# A nurse is implementing the IHI central-line-associated bloodstream infection (CLABSI) prevention bundle for a patient with a triple-lumen subclavian central venous catheter. From the actions below, select the FIVE that are evidence-based components of the CLABSI prevention bundle.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=373865&lang=en  
> language: en  
> subject: Safety and Infection Prevention and Control  
> category: SIPC

## Question

A nurse is implementing the IHI central-line-associated bloodstream infection (CLABSI) prevention bundle for a patient with a triple-lumen subclavian central venous catheter. From the actions below, select the FIVE that are evidence-based components of the CLABSI prevention bundle.

1Hand hygiene before insertion and before any line manipulation, including hub access.
2Maximal sterile barrier precautions during insertion (cap, mask, sterile gown, sterile gloves, full-body sterile drape).
3Chlorhexidine ≥ 0.5% in alcohol skin antisepsis at insertion site (allow to fully dry before puncture).
4Daily review of line necessity and prompt removal when no longer needed.
5Optimal site selection (subclavian preferred over femoral when possible) and aseptic technique during insertion.
6Routine scheduled line replacement every 5 days regardless of clinical condition.
7Povidone-iodine skin antisepsis at the insertion site as the preferred agent.
8Application of antibiotic ointment to the insertion site at every dressing change.
9Routine prophylactic systemic antibiotics for all patients with central lines.

## Explanation

The IHI central-line bundle includes: hand hygiene, maximal sterile barriers at insertion, chlorhexidine ≥ 0.5% skin antisepsis, daily review of line necessity (and prompt removal), and optimal site selection (subclavian or jugular preferred over femoral). The four extras (routine line change every 5 days, povidone-iodine antisepsis, antibiotic ointment to insertion site, and routine prophylactic antibiotics) are NOT recommended — daily review and prompt removal is the bundle component, not scheduled changes; CHG-alcohol is preferred over povidone for routine antisepsis; antibiotic ointment is no longer recommended for non-tunneled lines; and prophylactic antibiotics increase resistance without reducing CLABSI.

## In-depth explanation

The CLABSI bundle is the most-cited example of a "checklist saves lives" intervention — Pronovost's Michigan ICU study reduced CLABSI rates by ~66%. Memorize: hand hygiene, max barriers, CHG, daily review, site selection. "Scrub the hub" before each access is also part of maintenance.

## Clinical scenario

**ICU patient with a triple-lumen subclavian central venous catheter**. The unit follows the **IHI central-line bundle** for CLABSI prevention with daily compliance audits and CLABSI surveillance.

## Key concepts

- **CLABSI bundle** — Evidence-based prevention bundle for central-line-associated bloodstream infection.
- **Maximal sterile barrier** — Cap, mask, sterile gown, sterile gloves, and full-body sterile drape during line insertion.
- **Daily line review** — Daily assessment of necessity and prompt removal of unneeded central lines reduces dwell-time CLABSI risk.

## Related questions

- [A patient on day 8 of induction chemotherapy for acute myeloid leukemia has an absolute ne…](https://mymerci.kr/pages/nclex_q.php?qn_id=372846&lang=en)
- [A patient is admitted with a urine culture positive for Klebsiella pneumoniae carbapenemas…](https://mymerci.kr/pages/nclex_q.php?qn_id=373257&lang=en)
- [A perioperative nurse is implementing the surgical site infection (SSI) prevention bundle …](https://mymerci.kr/pages/nclex_q.php?qn_id=374199&lang=en)
- [A nurse is administering doxorubicin (a vesicant chemotherapy agent) through a peripheral …](https://mymerci.kr/pages/nclex_q.php?qn_id=374920&lang=en)
- [A patient is admitted with confirmed Clostridioides difficile (C. diff) infection — profus…](https://mymerci.kr/pages/nclex_q.php?qn_id=374937&lang=en)
- [A home health nurse visiting a 78-year-old with dementia notices unexplained bruises in va…](https://mymerci.kr/pages/nclex_q.php?qn_id=374965&lang=en)
- [A client admitted 18 hours after the last alcohol drink has tremor, diaphoresis, BP 168/96…](https://mymerci.kr/pages/nclex_q.php?qn_id=374984&lang=en)
- [An 8-year-old with severe hemophilia A presents with painful right knee swelling after a f…](https://mymerci.kr/pages/nclex_q.php?qn_id=375013&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=373865&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=373865&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=373865&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=373865&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=373865&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._