Trauma and Intensive Care Nursing Knowledge and Attitude of Foley Catheter Insertion and Maintenance

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Abstract

In the acute care setting, the majority of urinary tract infections are associated with indwelling urinary catheters. Despite guidelines for proper use, catheter-associated urinary tract infections (CAUTIs) continue to occur in critically ill/injured patients. There is a paucity of data on the translation between CAUTI prevention education and behavioral change. This project evaluated nurse's clinical knowledge and attitude toward Foley catheter insertion and maintenance to determine the benefits of addressing gaps in knowledge and inconsistencies in attitude through education.

A prospective cohort study was conducted with registered nurses from the emergency room, trauma/surgical, and medical intensive care units. Participant's clinical knowledge and attitude toward Foley catheter usage and CAUTIs were evaluated using a 20-question survey tool before and after a CAUTI education program.

Forty-eight nurses completed the presurvey, educational training, and postsurvey. The mean postsurvey score was significantly higher (86.9 ± 8.3%) than the presurvey score (76.0 ± 12.3%) for the knowledge section of the survey. There was no marked difference in participant attitude following the educational training, with mean presurvey and postsurvey scores of 91.3 ± 7.0% and 89.8 ± 5.3%, respectively. After the course, participants were more confident in their clinical knowledge; however, perception regarding CAUTI prevention did not improve. A series of unannounced rounding observations before and after the intervention showed an improvement in proper Foley catheter maintenance.

Catheter-associated urinary tract infection prevention education was an effective countermeasure to address gaps in clinical knowledge, but modifying attitudes was difficult to achieve. In the short term, the training appeared to improve proper maintenance in clinical practice.

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