Catheter-associated urinary tract infection rates and barriers to implementation of their evidence-based preventive measures in Kiambu County Referral Hospitals, Kenya

Abstract

Objectives: To determine Catheter-Associated Urinary Tract Infection (CAUTI) Rates among patients in medical-surgical wards at Kiambu  county referral hospitals. To assess the barriers to implementation of CAUTI evidence-based preventive measures among nurses in  medical-surgical wards at Kiambu county referral hospitals.

Study Design: Descriptive cross-sectional study.

Setting: Kiambu and Thika  County Referral Hospital’s adult medical-surgical wards.

Participants: The study population was 162 patients with Indwelling Urinary Catheters (IUC) and 83 nurses working in medical-surgical wards at Kiambu and Thika county referral hospitals.

Main outcome  measures: CAUTI rates and barriers to implementation of their evidence-based preventive measures.

Results: The cumulative CAUTI  incidence for the two county referral hospitals was 7.13 CAUTIs per 1000 IUC days: 7.14 CAUTIs/1000 IUC days and 7.09 CAUTIs/1000 IUC  days in Kiambu and Thika county referral hospitals respectively. The most prominent barriers to CAUTI evidence-based preventive  measures were lack of ongoing medical education on CAUTI prevention (Mdn= 4, IQR= 1), absence of CAUTI preventive measure audits  (Mdn= 4, IQR= 1), and insufficient staffing and heavy workload (Mdn= 5, IQR= 1).

Conclusion: CAUTI rates were high since even a single  event is one too many. These high CAUTI rates can be attributed to the identified barriers: Lack of continuing medical education and  audits on CAUTI evidence-based preventive measures and inadequate resources in terms of staffing have made achieving zero CAUTI  rates impractical. The findings will contribute to the Global Patient Safety Action Plan 2021-2030 which aims at eliminating avoidable harm  in healthcare.