Date of Graduation

Summer 8-12-2026

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Jennifer Zesati

Abstract

Catheter-associated urinary tract infections (CAUTIs) remain among the most common preventable healthcare-associated infections, with CMS eliminating reimbursement for hospital-acquired cases since 2008. Within a five-unit, high-acuity microsystem at an urban acute care hospital, four CAUTIs were documented between January and July 2026 despite established prevention protocols. Adherence gaps were identified in catheter necessity assessment, maintenance practices, and nurse-driven removal protocol use. This quality improvement project was guided by the Johns Hopkins Evidence-Based Practice framework and Lewin's Change Theory. A targeted nursing education intervention addressing bladder scanning, dependent loop identification, and catheter care bundle adherence was implemented across the microsystem over a ten-week period. Using a Plan-Do-Study-Act cycle, roving in-service education was delivered to 211 nurses, with pre- and post-learning surveys assessing knowledge and confidence (n = 97 and n = 103, respectively). The cumulative composite score increased from 78.0% to 84.1%, a 6.1 percentage point gain that fell short of the 20-point target but was driven by substantial knowledge gains, particularly in correct identification of the 48-hour bladder scan and straight catheterization timeline (+38.8 points) and accurate dependent loop identification (+14.0 points). These findings support structured, low-cost nursing education as a feasible strategy for strengthening CAUTI prevention practice readiness, while underscoring the need for sustained reinforcement and continued surveillance to determine downstream effects on infection rates.

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