Chlorhexidine bathing decreases hosp-acq infection - page 2
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... Read More
Mar 6, '13I did not read the whole article, but would the pts not be at higher risk of skin breakdown due to dry skin?
Mar 6, '13We 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.
Mar 6, '13I 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.
Mar 6, '13FWIW, 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.
Mar 6, '13Our 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.
Mar 6, '13We 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
Mar 6, '13Well, 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.
Mar 7, '13Very interesting. We started using chlorhexidine wipes in my hospital sometime in the past year. My only concern is that using them every day might actually increase the risk of super bugs in the long run. We have all these powerful antibiotics and cleaning supplies...and MRSA/C.diff/other super bugs are what have evolved over time to withstand all this. Could introducing another strong cleaner eventually help create a new super bug?
Mar 7, '13I question "evidence based practice". It is used by companies to sell products to a hospital. Why not just bathe patients with soap and water and cleanse around an incision or break in the skin with chlorahexadine.
Mar 7, '13Quote from Rhi007CHG is incompatible with many moisturizers/lotions/shampoos. You'd have to check with a list of approved products. And no lotion at all if they're going to OR that day.Good grief!!!! Imagine the skin lotion you would go through
Mar 7, '13Quote from yuzzamatuzzIt is important to understand the COMPLETELY DIFFERENT MECHANISMS by which antibiotics and disinfectants work, and how MDROs develop. You seriously need to review these basic concepts. This is basic nursing fundamentals and pharm 101.Very interesting. We started using chlorhexidine wipes in my hospital sometime in the past year. My only concern is that using them every day might actually increase the risk of super bugs in the long run. We have all these powerful antibiotics and cleaning supplies...and MRSA/C.diff/other super bugs are what have evolved over time to withstand all this. Could introducing another strong cleaner eventually help create a new super bug?
By your logic we'd better stop using bleach... we don't treat patients with PO bleach... or IV chlorhexidine.
Mar 7, '13Quote from CVmursenaryWow... seriously?I question "evidence based practice". It is used by companies to sell products to a hospital. Why not just bathe patients with soap and water and cleanse around an incision or break in the skin with chlorahexadine.