<h3>Background</h3> Urinary tract infections are among the most common causes of hospital-acquired infections affecting critical care patients. The objective of this project was to create a urine specimen algorithm to decrease inappropriate uses of urine cultures in combination with a nurse-driven Foley removal protocol. The combination of the two have led to a 65% decrease in catheter-associated urinary tract infections (CAUTIs) in our critical care unit (CCU). <h3>Methods</h3> An evaluation study design was used to determine the effectiveness of the combination of a nurse-driven Foley removal protocol with a urine specimen algorithm to decrease CAUTIs in our CCU. The nurse-driven Foley removal protocol was used each shift for appropriateness. If the patient continued to require collection of urine for treatment management, an appropriate external urinary catheter was placed. Education on the nurse-driven Foley removal protocol and the urine specimen algorithm was provided to providers and nurses. Designated unit champions rounded every two hours providing peri-care and assessing the patient's external urinary catheters. When a urinalysis or urine culture was ordered on a patient, providers and nursing collaborated and followed the urine specimen algorithm to prevent inappropriate uses of urine cultures. <h3>Results</h3> Baseline CAUTI data consisted of 14 events for January through October 2020. Our standardized infection ratio (SIR) for our baseline period was 3.22. After implementation of the nurse-driven Foley removal protocol and the urine specimen algorithm for the same timeframe in 2021, the number of CAUTI events were five with an SIR of 1.63. <h3>Conclusions</h3> Implementing nurse-led interventions in conjunction with a competency checkoff reduced CAUTI rates. Medical professionals inserting an indwelling urinary catheter (IUC) should participate in training to develop competency and become confident in their skills. Collaboration of patient care teams to validate the continuation of IUCs via the use of a protocol helped decrease CAUTI rates.