Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute-Care Hospitals

1. Provide easy access to an evidence-based list of indications for CVC use to minimize unnecessary CVC placement. (L = Low)

2. Require education and competency assessment of healthcare personnel (HCP) involved in insertion, care, and maintenance of CVCs about CLABSI prevention. (M = Moderate)

3. Bathe ICU patients over 2 months of age with a chlorhexidine preparation on a daily basis. (H = High)

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 = Moderate)

2. Perform hand hygiene prior to catheter insertion or manipulation. (M = Moderate)

3. The subclavian site is preferred to reduce infectious complications when the catheter is placed in the ICU setting. (H = High)

4. Use an all-inclusive catheter cart or kit. (M = Moderate)

5. Use ultrasound guidance for catheter insertion. (H = High)

6. Use maximum sterile barrier precautions during CVC insertion. (M = Moderate)

7. Use an alcoholic chlorhexidine antiseptic for skin preparation. (H = High)

1. Ensure appropriate nurse-to-patient ratio and limit use of float nurses in ICUs. (H = High)

2. Use chlorhexidine-containing dressings for CVCs in patients over 2 months of age. (H = High)

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 = Moderate)

4. Disinfect catheter hubs, needleless connectors, and injection ports before accessing the catheter. (M = Moderate)

5. Remove non-essential catheters. (M = Moderate)

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 = High)

7. Perform surveillance for CLABSI in ICU and non-ICU settings. (H = High)