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Central Line Insertion Bundle
Central Line Insertion Bundle
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Created by Qualaris Staff
Infection Prevention
Critical Access Hospital
Table of Contents
Audit Form
Audit Form
Central Line Insertion Bundle
Required
Observed Date
Unit
ED
ICU
Med-Surg
PACU
Rehab
Physician
Do not enter protected health information (PHI)
Assisted by
Nurse
Tech
Central Line Insertion Bundle Checklist
Mark all as...
Procedure prep guidelines followed?
Yes
No
N/A
During procedure, guidelines followed?
Yes
No
After procedure, guidelines followed?
Yes
No
