Table 3 Process indicators CVC insertion monitoring form

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