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Related Experiment Video

Updated: Sep 30, 2025

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit

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Published on: July 13, 2019

Using statistical process control charts to measure changes from a nurse-driven protocol to remove urinary catheters.

Staci S Reynolds¹, Halie Lozano², Monique Fleurant³

¹Duke University School of Nursing, Durham, NC; Duke University Hospital, Infection Prevention and Hospital Epidemiology, Durham, NC.

American Journal of Infection Control

|March 12, 2022

Summary

A nurse-driven protocol (NDP) for urinary catheter removal did not reduce catheter use or infections. Further interventions are needed to enhance CAUTI prevention programs.

Keywords:

Catheter-associated urinary tract infection Indwelling urinary catheter Nurse-driven protocol Quality improvement

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An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection

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Area of Science:

Healthcare Quality Improvement
Infection Prevention
Nursing Practice

Background:

Catheter-associated urinary tract infections (CAUTI) are a significant healthcare concern.
Nurse-driven protocols (NDP) aim to reduce indwelling urinary catheter use and subsequent CAUTI.
Implementing an NDP is a strategy to improve patient outcomes and reduce healthcare-associated infections.

Purpose of the Study:

To implement a comprehensive nurse-driven protocol (NDP) for indwelling urinary catheter removal.
To reduce indwelling urinary catheter utilization and CAUTI rates within a large academic health system.

Main Methods:

Utilized statistical process control charts to monitor urinary catheter utilization and CAUTI rates.
Developed a formal protocol to guide nurses in removing unnecessary indwelling urinary catheters.
Integrated changes into the electronic health record to support protocol implementation.

Main Results:

Statistical process control charts did not show a reduction in urinary catheter utilization or CAUTI rates.
The NDP was documented approximately 600 times monthly, indicating consistent use.
An average of 6% of catheters removed via the NDP were reinserted within 48 hours.

Conclusions:

The implemented nurse-driven protocol did not decrease urinary catheter utilization or CAUTI rates.
The study evaluated process and balancing measures, contributing novel data to existing literature.
Additional interventions are recommended to complement NDPs within comprehensive CAUTI prevention strategies.