Nurses' Knowledge, Practice, and Associated Factors Regarding Catheter-Associated Urinary Tract Infection Prevention: A Systematic Review and Meta-Analysis.

BACKGROUND

Catheter associated urinary tract infections remain among the most prevalent hospital-acquired infections. However, no pooled estimates of nurse's knowledge and practice towards catheter associated urinary tract infection prevention currently exist in Africa and Asia.

OBJECTIVE

To assess nurses' knowledge, practice and associated factors towards Catheter associated urinary tract infection prevention.

METHODS

The researchers conducted extensive search of institutional repositories, PubMed, Science Direct, Hinari, Cochrane, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the study. STATA 17 was used for data analysis, and funnel plot, Eggers test and meta-regression were used to examine publication bias and heterogeneity. Additionally, sensitivity analyses, and subgroup analysis were conducted. Studies on knowledge and practice toward catheter-associated urinary infection prevention among nurses were included and studies conducted other than nurses were excluded. A total of 8,647 articles were retrieved from online databases, of which only 21 articles were eligible for final analysis.

RESULTS

Nurses' overall CAUTI preventive knowledge (61%, I2=3.47%) and practice (55%, I2=0.46%) are moderate, indicating a gap between knowledge and practice. The availability of guidelines (OR: 2.67, CI: 1.84-3.51, p<0.001), training (OR: 1.82, 95% CI: 1.43-2.32, p <0.001), and five to ten years of work experience (OR: 2.15, 95% CI: 1.45-3.17, p<0.001) were all factors that were substantially associated with having good knowledge. Good practice was determined by good knowledge (OR: 2.66 (95% CI: 1.09-6.52), I2 = 83.34%, p = 0.031), a good attitude (OR: 2.38 (95% CI: 1.80-3.15), I2=22.3 %, p<0.001) and having infection prevention guidelines (OR: 2.23 (95% CI: 1.50, 3.32, I2 = 0.0%, p <0.001).

CONCLUSION

The knowledge and practice of catheter-associated urinary tract infection prevention among nurses in Africa and Asia were at a moderate level. However, significant regional disparities still exist, most likely due to variations in healthcare systems, resources, and research techniques.