Evaluating nursing interventions to prevent catheter-associated urinary tract infection in ICU patients: a quasi-experimental study

Abstract

Background: Catheter-associated urinary tract infection (CAUTI) is a significant threat to patient safety in intensive care units (ICU). Although evidence-based guidelines for CAUTI prevention, adherence remains suboptimal, particularly among ICU nurses in China. Objective: To evaluate the effect of a preventive management intervention based on the Management by Objectives (MBO) theory on CAUTI prevention in an ICU setting. Methods: A quasi-experimental study with a historical control group was conducted. Patients admitted between January and December 2021 constituted the control group and received routine care. Patients admitted between January 2022 and December 2023 constituted the intervention group and received the MBO-based preventive management in addition to routine care. We compared the two groups on the health outcomes: the incidence of CAUTI, urinary catheter indwelling rate, catheter indwelling days, compliance with bundle measures, hand hygiene compliance, antibiotic use, ICU length of stay, and clinical outcomes. Results: A total of 1606 patients were included. The overall urinary catheter indwelling rate was 77.59%, and only 5 CAUTI cases occurred. The CAUTI incidence was 0.41% in the control group (2021). During the intervention period, the incidence was 0.32% in the first year (2022) and 0.19% in the second year (2023), respectively. The difference in CAUTI incidence between the control and intervention groups was not statistically significant (P > 0.05). However, the catheter indwelling rate in the second intervention year was significantly lower than in the control year (P < 0.05). Furthermore, the ICU length of stay and clinical outcomes in the second intervention year showed significant improvement compared to both the control group and the first intervention year (P < 0.05). Conclusion: The MBO-based preventive management intervention was associated with a significant reduction in catheter indwelling rates and ICU length of stay. This demonstrates that the intervention can improve nursing practices regarding catheter management and enhance patient outcomes in the ICU.