Background: Intravascular catheters are the most frequently used medical devises in hospital settings. Although such catheters provide necessary vascular access, their use puts patients at risk for local and systemic infectious complications, and cause significant morbidity, mortality, and excess hospital costs. Implementing evidence-based practice guidelines is vital to prevent catheter-related bloodstream infection (CR-BSI) in the clinical settings; however, there are many evidence-based guidelines developed by different academic societies based on the Western countries. How to search an evidence-based guideline and cross cultural adaptation in different healthcare setting is crucial for the Taiwanese healthcare administrators. Objectives: The objectives of this review were to determine the best available evidence and cross cultural adaptation in clinical settings on the intravascular catheters care in preventing of CR-BSI for adult patients in Taiwan. Search strategy: The search strategy aimed to find published systematic reviews and clinical guidelines and was limited to reports published in the English or Chinese language from 2000 to 2008. Reference lists of studies that met the inclusion criteria were searched for additional studies. Types of studies: This review included any systematic reviews and guidelines that included the interventions for preventing CR-BSI in adults. Types of participants: The types of participants to be included in this systematic review were aged over 18 years old, using intravascular catheters and staying in the acute care settings. Types of interventions: The review considered systematic reviews and guidelines that aimed any stages of catheter in used in preventing CR-BSI, including catheter insertions, texture of the catheters, daily care and removal of catheters. Types of outcome measures: The outcome measures including: (1) CR-BSI rates, (2) Length of stay and (3) Mortality rates. Types of languages: The review focusing on the language on English and Chinese. Data collection and analysis: Critical Appraisal Tool from Joanna Briggs Institute and Appraisal of Guidelines for Research & Evaluation (AGREE) were used for data extracted to determine the current best interventions for preventing CR-BSI. Two sessions of expert focus group were hold to evaluate feasibility and the meaningfulness of each intervention. After revised the interventions based on the focus groups suggestions, a questionnaire survey was conducted to investigate the usefulness of interventions nationwide. Results: The search process identified 18,088 systematic reviews and clinical guidelines that addressed the objectives of the review protocol. Fifty-eight articles were selected for further evaluation. After the rigorous appraisal by two independent reviewers, 24 articles were considered to be eligible for the present review and 35 articles were excluded. The data from eligible articles were formed the guideline proposal which including 18 preventing interventions and 36 daily care interventions. According to the evidence level (AHCPR 1992) and recommendation grade (AHCPR 1994), in those 54 interventions, 12 interventions were in IA level of evidence, 9 were IB, 2 were II, and 1 were IIA level, 11 interventions were graded as recommendation A, 7 graded as B and 8 graded as C. 3 interventions were not graded. Two Doctors, 1 infection control specialist and 14 experienced nurses from nationwide formed two focus groups and reviewed the proposed guidelines. Only one intervention was not accepted by the experts due to different race, which is when a patient using CVP needs heparin 2500U subcutaneous injection daily for preventing thrombus. The evidence level of heparization is level I and still included in proposed guideline. A questionnaire (possible answer: yes/no) survey was conduct to investigate the difference between current practice and proposed guidelines, 400 questionnaires were disseminated and 240 participants responded. Five of 54 interventions, the average agreement rate were below 70%; 1 intervention was preventive intervention and 4 were daily care interventions (including the daily heparization). Conclusions: The current guideline was confirmed by national experts and evaluated by the first line clinicians. However, the heparization intervention needs to be further investigated, and the other four interventions indicated that the first line clinicians needs further education of catheters daily care for preventing CR-BSI.