CAUTI-bundle application in patients' care among nurses in a Nigerian tertiary health facility

Abstract

Catheter associated urinary tract infection (CAUTI) is the most prevalent healthcare-associated infection worldwide, and the use of care bundles such as CAUTI bundles has been identified as the most effective ways of preventing it. This cross sectional descriptive study thus, evaluated the application and barriers to application of CAUTI bundles in patients' care among nurses in a tertiary government hospitals. Census method was used to recruit into the study all 446 registered nurses and midwives who met the inclusion criteria in the institution; thus, no sampling was done to select the participants from the study area. Data were collected by means of researchers' developed and validated semi-structured self-administered questionnaire delivered through Google drive. Univariate and bivariate data analyses were conducted with the aid of SPSS version 24. Results of the study revealed that only 7 (1.9%) of the nurses claimed they always use written guidelines during catheter insertion, whilst majority 57.4% do not follow any written protocol or guidelines when inserting catheter. The use of aseptic non-touch technique was always done by 80% of the respondents. In general, score on compliance with the bundles was poor, as only 46.4% of the respondents correctly apply the bundles to patients' care. Barriers to application of the bundles as revealed by the results include; lack of written policy/guideline documents on CAUTI bundles in the facility (100%), lack of existing monitoring and feedback tools (98.9%), Supervisors/staff do not feel empowered to challenge suboptimal practices in a safe way (52.4%), lack of team meeting/ward round routinely addressing patients with indwelling urinary catheter (78.6%). It is thus, imperative to conclude that although the nurses in this study have some knowledge about the catheter associated urinary tract infections' bundles, their application of the bundles to patients' care is very poor, and was found to be due to some modifiable barriers. These barriers are some of the areas nurse educators and hospital policy-makers should focus in their bid to curbing healthcare acquired infections.