Central Line Insertion Practices (CLIP) Adherence Monitoring Form

Following specific guidelines of a central venous access insertion procedure can reduce the risk of central line associated bloodstream infections. Despite scientific support for evidence-based practices proven to reduce infection, reports suggest adherence to these practices remains low throughout the United States. Clinicians and hospitals are now being held accountable for these hospital-acquired infections. As of October 2008, hospitals are no longer reimbursed for hospital-acquired infections involving central catheters. Additional legislation affecting hospital reimbursement for central line procedures will continue to emphasize improved practices and target demonstrated reduction in infection rates with milestones in 2011 and 2013.

The National Healthcare Safety Network has issued a Central Line Insertion Practices (CLIP) Adherence Monitoring Form to assist clinicians in adhering to standards and guidelines proven to reduce and eliminate CLABSIs. These standards include:

• Observation: Accountable to ensure inserter is following protocol.
• Experience and comfort of inserter: Inserter must have received special training to insert device.
• Reason for insertion: Is the access device necessary?
• Performance of hand hygiene prior to central line insertion: Basis for aseptic technique.
• Maximal sterile barrier precautions used: Keep sterile fields clear from contamination.
• Skin preparation: Kill bacteria prior to insertion to eliminate infection.
• Selection insertion site: Healthy vasculature available to deliver therapy.
• Number of lumens: Use least amount necessary to deliver therapy (7).

Each of these components was developed specifically to increase awareness and to provide a safer, more effective process while eliminating risk associated with catheter placement and post-insertion complications. Insertion documentation should include adherence to these guidelines.


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Ultrasound Theory and Point of Care Application