Questions: Which action would be most effective in reducing the incidence of hospital-associated urinary tract infections? Encourage adequate fluid intake. Try to limit the use of indwelling urinary catheters. Teach nursing assistive personnel to provide good perineal hygiene. Monitor for signs of urinary tract infections in clients with increased risk factors.

The answer is the second one: Try to limit the use of indwelling urinary catheters.

Explanation for each option:

1. Encourage adequate fluid intake: While encouraging adequate fluid intake can help maintain urinary health and potentially reduce the risk of urinary tract infections (UTIs), it is not the most effective action specifically for reducing hospital-associated UTIs.

2. Try to limit the use of indwelling urinary catheters: This is the most effective action. Indwelling urinary catheters are a significant risk factor for hospital-associated UTIs. By limiting their use, the incidence of these infections can be significantly reduced. This approach is supported by numerous guidelines and studies that emphasize the importance of minimizing catheter use to prevent catheter-associated urinary tract infections (CAUTIs).

3. Teach nursing assistive personnel to provide good perineal hygiene: Good perineal hygiene is important for preventing infections, but it is not as directly impactful as reducing the use of indwelling catheters in the context of hospital-associated UTIs.

4. Monitor for signs of urinary tract infections in clients with increased risk factors: Monitoring for signs of UTIs is important for early detection and treatment, but it does not directly reduce the incidence of infections. It is more of a reactive measure rather than a preventive one.

Summary: The most effective action in reducing the incidence of hospital-associated urinary tract infections is to try to limit the use of indwelling urinary catheters.