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

From: Implementation of a children’s hospital-wide central venous catheter insertion and maintenance bundle

Insertion bundle Components
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  
  1. #My 5 moments adopted from the CDC [23].
  2. CVC central venous catheter.