Preventing Central Line Infections

Children with a central line are at risk for developing a specific type of infection called a central line-associated bloodstream infection, also known as "CLABSI." Even if your child is receiving antibiotics, they are still at risk for CLABSI. Your child’s central line is a very important part of their treatment, and it requires specific care. Patients, family members, visitors and staff should follow these steps to prevent an infection.

Instructions for preventing infection: Hand hygiene

We ask both staff and families to follow these guidelines. Use soap and water to wash your hands: 

• If hands are visibly soiled.

• After coming in contact with stool or vomit.

• Before and after eating.

• After using the bathroom.

• After handling hazardous medicines.

• Before touching your child’s central line or supplies.

Instructions: 

• Turn on the water and wet your hands and wrists.

• Use liquid soap from a pump dispenser to scrub your hands for at least 15 seconds, making sure to cover all surfaces.

• Rinse your hands

• Dry your hands with a clean paper towel. Use this paper towel to turn off the faucet.

Alcohol-based hand sanitizer is preferred at other times as a quick and effective method for cleaning hands when used appropriately.

• Use enough sanitizer to be able to rub your hands together for at least 15 seconds, covering all surfaces.

• Allow the hand sanitizer to dry completely.

Instructions for preventing infection: Daily hygiene

Each day in the hospital, your child must:

1. Complete daily bathing treatments.

   • Make sure your room is cleaned by Environmental Services every day.

   • Newborns (born at 37 weeks or after) and older infants: use CHG wipes every 24 hours.

   • Older children: use CHG foam every 24 hours.

   • CHG (chlorhexidine gluconate) is a hospital-grade cleanser that removes more bacteria than regular soap.

   • If your child also has a soap-and-water bath or shower, do it right before the CHG treatment.

2. Wear clean clothing or gown.

   • Change daily or anytime clothing becomes dirty.

   • Babies may wear only a diaper.

3. Change bed linens with the bath every day. This includes washing blankets, pillows, and stuffed animals from home if your unit permits them.

4. Perform mouth care twice a day.

   • Children with teeth: brush with toothbrush and toothpaste.

   • Babies without teeth: wipe gums with a soft, clean cloth.

   • Some children may need extra mouth care using special solutions.

   • Mouth care is important even if your child isn’t eating.

Instructions for preventing infection: Central line protection

• Try to prevent the line and tubing from dragging on the ground.

• Don't pull on the central line tubing.

• Secure the line to prevent your child from chewing on or playing with it.

• Keep the central line and tubing away from food, drinks, diapers, urinals, G tubes or ostomies.

  • Learn more about AquaGuard to protect central line caps and IV tubing or to protect the dressing.

  • Learn more about ValGuard to protect central line caps and IV tubing.

• Never disconnect the IV tubing.

• Never reconnect IV tubing or caps that have disconnected. Call your child’s nurse right away if you see this.

• Don't touch the central line dressing. Inform the nurse if the dressing is loose, dirty, or wet.

• Partner with nursing to distract or hug your child so the central line can be safely cared for. Child Life is also a great resource.

Steps the care team takes to protect the central line

• Clean hands prior to touching the central line. There will be times when staff are required to wear gloves when touching the line, but for most care clean hands are preferred over gloves.

• Scrub central line connections for 15 seconds and let the dry for 15 seconds with each entry.

• Clean the patient's skin with an antibacterial solution for 30 seconds during a dressing change or port access.

• Make sure that everyone near the patient wears a mask during a dressing change, cap change, or port access.

• Make sure that the patient has a CHG treatment, linen, and clothing change every 24 hours, all at the same time.

• Make sure that daily mouth care has been completed.

• Remove the central line when it is no longer needed.

• Environmental Services will clean your child’s room every day to help prevent infection. If the room has not been cleaned, please tell your child’s care team and they will speak to a supervisor.

  • We can work together to keep the room uncluttered so that it can be cleaned.

  • For patients in the NICU: Do not bring in items like stuffed animals or decorations that can get dusty and increase the risk of infection.

If your child goes home with a central line, your team will: 

• Provide education about preventing infection to caregivers who will access the central line or monitor the dressing or infusions at home. Ask about education early so you have time to practice skills before going home.

• Continue infection prevention steps listed above once home. One difference is that CHG treatments are not routinely done at home. Good hygiene practices at home are still important though. This includes keeping skin and hair clean without getting the central line or tubing wet. Practice using AquaGuard with your bedside nurse before going home.

If your child gets a central line infection (CLABSI)

Everyone at CHOP works to keep central lines safe and prevent infection.

If your child develops a CLABSI, the care team may talk with you about how to lower the risk of future infections. This may include changes to care at home or in the hospital.

Don't be afraid to speak up! It is ok to ask your healthcare team questions.

Reviewed May 2025 by Jean Abraitis, BSN, RN, Maureen Baylis, MSN, RN, Katy Murtaugh, BSN, RN, Lauren Le Goff, MS, CIC, Samantha Steich, BSN, RN, Melanie Brandan MSN, RN, VA-BC, Megan Lynch, MSN, RN