10 May HOW IS HAND HYGIENE PERFORMED PRIOR TO CVC INSERTION?
Completion by the Medical Director or their nominee who’s responsibility it is to insert CVCs
1. Position held:
a. Neonatal consultant,
b. Neonatal fellow,
c. Neonatal nurse practitioner,
d. Other (please specify)
2. Which types of CVC do you use in your unit? (select all that apply)
a. UVC (umbilical venous catheter),
b. PICC (peripherally inserted central catheters or long line or PCVC), c. Femoral,
d. Tunnelled (Broviac, Hickmans),
e. Other (please specify)
3. Do you have a unit protocol/ procedure/guideline on CVC insertion for the following? a. PICC YES/NO/N/A
b. UVC YES/NO/N/A
c. Femoral YES/NO /N/A
d. Other (please specify)
4. Do you have a dedicated team for CVC insertion?
YES/NO
5. Do you have a trolley designated for CVC insertion/management? YES/NO
6. Is there a preference for the site of insertion, such as upper limb or lower limb?
YES/NO
If you answered yes please specify?
7. How is hand hygiene performed prior to CVC insertion?
a. Site palpated, then hands washed immediately prior to applying gloves
b. Site palpated, then alcohol hand rub immediately prior to applying gloves
c. Hands washed, then site palpated, gloves applied
d. Hands cleaned with alcohol rub, then site palpated, gloves applied
e. Hands washed, gloves applied, then site palpated
f. Hands cleaned with alcohol rub, gloves applied, then site palpated
g. Other (please specify)
8. Which of the following are used during CVC insertion? (select all that apply) a. Sterile glove (single)
b. Sterile glove (double)
c. Non--sterile glove
d. Surgical Hat/Cap
e. Surgical gown
f. Surgical mask
g. Full body sterile drapes
h. Dressing trolley
i. Sterile dressing pack / sterile tray / sterile designated CVC set
j. Insertion checklist to observe for adherence to practice
k. Observer to watch for breech in maintaining sterility
l. Other (please specify)
9. In a non--emergent setting is CVC insertion always stopped if there is a breach in infection control practices?
YES/NO/No designated observer to watch or stop procedure
10. Which cleaning solution is usually used to prep the skin prior to insertion? a. 70% alcohol / Alcohol swab
b. > 0.5% Chlorhexidine gluconate with alcohol
c. Tincture of iodine
d. Povidone--iodine
e. Other (please specify)
11. Is it practice to allow the skin preparation to dry prior to inserting the catheter? YES/NO
12. Which type of catheter is most commonly used?
a. Polytetrafluoroethylene
b. Polyurethane
c. Polyethylene
d. Polyvinyl chloride
e. Silastic
f. Other (Please specify)
13. Do you use antimicrobial/Antiseptic impregnated catheters and cuffs, such as
Chlorhexidine/silver sulfadiazine catheters or Micocycline/Rifampin catheters to prevent infections?
Routinely / Never / Occasionally
If you occasionally use please specify when?
14. Which type of impregnated catheters do you use?
a. Chlorhexidine/silver sulfadiazine catheters
b. Micocycline/Rifampin catheters
c. Other (Please specify)
15. What is used to dress the catheter site for PICC lines? (Select all that apply) a. Sterile gauze
b. Steri--strips
c. Sutures
d. Transparent semipermeable dressing ( i.e. Tegaderm, Opsite) e. Non--sterile tape
f. Other (please name)
16. What is used to dress the catheter site for femoral lines? (Select all that apply) a. Sterile gauze
b. Steri--strips
c. Sutures
d. Transparent semipermeable dressing ( i.e. Tegaderm, Opsite) e. Non--sterile tape
f. Other (please name)
17. What is used to dress the catheter site for tunnelled lines? (Select all that apply) a. Sterile gauze
b. Steri--strips
c. Sutures
d. Transparent semipermeable dressing ( i.e. Tegaderm, Opsite) e. Non--sterile tape
f. Other (please name)
18. Do you routinely use chlorhexidine--impregnated sponge dressing for short term catheters (PICC) YES/NO/Depends on gestation and /or weight (please specify)
19. Do your infants routinely, with CVCs in situ, receive systemic antimicrobial prophylaxis before or during use to prevent infection?
YES/NO
20. Do you use prophylactic antimicrobial lock solution in patients with long term catheters (i.e. femoral lines, tunnelled catheters)
YES/NO/Sometimes
If you answered sometimes can you please state when prophylactic antimicrobial solution would be used?
21. Do you use prophylactic antimicrobial lock solution in patients with PICC catheters?
YES/NO/Sometimes
If you answered sometimes can you please state when prophylactic antimicrobial lock solution would be used?
22. Do you use antimicrobial lock solution in patients with suspected or proven line infection?
YES/NO/Sometimes If you answered sometimes can you please state when an antimicrobial lock solution would be used?
23. Do you routinely use low dose heparin to fluid infused through:
a. UVC (YES/NO)
b. UAC (YES/NO)
c. PICC (YES/NO)
d. Femoral catheters (YES/NO)
e. Tunnelled catheters (YES/NO)
24. When using multi--lumen CVCs which lumen do you heparinise? a. None
b. All of them (when possible)
c. The proximal
d. The distal
e. The medium
25. How do you ascertain correct position of a CVC?
a. X--ray without contrast
b. X--ray with contrast
c. Ultrasound
d. Other
26. Are CVCs discussed daily on the medical round? YES/NO
If you answered yes what is discussed?
27. How frequently do the medical team assess the CVC insertion site? (Check all that apply) a. When the nurse asks the doctor to look
b. Daily
c. Not routinely assessed
d. 2nd daily
e. Weekly
f. Other (please specify)
28. What is the policy on line removal with proven or strongly suspected CRBSI?
a. Remove CVC immediately, regardless of type of infective microorganism
b. A trial of IV antibiotics and removal of line based on type of microorganism
c. A trial of IV antibiotics to eradicate line infection, regardless of type of infective microorganism
How long are UVC usually left in situ?
d. < 7 days
e. 7--10 days
f. 11--14 days
g. < 14 days
h. 15 – 21 days
i. 22--28 days
29. Do you routinely remove PICC after a specified time?
YES/NO
If you answered yes please specify?
30. Do you routinely prescribe antibiotics for CVC removal?
YES/NO
31. Do staff involved in catheter insertion receive annual education on CVC insertion, including prevention of infection?
YES/NO
32. Do staff involved in catheter insertion have their knowledge assessed on CVC insertion, including preventing infection during insertion?
YES/NO
33. Does all medical staff receive feedback on the number of catheter related blood stream infections?
YES/NO
Maintenance Survey
(web link: https://www.surveymonkey.com/s/WBQ9RWR )
Completion by the Nurse Manager or their nominee
34. Position held:
a. Nurse Unit Manager
b. Nurse Educator
c. Nurse consultant
d. Other (please specify)
35. Do you have a Unit protocol/ procedure/guideline on the management of the following
CVCs?
a. UVC (umbilical venous catheter), YES/NO/Don’t use
b. PICC (peripherally inserted central catheters or long line or PCVC), YES/NO/Don’t use c. Femoral, YES/NO/Don’t use
d. Tunnelled (Broviac, Hickmans) YES/NO/Don’t use
e. Other (please specify)
36. Has your unit adopted the principles of ANTT (Aseptic Non Touch Technique) when handling CVCs?
a. Yes
b. NO
37. Which of the following are used when accessing a UVC (e.g. for medications)? (select all that apply)
a. Sterile glove
b. Non--sterile gloves
c. Hat
d. Gown
e. Mask
f. Full body sterile drapes
g. Dressing trolley
h. Sterile dressing pack / tray
i. Unsterile tray
j. Checklist to observe for adherence to practice
k. Observer to watch for breech in maintaining sterility
l. Other (please specify)
38. Which of the following are used when accessing a PICC (e.g. for medications)? (select all that apply)
a. Sterile glove
b. Non--sterile gloves
c. Hat
d. Gown
e. Mask
f. Full body sterile drapes
g. Dressing trolley
h. Sterile dressing pack / tray
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