Table 3

Evidence-Based Strategies for Central Line Infection Prevention

  • Education and training should be provided for staff who insert and maintain intravenous lines.
  • Maximal sterile barriers should be used during catheter insertion (cap, mask, sterile gown and gloves, and a large sterile drape).
  • A 2% chlorhexidine preparation is the preferred skin antiseptic, to be applied prior to insertion.
  • Antiseptic- or antibiotic-impregnated catheters should be reserved for very high-risk patients or situations in which catheter-related BSI rates are high despite careful attention to these recommendations.
  • Replace peripheral intravenous sites in the adult patient population at least every 96 hours but no more frequently than every 72 hours. Peripheral venous catheters in children should be left in until the intravenous therapy is completed, unless complications such as phlebitis or infiltration occur.
  • Replace intravenous tubing at least every 96 hours but no more frequently than every 72 hours.
  • Replace intravenous catheters as soon as possible when adherence to aseptic technique during catheter insertion cannot be ensured (i.e., prehospital, code situation).
  • Central lines should not routinely be replaced at scheduled intervals.
  • Consider use of a central line insertion checklist to ensure all processes related to central line insertion are executed for each line placement.
  • Consider use of a central line insertion cart to avoid the difficulty of finding necessary equipment to institute maximal barrier precautions.
  • Replace central line dressings whenever damp, loose, or soiled or at a frequency of every 2 days for gauze dressings and every 7 days for transparent dressings.
    Avoid use of antibiotic ointment at insertion sites because it can promote fungal infections and antibiotic resistance.
  • Include daily review of line necessity.
  • Assess competency of staff who insert and care for intravascular catheters.

Sources: Adapted from: O’Grady NP, et al., Guidelines for the Prevention of Intravascular Catheter-Related Infections, Centers for Disease Control and Prevention, MMWR Recomm Rep 2002;51(RR-10):1–29; Institute for Healthcare Improvement, Getting Started Kit: Prevent Central Line Infections, 2006, available at: http://www​​/rdonlyres/BF4CC102-C564-4436-AC3A-0C57B1202872​/0/CentralLinesHowtoGuideFINAL720.pdf (accessed March 11, 2006); and American Association of Critical Care Nurses practice alert: Preventing Catheter-Related Bloodstream Infections, www​ (accessed March 5, 2006).

From: Chapter 42, Targeting Health Care–Associated Infections: Evidence-Based Strategies

Cover of Patient Safety and Quality
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Hughes RG, editor.

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