Table 5 Prevention plan as proposed by Dimick et al. 2003

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.