Compliance with CDC guidelines for Catheter associated Urinary tract infection prevention among nurses at Embu level 5 Hospital.

Abstract

Urinary tract infections directly related to catheterization account for approximately 40% of all healthcare related infections worldwide. Capping the utilization of urinary catheters and duration of placement, adherence to proper catheter care, and using aseptic technique have been identified as key interventions in the fight against CAUTI. Nurses thus play a huge role in preventing CAUTI since they are the primary care givers. In line with this, the Centers for Disease Control (CDC) developed recommendations to guide prevention strategies for CAUTI in healthcare facilities worldwide. However, despite demonstration of the effectiveness of these guidelines in averting CAUTI, uptake of these recommendations hasn’t been investigated in health care institutions locally. This study was aimed at assessing compliance with CDC guidelines for prevention of CAUTI among nurses at Embu Level 5 Hospital in Embu County. Both quantitative and qualitative data were collected with the use of a descriptive cross-sectional study that employed the use of a concurrent mixed method design. The study was conducted at Embu Level 5 hospital in the surgical, medical and gynecological/obstetric wards. The total population of nursing staff in the hospital is 217 nurses and 130 nurses were sampled from this population. Systematic random sampling was employed to choose subjects to be included in the study, where every 2nd nurse was selected. A structured questionnaire was utilized to collect quantitative data from the nurses and an observation check list for selected participants to assess catheter insertion technique. Qualitative data was collected through a key informant interview guide for ward in-charges and their deputies. In order to safeguard reliability and validity of the research tools a pilot study was carried out at Thika Level 5 hospital. Thematic analysis was utilized to analyze qualitative data which was submitted by way of narration. The statistical package SPSS version 21 was utilized to perform quantitative data analysis. Descriptive statistics that is, frequencies and mean together with inferential statistics that is, Chi-square test and independent t-test were utilized for exploration of data and a p-value of < 0.05 was deemed significant. Tables and charts were then employed to proffer the data. A total of 93 nurses were involved in the study with an 86% response rate. The study findings revealed that the nurses’ level of compliance of the CDC guidelines for CAUTI prevention was low (46.7%). There were no significant associations established between nurse related factors and compliance with CDC guidelines for CAUTI prevention (p > 0.05). Statistically significant relationships were however found between institution-related factors that is, regular training on CAUTI prevention, having adequate staffing and support from ward in charges and hospital administration and compliance with specific guideline statements for prevention of CAUTI (p < 0.05). In line with the study’s findings, it is thus proposed that the hospital management organize regular training for nurses on CAUTI prevention and provide adequate staffing to improve compliance with guidelines for CAUTI prevention. Similar studies in other county and sub-county hospitals are recommended