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Table 3 Process indicators CVC insertion monitoring form

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

  Process indicator Satisfied
1 Skin cleaned with alcohol 70% with chlorhexidine 0.2%; or chlorhexidine 0.2% in water in infants with a gestational age < 26 weeks Yes O No O
2 Air dry of at least 30 seconds after skin preparation prior to guide-wire insertion Yes O No O
3 New needle used after each attempt to insert a CVC through the intact skin Yes O No O
4 Sterile drape covering the patient for least 80% Yes O No O
5 The provider inserting the CVC used maximum sterile barrier e.g. sterile gown, double sterile gloves, mask, and hat Yes O No O
6 Optimal insertion site was selected or another site was argued for Yes O No O
7 Echo use during insertion of jugularis and subclavia catheter Yes O No O
8 Chlorhexidine impregnated sponge used in infants < 40 weeks gestational age Yes O No O
  1. CVC central venous catheter.