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UWHC,

Nursing,Employee Health,Clinicians,Patient Care,Safety,

Clinical Hub,References,Infection Control,Infection Control,Hospital Acquired Infections (HAI)

CLABSI Prevention

CLABSI Prevention - Clinical Hub, References, Infection Control, Infection Control, Hospital Acquired Infections (HAI)

Focus

Line Necessity

CVAD indications include: 

Indications for a central vascular access device (CVAD) can change daily. Limiting the duration of use for central lines will decrease the patient’s risk for central line-associated infection (CLABSI) and deep vein thrombosis (DVT). Ask: 

  1. What is the current indication for this CVAD?
    1. Blood sampling for routine laboratory testing is generally not a true indication for maintaining CVAD placement.
    2. Antibiotic therapy is not necessarily an indication for maintaining CVAD placement.
  2. Does this patient’s infusate(s) require a central line for administration or can therapy be accomplished with another vascular access device (e.g., ultrasound placed peripheral IV or midline catheter)?
    1. Refer to the Intravenous Administration of Formulary Medications – Adult – Inpatient/Ambulatory or Intravenous Administration of Formulary Medications – Neonatal/Pediatric – Inpatient/Ambulatory Clinical Practice Guidelines to determine if central vascular access is required.
  3. Is the CVAD necessary for ongoing therapy?
    1. It’s tempting to maintain CVAD placement “just in case.” Unless the patient’s plan of care outlines intended ongoing therapy that requires a CVAD (e.g., outpatient use for extended treatment), it’s best to remove the device.

Line Maintenance

The CVAD Maintenance bundle provides evidence-based interventions for the maintenance of central lines to prevent central line associated blood stream infections (CLABSIs).

Please refer to the CVAD Maintenance Bundle for expectations with maintenance practices.

CHG Treatment

Resources

Adult Inpatient 2 Person Dressing Change

2 Person Dressing Change Video

Two-person Adult Central Vascular Access Device (CVAD) Dressing Change Skills Checklist

Central Line Audit Forms

Guidelines, Policies and Protocols

Insertion

Maintenance

Midline

Midline Intravenous Peripheral Catheters: Use, Maintenance and Removal (Adult)

Your Midline Intravascular Catheter

Patient Education

Understanding your Peripherally Inserted Central Catheter (PICC)

Removal

Videos

3M Tegaderm CHG Dressing Application and Removal – IJ

3M Tegaderm CHG Dressing Application and Removal – PICC

Scrub the Hub (Video)