Prevention of catheter associated urinary tract infections: Assessment of knowledge and practices among nurses in a tertiary care centre in Nigeria

Abstract

Background: Catheter-associated urinary tract infections (CAUTI) are responsible for up to 80% of healthcare associated infections. Recommended strategies to prevent CAUTI are based on implementation of a ‘care bundle’. Nurses are responsible for catheter care, yet few studies have been conducted in developing countries to assess their understanding of CAUTI and the care bundle. The study aimed to assess the knowledge and practices toward prevention of CAUTI among nurses. Methods and materials: A cross-sectional study was carried out in a tertiary hospital in Edo state, Nigeria between January and July 2019 among 200 consenting nurses recruited through a systematic sampling process. Data was collected using pretested questionnaires. A checklist was used for observation of patients with an indwelling catheter to assess compliance with CAUTI maintenance bundle. Analysis was done using the Statistical package for social sciences. Ethical approval was obtained. Results: One hundred and eighty nurses completed the study giving a response rate of 90%. Majority, 138 (76.7%) had fair knowledge of CAUTI and its prevention, 42 (23.3%) had poor knowledge. Gaps in knowledge were observed in the areas of appropriate indications for urinary catheterization, catheter care including removal, and risk factors for CAUTI. One hundred and forty-nine (82,8%) respondents had positive attitude although slightly above half erroneously believed that catheter removal should be at the convenience of nurses. Neither knowledge nor attitude was associated with any demographic characteristic. One hundred and three (71.0%) respondents had good practice and 42 (29.0%) poor practice of the CAUTI bundle. Practice was not associated with any demographic variable, but significantly associated with knowledge (χ2 8.62, df = 1, p < 0.001). One hundred and fifty-eight (87.8%) respondents had received training on catheter care as part of their nursing education, however there was no association between previous training and knowledge or practice of CAUTI prevention. Findings from the check list showed meatal hygiene not performed daily (23.8%) and urine bag and tubing on the floor (38.1%). Conclusion: There is an urgent need for education intervention to improve the knowledge and practices of CAUTI prevention bundle among nurses in the study area.