|
| Insertion bundle |
| (1) Strict hand hygiene |
| (2) Full sterile barrier precautions |
| (a) Catheter insertion training for all credentialed providers |
| (b) Fully stocked insertion bin/cart |
| (c) Sterile gown, hat, mask, gloves worn by provider inserting the line |
| (d) Large sterile drape covering 80–100% of the patient and bed |
| (3) Chlorhexidine skin scrub at insertion site (2 minute scrub, 1 minute air-dry) |
| (4) Chlorhexidine-impregnated sponge placed at insertion site |
| (5) Insertion checklist |
| (6) Staff empowerment to stop procedure, if necessary |
|
| Maintenance bundle |
| (1) Strict hand hygiene |
| (a) Hand washing or use of an alcohol-based hand gel by all personnel prior to any catheter care |
| (b) Wear gloves for all catheter manipulations, medication administration, and so forth |
| (2) Catheter site care |
| (a) Change clear dressing every 7 days unless visibly soiled, loosened, or dampened |
| (b) Change sterile gauze dressing every 2 days unless visibly soiled, loosened, or dampened |
| (c) Chlorhexidine scrub to site with dressing changes (30 second scrub followed by 30-second air-dry) |
| (d) No iodine ointment at site |
| (e) Chlorhexidine-impregnated sponge placed at insertion site with every dressing change |
| (f) Prepackaged dressing change kit used for all dressing changes |
| (3) Catheter/hub/cap/tubing care |
| (a) Replace continuous administration sets no more frequently than every 72 hours (no less frequently than every 96 hours), unless visibly soiled or contaminated |
| (b) Replace intermittent administration sets every 24 hours or sooner if visibly soiled or contaminated |
| (c) Replace tubing used to administer blood, blood products, or lipids within 24 hours of initiating infusion |
| (d) Cap change every 7 days and within 24 hours of blood product administration (sooner if visibly soiled or contaminated) |
| (e) Prepackaged cap change kit |
| (4) Daily discussion of line necessity and integrity |
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