Effectiveness of a Nurse-Led Urinary Catheter Care Intervention on Catheter-Associated Urinary Tract Infection among Female Patients with Indwelling Urinary Catheters: A Pre-Experimental Study

Abstract

Background: Indwelling urinary catheters are frequently used in hospitalized patients for appropriate clinical indications but may increase the risk of catheter-associated urinary tract infection (CAUTI), particularly with prolonged catheterization. Nurses play an important role in maintaining urinary catheters and providing patients with education regarding safe catheter-care practices. Objective: This study aimed to evaluate the effectiveness of a nurse-led urinary catheter care intervention on catheter-care knowledge and CAUTI-related outcomes among female patients with indwelling urinary catheters. Methods: A quantitative research approach with a pre-experimental one-group pre-test–post-test design was adopted. The study was conducted among 100 adult female patients with indwelling urinary catheters in a selected hospital in Odisha, India, from February 01, 2026, to April 30, 2026. Participants were selected using a non-probability convenience sampling technique. Data were collected using a structured tool comprising sociodemographic and clinical characteristics, a structured questionnaire assessing knowledge regarding urinary catheter care, and a CAUTI assessment record. Participants received a structured nurse-led educational intervention covering hand hygiene, catheter and perineal hygiene, maintenance of the closed drainage system, drainage-bag positioning, prevention of kinking and obstruction, avoidance of unnecessary catheter manipulation, recognition of warning signs, and timely review of the continuing need for catheterization. Pre-test and post-test knowledge scores were compared using a paired t-test. Results: The mean catheter-care knowledge score increased from 12.36 ± 3.42 in the pre-test to 18.74 ± 2.61 in the post-test, with a mean improvement of 6.38 points. The paired t-test demonstrated a statistically significant improvement in knowledge (t = 18.52, P < 0.001). Regarding CAUTI status, 20 (20%) participants were classified as CAUTI-positive before the intervention, compared with 8 (8%) after the intervention. The proportion classified as CAUTI-negative increased from 80 (80%) to 92 (92%), representing a 12%-point reduction in the observed proportion of CAUTI-positive participants. Conclusion: The nurse-led urinary catheter care intervention was associated with a significant improvement in catheter-care knowledge and a reduction in the proportion of participants classified as having CAUTI after the intervention. The findings support structured nurse-led patient education as a component of comprehensive urinary catheter-care and infection-prevention practices. However, because the study used a one-group pre-experimental design without a control group, the observed change in CAUTI status cannot be attributed solely to the intervention.