Date of Completion
Summer 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Melanie Brewer, DNSc, RN, FNP-BC, NEA-BC, FAANP
Abstract
Problem: Catheter-associated urinary tract infections (CAUTI) harm patients and increase healthcare costs. In fiscal year 2025, the progressive care unit reported a CAUTI rate 2.5 times the National Healthcare Safety Network benchmark of 1.0 infection per 1,000 catheter days. A gap analysis revealed that the project site lacked a policy mandating chlorhexidine baths for catheterized patients, resulting in suboptimal catheter hygiene and ineffective bactericidal intervention.
Aim of the Project: The aim of the quality improvement project was to reduce CAUTI rates by 50% through daily chlorhexidine baths for catheterized patients in the progressive care unit.
Review of the Evidence: Recent studies support the daily use of 2% chlorhexidine wipes to reduce infection in catheterized patients, with reported CAUTI reductions ranging from 52% to 88.8%. Empirical evidence frequently included chlorhexidine baths as part of a toolkit or a bundled approach to CAUTI reduction. Embedding evidence-based interventions in policy is recommended to sustain clinical practice.
Project Design: Guided by the Institute for Healthcare Improvement Model for Improvement and the OhioHealth Change Management Model, the quality improvement project design used iterative Plan-Do-Study-Act cycles to drive practice change and improve chlorhexidine bathing compliance through staff and patient education. Compliance was verified through chart audits.
Intervention: The intervention involved neck-to-toe, daily bathing of catheterized patients using 2% chlorhexidine wipes. Implementation required informational huddles for staff, use of electronic health record dot phrases, interdepartmental collaboration for supply management, and patient rounding.
Significant Findings/Outcomes: To date, there have been no reported CAUTIs in over 375 days. During the 10-week project, the bathing compliance rate was 90.92%. With the elimination of CAUTIs, there is a $120,822 cost reduction compared with six infections in fiscal year 2025. In addition, urinary catheter days gradually decreased, resulting in a 15-day reduction over the 10-week project period from January 5, 2026 to March 15, 2026.
Implications for Nursing: The quality improvement project findings underscore advanced practice nursing’s ability to apply the American Association of Colleges of Nursing Essentials in solving a practice problem. By aligning with the Institute for Healthcare Improvement’s Quintuple Aim framework, evidence-based practice change can improve the patient experience through better outcomes and lower costs of care.
Recommended Citation
Bylsma, Kelli S., "Reducing Catheter-Associated Urinary Tract Infections in Progressive Care" (2026). Doctor of Nursing Practice (DNP) Scholarly Project. 56.
https://fuse.franklin.edu/dnp-project/56
Rights
Copyright, all rights reserved
