Knowledge, attitude and practices of nurses towards the prevention of catheter-associated urinary tract infection in selected Referral Hospitals in Rwanda.

Abstract

Catheter-associated urinary tract infection (CAUTI) is the most common health care-associated infection accounting for 80% of all hospital acquired infection and is mostly related to the use of urinary catheter frequently found in severely ill patients. Although, many preventive measures and guidelines to prevent CAUTI exist in different healthcare settings, the prevalence of CAUTI and urinary catheter (UC) use is still a major issue as 25 % of hospitalized patients receive urinary catheters, sometimes unnecessarily. Aim: The aim of this study was to assess the level of knowledge, attitudes, and skills of nurses regarding CAUTI prevention in selected referral hospitals in Rwanda. Method: A descriptive quantitative approach and a cross-sectional design was used for the data collection. The research survey builds on the World Health Organization (WHO) defined standards for precautions of infection control and the Center for Disease Control (CDC) 2009 guidelines for indication of catheterization, and measures for CAUTI prevention. The research study included all registered nurses working in ICU of two referral hospitals in Kigali who were fulfilling the inclusion criteria. Total population purposeful sampling method was used as the population to be studied was small and needed to be used as whole without selecting some units. The final collected data was coded and analyzed using SPSS. Frequency, Mean and other statistics were calculated. Only P-value less than 0.05 were set as statistically significant. Results and discussion: A total of 53 nurses working in intensive care unit were included in the study with 86.8% of response rate. Based on the results of the present study, a high percentage has shown a good implementation of different practices (79.9%) towards catheter indications and CAUTI prevention. However respondents’ knowledge (64.52%) was not satisfactory and among respondents, 52.83% show a positive attitude. Lastly, there were no influence of demographics characteristics on knowledge, attitudes and practice in this study (p> 0.05). Conclusion: The findings of the study show a low level of knowledge among nurses but no demographic factor was seen as a barrier to nurses’ KAP towards the prevention of CAUTI. Therefore there is a need for further study to establish factors contributing to low level of knowledge, attitude and practice, perhaps using a qualitative study. Nurses should be empowered by in service training towards infection control especially CAUTI.