Using Evidence-Based Practice to Reduce CAUTIs

By Karen Roush, AJN clinical managing editor

Using evidence-based practice to . . .

Fill in the blank. There’s something on your unit that could be improved—the rate of ventilator-associated pneumonia (VAP), the engagement of family in care, the readmission rate of patients with heart failure, patient satisfaction with pain management. Whatever it may be, you have the ability to improve it. This month we have a CE article (link is below) about an evidence-based practice (EBP) project to reduce catheter-associated urinary tract infections (CAUTIs).

Scanning electron micrograph of S. aureus bacteria on the luminal surface of an indwelling catheter with interwoven complex matrix of extracellular polymeric substances known as a biofilm/ CDC

The really interesting thing about this article, and what makes it especially helpful for beginner quality improvers out there, is that it doesn’t just describe an effective project to reduce CAUTIs. It also describes how to do an EBP project, step-by-step. The author, Tina Magers, a novice EBP mentor, followed the seven steps outlined in AJN’s Evidence-Based Practice series and describes the actions involved in each step. It’s a great how-to on applying evidence to practice. Here’s the overview/abstract of this useful June CE article, “Using Evidence-Based Practice to Reduce Catheter-Associated Urinary Tract Infections”:

Overview: In November 2009, AJN launched a 12-part series, Evidence-Based Practice, Step by Step, authored by nursing leaders from the Arizona State University College of Nursing and Health Innovation’s Center for the Advancement of Evidence-Based Practice. Through hypothetical scenarios, based on the authors’ collective clinical experience, the series illustrated the seven steps of evidence-based practice (EBP), defined as “a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values.” This article reports on an EBP project in which the seven-step approach to EBP described in the AJN series was used to reduce the incidence of catheter-associated urinary tract infection among adult patients in a long-term acute care hospital by reducing the duration of catheterization.

Keywords: catheter-associated urinary tract infection, evidence-based practice, hospital-acquired infection, nurse protocol, quality improvement, urethral catheterization