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A1. Procedure
The procedure for central venous catheter (CVC) insertion is as follows: 1. Prepare the patient by having them lay down in the supine position 2. Remove all jewelry around the neck 3. Apply non-sterile gloves 4. Apply Betadine to cleanse the neck in a back and forth motion

Central venous catheters (CVCs) are used on a routine basis to gain vascular access during procedures in dialysis, infusion of chemotherapy and Apheresis. While CVCs can be lifesaving they also have significant risks of surgical-site infection (SSIs). Providone-iodine (Betadine) has been the primary cleanser for central line placement for the last decade, but surgical- site infections (SSI) continue to increase raising the question if betadine is a sufficient agent for surgical insertion of a CVC or is there an alternative proven through evidence- based practice to be a more effective anti-microbial.
A2a. Basis for Practice Procedures and protocols are researched by the safety committee who release their findings to the clinical practice committee for review and evaluation. In a culture that use to accept betadine as the primary anti-microbial agent to cleanse the skin prior to CVC insertion has been questioned and through evidence based practice is in favor of using chlorhexidine gluconate (CHG) as the primary agent by identifying and concluding that it is superior to betadine by reducing the risk of SSIs by approximately 50% (Chaiyakunapruk, Veenstra, Saint, and Lipsky (2009). If the clinical practice committee approves the use of CHG for CVC insertion it is communicated to the department of nursing followed by the nurse managers, educators and staff nurses.
A2b. Rationale CHG and betadine are anti-microbial agents that reduce the incidence of primary SSIs. Cleansing the surgical incision site of the CVC is practiced by disinfecting the skin

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