Implementing a Foley Insertion Bundle

IMPLEMENTING A FOLEY INSERTION

BUNDLE

Robin Haag, RN, BC, MADirector Infection Control/Prevention& HIV Services

Bundle Approach

Structured way of improving the processes of care and patient outcomes

Straightforward set of evidence-based practices 

When performed collectively have been proven to improve patient outcomes

CAUTI Prevention Bundle Catheter insertion using

sterile technique Written order for

catheter that includes justification

Automatic stop order at 48 hours

Daily review of catheter necessity

Tamper evident seal unbroken (closed system)

Drainage bag lower than patient’s bladder

Bag and tubing above the floor

Catheter secured to leg

Free flow of urine Linen clip Tubing not kinked or

dependent Daily description of urine Remove catheter from

patient’s with UTI Daily peri-care and after

each bowel movement Patient specific urinal for

bag drainage Urinal cleaned after

each use Hand hygiene before and

after touch any part of a urinary drainage system

PI Bundle Tool

Check Check Check Check Check

Corrective Actions Device Prevalence Bundle Rounds

Every DayEvery Shift

Interdisciplinary roundsAssess Need for CatheterActive Order List

○ HNs○ Nursing Directors○ Providers

Education Round the Clock

Actual DataPrevention

CompetenciesNursingProviders

○ DoctorsHousestaff

○ PAs○ Medical Students

Insertion Observation Form

For the Future Ongoing competencies Bundle PI Insertion observation Hospital wide bladder scanning Only nurses inserting ??? Mini-RCAs for CAUTIs

Unit Level Accountability○ Closing the loop○ Report in Department PI meetings○ Report to IC/IP meeting

Robin Haag (718) 616 - 3106

haagr@nychhc.org