Central Vascular Catheter Insertion Checklist
Example of SOP for using the catheter
Central Vascular Catheter
Insertion Checklist
Standard Operating Procedure
Perform optimal care
Improving process to improve outcome
This checklist is adapted with kind permission from the checklist devised at Johns Hopkins Hospitals
Central Vascular Catheter Insertion Checklist
Example of SOP for using the catheter
The example of a Standard Operating Procedure overleaf illustrates one way to
deploy the CVC insertion checklist. You can use it as somewhere to start, but it is
anticipated that locally the checklist will be used in many different ways, for
example, local decisions include: who does it, and how the data are
collected/monitored. Some items on the checklist may be locally redundant and could
be removed. Successful implementation of this checklist can be achieved using the
SPSP rapid cycle testing methodology.
Please use this procedure as a starting point but do not consider it to be prescriptive.
How you reliably put this checklist into use is up to you and your team locally.
Please note SICSAG have also produced an insertion bundle. What is important is
that there is a checklist, which is evidence based and that checklist reliably aids those
inserting CVCs to do so correctly. The SICSAG insertion bundle can be found at the
following web address: http://www.sicsag.scot.nhs.uk/SubGroup/HAI.html
HPS would be delighted to assist in the sharing of good practice, please let us know
of anything you have identified that could help someone else do it better quicker.
Email: HPSinfectioncontrol@hps.scot.nhs.uk
Other
tools
that
may
help
you
with
http://www.hps.scot.nhs.uk/haiic/ic/index.aspx
this
bundle
are
found
at
Central Vascular Catheter Insertion Checklist
Example of SOP for using the catheter
Example of how to use the Central Vascular Catheter (CVC) Insertion Checklist
Statement
CVCs are the leading cause of device-related blood stream infections [1]. Micro-organisms
that gain entry during the insertion procedure can subsequently cause infection of the line [2-4].
It has been shown that use of Checklists can significantly improve the chances of getting the
procedure right every time [5].
Objectives
1.
To ensure the Central Vascular Catheter insertion procedure in OUR hospital/ward/
unit/theatre is optimal, evidence-based and minimises the risk of harm to the patient.
2.
Requirements
To be able to demonstrate quality CVC care in OUR hospital/unit/ward/theatre.
Knowledge of where all central lines are inserted within the hospital.
Agreement with those in charge of all the clinical units that insertion checklists will be used
every time a CVC is inserted.
A mechanism for knowing when a line has been inserted.
HCWs committed to patient safety.
The correct procedure clearly displayed within every unit where CVC insertion takes place.
In addition to the collection of sundries and equipment for the procedure, a nominated observer
trained to use the checklist and knowledgeable on how the procedure should be done.
Procedure
1.
Every time a CVC is to be inserted the person who will insert the CVC should nominate an
observer to complete the checklist.
2.
The observer will observe the procedure and record observations on the checklist.
(The observer may also be assisting the operator during the procedure and complete the
checklist at the end of the procedure).
After care
Complete form.
Give it to:
Discuss and display the data when it has been returned.
Central Vascular Catheter Insertion Checklist
Example of SOP for using the catheter
Date:
Location:
Time
ITU
SHDU
:
(24hr clock)
MHDU
A&E
Theatres
Other state:_______________
Planned Procedure
Yes … No … Guidewire exchange (not recommended) Yes
Emergency Procedure
Yes
No
No
I confirm that I have completed an approved CVC education package and that I have
Yes
been signed off as being competent.
box or the box below
I have not completed the above package but consider myself to be competent in CVC
Yes
tick this
insertion. (Perform under supervision if operator has inserted <3 CVCs).
The Procedure
The operator (and supervisor) performed a Surgical Scrub
Yes … No
The operator (and supervisor) wore hat, mask, sterile gown and sterile gloves
Yes … No
Chlorexidine 2% in alcohol was applied to the insertion site and allowed to dry before
Yes … No
the procedure was progressed.
Yes … No
Sterile drapes were placed to create a sterile operating field.
Number of skin punctures:
1
2
3
≥4
Number of needle passes:
1
2
3
≥4
(Seek the help of a supervisor if more than 3 unsuccessful insertions)
Type of Catheter
Insertion site
Side inserted
CVC
IJV
Right
Introducer
Subclavian
Left
Vascath
Femoral
(If possible avoid using the femoral site)
Other:
____________________________________
A sterile field was maintained throughout the procedure
Yes … No
Ultrasound was performed.
Yes … No
Ultrasound was performed in real-time
Yes … No
Clean blood from the site using chlorhexidene 2% in alcohol and dry site
Yes … No
The CVC was secured with: ____________________________________
A sterile CVC dressing was placed over the insertion site. (The dressing must be
Yes … No
specifically designed for vascular catheter insertion site protection).
Name of Operator:
_____________________________________
Name of supervisor (if applicable)
_____________________________________
Name of Observer:
_____________________________________
Local process notes:
Central Vascular Catheter Insertion Checklist
Example of SOP for using the catheter
References:
1.
2.
3.
4.
5.
Coello, R., et al., Device-related sources of bacteraemia in English hospitals-opportunities for the prevention of hospital-acquired bacteraemia. J Hosp
Infect, 2003. 53(1): p. 46-57.
Pratt, R.J., et al., epic2: National evidence-based guidelines for preventing
healthcare-associated infections in NHS hospitals in England. J Hosp Infect,
2007. 65 Suppl 1: p. S1-64.
Pascual, A., Pathogenesis of catheter-related infections: lessons for new
designs. Clin Microbiol Infect, 2002. 8(5): p. 256-64.
O'Grady, N.P., et al., Guidelines for the prevention of intravascular catheterrelated infections. Centers for Disease Control and Prevention. MMWR
Recomm Rep, 2002. 51(RR-10): p. 1-29.
Berenholtz, S.M., et al., Eliminating catheter-related bloodstream infections in
the intensive care unit. Crit Care Med, 2004. 32(10): p. 2014-20.