NHSN Logo Central-line Insertion Practices (CLIP)

Patient Ned Nuclear
Date of birth July 14, 2014 Sex Male
Race White Ethnicity Not Hispanic or Latino
Contact info address not available
Telecom information not available
Patient IDs 12345 (2.16.840.1.113883.19.5)
Document Id 20202201 (2.16.840.1.113883.3.117.1.1.5.2.1.1.2)
Document Created August 15, 2014
Author anAuthorID (2.16.840.1.113883.3.117.1.1.5.1.1.2)
Encounter Date  From ,
Encounter Location 9W (2.16.840.1.113883.3.117.1.1.5.1.1) (Medical/Surgical Critical Care)
Document maintained by 2.16.840.1.114222.4.3.2.11
Legal authenticator aLegalAuthenticatorID (2.16.840.1.113883.3.117.1.1.5.1.1.2)
signed date/time: August 16, 2014

Table of Contents


Procedure Details

Type of procedure Central-line Insertion
Procedure date August 15, 2014
Procedure site Femoral vein structure (body structure)
Role of performer Physician assistant
Catheter type Non-tunneled (dialysis)
Recorder was performer Yes
Inserter was a member of PICC/IV Team Yes
Reason for procedure To address a new indication for a central line

Risk Factors

  1. Preparation
    Hand hygiene Yes
    Skin preparation solutions Alcohol: Yes
    povidone-iodine: No
    chlorhexidine gluconate: No (contraindicated)
    Contraindication type Patient has a documented/known allergy/reaction to chlorhexidine gluconate-based products that would preclude its use
    Contraindication type Facility restrictions or safety concerns for chlorhexidine gluconate use in premature infants precludes its use
    Use of Sterile Technique Mask
    Large sterile drape
  2. Solutions Dried
    Solution(s) had dried Yes
Antimicrobial coated catheter used Yes

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