Impact of Catheter-associated Urinary Tract Infection (CAUTI) Education Package on Nurses’ Knowledge and Practices

Abstract

Objectives: The purpose of this study was to determine the impact of a catheter-associated urinary tract infection (CAUTI) education package on the knowledge and indwelling catheter management practices of nurses. Specific objectives include: to identify baseline data on nurses’ attitude, knowledge and catheter management practices and to develop an educational intervention aimed at addressing knowledge or care management deficits. Methods: The study was conducted at two post-operative wards of a tertiary public hospital. A multi-phased mixed methods approach utilising focus group discussions, pre-test and posttest and document analysis of catheter maintenance checklists was conducted. The first phase was exploratory and focus groups were utilised to identify existing attitude associated with catheter management. Following this, an education session focusing on evidence-based guidelines was developed to address deficits from phase one. After the education session, pretest and post-test was conducted to compare the nurses' level of knowledge on CAUTI prevention. Document analysis of checklists was conducted post-intervention to evaluate how knowledge gained translated into practice. Findings: Focus groups revealed that nurses had diverse training, and had feelings of inadequacy and lack of confidence related to catheter management skills, hence the diversity in practices. Diversity in practice can be addressed by standardising organisational policies. Nurses feel responsible for catheter care and expressed the need for empowerment to make catheter care decisions. Fourteen participants completed the pre and post-test. Statistical analyses utilising paired t-test indicate a significant difference (p < 0.0001) in the overall score of participants between the pre and post-test, with a mean difference of 6.64 and 95% CI of (4.96, 8.33). Document analysis of catheter maintenance checklists revealed that while documentation is not optimal, nurses adhered to catheter care evidence-based guidelines. The checklist itself served as procedure prompt and improved care documentation. Conclusion: The introduction of a CAUTI education package had a significant impact on nurse’s knowledge and indwelling catheter management practices. Effective CAUTI prevention education required that all components of catheter care be addressed. Catheter care involves collaborative care, thus, continuous education of nurses and everyone involved in catheter care utilising multi-faceted strategies is essential in CAUTI prevention.