Table 1 Hospital guidelines for the prevention of catheter-associated bloodstream infection

1.

Use a subclavian site, rather than a jugular or a femoral site, in adult patients to minimize infection risk for nontunneled CVC placement.

2.

Avoid using the femoral vein for central venous access in adult patients.

3.

Use a CVC with the minimum number of ports or lumens essential for the management of the patient.

4.

Promptly remove any intravascular catheter that is no longer essential.

5.

Perform hand hygiene procedures, either by washing hands with conventional soap and water or with alcohol-based hand rubs (ABHR). Hand hygiene should be performed before and after palpating catheter insertion sites as well as before and after inserting, replacing, accessing, repairing, or dressing an intravascular catheter.

6.

Maintain aseptic technique for the insertion and care of intravascular catheters.

7.

Use maximal sterile barrier precautions, including the use of a cap, mask, sterile gown, sterile gloves, and a sterile full body drape, for the insertion of CVCs, PICCs, or guidewire exchange.

8.

Prepare clean skin with a >0.5% chlorhexidine preparation with alcohol before central venous catheter insertion and during dressing changes.

9.

Use either sterile gauze or sterile, transparent, semipermeable dressing to cover the catheter site.

10.

Use a sterile sleeve for all pulmonary artery catheters.

11.

Do not administer systemic antimicrobial prophylaxis routinely before insertion or during use of an intravascular catheter to prevent catheter colonization or CRBSI.

12.

Do not routinely replace CVCs, PICCs, hemodialysis catheters, or pulmonary artery catheters to prevent catheter-related infections.