Practice Tip of the Week | Reducing CAUTI Incidence through a Multimodal Educational Approach

By Malinda Sykora, MBA-HCM, MSN, RN-BC 

Catheter-Associated Urinary Tract Infections (CAUTIs) are among the most prevalent and preventable healthcare-associated infections in acute care settings. These infections not only contribute to increased patient morbidity and mortality but also impose significant financial burdens on healthcare systems due to prolonged hospitalizations, penalties related to quality metrics, and additional resource utilization. For frontline nurses and nurse leaders alike, understanding the root causes of CAUTIs and implementing evidence-based prevention strategies is crucial. With evolving expectations around patient safety and value-based care, CAUTI reduction has become a defining quality benchmark for hospitals across the country. This article provides TNA members with practical, evidence-informed insights—the golden nuggets—on how to mitigate CAUTI risk through clinical vigilance, policy alignment, and interdisciplinary collaboration. Whether you serve at the bedside, guide through education, or lead from the frontlines of administration, this article offers practical, evidence-based strategies to drive better patient outcomes, ensure regulatory compliance, and advance the overall quality of care within your organization.

The Problem

CAUTIs remain a persistent challenge in healthcare settings due to their high prevalence and the complications that often arise as a result—such as increased patient morbidity, longer hospital stays, and higher healthcare costs. While evidence-based protocols for prevention are well established, many hospitals continue to face difficulties with consistent and effective implementation. To address this gap, a multimodal educational strategy targeting both new and existing staff was explored as a potential solution to reduce the incidence of CAUTIs. What We Know Rising Concern & Response: In 2023, an increase in catheter line days at the facility correlated with a rise in CAUTI cases, highlighting the need for effective interventions to reduce infection rates (Werneburg, 2022). Educational Strategy Implemented: A comprehensive education-based approach was deployed, including enhanced training for both new hires and experienced staff, supported by signed attestations to reinforce understanding and accountability. Positive Outcomes Achieved: These targeted strategies resulted in a significant reduction in CAUTI rates, improving patient outcomes, strengthening patient safety, and advancing the quality of care delivered.

Methods The intervention involved two key components. New team members joining the organization received initial CAUTI education during general nursing orientation, which included case studies, visual aids, and demonstrations. For existing personnel, a CAUTI Roadshow was organized. The best practice team members provided information on essential topics, including two-person catheter insertion, dependent loops, catheter maintenance, and ensuring that patients had the appropriate orders for their indwelling foley catheters. Nurses were also required to complete an attestation confirming their understanding of the educational material.  Implementation The project implementation included education on dependent loop management, The implementation of a two-person catheter insertion procedure has been shown to significantly reduce the incidence of catheter-associated urinary tract infections (Rahmawati, Tamaela, Anika, & Wicaksana, 2021), proper catheter maintenance, and verification of indwelling foley catheter orders. ResultsPreliminary findings suggest this comprehensive educational approach has had a significant impact on reducing CAUTIs. In 2023, nine CAUTIs were reported at this time, whereas in 2024, that number has dropped to just two, resulting in improved patient outcomes and better overall healthcare quality. Compliance with Indwelling Urinary Catheter (IUC) orders increased dramatically from 50.5% in 2023 to 95% in 2024 following the introduction of educational initiatives. Additionally, the two-person catheter insertion rate rose from 63.6% to 76.5%. Compliance with proper management of dependent loops also showed improvement, increasing from 66% to 74%.  Recommendations: Adopt a multimodal teaching strategy hospital-wide. Regularly reinforce education through mobile training models. Track compliance metrics and tie them to staff evaluations or quality dashboards.

Conclusion One of the most impactful moments in this journey came when a night shift nurse shared that she paused a procedure mid-way to ensure a second nurse was present, saying, “I remembered the roadshow.” That moment marked a turning point—a visible shift in culture and mindset. Today, with compliance rates at an all-time high and CAUTIs reduced to just three, the team feels empowered and unified. They not only understand the ‘what’ but also the ‘why’ behind every protocol, which has transformed behavior from obligation to ownership. This sense of accountability has fostered a culture of safety, collaboration, and shared purpose throughout the organization. Regular Best Practice meetings now serve as dynamic spaces for celebrating wins, exchanging insights, and reinforcing a collective commitment to excellence. Through education, engagement, and empowerment, we’ve not only improved outcomes—we’ve ignited a movement.

Editor’s Note: For more work on CAUTI prevention, check out this previously published Practice Tip: A Journey to Zero Harm.

REFERENCES Rahmawati, L., Mariana Tamaela, J., Anika, L., & Wicaksana, A. L. (2021). The two-person catheter insertion procedure reduces catheter-associated urinary tract infections. Enfermería Clínica, 31, 478–482. https://doi.org/10.1016/j.enfcli.2020.10.047   Werneburg G. T. (2022Urinary Tract Infections: Current Challe). Catheter-Associated nges and Future Prospects. Research and reports in urology, 14, 109–133. https://doi.org/10.2147/RRU.S273663