1) | Catheters are inserted by 1 resident physician, who uses maximal barrier precautions, |
2) | Single-lumen catheters only are used, |
3) | The catheters are inserted in the subclavian site, |
4) | The insertion sites are checked daily, |
5) | TPN solution only is delivered through the catheter (to minimise hub manipulation), and |
6) | Whenever a patient is transferred from another institution, blood samples are obtained through any indwelling catheters and are cultured; the cultures must be negative for pathogens before TPN therapy is started. |