Removing Foleys: Deploying a Nurse-Driven Protocol
Urinary tract infections (UTI) are the most common hospital acquired infections (HAI) and account for approximately 40% of all HAI. Once bacteriuria develops, approximately 25 % develop symptomatic UTI and approximately 3% develop bacteremia (AHRQ, 2007).
Catheter associated urinary tract infections (CAUTI) account for more than 75% of all hospital acquired UTI. Evidence shows that foley catheters are frequently kept in place when no longer medically necessary The risk of acquiring a CAUTI increases by 3 to 5% each day a foley remains in place (APIC, 2005). Removing unnecessary foley catheters is one effective strategy to reduce hospital acquired UTI’s (AHRQ, 2007).
October 1, 2008:
Several nursing units will pilot a protocol, but WILL NOT remove the foley catheter without a physician order.
December 1, 2008:
Lancaster General Health will be deploying a nurse driven protocol to assess daily for the necessity of the indwelling foley catheter, and to initiate their removal if a clear reason to maintain the foley is not determined. Protocol criteria are being developed.
Please direct questions regarding this protocol to any of the ISL physicians or any of the Infection Control nurses.
References:
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Association for Professionals in Infection Control and Epidemiology, Inc. (APIC 2005). Urinary Tract Infections (2nd ed., Ch 25). Washington, DC: Leithauser, D.
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Agency for Healthcare Research and Quality (AHRQ-January 2007). Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (AHRQ Publication No. 04(07)-0051-6