Foley Catheter Removal for SCIP Core Measure

[NurseAnnie123]

I work for a small facility, and we are having a problem with the SCIP Core Measure regarding foley catheter removal. According to this Core Measure, foley catheters on surgical patients are to be removed by the end of POD #2 unless the MD documents a reason to leave it (or unless the patient is in ICU on diuretics). What processes has your facility put into place to improve your scores in this area??

[UpinawayRN]

Loud sticker on front of charts help, as does the chart "checkers" routinely checking through to make sure forms are carried out. I think they also just started changing the color of scip pt charts. Religiously dating foleys also.

[Double-Helix, BSN, RN]

Our nurses round with the doctors every morning, and if the patient has a foley it's the nurse's responsibility to bring it up at rounds and dicuss whether the foley is necessary. If it's not, we pull it.

[DutchRN09]

Stickers in the chart, the DR has to sign QD if Foley stays in

[Flo., BSN, RN]

We have the foley police at work. They will call the RN, MD, PA etc until the foley is removed or a proper reason is charted. We have computerized charting so they can watch from any where. But the thing that helped the most is standardized orders. 90%of our foleys are removed POD1 or documented otherwise.

[Sewbusy~RN]

We also put stickers in charts, bright orange labels on the foley bags and on the front of the Kardex. In addition, foley removal is now a nursing judgement where I work, but we don't touch them without an order if it is a neuro or GU patient, and a few other situations.

[noyesno, MSN, APRN, NP]

We have the "foley police," they enforce foley violations by calling the nurse over and over again until the foley comes out.

Ours have to come out by POD #1.

[sapphire18]

We don't even have the "in ICU on diuretics exception"...it's supposed to be out by the end of POD#2 no matter what (unless MD documents a reason that it needs to be left in), but honestly most of our pts have their foleys in for their whole ICU stay for the reason of accurate I&Os. It's impossible to document accurate output for an incontinent pt, which most of them are. Or bedpans that end up spilling, etc. When I worked on a step-down unit though, we removed most of our pt's foleys and accurate I&Os were usually less of an issue; pts were on much less IVFs/drips.

[beckster_01, BSN, RN]

At my facility I consider it a nursing responsibility to evaluate if a foley is appropriate. If I don't see a clear indication (lasix gtt or needing strict, accurate I&O's are the only exceptions), I get an order to pull it. We do have foley police as well, they just go through the charts and make sure that the order specifies why the foley is still in if it is clinically indicated.

[noyesno, MSN, APRN, NP]

Bad nurse, bad nurse

Whatcha gonna do, whatcha gonna do

When the foley police come for you

I should probably write a song. JK.