Table 2.

Major components of CVC insertion bundle and maintenance bundle in The Erasmus MC-Sophia Children’s Hospital

Insertion bundle	Components
Strict hand hygiene according to “my 5 moments”#
Full sterile barrier	Hygienic precaution training for all healthcare workers who insert CVCs
	Sterile gown, mask, hat, double sterile gloves worn by the healthcare worker who inserts the CVC
	Use of pre-packaged CVC insertion kit
	Sterile drape covering the patient for least 80%
Physical barrier between the environment and the child, insertion cart, and healthcare worker who inserts the CVC
Insertion site cleaned with alcohol 70% with chlorhexidine 0.5% (chlorhexedine 0.2% in water for infants < 26 weeks gestational age)
Use of a timer displayed at the bedside’s screen to secure an air dry time of at least 30 seconds
Use a new needle after each attempt to insert a CVC through the intact skin
Chlorhexedine impregnated sponge attached at insertion site (not in infants < 40 weeks gestational age)
Maintenance bundle
Strict hand hygiene according to “my 5 moments”#
Hand hygiene	Hand washing when entering the unit, after using the bathroom, and when hands are visually soiled
	Hand disinfection during all other occasions
	Using gloves when risk of contact with body fluids
Catheter site care	Daily inspection of insertion site (e.g. redness, collection of fluids, swelling)
	Change transparent semi permeable dressing on indication only (e.g. loosened, collection of fluids)
Hub care	Disinfection of the hub with alcohol 70% and air dry for at least 30 seconds
	Use of a timer displayed at the bedside’s screen to secure an air dry time of at least 30 seconds
Tubing care	Replace continuous tubing sets every 96 hours, unless visually soiled of contaminated
	Daily replace tube containing lipids, medication, blood or blood products
	Remove intermitted administration sets directly after administration of medication
Daily question whether CVC still needed

^#My 5 moments adopted from the CDC [23].

CVC central venous catheter.