Implementation of HOUDINI Guidelines Nurse-Driven Protocol to Lower Catheter-Associated Urinary Tract Infections and Foley Utilization Days

Catheter-associated urinary tract infections are a common issue in healthcare settings. These issues contribute to hospital-acquired infections and can lead to complications and increased healthcare costs. The quality project evaluated the impact of the HOUDINI guidelines nursedriven protocol to reduce infection rates and Foley utilization days. A structured guideline for Foley catheter safe removal was implemented using a quantitative method. Catheter-associated urinary tract infection rates and Foley utilization days pre- and postintervention were tracked. Data were collected using the electronic health records, infection control data sheets, and the HOUDINI checklists. A baseline assessment of catheter-associated urinary tract infections rates was analyzed for 8 months before project implementation. The implementation of the HOUDINI guidelines nurse-driven protocol began and was run for 12 weeks, and the results were monitored for 6 months postimplementation. The sample population included adult patients 18 and older with Foley catheters admitted on the medical-surgical unit. The quality improvement data analysis results revealed that implementing the HOUDINI guidelines nurse-driven protocol did not have statistical significance for reducing Catheter-associated urinary tract infections and foley utilization days. The observed effects could have been influenced by criteria identified on the HOUDINI checklist, unknown renal conditions, and other unknown issues that contributed to prolonged use of Foleys. Consequently, future quality improvement projects were recommended with robust designs. Using the findings from the project can be used to further assess best practices in Foley catheter management utilizing the HOUDINI guidelines nurse-driven protocol. Keywords: HOUDINI, catheter-associated urinary tract infection, evidence-based practice, catheter removal protocol, healthcare-associated infections, patient safety, nursing intervention, quality improvement.