At insertion:
Î Have a process in place to ensure adherence to infection prevention
practices at the time of CVC insertion in ICU and non-ICU settings, such
as a checklist (II).
Î Perform hand hygiene prior to catheter insertion or manipulation (II).
Î Avoid using the femoral vein for central venous access in obese adult
patients when the catheter is placed under planned and controlled
conditions (I).
Î Use an all-inclusive catheter cart or kit (II).
Î Use ultrasound guidance for internal jugular catheter insertion (I).
Î Use maximum sterile barrier precautions during CVC insertion (II).
Î Use an alcoholic chlorhexidine antiseptic for skin preparation (I).
After insertion:
Î Ensure appropriate nurse-to-patient ratio and limit the use of float
nurses in ICUs (I).
Î Disinfect catheter hubs, needleless connectors, and injection ports
before accessing the catheter (II).
Î Remove nonessential catheters (II).
Î For nontunneled CVCs in adults and children, change transparent
dressings and perform site care with a chlorhexidine-based antiseptic
every 5-7 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 (II).
Î Perform surveillance for CLABSI in ICU and non-ICU settings (I).
Special Approaches for Preventing CLABSI:
Î Use antiseptic- or antimicrobial-impregnated CVCs in adult patients (I).
Î Use chlorhexidine-containing dressings for CVCs in patients over
2 months of age (I).
Î Use an antiseptic-containing hub/connector cap/port protector to cover
connectors (I).
Î Use silver zeolite–impregnated umbilical catheters in preterm infants
(in countries where it is approved for use in children) (I).
Î Use antimicrobial locks for CVCs (I).
Î Use recombinant tissue plasminogen activating factor once weekly after
hemodialysis in patients undergoing hemodialysis through a CVC (I).
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