Hospital-acquired infections (HAIs) kill approximately 99,000 patients annually in the U.S. and add an estimated $28–45 billion in healthcare costs. Since 2008, CMS no longer reimburses hospitals for several HAI types that develop during inpatient care — creating a direct financial incentive alongside the patient safety imperative. For nursing capstones, HAI prevention is ideal because the primary prevention measures are nursing-owned (hand hygiene, catheter care, ventilator bundle compliance), the outcome metrics are standardized through CDC NHSN reporting, and the evidence base includes high-quality RCTs and systematic reviews.
Choosing your HAI focus: CLABSI, CAUTI, or HAP
Pick one infection type and one unit setting. Trying to address all HAIs in a single BSN capstone project dilutes the intervention specificity and makes the implementation plan unworkable.
| HAI type | Full name | Primary nursing intervention | Best unit setting |
|---|---|---|---|
| CLABSI | Central line-associated bloodstream infection | Central line insertion checklist, daily necessity review, dressing change protocol, hand hygiene | ICU, oncology, any unit with central lines |
| CAUTI | Catheter-associated urinary tract infection | Urinary catheter necessity assessment, catheter care bundle, early removal protocol, aseptic insertion | Medical-surgical, ICU, long-term acute care |
| HAP/VAP | Hospital-acquired pneumonia / ventilator-associated pneumonia | Ventilator bundle (HOB elevation, oral care, sedation vacation, daily extubation readiness), early mobility | ICU (VAP); medical-surgical (HAP) |
| C. diff (CDI) | Clostridioides difficile infection | Contact precautions, antibiotic stewardship awareness, hand washing (soap/water, not alcohol gel) | Any inpatient unit; especially post-antibiotic patients |
PICOT examples for HAI prevention
CAUTI-focused example (most common BSN choice)
Strong PICOT: In adult patients with indwelling urinary catheters on a 28-bed medical-surgical unit, does a nurse-driven catheter removal protocol (daily necessity assessment using a standardized criteria checklist) reduce CAUTI rate per 1,000 catheter days compared to physician-order-only removal over a 90-day pilot?
Why it works: population (adult patients with indwelling catheters), setting (specific unit), intervention (nurse-driven — not physician-driven — removal protocol), comparison (current practice), outcome (CAUTI rate per 1,000 catheter days — standard CDC metric), time (90 days).
The prevention bundles: what your implementation plan must reference
Every HAI prevention project should be anchored to a validated prevention bundle. Using a bundle demonstrates that your intervention is evidence-based, not invented, and that it aligns with national guidelines:
- CLABSI bundle (CDC/IHI): hand hygiene, maximal barrier precautions during insertion, chlorhexidine skin antisepsis, optimal catheter site selection (avoid femoral), daily review of necessity with prompt removal
- CAUTI bundle (CDC/IHI): insert only when necessary, maintain aseptic technique, maintain closed drainage system, daily review of necessity, nurse-driven removal protocol when criteria met
- VAP bundle (IHI): HOB elevation 30–45°, daily sedation vacation, daily assessment of readiness to extubate, peptic ulcer prophylaxis, DVT prophylaxis, oral hygiene with chlorhexidine
Get help with your HAI prevention capstone
Tell your writer which infection type (CLABSI, CAUTI, HAP), your unit setting, and your PICOT. A complete, bundle-anchored capstone proposal comes back ready to submit.
Start your project Compare: pressure injuriesCDC NHSN metrics: use these in your capstone
The CDC National Healthcare Safety Network (NHSN) is the national HAI surveillance system. Every accredited U.S. hospital reports to NHSN. Using NHSN metrics in your outcome section demonstrates current clinical knowledge:
- CAUTI rate: catheter-associated UTIs per 1,000 urinary catheter days
- CLABSI rate: central line-associated BSIs per 1,000 central line days
- VAP rate: ventilator-associated pneumonias per 1,000 ventilator days
- SIR (Standardized Infection Ratio): observed infections / predicted infections; allows comparison to national baseline; a SIR <1.0 means performing better than national average
Related guides
HAI prevention capstone FAQ
CAUTI is generally easier to scope for a BSN capstone because the intervention (nurse-driven catheter removal) is fully within nursing's independent scope of practice. CLABSI prevention involves insertion technique (usually a physician or advanced practice procedure) and is harder to frame as a purely nursing-owned intervention at the BSN level. CAUTI daily assessment and removal protocols are nursing-driven and well-supported by BSN-level evidence.
For a proposal-style capstone, no. You use published national NHSN data to establish baseline rates and clinical significance, then propose your intervention and evaluation plan. If your program requires a pilot component, de-identified aggregate unit-level CAUTI or CLABSI rates are typically available from your infection control department without IRB involvement — they are publicly reported quality data.