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Nurse-Driven Catheter-Associated Urinary Tract Infection Reduction Process and Protocol: Development Through an Academic-Practice Partnership

Johnson, Pamela DNP, RN; Gilman, Anna BSN, RN; Lintner, Alicia MSN, CRNP-BC, CCRN; Buckner, Ellen PhD, RN, CNE, AE-C

doi: 10.1097/CNQ.0000000000000129
Original Articles
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Translating evidence-based practices to the bedside can be facilitated by an active academic-practice partnership between nursing faculty and frontline nursing staff. A collaborative effort between the university's academic nurses and the medical center's clinical nurses explored, created, implemented, and evaluated an evidence-based nurse-driven protocol for decreasing the rate of catheter-associated urinary tract infections. The nurse-driven protocol was piloted in 4 intensive care units and included nurse-driven orders for catheter discontinuation, utilization of smaller bore urinary catheters, addition of silver-based cleansing products for urinary catheter care, and education of staff on routine catheter care and maintenance. Data were collected for more than 8 months pre- and postimplementation of the nurse-driven protocol. Postimplementation data revealed a 28% reduction in catheter-associated urinary tract infections in the intensive care units as compared with preimplementation. Secondary benefits of this academic-practice partnership included strengthening the legitimacy of classroom content as lessons learned were integrated into courses in the nursing curriculum. The result of the partnership was a stronger sense of collaboration and collegiality between hospital staff and the university faculty. Transformative leadership engaged numerous stakeholders through collaborative efforts to realize best practices. An academic-practice partnership facilitates transformative change and provides structural stability and sustainability.

Adult Health Nursing Department, University of South Alabama College of Nursing, Mobile (Drs Johnson and Buckner); Staff Development, University of South Alabama Medical Center, Mobile (Ms Gilman); and Arnold Luterman Regional Burn Center, University of South Alabama Medical Center, Mobile (Ms Lintner).

Correspondence: Pamela Johnson DNP, RN, Adult Health Nursing Department, University of South Alabama College of Nursing, 5721 USA Dr North, HAHN 4068, Mobile, AL 36688 (pamjohnson@southalabama.edu).

The authors are grateful to the University of South Alabama Medical Center for its support and participation in development and successful implementation of this protocol, especially: the CAUTI prevention action team; evidence-based practice committee members, and physicians and nurses in the medical surgical ICU, progressive care unit, surgical trauma ICU, and Burn ICU.

There is no actual or potential conflict of interest including financial, personal, or other relationships with organizations and companies that could inappropriately influence this article.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this study.

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