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Implementing a Foley Insertion Bundle

Robin Haag, RN, BC, MA Director Infection Control/Prevention & HIV Services. Implementing a Foley Insertion Bundle. Bundle Approach. Structured way of improving the processes of care and patient outcomes Straightforward set of evidence-based practices 

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Implementing a Foley Insertion Bundle

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  1. Robin Haag, RN, BC, MA Director Infection Control/Prevention & HIV Services Implementing a Foley Insertion Bundle

  2. 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

  3. 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

  4. PI Bundle Tool

  5. Check CheckCheckCheckCheck

  6. Corrective Actions • Device Prevalence • Bundle Rounds • Every Day • Every Shift • Interdisciplinary rounds • Assess Need for Catheter • Active Order List • HNs • Nursing Directors • Providers

  7. Education • Round the Clock • Actual Data • Prevention • Competencies • Nursing • Providers • Doctors • Housestaff • PAs • Medical Students • Insertion Observation Form

  8. 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

  9. Robin Haag • (718) 616 - 3106 • haagr@nychhc.org

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