Recommendations
Table 2. Recommendations to Prevent CLABSI
Essential Practices: should be adopted by all acute-care hospitals unless a clear and
compelling rationale for an alternative approach is present
Before Insertion
1. Provide easy access to an evidence-based list of indications for CVC use to minimize
unnecessary CVC placement (L).
2. Require education and competency assessment of healthcare personnel (HCP)
involved in insertion, care, and maintenance of CVCs about CLABSI prevention (M).
3. Bathe ICU patients over 2 months of age with a chlorhexidine preparation on a daily
basis (H).
At Insertion
1. In ICU and non-ICU settings, have a process in place, such as a checklist, to ensure
adherence to infection prevention practices at the time of CVC insertion (M).
2. Perform hand hygiene prior to catheter insertion or manipulation (M).
3. The subclavian site is preferred to reduce infectious complications when the catheter is
placed in the ICU setting (H).
4. Use an all-inclusive catheter cart or kit (M).
5. Use ultrasound guidance for catheter insertion (H).
6. Use maximum sterile barrier precautions during CVC insertion (M).
7. Use an alcoholic chlorhexidine antiseptic for skin preparation (H).
Aer Insertion
1. Ensure appropriate nurse-to-patient ratio and limit use of float nurses in ICUs (H).
2. Use chlorhexidine-containing dressings for CVCs in patients over 2 months of age
(H).
3. For non-tunneled CVCs in adults and children, change transparent dressings and
perform site care with a chlorhexidine-based antiseptic at least every 7 days or
immediately if the dressing is soiled, loose, or damp. Change gauze dressings every 2
days or earlier if the dressing is soiled, loose, or damp (M).
4. Disinfect catheter hubs, needleless connectors, and injection ports before accessing the
catheter (M).
5. Remove non-essential catheters (M).
6. Routine replacement of administration sets not used for blood, blood products, or
lipid formulations can be performed at intervals up to 7 days (H).
7. Perform surveillance for CLABSI in ICU and non-ICU settings (H).
