PICOT Question for CAUTIs Mitigation: NSG 5111 Paper


The next steps in the evidence-based practice (EBP) process include implementing and translating the intervention chosen in the PICOT question (BELOW) into the clinical setting. Pilot projects are often used before implementation into an entire organization. Discuss the following questions related to implementing the chosen PICOT intervention as if the masters were facilitating a pilot […]

Pilot Study for CAUTIs Mitigation Initiative


Educational initiatives in the healthcare system can potentially reduce the occurrence rates of Catheter-associated urinary tract infections (CAUTIs) in geriatric patients. Since the disease impacts a significant portion of post-op elderly individuals, the education measures involving the healthcare practitioner, patients, and caregivers come as relevant measures in enhancing patient-centered service delivery. Practical studies become necessary in line with the related PICOT question to reduce the incidence of post-op CAUTIs. In this article, the pilot study’s implementation gets outlined to measure the effectiveness of the education-based intervention to mitigate CAUTIs occurrences in a hospital setting.

PICOT Question and Problem

In post-up geriatric patients (Population), does the incorporation of educational strategies into the patient’s plan of care and use of urinary catheters (Intervention), compared to the use of urinary catheters alone (Comparison), decrease the incidence of inpatient Catheter-Associated Urinary Tract Infections (Outcome) over two weeks (Time)?

Based on the PICOT question above, the problem addressed came from the significant prevalence of CAUTIs in post-operation geriatric patients. In particular, the PICOT question examines the impact of educational programs on the occurrence of CAUTIs in post-op geriatric patients in two weeks, in contrast with the sole usage of urinary catheters. As a result, the PICOT question aims to provide evidence for the change in hospital-acquired infection rates due to the patient advocacy role played by the nurses through increasing awareness around CAUTIs.

The Intervention

With an aging American population, CAUTIs are relevant and latent healthcare problems. As such, the master-prepared nurse must transform the healthcare system by educating the nurses, patients, and their caregivers. Increased awareness within the healthcare system can enhance patient self-care and the caregivers (e.g., family members) ability to provide evidence-based medical care to geriatric patients. Additionally, the master-prepared nurse needs to implement the change in the healthcare system in a strategic and gradual change model that allows the involved parties to internalize the new process (Lowe et al., 2018). The strategic implementation, backed by scholarly measures, helps mitigate the barriers to the intervention’s execution during the pilot test.

The Pilot Project

CAUTIs present a significant challenge in geriatric patients causing considerable discomfort, acute pains, suffering, and embarrassment (Shaver et al., 2018). In line with this, the pilot study is based on post-op geriatric patients aged sixty years, and above since up to 16 percent of the admitted elderly individuals receive an indwelling urinary catheter (Parker et al., 2017). Nurses will initially receive training headed by master-prepared nurses in short sessions for one week. In a period of two weeks, the patients, nurses, and caregivers will get involved in a pilot project. The nurses will educate the patients and caregivers within the hospital setting on evidence-based care measures and the use of urinary catheters.

Using the IOWA model, the problem of the occurrence rates of CAUTIs will form the focus of the pilot study. A team of healthcare practitioners, including the nurse, doctor, and medical officer, will work to evaluate and implement the evidence-based practice (EBP) change. The results of the pilot study will be used with the statistical changes to determine the efficiency of the intervention and to make any appropriate modifications. If the intervention results in significantly improved outcomes, the measures will be considered for full implementation in the healthcare system.

Strategies for Change

During the implementation of the intervention on CAUSTIs, the master-prepared nurse can use feedback and tailored education interventions to create a smooth transition. As a nursing leader, the role of a change agent would include initiating measures in line with the strategies. For the feedback strategy, the implementation of the change will be primarily based on the feedback of summarized healthcare performance (Allen & Molloy, 2017). From the feedback, the nursing leader will find areas that resist the change and the associated issues to consider for modification. On the other hand, the interactive educational strategy utilizes stage-specific skills and designs to shift the nursing practice from one stage to the next. Here, the evaluation of challenges that may emerge highlights the negative attitudes and the new skills required to be taught to allow the smooth implementation of the initiative.

Stakeholders and their Roles

The involved stakeholders for the intervention will include the medical practitioners, patients, and caregivers for the post-op geriatric cases. The doctors, clinical officers, and nurses will evaluate the patient results to evaluate the intervention strategy. Similarly, these medical practitioners will help the master’s prepared nurses to educate the patients on evidence-based catheter care and handling methods. Furthermore, nurses come as the change agents by directly delivering and illustrating the key messages for the awareness initiative. Caregivers will be educated to provide quality care for geriatric patients in home-based care for cases where elderly individuals cannot self-manage their condition per the evidence-based catheter usage measures.

Engagement of Stakeholders

Stakeholder involvement is a crucial step in improving patient outcomes in healthcare initiatives. As a result, the CAUTIs intervention measures can engage stakeholders through reciprocal relationships and co-learning initiatives to foster the contribution of the involved parties. Reciprocal relationship principles share the roles and decision-making between caregivers, nurses, doctors, and patients to improve the engagement and understanding between the participants (Hanson et al., 2017). Moreover, the co-learning strategies will involve the stakeholders in the research process to help foster an understanding of the process by the patients and for the researchers to understand the patient-centeredness of the initiative (Hanson et al., 2017). The improved engagement of the involved parties is expected to enhance the initiative’s outcome and overall impact on the patient outcome.

Practice Guidelines

One practical educational guideline for the CAUTIs intervention involves nurses using return demonstration in treating geriatric patients in hospital settings. Return demonstration guidelines ensure the nurse includes the patient in their treatment from admission to the hospital to discharge, improving the patient’s outcome (Hanson et al., 2017). In this case, the leading nurse will form measures the enhanced patient interaction throughout the pilot project to improve patient understanding through the return demonstrations. Furthermore, since the nurse will be trained in the evidence-based measures to improve care in CAUTIs, the interaction will be educative and adjusted to suit the patients learning styles. Family members and caregivers available during the process will be involved in the return demonstration according to the intervention guidelines.

Measurement of Outcomes

Improved outcomes in a healthcare system involve ensuring the continuity of care after discharge, improving patient support and engagement, and improving the health of populations (Hanson et al., 2017). As such, the intervention of the CAUTIs education measures among geriatric patients will be measured along these lines using questionnaires, interviews, and infection rates from the hospital. At the end of the two weeks, the patients, nurses, and caregivers will get involved in voluntary interviews and questionnaire filling to determine their response to their initiative and level of awareness. For the continuity of care after leaving the hospital, the patient and caregivers’ level of knowledge will act as indicators of any significant change from the educational intervention. Similarly, the difference in infection rates at the hospital in contrast to the use of urinary catheters alone will highlight any improvement in the population’s health.

Organizational Resources Needed

Human resources and capital will be necessary to implement the pilot study and health intervention for geriatric patients. In the initial training of the nurses, the program will require support for the education of the health practitioners, that will be required to attend short sessions for a week before involving the patients and caregivers. As this training will interfere with the shift schedule, the nurses will need extra paid shifts to fill in the regular duties. Similarly, master-prepared nurses will become essential to carry out nurse training in a short period. In the pilot study, technology-aided teaching methods for elderly patients will also be utilized to suit the patient’s learning needs and improve the outcomes of the intervention (Hanson et al., 2017). The human and financial resources will be crucial to the effectiveness of the response to CAUTIs treatment and prevention.


The pilot study will allow the intervention in CAUTI treatment and prevention among geriatric patients to be monitored and adjusted to improve efficiency. Practical application of the initiative will enable healthcare practitioners to measure the significant changes in elderly patients’ CAUTIs infection rates and determine the suitability of the intervention. Similarly, the feedback from the participants will indicate areas of improvement and any resistance to the change, which can be modified accordingly. At the end of the two weeks, the pilot study will report the ability of the educational initiative to improve the nurses, patients, and caregivers’ knowledge of evidence-based prevention measures for CAUTIs.


Allen, L., & Molloy, E. (2017). The influence of a preceptor-student ‘Daily Feedback Tool’ on clinical feedback practices in nursing education: A qualitative study. Nurse Education Today49, 57-62.

Hanson, H., Warkentin, L., Wilson, R., Sandhu, N., Slaughter, S., & Khadaroo, R. (2017). Facilitators and barriers of change toward an elder-friendly surgical environment: perspectives of clinician stakeholder groups. BMC Health Services Research17(1).

Lowe, G., Plummer, V., & Boyd, L. (2018). Nurse practitioner integration: Qualitative experiences of the change management process. Journal of Nursing Management26(8), 992-1001.

Parker, V., Giles, M., Graham, L., Suthers, B., Watts, W., O’Brien, T., & Searles, A. (2017). Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Services Research17(1).

Shaver, B., Eyerly-Webb, S. A., Gibney, Z., Silverman, L., Pineda, C., & Solomon, R. J. (2018). Trauma and intensive care nursing knowledge and attitude of foley catheter insertion and maintenance. Journal of Trauma Nursing25(1), 66-72.

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Published On: 01-01-1970

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