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AssociatedBloodStreamInfections
Based on 2011 CDC guideline for prevention of intravascular catheter-associated bloodstream infections:
http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf
ForClinicians:
Promptlyremoveunnecessarycentrallines
Performdailyauditstoassesswhethereachcentrallineisstillneeded
Followproperinsertionpractices
Performhandhygienebeforeinsertion
Adheretoaseptictechnique
Usemaximalsterilebarrierprecautions(i.e.,mask,cap,gown,sterilegloves,andsterilefullbodydrape)
Performskinantisepsiswith>0.5%chlorhexidinewithalcohol
Choosethebestsitetominimizeinfectionsandmechanicalcomplications
o Avoidfemoralsiteinadultpatients
Coverthesitewithsterilegauzeorsterile,transparent,semipermeabledressings
Handleandmaintaincentrallinesappropriately
Complywithhandhygienerequirements
Scrubtheaccessportorhubimmediatelypriortoeachusewithanappropriateantiseptic(e.g.,chlorhexidine,povidone
iodine,aniodophor,or70%alcohol)
Accesscathetersonlywithsteriledevices
Replacedressingsthatarewet,soiled,ordislodged
Performdressingchangesunderaseptictechniqueusingcleanorsterilegloves
ForFacilities:
Empowerstafftostopnonemergentinsertionifproperproceduresarenotfollowed
Bundlesupplies(e.g.,inakit)toensureitemsarereadilyavailableforuse
Providethechecklistabovetoclinicians,toensureallinsertionpracticesarefollowed
Ensureefficientaccesstohandhygiene
Monitorandprovidepromptfeedbackforadherencetohandhygiene
http://www.cdc.gov/handhygiene/Measurement.html
Providerecurringeducationsessionsoncentrallineinsertion,handlingandmaintenance
Supplementalstrategiesforconsideration:
2%Chlorhexidinebathing
Antimicrobial/Antisepticimpregnatedcatheters
Chlorhexidineimpregnateddressings
NationalCenterforEmergingandZoonoticInfectiousDiseases
DivisionofHealthcareQualityPromotion