Marjon Borgert

146 Chapter 6 Supplementary File 4 Bundle elements Hand hygiene Maximal barrier precaution Full body drape Daily review of line necessity with prompt removal of unnecessary lines Optimal catheter site selection, with avoidance of femoral vein Chlorhexidine skin antisepsis PIC placement with ultrasound guidance to avoid CVC placement and to facilitate removal. Removal within 24h of all CVC's placed emergently Use of a checklist for insertion Daily checking of central line site for inflammation Time out note Cleaning of all ports with 2% chlorhexidine and 70% alcohol prior to assessing CL Chlorhexidine impregnated dressings and/or AB impregnated CLs for high risk pt. x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x Exline et al. Insertion bundle Jeong et al, Central line bundle McPeake et al. Insertion bundle Richardson et al, Central line bundle Render et al, Central line bundle Longmate et al, Insertion bundle Marra et al, Central line bundle Bonello et al, Central line bundle McNamara et al. Central line bundle Hocking et al, Insertion bundle Hocking et al. Maintainance Exline et al. Maintainance Intervene at the same time when non-compliance was detected (=time out procedure?) x Sterile techniques while inserting the CL and applying the dressing x Central line bundle Dressing with Chlorhexidine gluconate material x x x x x x Helmick et al. Central line bundle x x x x Sacks et al. Central line bundle Preferential use of the subclavian vein x x x x Khalid et al., insertion bundle x x Khalid et al., maintenance bundle Patient hygiene x Catheters coated internally with silver sulfadiazine and chlorhexidine acetate x Chlorhexidine mouthwash for oral care x