Developing effective clinical practice: preventing hospital-acquired,catheter-associated urinary tract infections — a step-by-step approach

Efforts to establish evidence-based, clinically effective practice are central to the quality improvement programmes of most NHS organisations. In spite of this, there appears to be widespread recognition that practice change is complex and notoriously difficult to bring about. This article describes one organisation's attempt to prevent hospital-acquired, catheter-associated urinary tract infections and the framework used to facilitate successful Trust-wide changes in practice. The framework, which takes the form of a practical eight-step approach based on the principles of audit, surveillance and effective change management, is offered as a tool to assist other organisations in their pursuit of clinical excellence.