Use antiseptic- or antimicrobial-impregnated CVCs (Quality of Evidence: HIGH in adult patients 38, 39, 169– 171 and Quality of Evidence: MODERATE in pediatric patients) 172, 173Ģ. Perform surveillance for CLABSI in ICU and non-ICU settings (Quality of Evidence: HIGH) 13, 165, 166ġ. Routine replacement of administration sets not used for blood, blood products, or lipid formulations can be performed at intervals up to 7 days (Quality of Evidence: HIGH) 164ħ. Remove nonessential catheters (Quality of Evidence: MODERATE)Ħ. Disinfect catheter hubs, needleless connectors, and injection ports before accessing the catheter (Quality of Evidence: MODERATE) 150– 154ĥ. Change gauze dressings every 2 days or earlier if the dressing is soiled, loose, or damp (Quality of Evidence: MODERATE) 145– 148Ĥ.

For non-tunneled CVCs in adults and children, change transparent dressings and perform site care with a chlorhexidine-based antiseptic at least every 7 days or immediately if the dressing is soiled, loose, or damp. Use chlorhexidine-containing dressings for CVCs in patients over 2 months of age (Quality of Evidence: HIGH) 45, 135– 142ģ. Ensure appropriate nurse-to-patient ratio and limit use of float nurses in ICUs (Quality of Evidence: HIGH) 34, 35Ģ. Use an alcoholic chlorhexidine antiseptic for skin preparation (Quality of Evidence: HIGH) 42, 129– 134ġ. Use maximum sterile barrier precautions during CVC insertion (Quality of Evidence: MODERATE) 123– 128ħ. Use ultrasound guidance for catheter insertion (Quality of Evidence: HIGH) 119, 120Ħ. Use an all-inclusive catheter cart or kit (Quality of Evidence: MODERATE) 118ĥ. The subclavian site is preferred to reduce infectious complications when the catheter is placed in the ICU setting (Quality of Evidence: HIGH) 33, 37, 108– 110Ĥ. Perform hand hygiene prior to catheter insertion or manipulation (Quality of Evidence: MODERATE) 102– 107ģ. In ICU and non-ICU settings, a facility should have a process in place, such as a checklist, to ensure adherence to infection prevention practices at the time of CVC insertion (Quality of Evidence: MODERATE) 101Ģ. Bathe ICU patients aged >2 months with a chlorhexidine preparation on a daily basis (Quality of Evidence: HIGH) 86– 90ġ. Require education and competency assessment of HCP involved in insertion, care, and maintenance of CVCs about CLABSI prevention (Quality of Evidence: MODERATE) 74– 78ģ. Provide easy access to an evidence-based list of indications for CVC use to minimize unnecessary CVC placement (Quality of Evidence: LOW)Ģ. It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.ġ. 1 This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA). This document updates the Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute-Care Hospitals published in 2014. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing their central line-associated bloodstream infection (CLABSI) prevention efforts. This resource is available to all AAMC COTH members.Previously published guidelines provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). In addition to the quarterly quality reports, the AAMC also provides a comprehensive list of the national quality measures by performance and reporting program, data collection date, and reporting and performance year. All of the measures in this report are reported on the Hospital Compare website. These measures are included in the Value-Based Purchasing (VBP) Program, Hospital Readmissions Reduction Program (HRRP), the Hospital Acquired Conditions (HAC) Program, and the Inpatient Quality Reporting (IQR) Program. AAMC creates and distributes quarterly quality reports to all Council of Teaching Hospitals and Health Systems (COTH) members displaying institutional performance, along with COTH and National benchmarks, on national quality measures.

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