A commitment to preventing catheter-associated blood stream infections gained national momentum with the 100,000 Lives Campaign. This study demonstrated that existing intensive care unit (ICU) policies vary widely from institution to institution in compliance with evidence-based guidelines. Based on a survey of 25 ICUs, investigators describe the spectrum of existing policies on use of tunneled catheters, sterile-barrier precautions, and educational programs directed at central venous catheter (CVC) insertion. The findings suggest a potential for improved standardization of policy across ICUs to improve patient outcomes from CVC insertion and care.