicaid since the patient contracted the infection through no fault of his own, but while under the care of the hospital staff. Deutsch does not agree with this decision and states that Medicare and Medicaid are doing more harm to the patients by withholding hospital payments and instead should invest more money into the Agency for Healthcare Research and Quality so that hospital staff can be trained properly on the procedures to take to avoid hospital acquired infections (2008).
It is reasonable for Medicare and Medicaid not to feel they should reimburse for hospital acquired infections because cases such as these can be seen as hospital neglect. In some cases, when patients acquire the infections it is due to negligence on the part of the caregiver by not performing proper hand hygiene or not caring for and cleaning the catheter sight properly. However, even with the most stringent set of hospital procedures in place to reduce infections, even a small percentage of patients may be prone to acquiring them. No matter how the patient acquired the infection, he is still left out in the cold if Medicare or Medicaid refuses payment. This is not fair to the patients and this is the point that Deutsch is making. Other means should be sought out, such as proper education instead of the complete withdrawal of the payments.
One thing to consider regarding this Medicare and Medicaid reimbursement issue is that both will reimburse in the case of self neglect (Franzini and Dyer, 2008). This is when the patient does not (for whatever) reasons take care of himself. Sometimes mental illness can be involved preventing the patient to properly care for himself, but sometimes the neglect is willful. A patient can be mentally sound but does not take the medications prescribed to him, yet Medicare will reimburse for this.
In essence, what should be done is what Deutsch suggests. More funding should to go into educating hospital staff on the proper procedures to prevent hospital acquired infections. Educating the staff seems to be a more effective measure than withholding payments. The withholding of payments for hospital acquired infections has the potential to put the patient at a disadvantage unless the hospital takes ownership and covers the costs associated with the infection.
Medicaid reimbursements have a direct impact on nurse staffing levels, in particular at nursing homes. Harrington et al. (2007), found that Medicaid only nursing homes had fewer nursing staff with fewer nursing hours than for profit nursing homes. This is important not because it is an indication of the quality of nurses at the Medicaid only facilities, but these facilities have a tendency to be short staff because of the reduction of reimbursements could mean more patient neglect and a higher chance for hospital acquired infections.
Lately, there has been a reduction in the Medicare and Medicaid patients that Advance Practice Nurses (APN) as well as physicians will treat (Cunningham and O’Malley, 2008; Frakes and Evans, 2006). The whole issue of what Medicare and Medicaid will reimburse can be detrimental to their business, especially if it is a private practice. The last thing these professionals need is to have payments withheld because they are being blamed as the cause of a patient getting an infection.
Stone (2009), states the following, “This is a radical change in reimbursement, which may result in a variety of practice changes. The first and most positive is that hospitals react as CMS hopes and find ways to improve processes and decrease health care-associated infections. The second is that there is no real change in the infection rate; in this case, hospitals may lose the incremental revenues or just change coding practices. The third and least positive response is that the policy results in perverse incentives for hospitals to engage in processes that are not in the patients’ best interest but protect the hospital” (p. 17A).
IV. DESCRIPTION OF PROJECT
The objective of this project is to come up with a set of policies regarding the ordering, use, and healthcare maintenance for Foley catheters at the Jim Thorpe Rehab Center. Based on the information presented in the Literature Review, the program will be designed to be conceptual because there is an abundance of information on the topic, yet the information will be refined even more to suit the purposes of the project.
We have learned that a number of patients are allergic to the latex Foley catheters and that there has been an overall reduction in the incidents of catheter induced urinary tract infections by using the all silicone, silver coated catheters. The silver coated catheters are more expensive than the latex catheters, but in the long run they make up for this by reducing the costs associated with caring for the urinary tract infections. What the Jim Thorpe Rehab facility needs to do find the money in the budget or somehow make budget transfers so that the silver coated catheters can be purchased. They could also get bids from at least three vendors of the catheters. If they buy a certain amount, they should be able to negotiate a discount in order to buy more catheters to be safely used on the patients.
In addition to buying the silver coated catheters, doctors and nursing staff must determine if a catheter will even be necessary for the patient after surgery or other medical procedures. Many hospital and healthcare staff use the catheters without fully considering that there may be other options. The literature has shown that there are other alternatives to the catheter depending on the condition of the patient such as the superabsorbent diapers which are now made in sizes to fit most everyone from children to adults of all shapes, sizes and weights. If a patient is totally incapacitated, then the Foley may be necessary. If the person isn’t 100% incapacitated, the superabsorbent diaper may be the best alternative as long as care is taken that the diaper is changed frequently.
Based on the literature, there are simple procedures that health care providers can do in order to improve the hygiene and reduce the transfer of infections to the patients. Because of the shortage of nurses and other healthcare professionals, many nurses find that the number of patients they must care for is overwhelming. In focusing on providing the best possible care for the patients, basic things such as the thorough washing of hands in between patient care is often forgotten. Studies have shown that because of this oversight, bacteria and infections are easily carried by the nurse or other healthcare professional from one patient to the next unknowingly. Two prevent this from happening, proper training should be mandatory.
The literature states that there is a hospital in Canada with an electronic monitoring system that encourages frequent hand washing. Because the system is electronic and would require constant maintenance, it would be easier for the Jim Thorpe Rehab facility to do something as simple as placing posters near the doors of each room that serve as a reminder for the nurse or other healthcare professional to wash their hands before caring for another patient. This would be one step to remind the staff and since human nature is sometimes very predictable, staff could have brief weekly meetings where the nurse in charge gives a gentle reminder and mail slots can be set up for personnel and a flyer reminding them of hand washing procedures could be placed in their mail slots on a regular basis.
Another issue regarding the catheters is the proper care and cleaning of them. Nurses and healthcare professionals should have ongoing training on the proper care of the catheters in order to prevent infection. Since Medicare and Medicaid will no longer pay for hospital-acquired infections, it is imperative that proper care be administered to eliminate any catheter induced urinary tract infections. These types of infections have a high morbidity rate as we have learned from the literature. Close to 100,000 patients per year die because of catheter induced urinary tract infections. Of all hospital acquired infections, the catheter induced urinary tract infections are at the top of the list and it is unfortunate because the majority of them can be prevented.
If a patient is lucky enough to withstand the infection, he still will need to take antibiotics and perhaps other types of medication to get rid of the infection. Some strains of bacteria associated with the urinary tract infection are resistant to antibiotics and the use of other types of antibiotics can be very costly. If the patient is on Medicare or Medicaid the Jim Thorpe Rehab facility must eat the cost. So, it is in the best interest of the facility to be proactive and concentrate on the prevention of the infections instead of waiting until something happens and then being in a reactionary role.
The strategies to be carried out in this project (based on the information gathered) are as follows:
1. Review budget carefully to determine if the facility can afford to purchase the all silicone, silver plated Foley catheters. If this isn’t feasible, patients needing to wear the catheter for more than three days should have the silver coated catheters and patients only needing a catheter for three days or less will get the latex catheters providing they are not allergic to them and that proper cleaning and care is administered.
2. Frequent reminders of hand washing between patients will be implemented in order to prevent the spread of bacteria and other germs from patient to patient.
3. All healthcare staff providing patient care will be required to undergo mandatory training on the proper care of the all silicone, silver coated Foley catheters. Staff will be required to sign a form stating that they have completed the training and will adhere to it when dealing with patients having a catheter.
V. EVALUATION OF OUTCOMES
The Jim Thorpe Rehab facility already has a low incidence of urinary tract infections due to Foley catheters. However, the facility does not have any documented procedures in place which give statistics on the duration of how long the catheter has been left in or the number of infections per year for the facility. The information is important and needs to be tracked for reporting purposes. A plan was developed to assist the facility with a plan that could be implemented immediately.
Since there was no documented information on the data that the facility needed, everything was measured from the day that the project was implemented and then reassessed over a six-month period. The reported outcomes are as follows:
Inputs — the inputs for the project were the silver coated Foley catheters, superabsorbent diapers and the facility patient-care staff members.
Activities — using silver coated Foley catheters on patients requiring the use of one for more than three days, frequent and thorough hand washing of the staff, proper cleaning and care of the Foley catheters, and mandatory training of staff on care and use of the catheters.
Outputs — the patients actually needed to have the Foley catheters inserted (latex and silver coated).
Outcomes — many patients were more than willing to wear the superabsorbent diapers as opposed to having the catheter inserted; the staff expressed appreciation over the hand washing reminders and did not feel that is was information overload; the staff were trained on the proper care and cleaning of the Foley catheters and willingly signed the consent for stating that they would adhere to the training they received.
Outcome targets — The targets over the six-month period were recorded and favorable. They are as follows:
At the end of the six-month period, the number of patients wearing the superabsorbent diapers as opposed to the Foley’s rose 10%.
At the end of the six-month period, the number of catheter induced infections was reduced from 23 patients to 14 patients.
After the end of the six-month period, all of the staff members reported remembering to wash their hands in between caring for patients.
After the end of the six-month period, all of the staff members had participated and completed the training successfully and the rehab center received a 100% return on the consent forms.
Based on the outcome targets, it appears that the program designed for the Jim Thorpe Rehab center is successful so far. These outcomes are considered short-term outcomes and the center needs to continue to follow the plan and evaluate it again in another six months. At this point, this will become a long-term outcomes evaluation with the expectation that there will be continued improvement.
This will be an ongoing project and will not terminate at the end of the one-year period. This is important because if on-going evaluation is not done, the climate or attitude of the staff might change and they could become lax on the procedures they have consented to perform. Also, any new staff members will need to be informed and trained and become a part of the evaluation project in order for the facility to run smoothly and improve on its process to cut down and even possibly eliminate catheter induced urinary tract infections.
VI. CONCLUSIONS AND RECOMMENDATION
The Jim Thorpe Rehab center is fortunate in that there is an abundance of information pertaining to the causes and reduction of catheter induced urinary tract infections. Although it is affiliated with the Southwest Medical Center which has been successful in its plan to reduce the urinary tract infections, the information cannot be shared between facilities because of hospital liability issues. As such, the Jim Thorpe Rehab center had to come up with its own plan to monitor and reduce the rate of urinary tract infections due to the Foley catheter. The facility already has a low rate of these types of infections and should be commended for wanting to further explore and implement policies that will further reduce the rate of infection.
As with any plan, there may be glitches and in this case, the glitches may be that there may still be a few patients that acquire infections. Since Medicare and Medicaid no longer reimburses for hospital acquired infections, documentation is key. The majority of patients at the Jim Thorpe are Medicare and Medicaid patients and the facility cannot afford a high rate of infections acquired at the facility because in the end, they will end up eating the cost. In order to have a leg to stand on, strong documentation of patient care is in order. The final recommendation for this one year project (which will be re-evaluated with the possibility of revisions) at the one-year period is as follows:
1. In addition to the steps outlined in the plan, patient charting is crucial. Patient care staff must chart when the Foley was inserted and whether or not it is a latex or silver coated.
2. Patient care staff must keep a detailed chart on each person with a Foley catheter and list the number of times per day the Foley was cleaned and monitored.
Another step that is recommended is to do anonymous patient surveys. Patients with Foley catheters could be asked, but not required, to fill out a survey that does not contain any personally identifiable information. The surveys could be placed in a boxed that is locked by an outside source that will evaluate the surveys. The information could be compiled into a report that is made available to the patient care staff so that they can judge how well they are performing by the people they are caring for. Should and incident arise where Medicare or Medicare refuses a claim, this information along with the other documentation the rehabilitation center has can help to build a strong case.
This is merely a suggestion and the patients in no way should be forced or coerced into completing the survey. Another recommendation is to have the patient care staff members fill out an anonymous survey on the plan that has been implemented. The survey would consist of Likert style questions as well as open-ended questions requiring a written response. The last part of the survey will be constructed to give the staff members an opportunity for suggestions or make comments on what they feel is working well, and what isn’t working well. Much like the patient surveys, this survey would not be mandatory, but highly encouraged because the staff’s input is important. Decisions should not be made, nor a plan implemented without their input.
Everyone must work together in order to make the plan successful. Evaluators must not jump in thinking they know everything, but they should get the input of the staff and even patients in order to ensure that the plan is carried through and is working. Catheter induced urinary tract infections are the highest type of hospital acquired infection, but it does not have to be so. This is an infection that is highly preventable, but only if certain basic steps are implemented before, during and after the catheter insertion. The procedures set forth in the plan developed for the Jim Thorpe Rehabilitation center are not only developed to assist the facility, but they have been developed to benefit the patients and staff in the hopes that the facility can reach a zero patient rate of infection.
Allen, S. (2005). Prevention and control of infection in the ICU. Current Anaesthesia & Critical Care, 16(4), 191-199.
Boscart, V, Levchenko, A., and Fernie, G. (2010). Defining the configuration of a hand hygiene monitoring system. American Journal of Infection Control, 38(7), 515-
Bystrom, C. (2005). Reduction of nosocomial catheter-associated urinary tract infection
(CAUTI) in a U.S. Southeastern teaching facility with an all-silicone silver Foley catheter. American Journal of Infection Control, 33(5), E57-E58.
Carling, P.C. And Bartley, J.M. (2010). Evaluating hygienic cleaning in health
care settings: What you do not know can harm your patients. American Journal of Infection Control, 38(5), S41-S50.
Caudill, T. (2005). Reduction in catheter-associated urinary tract infection (CAUTI)
using a silver-coated all-silicone Foley catheter vs. A silver-impregnated latex
Foley catheter in a Southeastern U.S. long-term acute care facility. American Journal of Infection Control, 33(5), E60.
Cunningham, P. And O’Malley, A.S. (2009). Do reimbursement delays discourage
Medicaid participation by physicians? Health Affairs, 28(1), w17-w28.
Davis, K. (2005). Reduction in catheter-associated urinary tract infections (CAUTIs)
using a silver-coated 100% silicone Foley catheter verses a silver-coated latex
Foley catheter in a Northeastern U.S. acute care hospital. American Journal of Infection Control, 33(5), E55-E56.
Deutsch, R. (2008). Federal role in reducing hospital-acquired conditions: Are
Medicare reimbursement incentives enough? Columbia Journal of Law and Social
Problems, 42(1), 1-41.
Dikon, A. And Olah, R. (2006). Silver coated Foley catheters — Initial cost is not the only thing to consider. American Journal of Infection Control, 34(5), E39-E40.
Drekonja, D.M. (2010). Internet survey of Foley catheter practices and knowledge among Minnesota nurses. American Journal of Infection Control, 38(1), 31-37.
Frakes, M.A. And Evans, T. (2006). An overview of Medicare reimbursement regulations for advanced practice nurses. Nursing Economics, 24(2), 56-66.
Franzini, L. And Dyer, C.B.. (2008). Healthcare costs and utilization of vulnerable elderly people to adult protective services for self-neglect. Journal of American Geriatrics Society, 56(4), 667-676.
Foster, K. And Smith, G. (2005). Clinical effectiveness of the silver-impregnated Foley
with bacteriostatic tubing/bag system compared with standard latex catheters and standard drain systems. American Journal of Infection Control, 33(5), E133-
Gokula, R. M . (2007). Emergency room staff education and use of a urinary catheter indication sheet improves appropriate use of Foley catheters. American Journal of Infection Control, 35(9), 589-593.
Graves, N., Tong, E., Morton, A.P., Halton, K., Curtis, M., Lairson, D., and Whitby, M.
(2007). Factors associated with health care-acquired urinary tract infection.
American Journal of Infection Control, 35(7), 398-392.
Harrington, C., Swan, J.H. And Carrillo, H. (2007). Nurse staffing levels and Medicaid reimbursement rates in nursing facilities. Health Services Research, 42(3), 1105-1129.
Hassan, M., Tuckman, H.P., Patrick, R.H., Kountz, D.S., and Kohn, J.L. (2010). Cost
of hospital-acquired infection. Hospital Topics, 88(3), 82-89.
Hutchins, A. (2006). Reducing the number one health care acquired infection utilizing a silver-impregnated Foley with bacteriostatic tubing/bag system. American Journal
of Infection Control, 34(5), E113.
Mack, D. (2005). What are the clinical benefits and economic impact associated with the use of silver hydrogel urinary catheter utilizing a novel bacteriostatic collection system? American Journal of Infection Control, 33(5), E171.
Malatestinic, W., Braun, L., Jorgenson, James A., Eskew, J. (2003). Components of Medicare reimbursement. American Journal of Health-SystemPharmacy, 60(3), 3,
McArdle, P. (2005). Increasing patient safety through the use of silver-coated 100%
silicone Foley catheter system. American Journal of Infection Control, 33(5),
Rothfeld, A.F. And Stickley, A. (2010). A program to limit urinary catheter use at an acute care hospital. American Journal of Infection Control, 38(7), 568-571.
Stone, P. (2009). Changes in Medicare reimbursement for hospital-acquired conditions including infections. American Journal of Infection Control, 37(7),
Sullivan, P., Reilly, L., Williams, K. And Fochesto, D. (2005). The effects of criteria-based Foley catheter guidelines in a 642 suburban hospital medical/surgical intensive care unit. American Journal of Infection Control, 33(5), E178.
Tsuchida, T., Makimotoa, K., Ohsakob, S., Miyoko, F., Kanedad, M., Miyazakie, T., Fujiwaraf, F., Tomoyuki S. (2008). Relationship between catheter care and catheter-associated urinary tract infection at Japanese general hospitals: A prospective observational study. International Journal of Nursing Studies, 45(3), 352-361.
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY!!!
We provide professional writing services to help you score straight A’s by submitting custom written assignments that mirror your guidelines.
Get result-oriented writing and never worry about grades anymore. We follow the highest quality standards to make sure that you get perfect assignments.
Our writers have experience in dealing with papers of every educational level. You can surely rely on the expertise of our qualified professionals.
Your deadline is our threshold for success and we take it very seriously. We make sure you receive your papers before your predefined time.
Someone from our customer support team is always here to respond to your questions. So, hit us up if you have got any ambiguity or concern.
Sit back and relax while we help you out with writing your papers. We have an ultimate policy for keeping your personal and order-related details a secret.
We assure you that your document will be thoroughly checked for plagiarism and grammatical errors as we use highly authentic and licit sources.
Still reluctant about placing an order? Our 100% Moneyback Guarantee backs you up on rare occasions where you aren’t satisfied with the writing.
You don’t have to wait for an update for hours; you can track the progress of your order any time you want. We share the status after each step.
Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.
Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.
From brainstorming your paper's outline to perfecting its grammar, we perform every step carefully to make your paper worthy of A grade.
Hire your preferred writer anytime. Simply specify if you want your preferred expert to write your paper and we’ll make that happen.
Get an elaborate and authentic grammar check report with your work to have the grammar goodness sealed in your document.
You can purchase this feature if you want our writers to sum up your paper in the form of a concise and well-articulated summary.
You don’t have to worry about plagiarism anymore. Get a plagiarism report to certify the uniqueness of your work.
Join us for the best experience while seeking writing assistance in your college life. A good grade is all you need to boost up your academic excellence and we are all about it.
We create perfect papers according to the guidelines.
We seamlessly edit out errors from your papers.
We thoroughly read your final draft to identify errors.
Work with ultimate peace of mind because we ensure that your academic work is our responsibility and your grades are a top concern for us!
Dedication. Quality. Commitment. Punctuality
Here is what we have achieved so far. These numbers are evidence that we go the extra mile to make your college journey successful.
We have the most intuitive and minimalistic process so that you can easily place an order. Just follow a few steps to unlock success.
We understand your guidelines first before delivering any writing service. You can discuss your writing needs and we will have them evaluated by our dedicated team.
We write your papers in a standardized way. We complete your work in such a way that it turns out to be a perfect description of your guidelines.
We promise you excellent grades and academic excellence that you always longed for. Our writers stay in touch with you via email.