Abstract

Abstract main body Introduction & Purpose Combating catheterassociated urinary tract infections (CAUTIs) is a priority in the worldwide
drive to reduce hospital acquired infections. Minimising catheter duration
Int.J. Behav. Med. (2018) 25 (Suppl 1):S1–S219 S73
is an effective method of reducing CAUTIs but current median duration
of postoperative catheters (3-days) is higher than the recommended one
day standard (CDC guidelines). A theory-based approach to understanding factors that influence the implementation of catheter removal guidance may help develop effective interventions to reduce CAUTI. This
study aimed to identify theory-based predictors of guidelinerecommended healthcare-professional (HCP) behaviour (conducting daily catheter removal assessments) to prompt catheter removal. Methods
Prospective correlational design involving HCPs from 11 medical and 13
surgical in-patient wards in North-East England, UK. HCPs (n=141) from
nursing and medical backgrounds involved in catheter care completed a
Theoretical Domains Framework (TDF) based questionnaire at baseline
and self-reported their catheter-removal behaviour at two-week followup. Following mapping of TDF domains to constructs of Social Cognitive
Theory (SCT), social support and habit, we then assessed predictors of
HCP intention and behaviour. Results With 96% response rate at followup, SCT constructs self-efficacy (MEAN=4.37, SD=1.41), outcome expectations (MEAN=5.85, SD=1.16)] and social support (MEAN=3.64,
SD=1.46) accounted for large amount of variance in HCPs intention
(MEAN=5.10, SD=1.54, R2adj = 0.55) and with addition of habit
(MEAN=4.16, SD=1.83) accounted for medium amount of variance in
prediction of HCP behaviour (MEAN=1.31, SD=1.06, R2adj = 0.20) to
conducting daily catheter removal assessments. Conclusion HCPs are
moderately motivated to perform catheter removal assessments.
However, variance in behaviour shows room for improvement. Future interventions targeting intention, social support and habit may prove successful to modify clinical behaviours for prompt catheter removal to reduce CAUTIs and variance in HCP behaviour. This has potential to influence catheter removal guidelines and current clinical practice.