Ms.

RUNA DEBBARMA
1 NAME OF CANDIDATE 1ST YEAR MSC NURSING
AND ADDRESS ATHAI BARI,
NORTHRAMACHANDRAGHAT,
KHOWAI, TRIPURA – 799207
2
NAME OF THE ACHARYA COLLEGE OF NURSING,
INSTITUTION BANGALORE- 560032
3 COURSE OF THE STUDY M.Sc. Nursing, 1st Year
AND SUBJECT Medical Surgical Nursing

4 DATE OF ADMISSION OF 12-01-2021

COURSE
A STUDY TO EVALUATE THE
5 TITLE OF THE STUDY EFFECTIVENESS OF STRUCTURED
TEACHING PROGRAMME ON
KNOWLEDGE REGARDING PREVENTION
OF CATHETER ASSOCIATED URINARY
TRACT INFECTION AMONG STAFF
NURSES WORKING IN A SELECTED
HOSPITALS, BANGALORE

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

SYNOPSIS PROFORMA FOR REGISTRATION OF

SUBJECTS DISSERTATION

1
6. BRIRF RESUME TO THE INTENDED WORK

“Health is not valued until sickness comes.” – Thomas Fuller

6.1 INTRODUCTION
In India, Catheter associated urinary tract infection (CAUTI) is the second most commonly
occurring Infection. The prevalence of catheter associated urinary tract infection in the
acute care setting is directly linked to the widespread use of Indwelling Catheterizations.
The highest rates were found to be in burn ICU and the lowest rates in medical surgical ICU.
the most common organism associated with Catheter associated urinary tract infection are
Escherichia coli (21.4%) candida (21%), enterococcus (14.9%), Klebsiella pneumonia (7.7%),
Enterobacter. (4.1%). 1
Catheter associated urinary tract infection can causes a number of complications like
cystitis, prostatitis, endocarditis, pyelonephritis, septic arthritis, meningitis. Yearly 13,000
deaths occur due to urinary tract infection. Urinary tract infections and for practices
maximum number of observations were made by concealed observations. 4
Catheter associated urinary tract infection (CAUTI) is the most common infections in the
context that is responsible for high morbidity, increased hospital stays and associated costs.
From the multivariate analysis five independent risk factors were determined female sex,
length of ICU, duration of catheterization. 2
Catheter associated urinary tract infection are the most commonly acquired healthcare
infections with an estimated prevalence of 1-10%.it has been recognized that the rates of
Catheter associated urinary tract infection can decreased by following proper protocols
regarding need and duration of catheterization. 3
In India catheter associated urinary tract infection is the second most common health care
associated infection. The most important predisposing factor for catheter associated urinary
tract infection is the insertion, prolonged use of indwelling urinary catheter . 9
Urinary tract infections are essential component of modern medical care. All health care
catheter associated urinary tract infection are caused by instrumentation of urinary tract at
the time of catheter insertion where organism maybe pushed into previously uninfected
bladder.6
Urinary tract infection is considered one of the most common bacterial infections and
worldwide more than one fifty million individuals. The most common causative organism of
are Escherichia coli in 24%, Candida in 24%, Enterococcus in 14%, Pseudomonas in 10%,
Klebsiella in 10%.7

2
Nurses are responsible and accountable for their actions, decisions and practices to
maintain the safety, wellbeing, interests, rights of patients the nurses must follow the right
action during catheter care of patient and must be the proper knowledge and
understanding of implication and care by following the updated policies. Nurses as a
healthcare provider are responsible for the care and maintenance of indwelling catheter. 5
Nurses play an important role in urinary catheter insertion maintenance and removal
therefor nurses should have adequate knowledge regarding infections control in the use of
urethral catheter and their practice must be adhere to healthcare setting an infections
control. Catheter associated urinary tract infection is consider as the most frequent
preventable infections, if nurses take into consideration to recommended catheter
placement indication.8

6.2 NEED FOR THE STUDY:

Catheter associated urinary tract infection is a system that makes urine and carries it out
of the body it includes bladder, kidney, ureters, urethra. When germs get into this system
that can cause an infection. Among bacterial infection, catheter associated urinary tract
infections is the 2nd most common infection which is seen by health care provider. The
infection is affecting more than million people per year. National ambulatory medical
survey reported that 7 million office visits as well as 1 million emergency room visit
1,00,000 hospitalizations occur due to catheter associated urinary tract infection. Among
adolescent’s girls, lower catheter associated urinary tract infection are very common. At
least one episode of catheter associated urinary tract infection will occur in nearly 5-6%
of girl during 1st grade to graduation from high school compare to boys, the recurrence
rate is 50% greater in girls. Due to catheter associated urinary tract infection every year
nearly 6-7 million young women visit physician. The lifetime incidence go catheter
associated urinary tract infection in US is found to be one in every 5 women 11 million
per year takes medicine for catheter associated urinary tract infection. More frequently
compare to men. Among adolescents girls catheter associated urinary tract infection
occur mort often which is related sexual activity and more commonly in voiding or
elimination syndrome.10

An experimental study was conducted in Kerala to evaluate the effectiveness of

structured teaching programme on prevention of uncomplicated catheter associated
urinary tract infection. Among staff nurses aged 15-35years .67members as experimental
group and 27 members as control group were selected. The results revealed that within 6
months 73% of women were free from catheter associated. Common risk factors for
catheter associated urinary tract infection is sexual intercourse pregnancy, poor hygiene,
dysfunctional voiding patterns or a history of female genital catheter associated urinary
tract infection. In women synthetic underwear and panty hose, tight jeans and wet
bathing suits, allergens irritants–famine hygiene sprays, bubbles baths, perfumed toilet
paper, sanitary napkins and soaps may aid in the development of cystitis in women.80%

3
of catheter associated urinary tract infection in adults are due to E. coli which is present
around the anus or vagina which may enter into the urethra while wiping from back to
front.11

An intervention study was conducted in Tainan science-based park to find the

effectiveness of structured teaching programme on prevention of catheter associated
urinary tract infection among 166 female staff nurses aged less than 20 years and more
than 30 years. Data were collected by using urine examination and standard examination.
The results revealed that after the Structured Teaching Programme, the prevalence of
catheter associated urinary tract infection was reduced from 9.8% to 1.6%. Urine voiding
and water intake three times or more during each shift were increased from 12.8% to
89.6% and 27.6% to 51.5% respectively. The study found that a significant association
between decrease in the prevalence of catheter associated urinary tract infection and
increase in the prevalence of water intake urine voiding three times or more in a day.
Silent catheter associated urinary tract infection may occur among girls which is due to
inadequate intake of water and in frequent passage of urine. The main reason for this is
unhygienic toilets and improper teaching regarding menstrual hygiene dehydration can
cause catheter associated urinary tract infection.12

A study was conducted on knowledge regarding catheter care among staff nurses was
conducted in Nellore appeared to show that the Majority of staff nurses 46% had
adequate knowledge 33% had moderate adequate knowledge and 20% had
inadequate knowledge regarding catheter care. The nurse to prevent catheter
associated urinary tract infection such as following aseptic insertion of the catheter by
properly trained staff, maintain a closed drainage and unobstructed urine flow be
sure there are no kinks in the tubing, etc. Nurse driven timely of urinary catheters,
urinary catheter care during placement. On a daily basis, Nurses assess all
catheterized patients for catheter use. They may use a standardization cheek list to
help them review all of the relevant factors, like how much time has passed since
post-operative catheter was placed, nurses will monitor and manage the catheter
according to infection control guidelines and to continue to assess the need for
catheter on a daily basis, nurses remove the catheter and the need to follow up
care.13
Catheter associated urinary tract infection may progress into renal damage, renal
Failure and sepsis, early recognition and prompt treatment help to prevent occurrence of
recurrent catheter associated urinary tract infection and possibility of complication. 14
Nurse’s perception and the practice correctly can minimize the indwelling catheter
associated urinary tract infection. Nurses had average knowledge on prevention of
Catheter associated urinary tract infection. Nurses are responsible and accountable
for their actions, decisions and practices to maintain the safety, wellbeing, interests
and rights of patients. During urinary catheter procedure nurses ensure the patients
that there is no harm in the insertion of urinary catheter insertion. The nurse must be

4
 implementing the proper knowledge and understanding of implications and to care
by following the updated policies, protocols, standards and approved practice of
evidence base guidelines clarify if any problem in the clinical decision order and
practice. Nurses can prevent patients from the catheter associated infection with the
application of the best practices for indwelling catheter care. Nurses have a vital role
in preventing healthcare associated infection. With developing technologies nurses
need to update themselves to face the challenges of dealing with and preventing
heath care associated infection. Nurses need to be educated and trained more on
infection control in the use of urethral catheter. 15
It is important to provide education and involvement of both medical and health
professionals to improve the health status of the adolescents. we feel there is a lack
of adequate knowledge and hygiene practices which are most common cause of
catheter associated urinary tract infection among adolescent girls. Nurses being the
part of health team have responsibility to educate the adolescent girls and show
correct pathway to prevent catheter associated urinary tract infection and promote
health. Hence the above-mentioned factors motivated the investigators to undertake
this study.16
6.3 REVIEW OF LITERATURE
Literature review is considered as systematic and critical review of the most important
scholarly literature or particular topic. The term refers to an extensive, exhaustive and
systematic examination of publication of the research study. The literature review
helped the investigator in developing a deeper understanding and insight into the
problem under study. It also helps in gaining information on the trends and development
in this area.
A review of literature related research and theory on topic has become a standard and
virtually essential activity of scientific research project “literature review is a critical
summary of research on a topic of interest, often prepared to put a research problem or as
the basis for an implementation project”. Review of literature was undertaken to gain in
depth.
REVIEW OF LITERATURE: -
A. Studies related to prevalence of catheter associated urinary tract infection.
B. Studies related to prevention of catheter associated urinary infection (CAUTI) among
staff nurse.
C. Studies related to structured teaching programme on knowledge regarding
prevention of catheter associated urinary tract infection (CAUTI) among staff nurses.
[A] STUDIES RELATED TO PREVALENCE OF CATHETER ASSOCIATED URINARY TRACT
INFECTION

In India, the prevalence of catheter-associated urinary tract infections (CAUTIs) in the CCUs
is directly linked to the widespread use of indwelling catheters in these settings. Catheter

5
associated urinary tract infection result in significant cost escalation for individual hospitals
as well as the healthcare system as a whole. A catheter associated urinary tract infection is
an inflammatory response to colonization of the urinary tract, most commonly by bacteria
or fungi. It should be differentiated from the mere detection of bacteria in the urinary tract.
This condition, referred to as asymptomatic bacteriuria, is common and does not require
treatment, especially in the patient with an indwelling urinary catheter. A Catheter
associated urinary tract infection occurs when a patient with an indwelling urinary catheter
develops 2 or more signs or symptoms of a catheter associated urinary tract infection such
as haematuria, fever, suprapubic or flank pain, change in urine character, and altered
mental status. Catheter associated urinary tract infection is classified as a complicated
urinary tract infection.

This study was designed to determine the prevalence of UTI by isolating and characterizing
the different bacterial etiological agents and to evaluate the factors associated with UTI.
About 150 million people suffer from UTIs each year globally which results in greater than 6
billion dollars in direct health care UTIs in Algeria among all patients admitted in acute care
units for more than 48 hours was reported to be 4.5%. In Senegal, the prevalence was
reported to be 0.7% among patients admitted in university hospital, Dakar Senegal, with, a
higher prevalence in women than males. In Nigeria, in a study conducted among 12,458
urine samples, reported prevalence of community-acquired and nosocomial UTIs were
12.3% and 9.3%, respectively. The prevalence in females and the prevalence in males were
14.6% and 7.4% respectively.in Uganda, the prevalence of UTI was found 29/218.and had a
20-60%drug resistance rate among antenatal mothers in Mulago hospital, Uganda.

The overall prevalence of UTI was 33.54% of which 66.78% were females and 33.22% were
from males. High prevalence was observed in females as compared to males (2:1). Though
the overall prevalence was high in old aged (>45 years) patients, in females’ high prevalence
was seen among middle-aged (31 to 45 years) patients and in male high prevalence was
seen among old age (>45 years) patients. From total 584 uropathogens, Escherichia coli
(53.77%) was the commonest isolate causing urinary tract infection followed by Klebsiella
pneumoniae (27.40%). The most effective antimicrobial agents in our study were
Meropenem, gentamicin, Nitrofurantoin.

[B] STUDIES RELATED TO PREVENTION OF CATHETER ASSOCIATED URINARY INFECTION

(CAUTI) AMONG STAFF NURSES.

A study was conducted in Bangalore to assess the effectiveness of cranberry and blueberry
products in preventing recurrent asymptomatic Catheter Associated Urinary Tract Infection
in women. The results showed that cranberry products significantly reduced the incidence
of recurrent Catheter Associated Urinary Tract Infection in 12 months as compared with
control group and evidence from good quality randomized controlled trials that cranberry
juice may decrease the number of asymptomatic catheters associated urinary tract infection

6
over 12 months period. Researchers concluded that cranberry product have a good effect in
reducing catheter associated urinary tract infection symptoms.

An experimental study was conducted in Norway to evaluate the effectiveness of

acupuncture treatment in prevention of uncomplicated recurrent lower catheter associated
urinary tract infection, among 94 women aged 18 to 60 years. 67 members as experimental
group and 27 members as control group were selected, the results revealed within 6
months, 73% of women in the experimental were free from catheter associated urinary
tract infection as compared to 52%in control group.

A Study was conducted on prevention of urinary tract infection, among adolescents in

Ahilya Nursing college, West Bengal. The sample size was 50 female adolescents, who were
prone to get urinary tract infection due to the presence of improper toilet hygiene.
Researcher had used convenient sampling technique and tested few strategies for
prevention of urinary tract infection such as use of antibiotics, functional foods, probiotics,
maintenance of good personal hygiene and menstrual hygiene. Researcher suggested that
80% of urinary tract infection among adolescent girls can be prevented by administration of
antibiotics, maintenance of personal hygiene, menstrual hygiene and functional food pared
to 52% in control group.

A case control study was conducted regarding dietary factors protecting girls from catheter
associated urinary tract infection, among 139 women participated, with mean age of 18 to
28 years in Oulu university of hospital. A questionnaire was used to collect the data
regarding women’s dietary and lifestyle habits. The results showed that increased
consumption of fresh fruit or berry juice reduces the risk for catheter associated urinary
tract infection. A study was conducted among 107 people with symptoms of catheter
associated urinary tract infection and 250-non-infected people selected randomly within the
community. Among infected members 27.85% were men and 72.2% were women. The
study showed that there was a highly significant difference between fluid intake among non-
infected (4 pints/day) and infected (2 pints per day) person.

[C] STUDIES RELATED TO STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE

REGARDING PREVENTION OF CATHETER ASSOCIATED URINARY TRACT INFECTION
AMONG STAFF NURSES

A study was conducted assess the effectiveness of a structured teaching programme on

prevention of urinary tract infection among 45 staff nurses aged between 19 to 25 years in
Tumkur Nursing college of Karnataka. Convenience sampling technique was used to select
the sample. The tools of the study included a knowledge questionnaire and background
information. The findings of the study revealed that the mean post-test knowledge score
(28.31) was higher than the mean pre-test knowledge score (15.35). The ‘t’ test computed
between pre-test and post-test showed that there was significant difference in the pre-test

7
and post-test knowledge score (t44=33.40, P<0.05). The researcher concluded that there was
significant gain in knowledge after the teaching programme.

Catheter associated urinary infection is a common healthcare related infection occurring in

patients admitted for various ailments. Approximately 80% hospital acquired urinary tract
infection are catheter associated. The purpose of the current research was to find out the
level of knowledge, attitude and practices on prevention of catheter associated urinary tract
infection among health care professional working in tertiary care hospital.

A descriptive study was done among 95 health care working in tertiary care hospital in
Chennai. The researcher administered standard questionnaire and statistically explored the
knowledge, attitude, and practice levels about prevention of catheter associated urinary
tract infection among the participants. Among 95 participants, 28.4% and 71.6% of the
individual had moderately adequate knowledge about catheter associated urinary tract
infection. About 4.2% of the participants had unfavorable,88.4% had moderately favourable
and 7.4% had favourable attitude towards prevention of catheter associated urinary tract
infection. There was Significant correlation between attitude and practice. The professional
experience of the participants showed statistically significant association with the level of
practice among Demographic variables.

The relevance that health care professional and adequate knowledge, attitude, practice on
prevention of catheter associated urinary tract infection. Medical education programs,
frequent auditing with a checklist about catheter care must be conducted to maintain the
achieved knowledge and practice levels.

A study was conducted to evaluate the impact of a catheter associated urinary tract
infection education package on nurses’ knowledge of indwelling catheter management. A
multiphase mixed- method approach with convenience sampling and using focus group An
evidence based education package with multi-faceted teaching methods was implemented
to address knowledge or care deficits. The catheter associated urinary tract infection
education package had a significant impact on nurses’ knowledge gaps. Effectiveness
catheter associated urinary tract infection prevention needs to address all catheter care
components through continuous education, using multi-faceted strategies, of everyone
involved in catheter care.

6.4 STATEMENT OF THE PROBLEM

- “A study to evaluate the effectiveness of structured teaching programme on knowledge

regarding prevention of catheter associated urinary tract infection (CAUTI) among staff
Nurses working in a selected Hospitals, Bangalore”

6.5 OBJECTIVES OF THE STUDY

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1.To assess the pre-test and post-test level of knowledge regarding prevention of Catheter
associated urinary tract infection among staff nurses.

2.To determine the effectiveness of the self-instructional module on prevention of catheter

associated urinary tract infection among staff nurses by comparing pre-test and post-test
score.

3.To find out the association between the pre-test level of knowledge scores of staff nurses
regarding prevention of catheter associated urinary tract infection with their selected
demographic variable.

6.6. OPERATIONAL DEFINITION: -

1. Evaluate: - In this study, it refers to judge or determine the effectiveness of self-
instructional module on knowledge of staff nurses regarding prevention of Catheter
associated urinary tract infection
2. Effectiveness: - In this study, it refers to gain in knowledge after administration of
structured teaching programme regarding prevention of catheter associated urinary
tract infection (CAUTI) among staff nurses.
3. Knowledge: - In this study, it refers to awareness and understanding of staff nurse
regarding prevention of catheter associated urinary infection (CAUTI) which will be
measured by structure knowledge questionnaires and it will be scored as adequate,
moderate and inadequate knowledge.
4. Prevention of Catheter Associated Urinary Tract Infection: - In this study, it refers to
the recommended appropriate use aseptic insertion, proper maintenance and timely
removal of indwelling catheter as well as use of established practice such as hand
hygiene.
5. Catheter associated urinary tract infection (CAUTI): -In this study, if refers to a type
of urinary tract infection, are caused by bacteria or yeast travels along a patient’s
catheter- a tube inserted into the bladder to drain the urine and causes an infection
in the kidney or bladder.
6. STAFF NURSES: -In this study, it refers to a registered nurse who has completed her
Diploma or BSc nursing working in hospital for more than 6 months.

6.7 RESEARCH HYPOTHESIS: -

H1: There will be significant difference between pre-test and post-test level of knowledge
score of staff nurses regarding prevention of Catheter associated urinary tract infection

H2: There is a significant association between pre-test level of knowledge scores of staff
nurses regarding prevention of Catheter associated urinary tract infection with their
selected socio demographic variables.

6.8 ASSUMPTIONS: -

9
The study assumes that

1. Nurses working in selected hospitals may have some knowledge regarding prevention of
catheter associated urinary tract infection.

2. E. Coli is the most frequent causes of catheter associated urinary tract infection.
however, increasingly, catheter associated urinary tract infection are caused by more
resistant Gram-negative species, including Klebsiella and pseudomonads, as well as resistant
E. coli, Enterococcus faecalis and staphylococcus saprophytic.

3.self-instructional module may help to enhance the knowledge of staff nurses regarding
prevention of Catheter associated urinary tract infection.

6.9 DELIMITATION: -
Delimitation of the study are:

1.study period limited to 4 weeks. (data collection)

2.The sample size will be limited to 60

3.measurement of knowledge aspect study

4. Will be limited to staff nurses selected hospital in Bangalore.

7 PROJECTED OUTCOME: The study will enhance the knowledge of staff nurses
regarding prevention of Catheter associated urinary tract infection.

7.1 MATERIALS AND METHODS:

7.1.1 SOURCE OF DATA: The data will be collected from the staff nurses of selected
hospital of Bangalore.

7.1.2 RESEARCH DESIGN: - The research design most suited for this study will quasi
experimental, one group pre-test and post-test study design.

GROUP PRE-TEST INTERVENTION POST-TEST

E 01 X 02

Where,

E = Experimental group.

01 = Pre-test to assess the level of knowledge about staff nurses regarding prevention of
Catheter associated urinary tract infection (CAUTI).

10
X = Intervention (Self-instructional module).

02 = Post-test to assess the level of knowledge about staff nurses regarding prevention of
Catheter Associated Urinary Tract Infection after 7 days administration of self-instructional
module.

7.1.3 VARIABLES UNDER STUDY:

Dependent variable: In this study, it refers to the level of knowledge of staff nurses
regarding prevention of Catheter associated urinary tract infection.

Independent variable: In this study, it refers to self-instructional module on prevention of

Catheter Associated Urinary Tract Infection.

Socio demographic variables: - In this study, it refers to demographic variables are age,
gender, marital status in year, religions, profession, qualification, profession experience,
previous information about catheter associated urinary tract infection (CAUTI), if yes source
of information.

7.1.4 SETTING: - The study will be conducted in the selected hospitals in Bangalore.

7.1.5 POPULATION: -
Target population: All the staff nurses.

Accessible population: Staff nurses who are working in selected hospitals, Bangalore.

7.1.6 SAMPLE: -The sample consists of staff nurses working in selected hospitals,
Bangalore and meet the inclusion criteria.

7.1.7 SAMPLE SIZE: - The sample size will be 60 staff nurses.

7.1.8 SAMPLING PROCEDURE

In this study, purposive sampling technique will be adopted to select the subjects who have
staff nurse for the study.

7.1.9 SAMPLING CRITERIA

INCLUSION CRITERIA: -

The staff nurses who are

 Willing to participate the study

 Present during the period of data collection

11
  Avail to understand Kannada or English

EXCLUSION CRITERIA: -

The staff nurses who are

 Nursing superintendent
 Nursing supervisor

7.2 DATA COLLECTION METHOD:

Instruments under study the tools consist of two sections

Section A: In this study, demographic variables are age, gender, marital status in year,
religions, profession, qualification, profession experience, previous information about
catheter associated urinary tract infection (CAUTI), if yes source of information.

Section B: It consists of structured knowledge questionnaire regarding prevention of

Catheter Associated Urinary Tract Infection among staff nurses.

7.2.1 PLAN FOR DATA COLLECTION:

The tools will be prepared for data collection on demographic profile and structure
knowledge questionnaire regarding Prevention of Catheter associated urinary tract
infection among staff nurses

The data collecting procedure will be carried out after obtaining permission for the
concern authorities.

At fast good report will be established with the sample and purpose of the study will be
explain to patients so as to get the cooperation from the procedure of data collection.
Demographic data will be assessed for 15 minutes followed by which structured
knowledge questionnaire will be administered for 30 minutes to access the knowledge
among staff nurses in selected hospitals, Bangalore. Researcher will provide structured
teaching programme regarding prevention of catheter associated urinary tract infection.
Post-test will be conducted after 7 days.

7.2.2 DATA ANALYSIS METHOD:

The collected data will be group and analyse during descriptive and inferential statistics and
the plan of data analysis will be as follows:

 Organize the data in master sheet/computer

 Frequencies and percentage for the data analysis of the background
 Computing ‘t’/value to find out the significance of difference between the mean
pretest and posttest knowledge score

12
  Association between pretest knowledge where calculated by Chi-square test.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION ON INTERVENTION TO BE

CONDUCTED ON PATIENTS OR OTHER HUMAN OR ANIMALS? IF SO
DESCRIBED BRIEFLY.
 Yes, this study requires administration of structured teaching programme
to the knowledge regarding prevention of Catheter associated urinary
tract infection among staff nurses

7.4 HAS ETHICAL CLEARANCE BEEN OBTAIN FROM YOUR INSTITUTION?

 Ethical clearance will be obtained from Research committee of Acharya
college of Nursing.
 Written permission will be obtained from concern authority of selected
hospitals, Bangalore.
 Permission form will be obtained from the staff nurses who are willing to
participated in the study.
 The purpose of the study will be explained to sample and written consent
will be received from them for participation in their study.

13
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14
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associated urinay tract infection Vasantha Gopalan 2007

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23. Nurses’ knowledge and practices toward prevention of catheter-associated urinary
tract infection at King Abdulaziz University Hospital February 2019 Salha Algarmi
Samah Sofar Dhuha Wazqar.

24. Nurses’ knowledge and practices toward prevention of catheter-associated urinary

tract infection at King Abdulaziz University Hospital.

25. Catheter associated urinary tract infections – Prevention better than cure – Gautam
Rawal, Sankalp Yadav, Sujana R. (Indian Journal of Immunology and respiratory
medicine, January-March 2017)

26. Urinary tract infections in the critical care unit: A brief review - Satyen Parida and
Sandeep Kumar Mishra

27. Micheal W, Johan W, Suen F, Carina K, Tor M (2007). Molecular epidemiology of

Staphylococcus saprophyticus isolated from women with uncomplicated
community- acquired urinary tract infection. J. Clin. Microbiol.,. 45: 1561-1564.

28. Brunners and suddarths’ A test book of medical surgical nursing, edition11th, page
no 1570-1578.

29. http://kidshealth.org/teen/sexual_health/stds/uti.html
30. https://www.healthgrades.com/right-care/kidneys-and-the-urinary-system/when-
to-see-a-doctor-for-a-urinary-tract-infection-uti

31. https://www.nhs.uk/conditions/urinary-tract-infections-utis/
32. https://www.webmd.com/women/guide/your-guide-urinary-tract-infections
33. https://www.healthxchange.sg/women/urology/urinary-tract-infection-risk-
factors-symptoms-treatment-prevention
34. https://www.hindawi.com/journals/ijmicro/2019/4246780/
35. "Role of home care nursing for patients with urinary catheterization – Zorger
Blog”
36. Medically reviewed by University of Illinois — Written---- by James
McIntosh on November 6, 2018, Urinary tract infections causes, symptoms,
prevention in Men and women, Treatment, home remedies
https://www.medicalnewstoday.com/articles/189953#home-remedies .
37. Staff nurses knowledge regarding nursing diagnosis - Anitha Victoria
Noronha, Nisha P Nair, Blessymol T M, Jisna Jose, Laxmi Wasti and Sruthi
Pramod
https://www.journalcra.com/article/staff-nurses-knowledge-regarding-
nursing-diagnosis

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