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).

Authors

Rittu K. Justin, THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON CIZIK SCHOOL OF NURSINGFollow

Author Biographical Info

Rittu Koshy Justin is a dedicated nursing professional pursuing a BSN- DNP focusing on Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) at UT Health Houston Cizik School of Nursing, which she began in Fall 2023. With thirteen years of nursing experience in Critical Care, specializing in neuroscience, Cardio-thoracic, and Oncology nursing, Rittu has built a strong foundation in patient-centered care. Her clinical interests include improving health outcomes for Intensive Care Unit patients through evidence-based practices, quality improvement initiatives, and interdisciplinary collaboration. Her DNP project focuses on improving patient outcomes by implementing nurse-driven Foley catheter removal protocol using a HOUDINI criterion for oncology patients. Rittu is passionate about advancing the critical care practice and is committed to making a meaningful impact for patients and nurses as a compassionate and knowledgeable nurse practitioner.

Date of Doctor of Nursing Practice Project Completion

Spring 5-6-2025

Faculty Advisor

Dr. Lisa Thomas, DNP, APRN, ACNS-BC, CRRN, NEA-BC, CNE

Abstract

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.

Keywords

Modified HOUDINI, HOUDINI for cancer patient, Nurse driven Foley Removal Protocol, ICU modified HOUDINI for cancer patients, NDFRP for oncology, HOUDINI for Oncology, Modified HOUDINI for ICU

Recommended Citation

Justin, Rittu K., "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)." (2025). Doctor of Nursing Practice Final Project Abstract. 63.
https://digitalcommons.library.tmc.edu/dnp_abstract/63