Factors associated with Saudi nurses’ knowledge, attitudes, and practices in preventing catheter-associated urinary tract infection in Aljouf City: a cross-sectional study

Abstract

Background – Catheter-associated urinary tract infection (CAUTI) is a leading healthcare-associated infection worldwide, associated with increased morbidity, prolonged hospitalization, higher costs, and antimicrobial resistance. Nurses play a critical role in prevention through evidence-based catheter insertion, maintenance, and timely removal. Aim – To assess factors associated with knowledge, attitudes, and preventive practices regarding CAUTI among nurses in Aljouf City, Saudi Arabia. Methods – A descriptive cross-sectional study was conducted among 184 registered nurses in governmental hospitals in Aljouf City using a structured questionnaire on demographics, knowledge, attitudes, and practices (KAP) toward CAUTI prevention. Data were analyzed with descriptive statistics, independent t-tests, ANOVA, and Spearman’s correlations. Results – Overall, 77.7% of nurses had good knowledge, 84.8% showed positive attitudes, and 84.8% had adequate preventive practices. Knowledge scores differed significantly by years of experience (p = 0.001), urinary catheter (UC) insertion frequency (p < 0.001), and CAUTI guideline awareness (p = 0.002). Attitudes varied by hospital (p = 0.014), ward (p = 0.007), and UC insertion frequency (p = 0.032). Practices differed by hospital (p = 0.006), UC insertion frequency (p = 0.009), and guideline awareness (p = 0.049). Spearman’s correlations showed weak knowledge-attitude (r = 0.231, p = 0.002), moderate knowledge-practice (r = 0.446, p < 0.001), and strong attitude-practice (r = 0.525, p < 0.001) associations. Multivariable logistic regression showed that attitude was the strongest independent factor associated with adequate practice (AOR = 0.251, p = 0.005). Conclusion – This study demonstrates generally favorable knowledge, attitudes, and practices toward CAUTI prevention among Al-Jouf nurses, with moderate correlations, attitudes showed the strongest association with preventive practices.