A quality improvement project on implementing a nurse-driven Foley catheter removal protocol using modified HOUDINI criteria for oncology patients to reduce the Catheter-Associated Urinary Tract Infection (CAUTI) and catheter days in the Intensive Ca

Abstract A quality improvement project on implementing a nurse-driven Foley catheter removal protocol using modified HOUDINI criteria for oncology patients to reduce the Catheter-Associated Urinary Tract Infection (CAUTI) and catheter days in the Intensive Care Unit (ICU). Purpose: This scholarly project aimed to develop modified criteria for oncology patients regarding Foley catheter removal guidance and implement a nurse initiative in the ICU to reduce CAUTI and catheter days. Background: CAUTIs are considered preventable nosocomial infections; hence, a nurse-driven Foley catheter removal protocol has become an essential strategy in healthcare to reduce CAUTIs. The project was implemented in a 43-bed ICU in an academic hospital at the Texas Medical Center. The 12-week pilot project included adult patients with a primary diagnosis of cancer. Methodology: A quantitative design with a PDSA framework was employed. The institutional infection control trend reports were utilized to obtain data on CAUTI rates and catheter days for 9 months, providing pre-and post-intervention data. A QR code and Qualtrics survey were used to monitor protocol compliance due to the lack of EPIC integration of the new criteria. Results: The nurse-driven protocol maintained zero CAUTIs and reduced catheter days by 9.4% by the end of implementation which further reduced to 713 catheter days (a 68.8% reduction) during the post-intervention phase. Implications of practice: Implementing an evidence-based practice will reduce CAUTI and catheter days. The trend suggests that the protocol can facilitate the early removal of Foley catheters.