Applied Nursing Research最新文献

{"title":"Safety attitudes among general practice nurses: A cross-sectional mixed-methods study","authors":"Yeojin Kil ,&nbsp;Roisin Doogue ,&nbsp;Anna V. Chatzi","doi":"10.1016/j.apnr.2025.152026","DOIUrl":"10.1016/j.apnr.2025.152026","url":null,"abstract":"<div><h3>Background</h3><div>Safety is a critical element within general practice as it is a unique environment with limited resources, diverse patients' needs, and varied healthcare environments. Within this landscape, general practice is a complex clinical environment with General Practice Nurses making up 45 % of the clinical workforce. Understanding the factors that influence general practice nurses' safety attitudes is important to improving patient care and organisational safety culture. This study aimed to explore factors associated with general practice nurses' safety attitudes, including demographics, safety perceptions, and experiences in practice.</div></div><div><h3>Methods</h3><div>A cross-sectional mixed methods study was conducted with survey comprising Likert scale and open-ended questions. A total of 302 fully completed responses were obtained from general practice nurses. Quantitative data were analysed to examine associations between safety attitudes and demographic characteristics. Qualitative data were thematically analysed to provide contextual insights into safety-related challenges.</div></div><div><h3>Results</h3><div>The length of work as a General Practice Nurse, regular operational briefings and smaller working teams are positively associated with the General Practice Nurses' safety attitudes. Participants expressed their preference towards regular and systematic communication. High workload, time pressures, inadequate communication, and unsupportive teamwork appeared as barriers of effective functioning within general practice.</div></div><div><h3>Conclusion</h3><div>Work experience and team size significantly impact safety attitudes, with experienced nurses and smaller teams showing better understanding and accountability. Regular operational briefings enhance collaboration and preparedness, while inconsistent communication leads to frustration. Positive perceptions of teamwork and communication are strongly linked to favourable safety attitudes, while excessive workload and limited autonomy pose challenges.</div></div><div><h3>Practical applications</h3><div>To improve safety within general practice, it is essential to address these issues through organisational support, systematic communication systems, and targeted training programmes.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152026"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian validation of the Watson Caritas Co-Worker Score for nurses and health care professionals Italian validation of the WCCS","authors":"Marika Lo Monaco ,&nbsp;Laura Maniscalco ,&nbsp;Mariachiara Figura ,&nbsp;Alessandro Stievano ,&nbsp;Domenica Matranga ,&nbsp;Jean Watson ,&nbsp;Cirus Rinaldi ,&nbsp;Daniela Nigrelli ,&nbsp;Ella Domanskaya ,&nbsp;Vincenzo Cascino ,&nbsp;Giuliano Anastasi ,&nbsp;Silvia Oggioni ,&nbsp;Irene Zerilli ,&nbsp;Roberto Latina","doi":"10.1016/j.apnr.2025.151990","DOIUrl":"10.1016/j.apnr.2025.151990","url":null,"abstract":"","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 151990"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributing factors to missed nursing care: A systematic review with clinical implications for practice and patient safety","authors":"Federica Breno ,&nbsp;Daniele Marchetti ,&nbsp;Daniela Cattani ,&nbsp;Simone Cosmai ,&nbsp;Stefano Mancin ,&nbsp;Diego Lopane ,&nbsp;Beatrice Mazzoleni","doi":"10.1016/j.apnr.2025.152002","DOIUrl":"10.1016/j.apnr.2025.152002","url":null,"abstract":"<div><h3>Objectives</h3><div>Missed Nursing Care (MNC) is increasingly recognized as an indicator of care quality and a potential contributor to adverse events. This systematic review aimed to explore the correlation between MNC and adverse events in hospitalized patients across public and private settings.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to PRISMA 2020 guidelines. Searches were performed in PubMed, Embase, CINAHL, Scopus, and TripDatabase between January and February 2025. Included studies were quantitative, published in English or Italian, and focused on acute hospital settings. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist; risk of bias was evaluated with ROBINS-I.</div></div><div><h3>Results</h3><div>Seven studies met the inclusion criteria, involving 13,619 nurses and 902 patients. Study designs included four cross-sectional, two observational (one correlational), and one secondary data analysis. Five studies reported a positive association between MNC and adverse events, while two found inverse or non-significant relationships. Common adverse outcomes included falls, infections, pressure ulcers, and medication errors.</div></div><div><h3>Conclusions</h3><div>Despite methodological heterogeneity and limitations—such as the use of non-validated tools or contextual differences—the evidence suggests a consistent association between MNC and adverse events. These findings underscore the importance of addressing missed care as a patient safety concern. Further longitudinal studies are needed to confirm causality and inform predictive models.</div></div><div><h3>Implications for nursing practice</h3><div>Recognition of the link between MNC and adverse events should prompt healthcare organizations to address care omissions through staffing optimization, safety culture, and clinical governance. Targeted interventions may reduce preventable harm and improve care quality.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152002"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' intention to leave: A cross-sectional study in the northern Italy","authors":"Paola Pinotti ,&nbsp;Simone Cosmai ,&nbsp;Diego Lopane ,&nbsp;Beatrice Mazzoleni ,&nbsp;Gianluca Solitro","doi":"10.1016/j.apnr.2025.152000","DOIUrl":"10.1016/j.apnr.2025.152000","url":null,"abstract":"<div><h3>Introduction</h3><div>A growing number of nurses are expressing the intention to leave their current jobs or the nursing profession entirely. This trend poses a significant threat to healthcare systems, contributing to increased adverse events, reduced quality of care, poorer patient outcomes, and elevated healthcare costs due to staff turnover and organizational instability.</div></div><div><h3>Objective</h3><div>This study aimed to examine job satisfaction and the intention to leave both current employment and the nursing profession among registered nurses affiliated with the Provincial Order of Nurses (Ordine delle Professioni Infermieristiche, OPI) in Bergamo, Northern Italy.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among all nurses registered with OPI Bergamo. A total of 1,167 nurses completed the questionnaire. The Italian validated version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess the quality of the nursing work environment. Descriptive statistics were employed to describe the sample and main variables. Logistic regression models were used to explore associations between job satisfaction and intention to leave.</div></div><div><h3>Results</h3><div>Overall, 56.4% of respondents (n = 659) reported an intention to leave their current job, while 46.6% considered leaving the nursing profession entirely. In both groups, the mean PES-NWI score was 2.18 (SD ± 0.46).</div></div><div><h3>Conclusions</h3><div>These findings indicate a high level of dissatisfaction among nurses in the Bergamo area, with substantial implications for workforce retention and healthcare system performance. Targeted strategies are urgently needed to improve work environments and reduce the risk of attrition among qualified nursing staff in Italy. Key words: Intention to leave, Job satisfaction, Work environment, PES-NWI (Practice Environment Scale of the Nursing Work Index), Hospital nurses.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152000"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the Male Nurse Identity Scale","authors":"Luhao Liu ,&nbsp;Xueting Wang ,&nbsp;Renjie Zhang ,&nbsp;Yuanyuan Li ,&nbsp;Minmin Leng ,&nbsp;Lijuan Yang ,&nbsp;Guangzhao Li ,&nbsp;Changan Li ,&nbsp;Heng Sun ,&nbsp;Tengfei Jiang","doi":"10.1016/j.apnr.2025.152001","DOIUrl":"10.1016/j.apnr.2025.152001","url":null,"abstract":"<div><h3>Aim</h3><div>To develop the Male Nurse Identity Scale (MNIS) and further evaluate its validity and reliability.</div></div><div><h3>Background</h3><div>In a context where occupational gender stereotypes continue to influence the nursing profession, the male nurse population often experiences identity dilemmas. The Male Nurse Identity Scale (MNIS) focuses on measuring multidimensional identity; to our knowledge, no similar instrument exists.</div></div><div><h3>Methods</h3><div>The MNIS was constructed through a systematic scale development process in which the total sample(n=837) was randomly split in half: Sample 1(n=418) was subjected to exploratory factor analysis (EFA) and Sample 2(n=419) was subjected to validation factor analysis (CFA); the full sample was analyzed for reliability.</div></div><div><h3>Results</h3><div>An exploratory factor analysis (EFA) of Sample 1 yielded a 19-item MNIS scale consisting of four dimensions: self-identity, role-identity, occupational group-identity, and occupational cultural-identity. Structural equation modeling (SEM) showed good model fit. Reliability analyses showed excellent internal consistency, with Cronbach's alpha coefficients ranging from 0.901 to 0.961 for the four dimensions.</div></div><div><h3>Conclusion</h3><div>The MNIS has strong validity and reliability, and it provides a valuable tool for enhancing the career development of male nurses and their retention in the healthcare workforce.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152001"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sense of coherence, self-efficacy, social support and perceived stress on postpartum depression during the transition to motherhood: A path analysis.","authors":"Lebeza Alemu Tenaw, Fei Wan Ngai, Ka Wai Katherine Lam","doi":"10.1016/j.apnr.2025.151998","DOIUrl":"10.1016/j.apnr.2025.151998","url":null,"abstract":"<p><strong>Background: </strong>The transition to motherhood is a women's life event that, while often joyful, can present challenges leading to postpartum depression. Understanding the roles of sense of coherence, self-efficacy, and social support in mitigating postpartum depression is crucial, particularly among Ethiopian mothers, where cultural practices may influence these dynamics.</p><p><strong>Objectives: </strong>The objective of this study to evaluate the effect of sense of coherence, self-efficacy, social support, and stress on postpartum depression during the transition to motherhood.</p><p><strong>Methods: </strong>This cross-sectional study involved 200 mothers recruited from Woldia Comprehensive Specialized Hospital, Ethiopia. The data collection conducted by two BSc midwives from 10 to 30 November 2024. Path analysis using Maximum Likelihood Estimation was performed to evaluate the effects of sense of coherence, self-efficacy, social support, and perceived stress on postpartum depression. Model fit evaluated using indices such as the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root-Mean-Square Error of Approximation (RMSEA).</p><p><strong>Results: </strong>The modified path model demonstrated a good fit with the data, indicated by χ² = 1.64 (p > 0.44), CFI = 1.00, TLI = 1.02, RMSEA <0.001, and SRMR = 0.02. The model explained 29.8 % of the variance in postpartum depression. A higher sense of coherence significantly predicted lower levels of postpartum depression, with a path coefficient of β = -0.15 (p = 0.02). Similarly, sense of coherence was associated with lower perceived stress (β = -0.21, p = 0.02), while perceived stress was a significant positive predictor of postpartum depression (β = 0.49, p < 0.001). The model also demonstrated that both social support and self-efficacy were inversely related to postpartum depression.</p><p><strong>Conclusions: </strong>Sense of coherence plays a direct role in preventing postpartum depression, while the effects of social support and self-efficacy on depressive symptoms are mediated through sense of coherence and perceived stress levels.</p>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"151998"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voices from the intensive care unit: A qualitative study on communication between family members and nurses","authors":"Essa Majed Tadros MSN, RN ,&nbsp;Hekmat Yousef Al-Akash PhD, RN ,&nbsp;Anas Ababneh PhD, RN ,&nbsp;Mariam Kawafha PhD, RN ,&nbsp;Osama A. Al-Kouri PhD, RN ,&nbsp;Suhair Hussni Al-Ghabeesh PhD, RN ,&nbsp;Zyad T. Saleh PhD, RN ,&nbsp;Ahmed Yahya Ayoub RN, PhDc, Case Manager ,&nbsp;Ahmad Rajeh Saifan PhD, RN","doi":"10.1016/j.apnr.2025.151991","DOIUrl":"10.1016/j.apnr.2025.151991","url":null,"abstract":"<div><h3>Background</h3><div>Effective communication between ICU nurses and patients' families is essential in ensuring optimal care, reducing anxiety, and enhancing decision-making. However, communication difficulties persist globally, particularly in intensive care units (ICUs) where patients are in critical condition and their families are distressed.</div><div>Aim</div><div>To explore the lived experiences of ICU nurses and family members in Jordan to understand how nurse workload, emotional stress, and cultural expectations influence the quality, clarity, and emotional tone of communication in intensive care settings.</div></div><div><h3>Study design</h3><div>A qualitative exploratory design was used. Individual face-to-face semi-structured interviews were done with 15 ICU nurses and 15 family members in two tertiary hospitals in Jordan. Braun and Clark's thematic analysis was utilized to generate the main themes and subthemes.</div></div><div><h3>Results</h3><div>The study identified three major themes: (1) communication disconnect and information gaps, including inadequate or inconsistent updates across shifts; (2) emotional load and its impact on communication, driven by family emotional overload and nurse burnout; and (3) balancing families' needs with nurses' workload, involving tensions between frequent updates, transparency, emotional support, and professional boundaries.</div></div><div><h3>Conclusions</h3><div>The study shows that ICU nurses in Jordanian hospitals face barriers to communicating with family members owing to irregular information distribution, emotional turmoil within families, and nurse exhaustion. These problems overlap with time pressure and workload stress, creating gaps in information flow, trust erosion, and emotional overload. Families' experiences could be improved through an improved ICU structure, easier communication pathways, enhanced nurse education and support, and improved family satisfaction.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 151991"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The chain mediating effects of psychological resilience and organizational commitment on the association between workplace incivility and job withdrawal among Chinese oncology nurses: A cross-sectional study.","authors":"Jiaxun Kang, Rui Zhao, Qiushi Zhang, Wenbo Jing, Hui Xu, Shanshan Wang","doi":"10.1016/j.apnr.2025.151999","DOIUrl":"10.1016/j.apnr.2025.151999","url":null,"abstract":"<p><strong>Background: </strong>Workplace incivility experienced by nurses has a substantial impact on job withdrawal, psychological resilience and organizational commitment also show certain associations with both incivility and work withdrawal. However, the specific mechanisms underlying these factors remain unclear.</p><p><strong>Aim: </strong>This study aimed to identify the relationship between workplace incivility and job withdrawal and the chain mediating effects of psychological resilience and organizational commitment.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with oncology nurses working in 7 hospitals using a convenience sampling method, which were all situated in central China, comprising four hospitals in Henan Province, two in Hunan Province, and one in Shandong Province. Demographic questionnaire and four validated and reliable scales were utilized for assessing demographic and occupational characteristics, workplace incivility, job withdrawal, psychological resilience, and organizational commitment. Participants (N = 1442) completed the survey.</p><p><strong>Results: </strong>The effects of workplace incivility, job withdrawal, psychological resilience, and organizational commitment were interrelated (all p < 0.01). Workplace incivility influenced job withdrawal through three statistically significant indirect pathways: (a) the mediating effect of psychological resilience (β = 0.017; SE = 0.003; 95 % CI: 0.012, 0.022); (b) the mediating effect of organizational commitment (β = 0.011; SE = 0.002; 95 % CI: 0.006, 0.015) and (c) the chain mediating effect between psychological resilience and organizational commitment (β = 0.001; SE = 0.004; 95 % CI: 0.001, 0.002).</p><p><strong>Conclusion: </strong>This study further elucidated the intrinsic connection between nurses' experiences of workplace incivility and their job withdrawal. This suggested that improving the working environment, reducing instances of uncivilized behavior in the workplace, enhancing psychological resilience and organizational commitment may contribute to reducing nurses' job withdrawal, thereby improving the quality of nursing care and ensuring patient safety.</p>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"151999"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience as a mediator between empathy and professional grief among nurses in high-mortality services","authors":"Ozkan Uguz ,&nbsp;Ozan Ozkol ,&nbsp;Dilay Gungor ,&nbsp;Zeynep Ozcan","doi":"10.1016/j.apnr.2025.152003","DOIUrl":"10.1016/j.apnr.2025.152003","url":null,"abstract":"<div><h3>Background</h3><div>Nurses working in high-mortality clinical services, such as intensive care, oncology, and palliative care units, frequently witness patient deaths. This repeated exposure places them at a high risk of bereavement reactions; however, limited research has explored how individual emotional traits, particularly empathy and resilience, shape this experience.</div></div><div><h3>Aims</h3><div>This study aimed to investigate the mediating role of resilience in the relationship between empathy and bereavement reactions—both short-term emotional reactions and long-term cumulative effects—among nurses working in high-mortality services.</div></div><div><h3>Methods</h3><div>A cross-sectional design was used. Data were collected online from 238 purposively sampled nurses working in a tertiary public hospital in northwestern Turkey. Standardized tools were used to measure empathy, resilience, and professional bereavement.</div></div><div><h3>Results</h3><div>Nurses reported moderate levels of bereavement reactions following patient deaths. Empathy was positively associated with both short-term bereavement reactions (β = 0.253, p = 0.001) and long-term cumulative effects (β = 0.359, p &lt; 0.001). Resilience partially mediated these associations, reducing the impact of empathy on both short-term bereavement reactions (β = 0.071, 95 % CI [0.017, 0.133]) and long-term cumulative effects (β = 0.137, 95 % CI [0.084, 0.193]).</div></div><div><h3>Conclusion</h3><div>Nurses in high-mortality services are particularly vulnerable to experiencing bereavement. While higher empathy intensifies bereavement reactions, resilience plays a protective role. Interventions aimed at strengthening resilience may help mitigate the negative effects of bereavement and promote emotional well-being, job sustainability, and improved patient care outcomes in these emotionally demanding settings.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152003"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-led implementation of evidence-based bundles to reduce CAUTIs in an academic acute care hospital: A four-year longitudinal quasi-experimental study","authors":"May Mei-Sheng Riley DNP, MSN, MPH, RN, ACNP, CCRN, CIC, FAPIC ,&nbsp;Wei-Chen Tung Ph.D., RN, FAAN ,&nbsp;Chris Tofanelli MSN, RN, CNS, PCCN","doi":"10.1016/j.apnr.2025.152004","DOIUrl":"10.1016/j.apnr.2025.152004","url":null,"abstract":"<div><h3>Aim</h3><div>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.</div></div><div><h3>Background</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = .007). Catheter SURs fell from 0.75 to 0.67, an 11 % reduction in utilization risk (<em>p</em> &lt; .001). Reinsertion rates decreased by approximately 6 %.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152004"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144924939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}