Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Janice Long

Abstract

Catheter-associated urinary tract infections (CAUTIs) occur frequently in Intensive Care Unit (ICU) patients, who are hospitals' most vulnerable population. This quality improvement project is the evaluation of 2 interventions used in one acute care facility's ICU to decrease CAUTI rates over a 3-year timeline. The 2 interventions used for the project were 1) an evidence-based guideline developed from the Comprehensive Unit-based Safety Program and 2) simulation-based education for teaching the guideline. Using the Iowa model and Havelock's theory of planned change as a framework, the 2 interventions were evaluated over a 3-year timeline: 2014 pre- intervention, 2015 intervention, and 2016 post-intervention. The results were compared quarterly for the 3 years using the standardized infection rate (SIR) and standard utilization ratio (SUR), which show the effectiveness of preventative activities. Data were obtained from the National Healthcare Safety Network and the results from the project showed an 82.46% decrease in SIR from 2014 through 2016 in Baseline 1, and a 71.33% decrease in SIR from 2015 through 2016 in Baseline 2. This is statistically significant for CAUTI reduction over a 3-year period (p < 0.001). For the SUR there was a 14.29% decrease from 2014 to 2016 in Baseline 1 and no statistically significant difference from 2015-16 in Baseline 2. It can be concluded that an evidence-based guideline taught through simulation significantly reduces SIR and has a positive effect on catheter use. This study contributes to positive social change because it promotes decreased patient length of stay and cost of care and decreases morbidity and mortality for patients. It also has a positive effect on health behavior-related outcomes for the ICU nurses for CAUTI prevention.

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