743: Comprehensive Strategy to Reduce Cautis in the Icu: A Quality Improvement Initiative

Introduction: Catheter-Associated Urinary Tract Infections (CAUTIs) are a significant concern in Intensive Care Units (ICUs), leading to increased patient morbidity, mortality, and healthcare costs. This quality improvement project aimed to reduce CAUTI rates in the ICU through a multifaceted intervention implemented. The primary objective was to decrease CAUTI rates by reducing unnecessary Foley catheter utilization. Methods: The intervention comprised several components: Daily Checklist for Foley Catheter Removal, Charge nurses ensuring prompt removal of Foley catheters unless clinically necessary, Weekly Audits of Foley Utilization (Audits monitored catheter use and adherence to guidelines), Performance Metric Emails (Weekly emails provided feedback on performance metrics to clinical teams), and collaboration and meetings with Urology, Trauma, Nephrology, Cardiothoracic Surgery (CTS), and Vascular Surgery. Criteria for Foley Catheter utilization: Foley catheters were placed or retained only for specific conditions such as genitourinary (GU) procedures, prone positioning, and chronic foleys. Intermittent straight catheterization was preferred if needed up to three times in 24 hours. Standardized Utilization Ratio (SUR) is the ratio of observed to expected catheter days, with a goal of < 0.5. Standardized Infection Ratio (SIR) is the ratio of observed to expected infections, with a goal of < 0.59. This data included patients in CY 2024 with intervention started in September 2024. Results: Data analysis revealed a significant decrease in Foley SUR across all ICUs: Medical ICU (MICU, reduction from 0.525 to 0.37, p = 0.001), Cardiovascular ICU (CVICU, reduction from 0.792 to 0.377, p = 0.001), and Neurotrauma ICU (NTICU, reduction from 0.539 to 0.361, p = 0.001). The overall SIR significantly improved from 1.1 to 0.39 (p = 0.0001). Conclusions: The comprehensive quality intervention was effective in reducing Foley catheter utilization and CAUTI rates in the ICU. Continued adherence to these practices is recommended to sustain and further improve patient outcomes.