Background: After an increase of central line-associated bloodstream infections (CLABSIs) at our community hospital in 2021, a case-control study suggested that patients with CLABSIs were 3.0 times more likely to have missed daily chlorhexidine gluconate (CHG) bathing than patients without CLABSIs.
Objective: To increase the rate of daily CHG bathing in hospitalized patients with central lines and subsequently reduce the number of CLABSIs.
Methods: Our pre-post intervention was launched on September 2022 and consisted of enhancements to the electronic health record (EHR) to simplify the identification of overdue CHG bathing instances to increase compliance, and therefore decrease the CLABSI rate at our hospital. A workflow was implemented Monday-Friday utilizing these EHR enhancements for active surveillance to engage frontline nursing staff and address gaps in care in real time.
Results: After the initiative was implemented, adherence to daily CHG bathing increased from 94.9% to 95.3%, with a considerable disparity between weekdays (97.6%) and weekends (89.3%). After weekend data were excluded, the post-intervention increase in the adherence rate was statistically significant ( = .003).
Discussion: This initiative underscored the importance of involving health care informatics partners and showed how technology can bridge gaps in health care quality. Outreach and reminders effectively improved CHG bathing adherence by emphasizing the importance of consistent communication and follow-up.
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| http://dx.doi.org/10.1177/17571774241301713 | DOI Listing |
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Background: After an increase of central line-associated bloodstream infections (CLABSIs) at our community hospital in 2021, a case-control study suggested that patients with CLABSIs were 3.0 times more likely to have missed daily chlorhexidine gluconate (CHG) bathing than patients without CLABSIs.
Objective: To increase the rate of daily CHG bathing in hospitalized patients with central lines and subsequently reduce the number of CLABSIs.
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Article Synopsis
- The study aimed to explore how the concentration of chlorhexidine gluconate (CHG) on the skin affects microbial colonization, particularly in adult patients in medical ICUs across several hospitals.
- By collecting skin swab samples and measuring CHG concentration, researchers found that higher CHG levels correlated with fewer detections of gram-positive bacteria and specific species, while gram-negative bacteria were less affected.
- The findings suggest that increasing CHG skin concentrations could enhance infection control for certain pathogens, although no specific threshold level was identified for reducing microbial detection.
Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection.
J Clin Med
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Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design.
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