The Effects of Implementing Guidelines to Prevent Catheter-Associated Urinary Tract Infection
Abstract
Abstract
Catheter-associated urinary tract infection (CAUTI) is a major hospital-acquired infection that significantly affects patient safety and the quality of nursing care. Therefore, the implementation of evidence-based guidelines for infection prevention is a crucial strategy for reducing its incidence.
This study employed a quasi-experimental research design to examine the effects of implementing CAUTI prevention guidelines on the incidence of infection and on professional nurses’ practices in caring for patients with indwelling urinary catheters, before and after guideline implementation. The sample consisted of 20 professional nurses selected by purposive sampling and patients who received indwelling urinary catheterization in the male surgical ward and the orthopedic ward of Uthai Thani Hospital. The patients were divided into a control group and an experimental group, with 32 patients in each group. The study was conducted from May 2025 to September 2025.
The instruments used for data collection included: (1) a demographic data record form for nurses and patients, (2) an observation form for CAUTI prevention practices, and (3) a hospital infection surveillance form. The intervention instrument was a set of CAUTI prevention guidelines comprising four activity domains: (1) assessment of the necessity for catheter insertion and timely removal, (2) use of aseptic technique during catheter insertion, (3) appropriate and proper catheter care, and (4) a surveillance and documentation system. These were implemented together with an educational program consisting of computer-based instruction, printed teaching materials, video media, and educational posters.
The research instruments were validated by three experts, yielding an Index of Item-Objective Congruence (IOC) of 0.97. The pilot testing demonstrated a Cronbach’s alpha coefficient of 0.96, indicating high reliability. Data were analyzed using descriptive statistics, including frequency, percentage, range, and median. Differences between groups were examined using the Chi-square test and Fisher’s exact test.
The results demonstrated that after implementation of the catheter-associated urinary tract infection (CAUTI) prevention guideline, the incidence of CAUTI showed a marked decreasing trend, declining from 2.28 to 0.69 episodes per 1,000 catheter-days. In addition, professional nurses’ adherence to the guideline significantly increased from 50.51% to 96.57% (p < 0.05). These findings indicate that the implementation of a structured, evidence-based CAUTI prevention guideline effectively reduces the risk of infection and substantially improves compliance with recommended catheter care practices. The guideline therefore provides a practical and efficient approach for enhancing the quality of nursing care and strengthening patient safety within the hospital setting.
Keywords : clinical practice guidelines, catheter-associated urinary tract infection: CAUTI nursing practice, infection prevention and control
