1. Reduction of Urinary Catheters and Associated Infections
Team Members:
Eileen Phillips (Lead), Emily Hunt, Susan Heimsoth, Christine Shaw
Executive Sponsors:
Dr. Kristin Hahn-Cover, John Hornick
Advisors:
Eric Franks, Anne Hackman
MHA Students: Amanda Boone, Evan Camden, Amber Romstad, Thaddeus Wakeman
October 16th, 2013

2. Aim Statement
To reduce the CAUTI rate in the Adult ICUs at UH to the NHSN* 25th percentile by reducing catheter utilization to NHSN* 25th percentile in the ICU’s through implementation of evidence-based practices including a modified HOUDINI indication protocol, education, and aligning data reporting for urinary catheters.
*National Healthcare Safety Network

3. FY2013 UH CAUTI Rates Current Goal Unit CAUTI Rate Pooled Mean
Percentiles
10%
25%
50% (Median)
75%
90%
BICU
4.66
4.10
0.00
2.80
5.20
8.60
CICU
0.73
2.20
0.10
1.60
4.50
MICU
2.76
2.60
0.70
2.00
3.40
5.00
NSICU
9.32
1.80
3.80
5.50
8.10
TSICU
2.92
0.20
1.30
2.50
6.00

4. FY2013 UH Catheter Utilization Rates
Current
Goal
Unit
Utilization Rate
Pooled Mean
Percentiles
10%
25%
50% (Median)
75%
90%
BICU
0.59
0.50
0.34
0.38
0.45
0.64
0.76
CICU
0.54
0.70
0.49
0.62
0.74
0.80
0.83
MICU
0.79
0.56
0.65
0.85
NSICU
0.66
0.61
0.71
TSICU
0.87
0.94

5. What is HOUDINI? H=Hematuria O=Obstruction urinary
U=Urological surgery
D=Decubitus ulcer
I=I&O (critical management)
N=Nursing supportive or palliative care
I=Immobility (unstable fracture)
Trovillion, E. et al. (2011). Development of a nurse-driven protocol to remove urinary catheters. Presented at SHEA 1-4 April Abstract 590.

6. Project Description
Implement electronic decision support through the EMR for catheter removal based on HOUDINI indications
Provide context-specific definitions for HOUDINI protocol (e.g. Critical I&O = ? )
Determine resources needed for alternatives to indwelling catheters
Change the culture of urinary catheter use and reporting

7. Question/Answer