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December 3, 2003

Internists' Adherence to Guidelines for Prevention of Intravascular Catheter Infections

JAMA. 2003;290(21):2802. doi:10.1001/jama.290.21.2802

To the Editors: Catheter-related bloodstream infections associated with the use of central venous catheters (CVCs) are a major source of morbidity in US intensive care units,1 accounting for approximately 80 000 infections annually. To prevent catheter-related bloodstream infections, national evidence-based guidelines published in 1996 recommended maximal barrier precautions (MBPs) (ie, mask, sterile gloves, gown, and large sterile drape) and skin antisepsis during CVC insertion.2 In 2001, the Agency for Healthcare Research and Quality supported an evidence-based review of best hospital safety practices, listing MBPs among the highest priorities.3 The 2002 update of national guidelines prioritized MBP use and skin antisepsis with 2% chlorhexidine gluconate (CHG),4 but physician adherence to recommendations supporting use of MBPs and CHG remains unknown.

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