Chlorhexidine bathing decreases hosp-acq infection - page 2
by GrnTea 11,828 Views | 47 Comments
Thought you all would be interested in this paper, especially those who prefer soap and water even when the hospital protocol is to use chlorhexidine. Effect of Daily Chlorhexidine Bathing on Hospital-Acquired... Read More
- 0Mar 5, '13 by Altra GuideQuote from BrandonLPNThe effectiveness of the chlorhexadine depends on it remaining in contact with the skin -- patients and families are educated not to "wipe it off".Couldn't they just make a bottle of body wash soap with chlorhexidine in it? That way one could still give a bed bath with soap and water and wash cloths. I still don't like the idea of giving a bed bath with just disposable wipes.
It does certainly go against many of our instincts regarding the benefits of good old soap & water. But its superiority vs. other cleansing methods, in certain settings, has been demonstrated.
- 2Mar 6, '13 by Miss LizzieWe just got an email from management at my hospital that all of our critical care units will be using chlorhexidine wipes instead of soap and water starting this month because of recent research that the wipes are more effective in preventing blood stream infection. Thank you for posting this because now I understand why my hospital is making this change.
- 3Mar 6, '13 by ♪♫ in my ♥I do wonder, though...
Are we going to realize 20 years down the road that chlorhexidine exposure is causing cancer clusters or liver damage among staff exposed to the stuff day after day after day?
Volatile or fat-soluble organics can play heck on the liver.
- 3Mar 6, '13 by CharleeFoxtrotFWIW, all new patients coming into our LTAC have a Chlorhexidine bath done for the first 3 days with special bath wipes. The wipes are heated, just like the standard ones we use as our facility doesn't allow soap/water/wash cloth bathing due to the increasing data that disposables are a better way to go. I've not noticed any really dry skin after the bath except on patient's feet-those seem to need extra lotion and attention.
- 4Mar 6, '13 by SummitRNOur ICU uses warmed chlorhexidine wipes, and I believe there is a bit of moisturizer impregnated. They work great, clean the patient, prevent infection, don't cause skin problems, and are very arguably better on friable skin than a rough washcloth with soap!
I don't understand the resistance to chlorhexidine I see in this thread. It seems to be an emotional reaction, not one based on evidence. Keep an open mind and listen to the data. Good nurses change their practice based on what is proven to work, not what they feel is better.
- 0Mar 6, '13 by marycarneyWe had a nurse-led initiative / research project on this in our hospital. Believe it was published in the AACN journal.
I'm doing an EBP project on pre-operative bathing of newborns undergoing cardiac surgery which will result in an open sternum for a number of days post-op and the effect of bathing on infection rates in these babies.
Edited to add:
Here's the article: it has to do with bath basin contamination actually.Last edit by JustBeachyNurse on Mar 8, '13 : Reason: ToS
- 3Mar 6, '13 by BrandonLPNWell, I come from a LTC perspective. To a bed bound LTC resident, it just seems to me that giving them a bed bath with wipes is..... Just unnecessary. They should get a bed bath with soapy water or, better yet, be put on the shower cart and get an actual shower. If chlorhexidine can be incorporated somehow into a traditional bed bath, great. If not, oh well. Our residents need to be clean and comfortable. Strict asepsis isn't necessary in their day to day lives any more than it is in ours.
Acute care is obviously a whole other kettle of fish, but in LTC we do many things that probably aren't 100% best possible evidence based practice.
I understand that carb counting is better practice for insulin administration, but monitoring and controlling what our residents eat to that extent is too invasive. There's a reason carb counting is rare in LTC. It's not because we're resistant to change, it's just that it's not necessary or even desirable.
I understand that best practice dictates levothyroxine be giving on an empty stomach. But I'm not gonna wake a 90 year old up at 5am every single day to give it. Give it at HS. No, their stomachs aren't completely empty, but they're empty enough.
I know there's a lot of nurses who resist new techniques even in the face of evidence and established studies. They cling to old ways more out of tradition than out of critical thinking. This is wrong.
But I also know some nurses who think every "best practice" policy should be implemented across the board in every setting of nursing. This is wrong, too.