A study of nurses' views about the prevention of nosocomial urinary tract infections

This study sought to discover the contribution of nursing practice to the prevention of hospital-acquired or nosocomial urinary tract infections (NUTIs), the most commonly occurring nosocomial infection. Seventy-five per cent of such infections are associated with urethral catheters. The practices of nurses who are caring for patients on a 24 h basis would appear to be fundamental to achieving any reduction in the incidence of NUTIs. This qualitative study utilized unstructured interviews to explore the views of 12 registered nurses about three key issues: first, what care do nurses give with the aim of preventing catheter-associated NUTIs; secondly, what improvements in practice would further prevent catheter-associated NUTIs; thirdly, what do nurses see as constraints to the prevention of catheter-associated NUTIs? The nurses identified many of the measures that were cited in the literature as effective for preventing NUTIs; however in reality, they stated that their practice differed because of a lack of time to give care and to update themselves. The consequences of under-staffing were that junior and temporary staff (whose competence in preventing NUTIs was questioned) worked unsupervised. Those interviewed identified feelings of powerlessness in effecting preventative measures, and identified not only the role of medical staff in influencing NUTIs but also their inconsistent approach to care. All these forces effectively limited the nurses' ability to prevent NUTIs. The study is concluded with recommendations for changes in practice and further research.