Having a dedicated nursing team assist with central-line insertions reduced infections by 47%, a three-year program at UNC Health in Chapel Hill, N.C. has shown.

The team of 4.5 full-time nurses was tasked with confirming compliance with a clinical checklist, watching for and enabling infection-prevention practices, and making sure supplies were available, according to the report published today in the American Journal of Infection Control (AJIC) .The team also did more than 100 audits of central lines each month and offered coaching to staff in 90% of cases over the three years, which ran from 2019 to 2022.

By the second year, they were assisting in 110 to 120 insertions a month and the proportion of infections in assisted cases fell from 19% before the program to 10% in year three, while the overall proportion of infections was stable. The study tracked infections within the first week because those would most likely be caused by the insertion process.

UNC Health had determined that prior to the program 80 percent of its central-line insertions did not follow all of its protocols.

Studies had previously shown the effectiveness of having a dedicated team for central-line insertions, but there was little on the use of specialized support teams, said Shelley Summerlin-Long, MPH, MSW, BSN, RN, senior quality improvement leader in the Department of Infection Prevention at UNC Health and the lead author of this study.

“We were eager to evaluate whether having a dedicated nursing team to observe and assist would make a difference in patient outcomes in our hospital,” she said. “The decrease of related infections by 47% during the team’s first three years is remarkable and offers clear validation of this approach.”

There are an estimated 28,000 deaths a year from bloodstream infections attributed to central lines.

“Decreasing central line-associated bloodstream infections improves the quality of care and saves lives,” said Patricia Jackson, RN, BSN, MA, CIC, FAPIC, 2023 APIC president. “The innovative approach described in this study shows that adding trained observers to assist with the placement of central lines has tremendous potential to reduce infections and prevent harm.”