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Healthcare-Associated Infections

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Prevention Prevention of Central Line-Associated Bloodstream Infection (CLABSI) Basic practices for prevention and monitoring of CLABSI: (recommended for all acute care hospitals) ÎBefore insertion > Educate healthcare personnel involved in the insertion, care, and maintenance of central venous catheters about CLABSI prevention (A-II). ÎAt insertion > Use a catheter checklist to ensure adherence to infection prevention practices at the time of central venous catheter insertion (B-II). > Perform hand hygiene before catheter insertion or manipulation (B-II). > Avoid using the femoral vein for central venous access in adult patients (A-I). > Use an all-inclusive catheter cart or kit (B-II). > Use maximum sterile barrier precautions during central venous catheter insertion (A-I). > Use a chlorhexidine-based antiseptic for skin preparation in patients older than 2 months of age (A-I). ÎAfter insertion > Disinfect catheter hubs, needleless connectors, and injection ports before accessing the catheter (B-II). > Remove nonessential catheters (A-II). > For non-tunneled central venous catheters in adults and adolescents, change transparent dressings and perform site care with a chlorhexidine-based antiseptic every 5-7 days or more frequently if the dressing is soiled, loose, or damp; change gauze dressings every 2 days or more frequently if the dressing is soiled, loose, or damp (A-I). > Replace administration sets not used for blood, blood products, or lipids at intervals not longer than 96 hours (A-II). > Perform surveillance for CLABSI (B-II). > Use antimicrobial ointments for hemodialysis catheter insertion sites (A-I). Special approaches for the prevention of CLABSI: (These special approaches are recommended for use in locations and/or populations within the hospital for which outcome data and/or risk assessment suggest lack of effective control despite implementation of basic practices.) ÎPerform a CLABSI risk assessment. ÎBathe intensive care unit (ICU) patients older than 2 months of age with a chlorhexidine preparation on a daily basis (B-II). ÎUse antiseptic- or antimicrobial-impregnated central venous catheters for adult patients (A-I). ÎUse chlorhexidine-containing sponge dressings for central venous catheters in patients older than 2 months of age (B-I). ÎUse antimicrobial locks for central venous catheters (A-I). * Recommended for all acute care hospitals. ** These special approaches are recommended for use in locations and/or populations within the hospital for which outcome data and/or risk assessment suggest lack of effective control despite implementation of basic practices.

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