Central Line Insertion Care Team Checklist

Clinicians can take steps to prevent central line-associated infections. This checklist from Johns Hopkins Medicine provides critical steps that have been shown to reduce these infections. It also stresses the need to document any deviations from the checklist.

Read the print version (PDF File) of this document from The Johns Hopkins Hospital Interdisciplinary Clinical Practice Manual.

Central Line Insertion Care Team Checklist

Patient Name __________________
Hx # ________________
Unit _________________
Date/Time ____________

A minimum of 5 supervised successful procedures in both the chest and femoral sites is required (10 total). If a physician successfully performs the 5 supervised lines in one site, they are independent for that site only. A total of 3 supervised re-wires is required prior to performing a rewire independently.

Supervisor Role: 2nd-year resident and above (approved for line placement).

Assistant Role: RN, ClinTech, MD, NP, PA (responsible for completing checklist).

If there is a deviation in any of the critical steps, immediately notify the operator and stop the procedure until corrected. If a correction is required, make a check mark in the "Yes with reminder" column and note what correction was made in the comment space, if applicable. Uncorrected deviations and complications of line placement are to be reported. Contact the Attending if any item on the checklist is not adhered to or with any concerns. Please return completed form to the designated person in your area.

Before the procedure, did the operator:

During the procedure, did the operator:

After the procedure, did the operator:

Operator: ________________________

Supervisor: _______________________

Assistant: ________________________