Examining instruments used to measure knowledge of catheter-associated urinary tract infection prevention in healthcare workers: a systematic review

Background: Catheter-associated urinary tract infection (CAUTI) is the most frequently occurring health care-associated infection among hospitalized patients. Adequate knowledge of CAUTI in health care workers supports effective prevention and control of the infection. This systematic review assesses instruments used to assess knowledge of CAUTI prevention in health care workers to inform future research. The catheter lifecycle model was used to evaluate the conceptual framework upon which the measurement instruments were based. Finally, the psychometric quality of these instruments was evaluated.

Methods: Five electronic databases were searched for published studies and instruments. The COnsensus-based Standards for the selection of health status Measurement INstruments checklist was used to assess the psychometric quality reporting of the instruments.

Results: Fifteen studies met the review inclusion criteria and 13 instruments were available for review. Most of the instruments did not address all knowledge components essential for CAUTI prevention as defined by the catheter lifecycle model. The psychometric quality of the instruments was not sufficiently evaluated.

Conclusions: Few instruments are available for CAUTI prevention knowledge measurement. The instruments were not closely aligned with the catheter lifecycle model as a framework. If CAUTI knowledge cannot be measured accurately using an effective instrument, this has the potential to impact negatively on clinical care and the focus of interventions. There is a need for a standardized instrument for the evaluation of CAUTI prevention knowledge so that targeted interventions can address knowledge deficits.