A new report published in the American Journal of InfectionControl (AJIC) demonstrates that implementing a dedicated team of nurses to assist with central line insertions can reduce patients’ risk of developing bloodstream infections due to those central lines.
In this report, infection preventionists at UNC Health found that having this dedicated team reduced the proportion of central line-associated bloodstream infections occurring within seven days of line placement by 47% among patients included in this program.
Clinical guidelines offer specific protocols for ensuring proper insertion of a central line, but an internal study of UNC Health providers found that more than 80 percent of insertions did not follow all recommended practices.
At UNC Health in the US, infection preventionists and hospital leadership aimed to improve patient outcomes by establishing a specialised nursing team dedicated to assisting with central line insertions. The team was tasked with confirming compliance with a clinical checklist, observing and enabling infection-prevention techniques, and ensuring the availability of needed supplies for the procedure.
- After a ramp-up period in the first year of the initiative, the nursing team routinely assisted with 110 to 120 central line insertions per month in the second and third years of the programme.
- When the programme began, an average of 60 central lines were placed each month without an assistance request for the specialised team. By the third year of the programme, that number had decreased to 44 insertions per month.
- During the three-year period, the overall proportion of central line-associated bloodstream infections remained stable at the hospital. Within that, the proportion of such infections among patients whose insertions were assisted by the nursing team decreased from 19% before programme implementation to 10% in year three, for an overall reduction of 47%.
- The team also conducted audits of more than 100 central lines each month and offered coaching to frontline staff in 90% of cases.
“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.”