Date of Award

Fall 12-22-2018

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice




Maryellen Roberts, DNP

Committee Member

Theresa Conklin, DNP

Committee Member

Charlene Ruggiero, RN


Purpose: This purpose of this project was to implement a quality improvement initiative

focusing on reducing catheter-associated urinary tract infections (CAUTIs) in the surgical setting of Overlook Hospital Medical Center. The project looked at current literature which discussed evidence-based and best practice used in preventing CAUTIs. The literature was presented to nurses and staff in the surgical setting.

Significance: The significance of the project was to initiate quality improvement by teaching

staff evidence-based and best practice in Foley usage and maintenance to reduce the frequency of


Methods: This project employed the methodology of Donabedian’s conceptual framework, Watson’s Theory of Caring, and Lewin’s Theory of Change. Interworking models were used to re-educate staff to enact change, emphasize a nurse-driven initiative, and to assess quality with achieving the overall goal of reducing CAUTIs by 50% or greater.

Project Outcomes: The Foley catheterization removal rate increased by 80%. There was an increased awareness of CAUTIs.

Clinical Relevance: Based off of the final results in the surgical setting, the project can be carried out throughout all departments and units at Overlook Hospital Medical Center.

Keywords: catheter-associated urinary tract infection (CAUTI), quality improvement

initiative, Foley catheters, best practice, evidence-based practice

Definition of Terms

According to McNeill “CAUTIs, urinary tract infections (UTIs) related to the placement of indwelling urinary catheters, are caused by bacteria . . .” (McNeill, 2017). Foley days refers to the number of days a patient has a Foley catheter inserted. Foley in refers to the insertion of a Foley catheter into a patient. Foley out refers to the removal of a Foley catheter from a patient