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Catheter-associated urinary tract infection (CAUTI) prevention and nurses’ checklist documentation of their indwelling catheter management practices
Te Ārai Pokenga Ia Tōnga Mimi i takea mai i te ngongo rerenga wai (CAUTI) me ngā Tuhinga Rārangi Whakamahara Tapuhi mō ā rātou Ritenga Whakahaere Rerenga Wai Noho Tūmau
Monina Hernandez, RN, MN(Hons), PGDipHSc, PGCertTT, Lecturer, School of Nursing, Massey University, Auckland, NZ
Anna King, RN, PhD, Lecturer, School of Nursing, University of Auckland, Auckland, NZ
Lisa Stewart, RN, MN(Hons), PGDipHSc, BA, Management Director BN, School of Nursing, University of Auckland, NZ
Reference: Hernandez, M., King, A., & Stewart, L. (2019). Catheter-associated urinary tract infection (CAUTI) prevention and nurses’ checklist documentation of their indwelling catheter management practices. Nursing Praxis in New Zealand, 35(1), 29-42.
The purpose of this study was to investigate through an audit, nurses’ catheter management practices as documented in a newly introduced self-administered indwelling catheter management checklist that incorporated four components of catheter care in a catheter-associated urinary tract infection (CAUTI) prevention bundle. The components of the bundle of care are: minimising inappropriate catheter use, aseptic insertion of catheters, catheter maintenance based on guidelines, and ongoing review and evaluation of catheter necessity. Implementation of these care components significantly decreased bacteriuria rates and CAUTI when put together in standardised clinical checklists and performed collectively by nurses. A quantitative research design, as part of a mixed methods research that investigated the impact of a CAUTI education package on nurses’ knowledge and indwelling catheter management practices, was used for this study. The study was conducted at two surgical wards in a public hospital in Auckland. Fifty nurses completed 175 checklists. Thirty-one percent (n=54) showed that all evidence based practices in the bundle of care were performed and documented by the nurses. The remaining checklists indicated that nurses did not perform some components of the bundle of care for unknown reasons. The findings were of sub-optimal performance of evidence-based catheter management practices by nurses. Whether this is a reflection of poor documentation or poor practice is not known. Catheter management practices impact on CAUTI prevention efforts when performed consistently as a bundle of care across all four components outlined in the checklist. Recommendations from this research include regular in-service education, complete and accurate documentation of care using the catheter maintenance checklist, regular audit of checklist use, and further research with a larger sample size.