The importance of extraluminal and intraluminal sources of infection cannot be underestimated. As early as the first half of the 1970’s Maki et al suggested that the “manipulation of virtually every component of the intravenous delivery system may result in contamination of the system” (Maki, Goldmann, and Rhame 1973). By the mid 1980‘s authors began to focus upon the impact of both intraluminal and site contamination as a main contribution to line infection (Cheesbrough, Finch and Burden 1986). More recently, a review by Mermel (2011) demonstrated the predominance of extraluminal sources of early central line associated infection (CLABSI) and an intraluminal route for those CLABSI associated with extended dwell time. Two broad approaches exist that underpin CLABSI prevention. The first being the role staff and procedures play in the prevention of CLABSI. This is followed by the impact of technology and innovation to prevent intraluminal and extraluminal sources of infection. Mermel (2000) demonstrates a variety of preventative strategies which include cutaneous antisepsis, sterile barrier precautions, catheter dressing, catheter maintenance, connection port, impregnated catheters.
Practitioners must not ignore the clinical importance of IV protection when implementing a strategic approach to infection prevention associated with vascular access.