A Multifaceted Educational Intervention for Catheter-Associated Urinary Tract Infection Prevention in Medical Wards: A Before-and-After Study

Objectives: To evaluate whether a multifaceted educational intervention was associated with changes in healthcare professionals’ knowledge, attitudes, self-reported practices, and catheter-associated urinary tract infection incidence in medical wards. Methods: This before-and-after intervention study was conducted in three internal medicine wards of a tertiary general hospital between September 2023 and December 2025, including a pre-intervention period (September 2023–April 2025), an intervention period (May–June 2025), and a post-intervention period (July–December 2025). The intervention included face-to-face education, interactive discussions, printed materials, posters, and ward-based reminders on evidence-based urinary catheter care. Healthcare professionals completed an anonymous structured questionnaire before and after the intervention, while catheter-associated urinary tract infection surveillance was conducted prospectively. Pre- and post-intervention questionnaire data were analyzed as independent groups. Results: We obtained questionnaire responses from 85 healthcare workers before the intervention and 78 after the intervention. The median total knowledge score increased significantly from 21 (interquartile range [IQR], 19–22) to 23 (IQR, 22–25; P < 0.001). Selected self-reported practices also improved significantly, whereas attitudes and perceptions were generally favorable at baseline and did not change significantly. The overall CAUTI rate decreased from 3.79 to 1.94 episodes per 1,000 catheter-days. After adjustment for ward, the post-intervention period was associated with a significantly lower CAUTI incidence (incidence rate ratio, 0.50; 95% confidence interval, 0.28–0.90; P = 0.020). Conclusion: The educational intervention was associated with improved knowledge, selected improvements in self-reported catheter-care practices, and lower catheter-associated urinary tract infection incidence.