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Clin Infect Dis. May 1, 2011; 52(9): 1087–1099.
PMCID: PMC3106267
Summary of Recommendations: Guidelines for the Prevention of Intravascular Catheter-related Infections
Naomi P. O'Grady,corresponding author1 Mary Alexander,2 Lillian A. Burns,3 E. Patchen Dellinger,4 Jeffrey Garland,5 Stephen O. Heard,6 Pamela A. Lipsett,7 Henry Masur,1 Leonard A. Mermel,8 Michele L. Pearson,9 Issam I. Raad,10 Adrienne G. Randolph,11 Mark E. Rupp,12 Sanjay Saint,13 and the Healthcare Infection Control Practices Advisory Committee (HICPAC) (Appendix 1)
1Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland
2Infusion Nurses Society, Norwood, Massachusetts
3Staten Island University Hospital, Staten Island, New York
4Department of Surgery, University of Washington, Seattle, Washington
5Department of Pediatrics, Wheaton Franciscan Healthcare-St. Joseph, Milwaukee, Wisconsin
6Department of Anesthesiology, University of Massachusetts Medical School, Worcester, Massachusetts
7Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
8Division of Infectious Diseases, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
9Office of Infectious Diseases, CDC, Atlanta, Georgia
10Department of Infectious Diseases, MD Anderson Cancer Center, Houston, Texas
11Department of Anesthesiology, The Children's Hospital, Boston, Massachusetts
12Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
13 Department of Internal Medicine, Ann Arbor VA Medical Center and University of Michigan, Ann Arbor, Michigan
corresponding authorCorresponding author.
Correspondence: Naomi P. O'Grady, MD, Critical Care Medicine Department, National Institutes of Health, Building 10, Room 2C145, Center Drive MSC 1662 Bethesda, MD 20892 (nogrady/at/mail.cc.nih.gov).
Received January 31, 2011; Accepted February 4, 2011.
These guidelines have been developed for healthcare personnel who insert intravascular catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home healthcare settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, healthcare infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicine (SCCM), in collaboration with the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), Surgical Infection Society (SIS), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), American Society of Critical Care Anesthesiologists (ASCCA), Association for Professionals in Infection Control and Epidemiology (APIC), Infusion Nurses Society (INS), Oncology Nursing Society (ONS), American Society for Parenteral and Enteral Nutrition (ASPEN), Society of Interventional Radiology (SIR), American Academy of Pediatrics (AAP), Pediatric Infectious Diseases Society (PIDS), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) and is intended to replace the Guideline for Prevention of Intravascular Catheter-Related Infections published in 2002. These guidelines are intended to provide evidence-based recommendations for preventing intravascular catheter-related infections. Major areas of emphasis include 1) educating and training healthcare personnel who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a > 0.5% chlorhexidine skin preparation with alcohol for antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters and chlorhexidine impregnated sponge dressings if the rate of infection is not decreasing despite adherence to other strategies (i.e, education and training, maximal sterile barrier precautions, and >0.5% chlorhexidine preparations with alcohol for skin antisepsis). These guidelines also emphasize performance improvement by implementing bundled strategies, and documenting and reporting rates of compliance with all components of the bundle as benchmarks for quality assurance and performance improvement.
As in previous guidelines issued by CDC and HICPAC, each recommendation is categorized on the basis of existing scientific data, theoretical rationale, applicability, and economic impact. The system for categorizing recommendations in this guideline is as follows:
  • Category IA. Strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiologic studies.
  • Category IB. Strongly recommended for implementation and supported by some experimental, clinical, or epidemiologic studies and a strong theoretical rationale; or an accepted practice (e.g., aseptic technique) supported by limited evidence.
  • Category IC. Required by state or federal regulations, rules, or standards.
  • Category II. Suggested for implementation and supported by suggestive clinical or epidemiologic studies or a theoretical rationale.
  • Unresolved issue. Represents an unresolved issue for which evidence is insufficient or no consensus regarding efficacy exists.
In the United States, 15 million central vascular catheter (CVC) days (i.e, the total number of days of exposure to CVCs among all patients in the selected population during the selected time period) occur in intensive care units (ICUs) each year [1]. Studies have variously addressed catheter-related bloodstream infections (CRBSI). These infections independently increase hospital costs and length of stay [25], but have not generally been shown to independently increase mortality. While 80,000 CRBSIs occur in ICUs each year [1], a total of 250,000 cases of BSIs have been estimated to occur annually, if entire hospitals are assessed [6]. By several analyses, the cost of these infections is substantial, both in terms of morbidity and financial resources expended. To improve patient outcome and to reduce healthcare costs, there is considerable interest by healthcare providers, insurers, regulators, and patient advocates in reducing the incidence of these infections. This effort should be multidisciplinary, involving healthcare professionals who order the insertion and removal of CVCs, those personnel who insert and maintain intravascular catheters, infection control personnel, healthcare managers including the chief executive officer (CEO) and those who allocate resources, and patients who are capable of assisting in the care of their catheters.
The goal of an effective prevention program should be the elimination of CRBSI from all patient-care areas. Although this is challenging, programs have demonstrated success, but sustained elimination requires continued effort. The goal of the measures discussed in this document is to reduce the rate to as low as feasible given the specific patient population being served, the universal presence of microorganisms in the human environment, and the limitations of current strategies and technologies.
Education, Training and Staffing
  • Educate healthcare personnel regarding the indications for intravascular catheter use, proper procedures for the insertion and maintenance of intravascular catheters, and appropriate infection control measures to prevent intravascular catheter-related infections [715]. Category IA
  • Periodically assess knowledge of and adherence to guidelines for all personnel involved in the insertion and maintenance of intravascular catheters [715]. Category IA
  • Designate only trained personnel who demonstrate competence for the insertion and maintenance of peripheral and central intravascular catheters. [1428]. Category IA
  • Ensure appropriate nursing staff levels in ICUs Observational studies suggest that a higher proportion of “pool nurses” or an elevated patient–to-nurse ratio is associated with CRBSI in ICUs where nurses are managing patients with CVCs [2931]. Category IB
Selection of Catheters and Sites
Peripheral Catheters and Midline Catheters
  • In adults, use an upper-extremity site for catheter insertion. Replace a catheter inserted in a lower extremity site to an upper extremity site as soon as possible. Category II
  • In pediatric patients, the upper or lower extremities or the scalp (in neonates or young infants) can be used as the catheter insertion site [32, 33]. Category II
  • Select catheters on the basis of the intended purpose and duration of use, known infectious and non-infectious complications (e.g., phlebitis and infiltration), and experience of individual catheter operators [3335]. Category IB
  • Avoid the use of steel needles for the administration of fluids and medication that might cause tissue necrosis if extravasation occurs [33, 34]. Category IA
  • Use a midline catheter or peripherally inserted central catheter (PICC), instead of a short peripheral catheter, when the duration of IV therapy will likely exceed six days. Category II
  • Evaluate the catheter insertion site daily by palpation through the dressing to discern tenderness and by inspection if a transparent dressing is in use. Gauze and opaque dressings should not be removed if the patient has no clinical signs of infection. If the patient has local tenderness or other signs of possible CRBSI, an opaque dressing should be removed and the site inspected visually. Category II
  • Remove peripheral venous catheters if the patients develops signs of phlebitis (warmth, tenderness, erythema or palpable venous cord), infection, or a malfunctioning catheter [36]. Category IB
Central Venous Catheters.
  • Weigh the risks and benefits of placing a central venous device at a recommended site to reduce infectious complications against the risk for mechanical complications (e.g., pneumothorax, subclavian artery puncture, subclavian vein laceration, subclavian vein stenosis, hemothorax, thrombosis, air embolism, and catheter misplacement) [3753]. Category IA
  • Avoid using the femoral vein for central venous access in adult patients [38, 50, 51, 54]. Category 1A
  • Use a subclavian site, rather than a jugular or a femoral site, in adult patients to minimize infection risk for nontunneled CVC placement [5052]. Category IB
  • No recommendation can be made for a preferred site of insertion to minimize infection risk for a tunneled CVC. Unresolved issue
  • Avoid the subclavian site in hemodialysis patients and patients with advanced kidney disease, to avoid subclavian vein stenosis [53,5558]. Category IA
  • Use a fistula or graft in patients with chronic renal failure instead of a CVC for permanent access for dialysis [59]. Category 1A
  • Use ultrasound guidance to place central venous catheters (if this technology is available) to reduce the number of cannulation attempts and mechanical complications. Ultrasound guidance should only be used by those fully trained in its technique. [6064]. Category 1B
  • Use a CVC with the minimum number of ports or lumens essential for the management of the patient [6568]. Category IB
  • No recommendation can be made regarding the use of a designated lumen for parenteral nutrition. Unresolved issue
  • Promptly remove any intravascular catheter that is no longer essential [6972]. Category IA
  • When adherence to aseptic technique cannot be ensured (i.e catheters inserted during a medical emergency), replace the catheter as soon as possible, i.e, within 48 hours [37,7376]. Category IB
Hand Hygiene and Aseptic Technique
  • Perform hand hygiene procedures, either by washing hands with conventional soap and water or with alcohol-based hand rubs (ABHR). Hand hygiene should be performed before and after palpating catheter insertion sites as well as before and after inserting, replacing, accessing, repairing, or dressing an intravascular catheter. Palpation of the insertion site should not be performed after the application of antiseptic, unless aseptic technique is maintained [12,7779]. Category IB
  • Maintain aseptic technique for the insertion and care of intravascular catheters [37, 73, 74, 76]. Category IB
  • Wear clean gloves, rather than sterile gloves, for the insertion of peripheral intravascular catheters, if the access site is not touched after the application of skin antiseptics. Category IC
  • Sterile gloves should be worn for the insertion of arterial, central, and midline catheters [37, 73, 74, 76]. Category IA
  • Use new sterile gloves before handling the new catheter when guidewire exchanges are performed. Category II
  • Wear either clean or sterile gloves when changing the dressing on intravascular catheters. Category IC
Maximal Sterile Barrier Precautions
  • Use maximal sterile barrier precautions, including the use of a cap, mask, sterile gown, sterile gloves, and a sterile full body drape, for the insertion of CVCs, PICCs, or guidewire exchange [14, 75, 76, 80]. Category IB
  • Use a sterile sleeve to protect pulmonary artery catheters during insertion [81]. Category IB
Skin Preparation
  • Prepare clean skin with an antiseptic (70% alcohol, tincture of iodine, an iodophor or chlorhexidine gluconate) before peripheral venous catheter insertion [83]. Category IB
  • Prepare clean skin with a >0.5% chlorhexidine preparation with alcohol before central venous catheter and peripheral arterial catheter insertion and during dressing changes. If there is a contraindication to chlorhexidine, tincture of iodine, an iodophor, or 70% alcohol can be used as alternatives [83, 84]. Category IA
  • No comparison has been made between using chlorhexidine preparations with alcohol and povidone-iodine in alcohol to prepare clean skin. Unresolved issue.
  • No recommendation can be made for the safety or efficacy of chlorhexidine in infants aged <2 months. Unresolved issue
  • Antiseptics should be allowed to dry according to the manufacturer's recommendation prior to placing the catheter [83, 84]. Category IB
Catheter Site Dressing Regimens
  • Use either sterile gauze or sterile, transparent, semi-permeable dressing to cover the catheter site [8588]. Category IA
  • If the patient is diaphoretic or if the site is bleeding or oozing, use gauze dressing until this is resolved [8588]. Category II
  • Replace catheter site dressing if the dressing becomes damp, loosened, or visibly soiled [84, 85]. Category IB
  • Do not use topical antibiotic ointment or creams on insertion sites, except for dialysis catheters, because of their potential to promote fungal infections and antimicrobial resistance [89, 90]. Category IB
  • Do not submerge the catheter or catheter site in water. Showering should be permitted if precautions can be taken to reduce the likelihood of introducing organisms into the catheter (e.g., if the catheter and connecting device are protected with an impermeable cover during the shower) [9193]. Category IB
  • Replace dressings used on short-term CVC sites every 2 days for gauze dressings. Category II
  • Replace dressings used on short-term CVC sites at least every 7 days for transparent dressings, except in those pediatric patients in which the risk for dislodging the catheter may outweigh the benefit of changing the dressing [88, 94]. Category IB
  • Replace transparent dressings used on tunneled or implanted CVC sites no more than once per week (unless the dressing is soiled or loose), until the insertion site has healed. Category II
  • No recommendation can be made regarding the necessity for any dressing on well-healed exit sites of long-term cuffed and tunneled CVCs. Unresolved issue
  • Ensure that catheter site care is compatible with the catheter material [95, 96]. Category IB
  • Use a sterile sleeve for all pulmonary artery catheters [81]. Category IB
  • Use a chlorhexidine-impregnated sponge dressing for temporary short-term catheters in patients older than 2 months of age if the CLABSI rate is not decreasing despite adherence to basic prevention measures, including education and training, appropriate use of chlorhexidine for skin antisepsis, and MSB [94, 9799]. Category 1B
  • No recommendation is made for other types of chlorhexidine dressings. Unresolved issue
  • Monitor the catheter sites visually when changing the dressing or by palpation through an intact dressing on a regular basis, depending on the clinical situation of the individual patient. If patients have tenderness at the insertion site, fever without obvious source, or other manifestations suggesting local or bloodstream infection, the dressing should be removed to allow thorough examination of the site [100102]. Category IB
  • Encourage patients to report any changes in their catheter site or any new discomfort to their provider. Category II
Patient Cleansing
Use a 2% chlorhexidine wash for daily skin cleansing to reduce CRBSI [103105]. Category II
Catheter Securement Devices
Use a sutureless securement device to reduce the risk of infection for intravascular catheters [106]. Category II
Antimicrobial/Antiseptic Impregnated Catheters and Cuffs
Use a chlorhexidine/silver sulfadiazine or minocycline/rifampin -impregnated CVC in patients whose catheter is expected to remain in place >5 days if, after successful implementation of a comprehensive strategy to reduce rates of CLABSI, the CLABSI rate is not decreasing. The comprehensive strategy should include at least the following three components: educating persons who insert and maintain catheters, use of maximal sterile barrier precautions, and a >0.5% chlorhexidine preparation with alcohol for skin antisepsis during CVC insertion [107114]. Category IA
Systemic Antibiotic Prophylaxis
Do not administer systemic antimicrobial prophylaxis routinely before insertion or during use of an intravascular catheter to prevent catheter colonization or CRBSI [115]. Category IB
Antibiotic/Antiseptic Ointments
Use povidone iodine antiseptic ointment or bacitracin/gramicidin/polymyxin B ointment at the hemodialysis catheter exit site after catheter insertion and at the end of each dialysis session only if this ointment does not interact with the material of the hemodialysis catheter per manufacturer's recommendation [59, 115119]. Category IB
Antibiotic Lock Prophylaxis, Antimicrobial Catheter Flush and Catheter Lock Prophylaxis
Use prophylactic antimicrobial lock solution in patients with long term catheters who have a history of multiple CRBSI despite optimal maximal adherence to aseptic technique [120138]. Category II
Anticoagulants
Do not routinely use anticoagulant therapy to reduce the risk of catheter-related infection in general patient populations [139]. Category II
Replacement of Peripheral and Midline Catheters
  • There is no need to replace peripheral catheters more frequently than every 72-96 hours to reduce risk of infection and phlebitis in adults [36, 140, 141]. Category 1B
  • No recommendation is made regarding replacement of peripheral catheters in adults only when clinically indicated [142144]. Unresolved issue
  • Replace peripheral catheters in children only when clinically indicated [32, 33]. Category 1B
  • Replace midline catheters only when there is a specific indication. Category II
Replacement of CVCs, Including PICCs and Hemodialysis Catheters
  • Do not routinely replace CVCs, PICCs, hemodialysis catheters, or pulmonary artery catheters to prevent catheter-related infections. Category IB
  • Do not remove CVCs or PICCs on the basis of fever alone. Use clinical judgment regarding the appropriateness of removing the catheter if infection is evidenced elsewhere or if a noninfectious cause of fever is suspected. Category II
  • Do not use guidewire exchanges routinely for non-tunneled catheters to prevent infection. Category IB
  • Do not use guidewire exchanges to replace a non-tunneled catheter suspected of infection. Category IB
  • Use a guidewire exchange to replace a malfunctioning non-tunneled catheter if no evidence of infection is present. Category IB
  • Use new sterile gloves before handling the new catheter when guidewire exchanges are performed. Category II
Umbilical Catheters
  • Remove and do not replace umbilical artery catheters if any signs of CRBSI, vascular insufficiency in the lower extremeties, or thrombosis are present [145]. Category II
  • Remove and do not replace umbilical venous catheters if any signs of CRBSI or thrombosis are present [145]. Category II
  • No recommendation can be made regarding attempts to salvage an umbilical catheter by administering antibiotic treatment through the catheter. Unresolved issue
  • Cleanse the umbilical insertion site with an antiseptic before catheter insertion. Avoid tincture of iodine because of the potential effect on the neonatal thyroid. Other iodine-containing products (e.g., povidone iodine) can be used [146150]. Category IB
  • Do not use topical antibiotic ointment or creams on umbilical catheter insertion sites because of the potential to promote fungal infections and antimicrobial resistance [89, 90]. Category IA
  • Add low-doses of heparin (0.25–1.0 U/ml) to the fluid infused through umbilical arterial catheters [151153]. Category IB
  • Remove umbilical catheters as soon as possible when no longer needed or when any sign of vascular insufficiency to the lower extremities is observed. Optimally, umbilical artery catheters should not be left in place >5 days [145, 154]. Category II
  • Umbilical venous catheters should be removed as soon as possible when no longer needed, but can be used up to 14 days if managed aseptically [155, 156]. Category II
  • An umbilical catheter may be replaced if it is malfunctioning, and there is no other indication for catheter removal, and the total duration of catheterization has not exceeded 5 days for an umbilical artery catheter or 14 days for an umbilical vein catheter. Category II
Peripheral Arterial Catheters and Pressure Monitoring Devices for Adult and Pediatric Patients
  • In adults, use of the radial, brachial or dorsalis pedis sites is preferred over the femoral or axillary sites of insertion to reduce the risk of infection [46, 47, 157, 158]. Category IB
  • In children, the brachial site should not be used. The vradial, dorsalis pedis, and posterior tibial sites are preferred over the femoral or axillary sites of insertion [46]. Category II
  • A minimum of a cap, mask, sterile gloves and a small sterile fenestrated drape should be used during peripheral arterial catheter insertion [47, 158, 159]. Category IB
  • During axillary or femoral artery catheter insertion, maximal sterile barriers precautions should be used. Category II
  • Replace arterial catheters only when there is a clinical indication. Category II
  • Remove the arterial catheter as soon as it is no longer needed. Category II
  • Use disposable, rather than reusable, transducer assemblies when possible [160164]. Category IB
  • Do not routinely replace arterial catheters to prevent catheter-related infections [165, 166, 167, 168]. Category II
  • Replace disposable or reusable transducers at 96-hour intervals. Replace other components of the system (including the tubing, continuous-flush device, and flush solution) at the time the transducer is replaced [37, 161]. Category IB
  • Keep all components of the pressure monitoring system (including calibration devices and flush solution) sterile [160, 169171]. Category IA
  • Minimize the number of manipulations of and entries into the pressure monitoring system. Use a closed flush system (i.e, continuous flush), rather than an open system (i.e, one that requires a syringe and stopcock), to maintain the patency of the pressure monitoring catheters [163, 172]. Category II
  • When the pressure monitoring system is accessed through a diaphragm, rather than a stopcock, scrub the diaphragm with an appropriate antiseptic before accessing the system [163]. Category IA
  • Do not administer dextrose-containing solutions or parenteral nutrition fluids through the pressure monitoring circuit [163, 173, 174]. Category IA
  • Sterilize reusable transducers according to the manufacturers' instructions if the use of disposable transducers is not feasible [163, 173176]. Category IA
Replacement of Administration Sets
  • In patients not receiving blood, blood products or fat emulsions, replace administration sets that are continuously used, including secondary sets and add-on devices, no more frequently than at 96-hour intervals, [177] but at least every 7 days [178181]. Category IA
  • No recommendation can be made regarding the frequency for replacing intermittently used administration sets.Unresolved issue
  • No recommendation can be made regarding the frequency for replacing needles to access implantable ports. Unresolved issue
  • Replace tubing used to administer blood, blood products, or fat emulsions (those combined with amino acids and glucose in a 3-in-1 admixture or infused separately) within 24 hours of initiating the infusion [182185]. Category IB
  • Replace tubing used to administer propofol infusions every 6 or 12 hours, when the vial is changed, per the manufacturer's recommendation (FDA website Medwatch) [186]. Category IA
  • No recommendation can be made regarding the length of time a needle used to access implanted ports can remain in place. Unresolved issue
Needleless Intravascular Catheter Systems
  • Change the needleless components at least as frequently as the administration set. There is no benefit to changing these more frequently than every 72 hours. [39, 187193]. Category II
  • Change needleless connectors no more frequently than every 72 hours or according to manufacturers' recommendations for the purpose of reducing infection rates [187, 189, 192, 193]. Category II
  • Ensure that all components of the system are compatible to minimize leaks and breaks in the system [194]. Category II
  • Minimize contamination risk by scrubbing the access port with an appropriate antiseptic (chlorhexidine, povidone iodine, an iodophor, or 70% alcohol) and accessing the port only with sterile devices [189, 192, 194196]. Category IA
  • Use a needleless system to access IV tubing. Category IC
  • When needleless systems are used, a split septum valve may be preferred over some mechanical valves due to increased risk of infection with the mechanical valves [197200]. Category II
Performance Improvement
Use hospital-specific or collaborative-based performance improvement initiatives in which multifaceted strategies are “bundled” together to improve compliance with evidence-based recommended practices [15, 69, 70, 201205]. Category IB
Acknowledgments
Notice to Readers. In 2009, the Centers for Disease Control and Prevention (CDC) and Healthcare Infection Control Practices Advisory Committee (HICPAC) integrated current advances in guideline production and implementation into its development process (http://www.cdc.gov/hicpac/guidelineMethod/guidelineMethod. html). The new methodology enables CDC and HICPAC to improve the validity and usability of its guidelines while also addressing emerging challenges in guideline development in the area of infection prevention and control. However, the Guidelines for the Prevention of Intravascular Catheter-Related Infections were initiated before the methodology was revised. Therefore, this guideline reflects the development methods that were used for guidelines produced prior to 2009. Future revisions will be performed using the updated methodology.
Financial support.E.P.D. Grant support through the NIH.
Potential conflicts of interest. N.P.O.'G. served as a board member for the ABIM Subspecialty Board for Critical Care Medicine. M.A. is an employee of the Infusion Nurses Society, Honoraria from 3M, Becton Dickinson, Smiths Medical. L.A.B. is a consultant for Institute of Healthcare Improvement, Board membership for Theradoc, Medline. Honoraria from APIC, Clorox. E.P.D. consulting from Merck, Baxter, Ortho-McNeil, Targanta, Schering-Plough, Optimer, Cadence, Cardinal, BDGeneOhm, WebEx, Cerebrio, and Tyco. Grant support through the NIH. Payment for lecture from Merck. Payment for development of educational presentation from Medscape. Travel and meeting expenses paid for by ASHP, IDSA, ASM, American College of Surgeons, NQF, SHEA/CDC, HHS, Trauma Shock Inflammation and Sepsis Meeting (Munich), University of Minnesota. J.G. Honoria from Ethicon. S.O.H. provides research support from Angiotech; Honoraria from Angiotech, Merck. L.A.M provides research support from Astellas, Theravance, Pfizer; Consulting for Ash Access, Cadence, CorMedix, Catheter Connections, Carefusion, Sage, Bard, Teleflex; Payment for manuscript preparation from Catheter Connections. I.I.R. provides research support from Cubist, Enzon, and Basilea;Consulting for Clorox; Stock Equity or Options in Great Lakes Pharmaceuticalsand Inventive Protocol; Speakers Bureau for Cook, Inc.; Royalty income (patents owned by MD Anderson on which Dr. Raad in an inventor: American Medical Systems, Cook, Inc., Cook urological, Teleflex, TyRx, Medtronic, Biomet, Great Lakes Pharmaceuticals. A.R. consulting income from Eisai Pharmaceuticals, Discovery Laboratories. M.E.R. provides research support from Molnlycke, Cardinal Healthcare Foundation, Sanofi-Pasteur, 3M, and Cubist; Consulting from Semprus; Honorarium for lectures from 3M, Carefusion, Baxter and Becton Dickinson. Previously served on Board of Directors for Society for Healthcare Epidemiology of America. All other authors: no conflicts.
Healthcare Infection Control Practices Advisory Committee (HICPAC)
Chairman
BRENNAN, Patrick J., MD
Chief Medical Officer
Division of Infectious Diseases
University of Pennsylvania Health System
Membership
BRATZLER, Dale, DO, MPH
President and CEO
Oklahoma Foundation for Medical Quality
BURNS, Lillian A., MT, MPH
Infection Control Coordinator
Greenwich Hospital, Infectious Diseases Department
ELWARD, Alexis, MD
Assistant Professor, Pediatrics Infectious Diseases
Washington University School of Medicine
Department of Pediatrics
Division of Infectious Diseases
HUANG, Susan, MD, MPH
Assistant Professor, Medical Director, Epidemiology and Infection Prevention
Division of Infectious Diseases, UC Irvine School of Medicine
LUNDSTROM, Tammy, MD, JDChief Medical OfficerProvidence Hospital
MCCARTER, Yvette S., PhD Director, Clinical Microbiology Laboratory
Department of Pathology
University of Florida Health Science Center
MURPHY, Denise M. RN, MPH, CIC
Vice President, Quality and Patient Safety
Main Line Health System
Executive Secretary
BELL, Michael R., MD
Deputy Director
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
OSTROFF, Stephen, MD
Director, Bureau of Epidemiology
Pennsylvania Department of Health
OLMSTED, Russell N., MPH, CIC
Epidemiologist
Infection Control Services
St. Joseph Mercy Health System
PEGUES, David Alexander, MD
Professor of Medicine, Hospital Epidemiologist
David Geffen School of Medicine at UCLA
PRONOVOST, Peter J., MD, PhD, FCCM
Director, Johns Hopkins Quality and Safety Research Group
Johns Hopkins Quality and Safety Research Group
SOULE, Barbara M., RN, MPA, CIC
Practice Leader
Infection Prevention and Control Services
Joint Commission Resources/Joint Commission International
SCHECTER, William, P., MD
Professor of Surgery
Department of Surgery
San Francisco General Hospital
Ex-officio Members
Agency for Healthcare Research and Quality (AHRQ)
BAINE, William B., MD
Senior Medical Advisor
Center for Outcomes and Evidence
Center for Medicare & Medicaid Services (CMS)
MILLER, Jeannie, RN, MPH
Deputy Director, Office of Clinical Standards and Quality
Food and Drug Administration (FDA)
MURPHEY, Sheila A., MD Branch Chief, Infection Control Devices
Division of Anesthesiology, General Hospital Infection Control Dental Devices
Center for Devices and Radiology Health
Liaisons
Advisory Council for the Elimination of Tuberculosis (ACET)
STRICOF, Rachel L., MPH
New York State Department of Health
American College of Occupational and Environmental Medicine
RUSSI, Mark, MD, MPH
Professor of Medicine
Yale University School of Medicine
Director, Occupational Health
Yale-New Haven Hospital
American Health Care Assn (AHCA)
FITZLER, Sandra L., RN
Senior Director of Clinical Services
American Hospital Association (AHA)
SCHULMAN, Roslyne, MHA, MBA
Director, Policy Development
Association of Professionals of InfectionControl and Epidemiology, Inc. (APIC)
DeBAUN, Barbara, MSN, RN, CIC
Association of periOperative Registered Nursed (AORN)
BLANCHARD, Joan C., RN, BSN
Council of State and Territorial Epidemiologists (CSTE)
KAINER, Marion MD, MPH
Director, Hospital Infections and Antimicrobial Resistance ProgramTennessee Department Health
National Institute of Health (NIH)
HENDERSON, David, MD
Deputy Director for Clinical Care
Associate Director for Hospital Epidemiology and Quality Improvement NIH Clinical Center
Department of Veterans Affairs (VA)
ROSELLE, Gary A., MD
National Program Director, Infectious Diseases
VA Central Office
Cincinnati VA Medical Center
Consumers Union
MCGIFFERT, Lisa
Senior Policy Analyst on Health Issues
Project Director Stop Hospital Infections Organization
Infectious Disease Society of America (IDSA)
Huskins, W. Charles MD, MSc Division of Pediatric Infectious Diseases
Assistant Professor of Pediatrics Mayo Clinic
Public Health Agency of Canada
PATON, Shirley, RN, MN
Senior Advisor Healthcare Acquired Infections
Center for Communicable Diseases and Infection Control
Society for Healthcare Epidemiology of America (SHEA)
MARAGAKIS, Lisa, MDAssistant Professor of Medicine John Hopkins Medical Institutions
Society of Hospital Medicine
Saint, Sanjay, MD, MPH Director, Ann Arbor VA Medical Center/University of Michigan Patient Safety Enhancement Program
The Joint Commission
WISE, Robert A., MD
Vice President
Division of Standards & Survey Methods
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