CAUTI (Catheter Associated Urinary Tract Infection)
Reduction Project
Instructions / Guidelines
Objectives
Reduce Catheter Associated Urinary Tract Infections (CAUTI)
Meet SCIP Guidelines established by TJC (Beginning October 1,
Protecting 5 Million lives from harm
Provide evidenced based guidelines for foley catheter removal
2009)
Foley Catheters Cause
 Infections,  Length of stay (0.5-1 day),  Cost $$$ ($500-$3000/event),
 Antibiotic Usage ( drug resistance), Patient Discomfort ,  Risk of falls (tethered to bed
1 point restraint),  risk of skin breakdown, DVT and pneumonia due to immobility
Urinary Tract Infection (UTI) and Indwelling Catheters
UTI - #1 Healthcare Associated Infection (HAI) directly associated foley catheters,
40% of all HAI are caused by UTI; 80% of these are secondary to foley catheters,
Risk of infection  5% each day,  25% @ one week, 100% @ 1 month foley is in use
When to Discontinue Foley Catheters? Beginning ~ January 1, 2010
Foley Catheter Decision-Making Algorithm (See Addendum #1)
Foley Catheter Checklist (See Addendum #2)
Foley Catheter Checklist Sticker (See Addendum #3)
MD alert sticker (See Addendum #4)
Nursing Assessment in GECE (See Addendum #5)
Post “STOP Nauti Cauti” Flyer On the Unit to remind staff to D/C the Foley (See Addendum
#6)
How does this apply to nursing?
Nurses need to advocate for the removal of unnecessary foley catheters.
Use of the criteria-based guidelines that are specific to each unit.
Mandatory education in eILN beginning January 2010
Nursing Guidelines
Use the decision-making algorithm.
Use Criteria-Based Foley Catheter Checklist daily for patient’s with indwelling foley
catheters
 If no criteria on the checklist are met, obtain a doctor’s order to D/C the foley catheter
 Some of the “OTHER” possible indications that may be used for exclusion of foley catheter
removal (Remember: DOCUMENTATION is necessary for exclusion rationale!): head
injury; spine not clear; clinical need, i.e. chemically paralyzed and sedated, 24 hour urine
collection; crush injury; pelvic fracture; strict hourly I&O
Alternatives to Foley Catheters
 External Catheter (Texas or Condom Catheter)
 In & Out Catheter (Less risk of infection than indwelling foley catheter)
 New Ultrasorb pads (Replaced Chux)
 Timed toileting
Foley Catheter Days: Beginning January 1, 2010, collect the number of patients with foley catheters
at the same time EVERY day. Fax monthly to 7815 (EX: some units are adding this to the charge
nurse report and gathering the # of Foley Catheters in the AM during safety huddle)
Education in employee portal beginning January, 2010
CAUTI 12-2009 KW
Addendum #1
CAUTI 12-2009 KW
Addendum #6 Unit Flyer
CAUTI 12-2009 KW
Foley Catheter Days 2010
January
February
March
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL
Recommendation:
Count the number of patients on your unit with a Foley at the same time every day.
At the end of the month total the column and fax to 7815
CAUTI 12-2009 KW
Foley Catheter Days 2010
April
May
June
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL
Recommendation:
Count the number of patients on your unit with a Foley at the same time every day.
At the end of the month total the column and fax to 7815
CAUTI 12-2009 KW
Foley Catheter Days 2010
July
August
September
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL
Recommendation:
Count the number of patients on your unit with a Foley at the same time every day.
At the end of the month total the column and fax to 7815
CAUTI 12-2009 KW
Foley Catheter Days 2010
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL
Recommendation:
Count the number of patients on your unit with a Foley at the same time every day.
At the end of the month total the column and fax to 7815
CAUTI 12-2009 KW