Date of Doctor of Nursing Practice Project Completion

Spring 4-22-2026

Faculty Advisor

Ramaswamy Padmavathy

Abstract

Purpose

The purpose of this project is to decrease the CAUTI rate among adult rehabilitation patients with indwelling catheters from 40% to 1% through improved staff hand hygiene (HH) compliance and to increase hand hygiene compliance from 45.24% to 60.47% within 3 months. The secondary aim is that staff will report self-improvement in hand hygiene knowledge and technique.

Background

Catheter-associated urinary tract infections (CAUTIs) are common preventable healthcare-associated infections. Inconsistent HH compliance among direct care staff remains a common challenge and can contribute to infection risks and transmission of microorganisms

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement model guided the implementation of staff education and training on HH and CAUTI prevention. The intervention included competency reinforcement, structured HH training, and placement of visual reminders throughout the unit. Direct staff observation, continuous monitoring, and real-time feedback were used to evaluate staff adherence and sustained practice change.

Results

Post-intervention findings showed significant improvements in staff confidence and knowledge regarding HH. Survey data (n=21) showed that recognition of Key moments for HH increased from 45% to 90%, correct HH technique rose from 40% to 80%, and understanding of microbial transmission rose from 52% to 85%. Overall HH compliance rate rose from 45.24% to 60.47%, and the CAUTI rate declined dramatically from 40% to 1%.

Implications

The findings of this project demonstrate that strengthening HH compliance is a practical and effective strategy for reducing CAUTI rates.

It is crucial to ensure that nurses and patient care technicians understand the evidence behind HH to sustain behavior change.

Nurse leaders play a critical role in policy improvements, championing and modeling best practices that prioritize infection prevention

 

Keywords

Hand Hygiene, HH, Catheter Associated Urinary Tract Infection, CAUTI

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