Benchmark – Evidence-Based Practice Project: Literature Review
Benchmark – Evidence-Based Practice Project: Literature Review
Catheter-associated urinary tract infections (CAUTIs) account for about 95% of healthcare-associated urinary tract infections in intensive care units and other healthcare settings. As such, CAUTIs are the most prevalent healthcare-acquired infections (HAIs) and lead to increased hospital stay, comorbidity, mortality, and a rise in the cost of healthcare for patients, healthcare facilities, and families (Mazi et al., 2024). According to the Centers for Disease Control and Prevention (CDC) (2026), more than 13,000 deaths occur every year associated with urinary tract infections, with a majority being CAUTIs. Therefore, developing effective evidence-based practice (EBP) interventions, such as nurse-led protocols and measures, can reduce and prevent CAUTIs, which the Centers for Medicare and Medicaid Services (CMS) considers preventable infections that are not reimbursed under the value-based care model. The purpose of this paper is to conduct a literature review that offers a concise comparison of existing evidence to demonstrate support for the proposed PICOT question.
PICOT Statement
Catheterized patients in the intensive care units (ICUs) increase the susceptibility of vulnerable patients to healthcare-associated infections, particularly catheter-associated urinary tract infections (CAUTIs), due to their fragility and increased utilization of catheters. As observed, CAUTIs are the most prevalent healthcare-associated infections and require nurses and other providers to develop evidence-based nurse-led bundle of care protocols to lower and prevent the susceptibility of these infections (Riley et al., 2025). Imperatively, the EBP paper proposes a nurse-led intervention based on the PICOT question below.
PICOT Question
In a catheterized intensive care unit (ICU) patient (P), does the use of nurse-led care bundle protocols (I), compared to standard measures and processes (C), reduce catheter-associated urinary tract infections (CAUTIs) by 80% (O) within six months (T)?
Search Methods
Identifying and evaluating the most appropriate sources is a critical factor when starting an evidence-based practice project proposal, as it allows one to get the right, correct, and current research evidence for the selected topic. My search strategy entailed using Google as the main search engine and using library databases that included PubMed, Google Scholar, and CINAHL. The third aspect was to use relevant search terms that included: “nurse-led protocols for CAUTIs,” “evidence-based practice CAUTI reduction strategies,” “CAUTIs and ICU nurses,” “prevalence of CAUTIs in ICU,” and “ICU bundle of care to reduce CAUTIs.” These search terms generated over 100 articles. Fourthly, I deployed the BOOLEAN operators like “AND” to narrow down the search by combining the terms, where the articles became 50. Using the CRAAP model, I ensured that the articles were current, relevant, authoritative, accurate, and purposeful. For instance, using currency, I ensured that all articles were published within the last five years and were relevant to the topic, as well as authored by authoritative researchers.
Synthesis of the Literature
Rosenthal, V. D., Memish, Z. A., Nicastri, E., Leone, S., & Bearman, G. (2025). Preventing catheter-associated Urinary Tract Infections: A position paper of the International Society
for Infectious Diseases, 2024 update. International Journal of Infectious Diseases,
151, 107304. https://doi.org/10.1016/j.ijid.2024.107304
In this article, the researchers provide an in-depth review of current recommendations and evidence-based strategies to prevent CAUTIs using data from 630 ICUs in 45 countries where 204, 770 patients were evaluated for over 637,000 ICU days and 7635 CAUTIs recorded. The findings from the study show significant variations in CAUTI rates, the associated healthcare costs, hospital stays, and mortality. The rationale for selecting this article is that it recommends evidence-based practice strategies as the most effective way to prevent and reduce CAUTI in ICU. The article supports the PICOT as it shows the impact of evidence-based interventions to reduce CAUTIs.
Yajun, L., Xuan, Z., Juan, T., Rui, T., Zuyan, X., Bingbing, Z., … & Tao, Z. (2025). Risk
Factors for catheter-associated urinary tract infection in an intensive care unit: a
matched case-control study. BMC Infectious Diseases, 25(1), 617.
DOI: 10.1186/s12879-025-10839-0
According to this study, CAUTIs are the most prevalent healthcare-associated infections in critical care settings like the ICU. Therefore, using 403 ICU patients with indwelling catheterization, the researchers’ aim was to determine the risk factors for CAUTIs among critically ill patients. The findings show that practices like repeat catheterization of urinary catheter and days of antibiotic use increased the risk of CAUTIs. The researchers also found that more hospitalizations are a risk factor for CAUTIs. The rationale for selecting this article is that it recommends an evidence-based practice for nurses to reduce catheter use. The authors assert that nurses and other providers should reduce catheterization and the length of antibiotics to reduce patients’ susceptibility to CAUTIs in the ICU.
Riley, M. M. S., Tung, W. C., & Tofanelli, C. (2025). Nurse-led implementation of evidence-
based bundles to reduce CAUTIs in an academic acute care hospital: A four-year
longitudinal quasi-experimental study. Applied Nursing Research, 152004.
https://doi.org/10.1016/j.apnr.2025.152004
In this article, the researchers evaluated the effectiveness of evidence-based catheter bundles using the plan-do-check-act (PDCA) model by nurses through a quasi-experimental study in a 780-bed teaching hospital with a sample patient population of 2448. The findings show that nurse-led evidence-based prevention bundles can reduce CAUTIs and catheter use by over 10% among patients. The rationale for selecting the article is to implement nurse-led care bundles as proven EBP interventions to reduce CAUTIs and risks associated with their occurrence.
Karami, A., Majedi, M. A., Kamyari, N., & Vatandost, S. (2025). Correlation between
nurses’ knowledge and practices in the prevention of catheter-associated urinary tract infection (CAUTI) with UTI incidence in the ICU. BMC nursing, 24(1), 1252. https://doi.org/10.1186/s12912-025-03910-3
The researchers use a cross-sectional study design to evaluate the relationship between nurses’ knowledge of CAUTIs and practices to prevent catheter-associated urinary tract infections (CAUTIs) among UTI patients in five ICUs and among 105 nurses. The rationale for choosing the article is that it supports the PICOT, as the findings show that nurses with better knowledge and practice experience on CAUTIs reduce the prevalence of CAUTIs since they can implement evidence-based practice interventions. The article is explicit that nurses play a core role in reducing CAUTI prevalence when they possess sufficient knowledge and experience in practice.
Comparison of Articles
These articles demonstrate certain similarities and differences based on various components like methods, themes, conclusions, limitations, and even controversies. All the articles focus on various aspects of CAUTIs, from causes to interventions and the role of nurses and other healthcare providers in reducing their occurrence. For instance, the articles by Karami et al. (2025) and Riley et al. (2025) have similar themes focusing on the importance of nurse-led EBP interventions to reduce and prevent CAUTIs in critical care settings. Similarly, the articles share research methods and qualitative approaches to gather experiences and aspects of CAUTIs. The articles also differ based on their methods, with articles by Yajun et al. (2025) and Rosenthal et al. (2025) using different methods, with the latter being a review and the former being a quantitative research study using the case-control method. However, the overriding theme in all articles is CAUTIs and their prevalence in healthcare, especially in the ICU and other critical care settings.
The limitations from the articles are diverse, with one that stands out as being confined only to the ICU, and not other critical care settings. Additionally, the articles are limited in their scope, except for the Rosenthal et al. (2025), which collected data from over 630 ICUs in 45 countries, showing high data levels that are critical to effective analysis and better findings. Lastly, the articles do not present any controversies based on their approaches to the subject of discussion. However, ethical considerations may present demanding situations if flouted by any of the articles.
Suggestions for Future Research
The articles show the increased attention on nurse-led interventions to reduce CAUTIs in the ICU. Further, these articles recommend the best practices by providers and other entities, including nursing organizations, to lower and prevent CAUTIs. However, gaps like the limited studies on patients, nurses’ knowledge, and a combination of such approaches demonstrate the need for future studies to enhance understanding and appreciate the role nurses play in reducing CAUTIs. More emphasis should be on nurse-led, evidence-based, and technology-integrated approaches that leverage nurses’ knowledge, experience, and collaboration among providers to improve outcomes, especially reducing and preventing CAUTIs among vulnerable patients in critical conditions and settings.
Conclusion
Evidence-based practice and decision-making have consistently been linked to better patient outcomes, patient safety, quality of care, and positive clinical results. The reviewed or evaluated literature, consisting of the selected article, reinforces the increasing role of nurse-led evidence-based care bundles to reduce and stop CAUTIs among patients in the ICU. The articles show that implementing nurse-based interventions can lower the prevalence of CAUTI, enabling facilities and providers to attain the best care outcomes.
References
Centers for Disease Control and Prevention (CDC) (2026). Urinary Tract Infection (Catheter-
Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract
Infection [UTI]) Events. https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf
Karami, A., Majedi, M. A., Kamyari, N., & Vatandost, S. (2025). Correlation between nurses’
knowledge and practices in the prevention of catheter-associated urinary tract infection
(CAUTI) with UTI incidence in the ICU. BMC nursing, 24(1), 1252. https://doi.org/10.1186/s12912-025-03910-3
Mazi, W. A., Bondad, M., Althumali, M., & Alzahrani, T. (2024). Reducing catheter-associated
urinary tract infections in the high dependency unit: an eighteen-month quality
improvement intervention study period. Infection Prevention in Practice, 6(2), 100362.
https://doi.org/10.1016/j.infpip.2024.100362
Riley, M. M. S., Tung, W. C., & Tofanelli, C. (2025). Nurse-led implementation of evidence-
based bundles to reduce CAUTIs in an academic acute care hospital: A four-year
longitudinal quasi-experimental study. Applied Nursing Research, 152004.
https://doi.org/10.1016/j.apnr.2025.152004
Rosenthal, V. D., Memish, Z. A., Nicastri, E., Leone, S., & Bearman, G. (2025). Preventing
catheter-associated Urinary Tract Infections: A position paper of the International Society
for Infectious Diseases, 2024 update. International Journal of Infectious Diseases, 151, 107304. https://doi.org/10.1016/j.ijid.2024.107304
Yajun, L., Xuan, Z., Juan, T., Rui, T., Zuyan, X., Bingbing, Z., … & Tao, Z. (2025). Risk factors
for catheter-associated urinary tract infection in an intensive care unit: a matched case-
control study. BMC Infectious Diseases, 25(1), 617. DOI: 10.1186/s12879-025-10839-0
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Assessment Traits
Benchmark
Requires Lopeswrite
Assessment Description
The purpose of this assignment is to write a review of the research articles you evaluated in the Evidence-Based Practice Project: Evaluation of Literature assignment in Topic 5. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.
A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review from this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.
In a paper of 1,250-1,500 words, select 4 of the 6 articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:
- Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
- Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
- Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
- Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
- Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
- Conclusion – Provide a summary statement of what you found in the literature.
- Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, document for an overview of the evidence-based practice project proposal assignments.
You are required to cite four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MBA-MSN; MSN
3.2: Analyze appropriate research from databases and other information sources to improve health care practices and processes.