Daily Bathing of Pediatric Inpatients with Chlorhexidine Gluconate to Prevent Hospital Acquired Infections

Abstract

Since the 1970’s, chlorhexidine gluconate (CHG) has been utilized in the United States to prevent infections. CHG is being used in skin preps, dressings, pre-operative patient bathing, ventilator bundles, and more. Given this success, many institutions have extended the use beyond surgical patients to daily routine bathing for their patients, to prevent hospital acquired infections (HAI). A six month analysis shows the effectiveness of daily inpatient CHG bathing implementation at a Midwest pediatric hospital demonstrating a significant avoidance in both cost and HAI. Daily CHG bathing was implemented in inpatient units beginning in November of 2013. A multidisciplinary team was formed combining leadership with frontline staff to implement a robust CHG bathing implementation plan. Multi-modal education was formulated which consisted of key content including the rationale for CHG bathing, contraindications, talking points, frequently asked questions, patient/family education, and references. Throughout the implementation, infection preventionists and educators discussed barriers to performing CHG bathing and worked with staff and families to ensure full adoption. Daily CHG bathing compliance was collected and disseminated to hospital leadership and staff on a regular basis. Bathing compliance increased from 45% to 81% compliance during the 6 month study period. Central Line- Associated Blood Stream Infections (CLABSI) decreased from 2.2 per 1000 line days during the 6 month baseline period 1.1 CLABSI per 1000 line days during the implementation period. During the baseline period, twenty-two CLABSIs were identified. During the implementation period, nine CLABSIs identified, equating to a 59% reduction in CLABSI, with a potential cost savings of $297,999. A successful implementation of daily CHG bathing for pediatric inpatients can help reduce hospital acquired infections and provide significant cost savings to the hospital. Further studies are needed to evaluate the use of CHG, in conjunction with other initiatives in the effort to prevent HAIs.