Prevention
Approaches that should NOT be considered a routine part of
CLABSI prevention
ÎÎDo NOT use antimicrobial prophylaxis for short-term or tunneled catheter
insertion, or while catheters are in situ (A-I).
ÎÎDo NOT routinely replace central venous or arterial catheters (A-I).
ÎÎDo NOT routinely use positive-pressure needleless connectors with
mechanical valves before a thorough assessment of risks, benefits, and
education regarding proper use (B-II).
Prevention of Ventilator-Associated Pneumonia (VAP)
Basic practices for prevention and monitoring of VAP*
ÎÎEducate healthcare personnel who care for patients undergoing ventilation
about VAP, including information about local epidemiology, risk factors,
and patient outcomes (A-II).
ÎÎImplement policies and practices for disinfection, sterilization, and
maintenance of respiratory equipment that are aligned with evidencebased standards (eg, guidelines from the Centers for Disease Control and
Prevention and professional organizations) (A-II).
ÎÎEducate clinicians who care for patients undergoing ventilation about
noninvasive ventilatory strategies (B-III).
ÎÎProvide easy access to noninvasive ventilation equipment and institute
protocols to promote the use of noninvasive ventilation (B-III).
ÎÎEnsure that all patients (except those with medical contraindications) are
maintained in a semirecumbent position (B-II).
ÎÎPerform regular antiseptic oral care in accordance with product guidelines
(A-I).
ÎÎPerform direct observation of compliance with VAP-specific process
measures (B-III).
ÎÎConduct active surveillance for VAP and associated process measures
in units that care for patients undergoing ventilation who are known or
suspected to be at high risk for VAP on the basis of risk assessment (A-II).
ÎÎRegularly provide ICU clinicians and senior hospital leaders with data on
VAP and VAP-related process measures (B-III).
Special approaches for the prevention of VAP**
ÎÎPerform a VAP risk assessment.
ÎÎUse an endotracheal tube with in-line and subglottic suctioning for all
eligible patients (B-II).
