We follow sterile procedure for insertion of both CVLs and art lines. That means the doc sets up a sterile field for all supplies, scrubs
, dons bouffant cap, mask, sterile gown and gloves, drapes the patient, uses a bucketful of Soluprep (regardless of age or weight) and applies the transparent dressing before taking down any of the drapes.
When accessing the line we create a mini sterile field with a 4x4, scrub the stopcock hub and change the dead-ender every time. Waste is 2-3 mL, depending on the line, and it's returned most of the time. Line changes are q 3 days for most infusions (nobody listens to the CDC here) except lipids and a couple others that are specified in our PPDM. Dressing changes are q 3 days unless there's gauze under it, then it's q day or as needed. We use Soluprep on everybody; we have no standardized kit so we have to collect a dressing tray, a handful of Soluprep swab sticks, a new Tegaderm IV dressing and anything else we might desire to use first. We don't use Biopatches although there are some on the central line cart. We've been told that the only lines we're EVER to put them on are femoral art lines, because "all of our CVLs are antimicrobial-impregnated and our arterial line catheters aren't".
We also don't use Interlink caps or Claves, the former because nobody bothered to inservice the staff when they were first acquired so people don't know they need to be primed before they're put on ports and there have been incidents of air in lines on ECMO patients. So we threw the baby out with the bathwater. We use MicroClaves on our ECMO circuits but not on our lines; our inpatient units and NICU, as well as the community hospitals and health centers, use them though. I haven't figured that one out yet.