Nurse-Led Implementation of Evidence-Based Bundles To Reduce CAUTIs in an Academic Acute Care Hospital: A Four-Year Longitudinal Quasi-Experimental Study

Publication Date

10-1-2025

Document Type

Article

Publication Title

Applied Nursing Research

Volume

85

DOI

10.1016/j.apnr.2025.152004

Abstract

Aim: This study aimed to evaluate the effectiveness of evidence-based catheter bundles, guided by the Plan-Do-Check-Act model, in reducing catheter-associated urinary tract infections (CAUTIs) and catheter usage at a 643-bed academic hospital. Background: Despite previous efforts, our facility's CAUTI rates remained high, leading to increased morbidity, extended hospital stays, and higher costs. A four-year project was initiated to implement targeted interventions. Method: This quasi-experimental study used a four-year strategy, including catheter insertion and maintenance bundles, a nurse-driven removal protocol, and extensive education. We compared pre- and post-intervention data on Standardized Infection Ratios (SIRs) and Standardized Utilization Ratios (SURs) with a goal of greater than 10 % reduction in both metrics; catheter reinsertion rates monitored as a secondary endpoint. Results: Among 2448 catheterized patients, CAUTI cases declined from 66 to 60. The SIR decreased from 0.93 to 0.58 post-intervention, a 38 % reduction in CAUTI risk (p = .007). Catheter SURs fell from 0.75 to 0.67, an 11 % reduction in utilization risk (p < .001). Reinsertion rates decreased by approximately 6 %. Conclusions: Nurse-led, evidence-based prevention bundles successfully reduced both CAUTIs and catheter use beyond the 10 % target. These findings underscore the critical role of nursing in driving practice change and improving patient safety.

Keywords

Catheter insertion bundle, Catheter utilization ratios, Catheter-associated urinary tract infection, Maintenance bundle, Standardized infection ratios

Department

Nursing

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