Use of central venous catheter-related bloodstream infection prevention practices by US hospitals

Mayo Clin Proc. 2007 Jun;82(6):672-8. doi: 10.4065/82.6.672.


Objective: To examine the extent to which US acute care hospitals have adopted recommended practices to prevent central venous catheter-related bloodstream infections (CR-BSIs).

Participants and methods: Between March 16, 2005, and August 1, 2005, a survey of infection control coordinators was conducted at a national random sample of nonfederal hospitals with an intensive care unit and more than 50 hospital beds (n=600) and at all Department of Veterans Affairs (VA) medical centers (n=119). Primary outcomes were regular use of 5 specific practices and a composite approach for preventing CR-BSIs.

Results: The overall survey response rate was 72% (n=516). A higher percentage of VA compared to non-VA hospitals reported using maximal sterile barrier precautions (84% vs 71%; P=.01); chlorhexidine gluconate for insertion site antisepsis (91% vs 69%; P<.001); and a composite approach (62% vs 44%; P=.003) combining concurrent use of maximal sterile barrier precautions, chlorhexidine gluconate, and avoidance of routine central line changes. Those hospitals having a higher safety culture score, having a certified infection control professional, and participating in an infection prevention collaborative were more likely to use CR-BSI prevention practices.

Conclusion: Most US hospitals are using maximal sterile barrier precautions and chlorhexidine gluconate, 2 of the most strongly recommended practices to prevent CR-BSIs. However, fewer than half of non-VA US hospitals reported concurrent use of maximal sterile barrier precautions, chlorhexidine gluconate, and avoidance of routine central line changes. Wider use of CR-BSI prevention practices by hospitals could be encouraged by fostering a culture of safety, participating in infection prevention collaboratives, and promoting infection control professional certification.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Bacteremia / etiology*
  • Bacteremia / prevention & control*
  • Catheterization, Central Venous / adverse effects*
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Data Collection
  • Hospitals / statistics & numerical data*
  • Hospitals, Veterans / statistics & numerical data*
  • Humans
  • Infection Control / methods*
  • Infection Control / statistics & numerical data
  • Intensive Care Units
  • Logistic Models
  • United States


  • Anti-Infective Agents
  • chlorhexidine gluconate
  • Chlorhexidine