Prevention of Central Venous Catheter Infections

Catheter insertion bundle

• Educate personnel about catheter insertion and care.
• Use chlorhexidine to prepare the insertion site.
• Use maximal barrier precautions and asepsis during catheter insertion.
• Consolidate insertion supplies (e.g., in an insertion kit or cart).
• Use a checklist to enhance adherence to the insertion bundle.
• Empower nurses to halt insertion if asepsis is breached.

Catheter maintenance bundle

• Cleanse pts daily with chlorhexidine.
• Maintain clean, dry dressings.
• Enforce hand hygiene among health care workers.

Ask daily: Is the catheter needed? Remove catheter if not needed or used.

Prevention of Ventilator-Associated Events

• Avoid mechanical ventilation whenever possible.
• Elevate head of bed to 30-45°.
• Decontaminate oropharynx regularly with chlorhexidine (controversial).
• Give “sedation vacation” and assess readiness to extubate daily.
• Use deep-vein thrombosis prophylaxis (unless contraindicated).

Prevention of Surgical-Site Infections

• Choose a surgeon wisely.
• Administer prophylactic antibiotics within 1 h before surgery; discontinue within 24 h.
• Limit any hair removal to the time of surgery; use clippers or do not remove hair at all.
• Prepare surgical site with chlorhexidine-alcohol.

Prevention of Urinary Tract Infections

• Place bladder catheters only when absolutely needed (e.g., to relieve obstruction), not solely for the provider's convenience.
• Use aseptic equipment and technique for catheter insertion and urinary tract instrumentation.
• Minimize manipulation or opening of drainage systems.
• Ask daily: Is the bladder catheter needed? Remove catheter if not needed.

Prevention of Pathogen Cross-Transmission

• Cleanse hands with alcohol hand rub before and after all contacts with pts or their environments.