Does your facility train all healthcare personnel who are given the responsibility to insert, assist with insertion, or maintain central venous catheters (“central lines”) on: Yes ☐ No ☐ Unk 9. Proper aseptic technique for central line insertion? Yes ☐ No ☐ Unk 10. Ultrasound guidance for central line insertion? Not Applicable Yes ☐ No ☐ Unk 11. Proper central line maintenance procedures? Yes ☐ No ☐ Unk 12. Proper technique for access of implanted ports? I. General Infrastructure, Capacity, and Processes, Response Comments (and/or “As Evidenced Continued By”) Does your facility conduct competency assessments* of all healthcare personnel who are given the responsibility to insert, assist with insertion, or maintain central venous catheters (“central lines”) on: * Competency assessment is defined as a process of ensuring that healthcare personnel demonstrate the skills and knowledge to perform a procedure properly and according to facility standards and policies. This may be done through direct observation by trained observers of personnel performing a simulated procedure on a mannequin or an actual procedure on a patient. Proper aseptic technique for central line Yes ☐ No ☐ Unk insertion: Yes ☐ No ☐ Unk Upon hire/during orientation? Yes ☐ No ☐ Unk At least annually? Whenever there is a change in supplies used during insertion? Ultrasound guidance for central line insertion: Not Applicable Upon hire/during orientation? Yes ☐ No ☐ Unk At least annually? Yes ☐ No ☐ Unk
Does your facility train all healthcare personnel who are given the responsibility to insert, assist with insertion, or maintain central venous catheters (“central lines”) on: 9. Proper aseptic technique for central line insertion? Yes ☐ No ☐ Unk 10. Ultrasound guidance for central line insertion? Yes ☐ No ☐ Unk Not Applicable 11. Proper central line maintenance procedures? Yes ☐ No ☐ Unk 12. Proper technique for access of implanted ports? Yes ☐ No ☐ Unk I. General Infrastructure, Capacity, and Processes, Continued Response Comments (and/or “As Evidenced By”) Does your facility conduct competency assessments* of all healthcare personnel who are given the responsibility to insert, assist with insertion, or maintain central venous catheters (“central lines”) on: * Competency assessment is defined as a process of ensuring that healthcare personnel demonstrate the skills and knowledge to perform a procedure properly and according to facility standards and policies. This may be done through direct observation by trained observers of personnel performing a simulated procedure on a mannequin or an actual procedure on a patient. Proper aseptic technique for central line insertion: Upon hire/during orientation? At least annually? Whenever there is a change in supplies used during insertion? Yes ☐ No ☐ Unk Yes ☐ No ☐ Unk Yes ☐ No ☐ Unk Ultrasound guidance for central line insertion: Upon hire/during orientation? At least annually? Yes ☐ No ☐ Unk Yes ☐ No ☐ Unk Not Applicable
TAP-CLABSI-Facility-Assessment-Tool_Final.docx