Catheter associated urinary tract infections (CAUTIs) are a leading cause of healthcare-associated infection, particularly in intensive care units (ICUs), where prolonged catheterisation and patient complexity increase risk. Reducing unnecessary catheter use and improving adherence to evidence-based practices are key priorities for patient safety. This case report describes a nurse-led, multidisciplinary quality improvement programme to reduce CAUTI rates in a transplant ICU through optimisation of catheter use and the introduction of non-invasive urinary management alternatives. Interventions included standardisation of catheter indication criteria, implementation of insertion, maintenance and early removal protocols, introduction of external urinary management devices and a structured staff education and audit programme. Performance was monitored using CAUTI incidence per 1,000 catheter days and compliance with catheter-related practices, supported by continuous audit and feedback. Following implementation, CAUTI rates decreased from a pre-intervention rate of 1.41 per 1,000 catheter days to sustained zero incidence between Q4 2018 and Q4 2024. Compliance with catheter care protocols improved, alongside increased documentation of indication for catheter use and earlier catheter removal. The adoption of external urinary catheter management devices contributed to reduced indwelling catheter use. In parallel, the unit reported zero device-related pressure injuries and improved patient comfort, as reflected in staff-reported patient feedback. This multifaceted approach achieved sustained elimination of CAUTI in a high-risk ICU setting, highlighting the effectiveness of nurse-led interventions, standardised practice, and non-invasive catheter alternatives in reducing device-associated harm.