Central Venous Catheter Insertion and Maintenance

Hand washing is an extremely effective way to prevent nosocomial infections, but fingernails often harbor microorganisms after thorough hand cleansing.  Lengthy or artificial fingernails increase this tendency for pathogenic organisms to remain on the hands.  For this reason, the Association of Operating Room Nurses has officially banned artificial nails in the operating room.  In general, health care providers should avoid wearing artificial nails at work and should keep their nails neatly trimmed.  (Of note, Vanderbilt has a policy prohibiting providers with direct patient contact from wearing artificial nails at work -- refer to Dress Code Policy available online here)

Good hand hygiene before catheter insertion or maintenance is important for reducing CVC-related infections.  Even if providers wear gloves, studies have consistently shown that hand washing immediately prior to the handling of a line reduces the incidence of infections.  Use of a waterless, alcohol-based gel is at least as effective as traditional soap and water. All VUMC staff are expected to adhere to good hand hygiene practices both before and after contact with patients and their environment (see Hand Hygiene Policy available here).

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