Chlorhexidine bathing decreases hosp-acq infection - page 3

by GrnTea

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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


  1. 0
    Thanks for the article! Interesting
  2. 1
    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?
    catlvr likes this.
  3. 0
    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.
  4. 0
    Quote from Rhi007
    Good grief!!!! Imagine the skin lotion you would go through
    CHG 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.
  5. 0
    Quote from yuzzamatuzz
    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?
    It 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.

    By your logic we'd better stop using bleach... we don't treat patients with PO bleach... or IV chlorhexidine.
  6. 1
    Quote from CVmursenary
    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.
    Wow... seriously?
    Enthused RN likes this.
  7. 0
    Try googling antibacterial+soap+super+bugs......
    Quote from SummitRN
    It 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.

    By your logic we'd better stop using bleach... we don't treat patients with PO bleach... or IV chlorhexidine.
  8. 0
    Thanks for the article! At school, my group is researching ways to lower CLABSI rates and we have been thinking about CHG baths in addition to several other methods. This is helpful.
  9. 0
    23% of small, is..very small. Perhaps if the handwashing was better, it would not be necessary?
    Quote from GrnTea
    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.
    MMS: Error



    Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection


    Michael W. Climo, M.D., Deborah S. Yokoe, M.D., M.P.H., David K. Warren, M.D., Trish M. Perl, M.D., Maureen Bolon, M.D., Loreen A. Herwaldt, M.D., Robert A. Weinstein, M.D., Kent A. Sepkowitz, M.D., John A. Jernigan, M.D., Kakotan Sanogo, M.S., and Edward S. Wong, M.D.
    N Engl J Med 2013; 368:533-542February 7, 2013DOI: 10.1056/NEJMoa1113849
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    AbstractArticleReferences
    BACKGROUND

    Results of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs).
    Full Text of Background...


    METHODS

    We conducted a multicenter, cluster-randomized, nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections. Nine intensive care and bone marrow transplantation units in six hospitals were randomly assigned to bathe patients either with no-rinse 2% chlorhexidine–impregnated washcloths or with nonantimicrobial washcloths for a 6-month period, exchanged for the alternate product during the subsequent 6 months. The incidence rates of acquisition of MDROs and the rates of hospital-acquired bloodstream infections were compared between the two periods by means of Poisson regression analysis.
    Full Text of Methods...


    RESULTS

    A total of 7727 patients were enrolled during the study. The overall rate of MDRO acquisition was 5.10 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.03), the equivalent of a 23% lower rate with chlorhexidine bathing. The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.007), a 28% lower rate with chlorhexidine-impregnated washcloths. No serious skin reactions were noted during either study period.
  10. 1
    Quote from BrandonLPN
    Well, I come from a LTC perspective. .... 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.

    You cannot be serious. It surely is not. Now that LTC facilities get admissions from hospitals all the time (gee, I wonder when that started?) the chance of importing resistant bugs is just as high as it is in a hospital. Best practices are not optional, they are our duty under the ANA Scope and Standards of Nursing Practice; you can look it up. If you, an LPN, cannot see your way clear to do them, then the RN who delegates to you is responsible to see that you do.

    Just because the facility is the resident's home does not mean at all that it's like your home, where the bugs you and your family are exposed to are mostly ... yours. These residents have diminished immune systems, too.

    I would dearly love to have a medical record or published words that says something like your quote above it to review in a legal case. You think that evidence-based practice is optional? You think that you can choose to give a med when you want to when it's specifically indicated to give at a different time or setting? You don't bother with looking at nutritional levels when caring for diabetics? Oh, boy. My spidey-sense feels the attorney salivating right now. You would be sooo going down. This is irresponsible in the extreme.
    ♪♫ in my ♥ likes this.


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