Table 1. Recommendations
10. reshold to consider implementing additional preventive measures:
• Zero CLABSIs is the aspirational and potentially achievable goal. While there is
no nationally endorsed threshold above which additional CLABSI prevention
measures should be implemented, a variety of quantitative or qualitative metrics
may be utilized to identify CLABSI prevention success over time and determine
when additional intervention is necessary.
• A decision to identify a threshold for action in an individual NICU should assess a
variety of factors including :
▶ An SIR or rate of CLABSI that is above goal or increasing despite the consistent
implementation of current organizational interventions.
▶ Local interest in setting a specific lower target with input from Infection
Prevention and Control (infection preventionists, healthcare epidemiologist).
▶ Patient mix and clinical acuity, which may predict general likelihood of CLABSI.
▶ Resource and personnel capacity for initiation and/or maintenance of specific
interventions and practice processes.
• Any quantitative or qualitative metric that is defined should be developed and
accepted by all stakeholders.
11. Preventive bundle elements, above and beyond those recommended by e
Centers for Disease Control and Prevention (CDC), to be considered by a NICU
experiencing ongoing CLABSI:
• Additional practices that lack robust evidence may be effective. There are many
different products, technologies, and processes that NICUs may consider.
• Implementation of an expanded NICU central line care bundle should take
into account the risks and benefits of additional measures, as well as the needs,
resources, and local expertise at individual institutions.
(cont'd)
Table 2. Adapted CDC Checklist for Prevention of CLABSI
a
Insertion Maintenance
☐ Perform hand hygiene before insertion. ☐ Perform hand hygiene.
☐ Adhere to aseptic technique. ☐ Bathe intensive care unit (ICU) patients
who are ≥2 months of age with CHG daily.
☐ Use maximal sterile barrier precautions
(i.e., mask, cap, gown, sterile gloves,
and sterile full body drape).
☐ Use only sterile devices to access catheters.
☐ Choose the best insertion site
to minimize infections and
noninfectious complications based on
individual patient characteristics.
☐ Prepare the insertion site with >0.5%
CHG with alcohol
a
(see Recommendation 1).
☐ Scrub the access port or hub with friction
immediately prior to each use with an
appropriate antiseptic (CHG, povidone
iodine, an iodophor, or 70% alcohol).
