Table 2 Major components of CVC insertion bundle and maintenance bundle in The Erasmus MC-Sophia Children’s Hospital

Strict hand hygiene according to “my 5 moments”^#

Full sterile barrier

Hygienic precaution training for all healthcare workers who insert CVCs

Sterile gown, mask, hat, double sterile gloves worn by the healthcare worker who inserts the CVC

Use of pre-packaged CVC insertion kit

Sterile drape covering the patient for least 80%

Physical barrier between the environment and the child, insertion cart, and healthcare worker who inserts the CVC

Insertion site cleaned with alcohol 70% with chlorhexidine 0.5% (chlorhexedine 0.2% in water for infants < 26 weeks gestational age)

Use of a timer displayed at the bedside’s screen to secure an air dry time of at least 30 seconds

Use a new needle after each attempt to insert a CVC through the intact skin

Chlorhexedine impregnated sponge attached at insertion site (not in infants < 40 weeks gestational age)

Maintenance bundle

Strict hand hygiene according to “my 5 moments”^#

Hand hygiene

Hand washing when entering the unit, after using the bathroom, and when hands are visually soiled

Hand disinfection during all other occasions

Using gloves when risk of contact with body fluids

Catheter site care

Daily inspection of insertion site (e.g. redness, collection of fluids, swelling)

Change transparent semi permeable dressing on indication only (e.g. loosened, collection of fluids)

Hub care

Disinfection of the hub with alcohol 70% and air dry for at least 30 seconds

Use of a timer displayed at the bedside’s screen to secure an air dry time of at least 30 seconds

Tubing care

Replace continuous tubing sets every 96 hours, unless visually soiled of contaminated

Daily replace tube containing lipids, medication, blood or blood products

Remove intermitted administration sets directly after administration of medication

Daily question whether CVC still needed