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The second aim of this QI project was to reduce the inci-dence of CAUTIs on the two units that experienced the high-est CAUTI rates across the hospi-tal’s units during the quarter prior to project implementation. To this end, CAUTI rates declined in both the neurotrau-ma intensive care and telemetry units in the quarter following the educational program. This find-ing is also consistent with the evidence-based literature and demonstrated that a multifac-eted, interactive CAUTI preven-tion educational program can effectively decrease the inci-dence of CAUTI among hospital-ized patients. There are a few limitations of this project worth noting. At the time this project was conducted, no reliability data were available for the survey used to measure nurses’ knowledge of appropriate indwelling urinary catheter care. The need exists for the develop-ment of an appropriate knowl-edge survey tool with demon-strated reliability. Several efforts were made by the project leader to enable all units’ nurses to attend an educational session (such as scheduling additional days and times, communication with the unit nurse managers, and letters and flyers posted throughout the units to remind nurses of the educational ses-QUALITY IMPROVEMENT RESEARCH PROJECTTable 4. Pre/Post-Intervention Nurses’ Knowledge Survey Subscale Item “Correct” Scoresa(N=59)Pre-Intervention n(%)Post-Intervention n(%Knowledge of institutional policies Facility has standardized orders? 54 (91.5) 58 (98.3) Facility has formalized system? 44 (74.6) 57 (96.6) Facility has standardized monitoring? 54 (91.5) 57 (96.6) Indications for Foley catheter use Critical illness and unstable volume statusb44 (74.6) 52 (88.1) Post-bladder obstructionb36 (61.0) 56 (94.9) Incontinence without breakdown 22 (37.3) 51 (86.4) Unable to stand to void 28 (47.5) 44 (74.6) New/change in diuretic dose 19 (32.2) 42 (71.2) Methods to prevent catheter related infections Remove catheter early 58 (98.3) 58 (98.3) Use condom catheter 52 (88.1) 58 (98.3) Intermittent straight catheterization 42 (71.2) 54 (91.5) Antimicrobial-coated catheter 46 (78.0) 40 (67.8) Antimicrobial agents in drainage bagc20 (33.9) 44 (74.6) Automated reminders53 (89.8)55 (93.2)aPossible score range 0 to 5 “correct” responses; higher score reflects higher level of knowledge. bAppropriate indication for catheterization. cIncorrect response.
280UROLOGIC NURSING / November-December 2018 / Volume 38 Number 6sions). While most nurses on the two units participated, the 12% who did not attend the educa-tional program may have differed from those who did attend, and therefore, findings may not be reflective of the entire population of nurses on the two hospital units. Further, generalizability cannot be extended to nurses on the other units of the hospital or to other hospitals because they may also differ from the cohort of nurses who participated in this project. Performance Improvement Model The Evidence-Based Change Model was utilized to develop this QI project by identifying the clinical problem; linking the problem with interventions and outcomes based on research; syn-thesizing the best practices; developing, implementing, and evaluating the program; and