Prevention of catheter-associated urinary tract infections in a respiratory care center: a best practice implementation project

ABSTRACT Introduction: Catheter-associated urinary tract infections (CAUTIs) are among the most common health care–associated infections, contributing to increased morbidity, prolonged hospitalization, and higher health care costs. Patients in respiratory care centers (RCCs) are at increased risk due to prolonged catheterization and high dependency on invasive devices. Despite established guidelines, gaps in adherence and challenges in sustaining recommended catheter management practices remain common. Objective: This project aimed to implement evidence-based practices for CAUTI prevention in patients admitted to an RCC and to support sustainable practice change through structured implementation and ongoing monitoring of clinical indicators. Methods: This best practice implementation project was conducted in the RCC of a tertiary medical center in Taiwan using the JBI Evidence Implementation Framework. A baseline audit was undertaken with six evidence-based criteria, followed by identification of barriers and development of targeted strategies using JBI's Getting Research into Practice (GRiP) approach. Implementation strategies included workflow clarification, targeted micro-learning and structured staff education, system-level support such as digital tools for checklist completion, and reinforcement of multidisciplinary collaboration. A follow-up audit was conducted to evaluate changes in compliance. Results: Baseline compliance varied across criteria, with high compliance in daily hygiene practices but lower compliance in staff education, protocol availability, and multidisciplinary involvement. Following implementation, compliance improved across all six criteria. The most notable improvements were observed in staff education and protocol availability, which increased from 16.67% to 100% and from 58.33% to 100%, respectively. Marked improvement was also observed in multidisciplinary involvement, while moderate improvements were seen in hand hygiene and timely catheter removal. Trends in catheter utilization and CAUTI incidence were monitored with CAUTI incidence remaining low during the extended post-implementation period despite variability in catheter utilization. This supported the sustainability of practice changes. Conclusions: A structured, framework-guided implementation approach led to improvements in compliance with evidence-based CAUTI prevention practices in an RCC. Addressing workflow barriers, incorporating system-level support, and strengthening multidisciplinary collaboration were important components of practice change. Spanish abstract: https://links.lww.com/IJEBH/A737