Chlorhexidine bathing decreases hosp-acq infection - page 4

by GrnTea 11,466 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


  1. 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.

    Is it all evidence-based practice you "question," or this one in particular?

    If you read the study, you will note that bathing with this product (and the study was not sponsored by a manufacturer) decreased infection significantly as described. The effect was ascribed to the idea that the body's entire bacterial load was decreased, thus decreasing the number of bacterial agents available to contaminate anything.

    Chlorhexidine has been used around line sites for ages; this represented an improvement in care. Did you read this study?
    ♪♫ in my ♥ likes this.
  2. 0
    I repeat, 23 % of small, is,.....very small.
    Quote from GrnTea

    Is it all evidence-based practice you "question," or this one in particular?

    If you read the study, you will note that bathing with this product (and the study was not sponsored by a manufacturer) decreased infection significantly as described. The effect was ascribed to the idea that the body's entire bacterial load was decreased, thus decreasing the number of bacterial agents available to contaminate anything.

    Chlorhexidine has been used around line sites for ages; this represented an improvement in care. Did you read this study?
  3. 0
    Quote from GrnTea

    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.
    I think you misunderstood.

    I give meds at scheduled times.... We don't schedule routine meds at 6am here in most cases.

    As for carb counting, well, you have to understand our residents get food from outside sources. They go out to eat with family. They have food brought in. Even the diabetics.

    It seems you thought I was refusing to count carbs as ordered or something. It's just not policy here. We don't ebb do sliding scales. We give a scheduled dose of novolg with meals
    and hold it if the BS is too low or the res isn't eating.

    If the doctor DID order a carb counting dosage regimen, of COURSE I'd follow it.

    And you think wipe baths should replace showers? I'm sorry, my residents enjoy their showers. To deny them this seems cruel. Every LTC facility I've seen only offers showers once or twice a week. They need that shower.
  4. 1
    What I meant was, you can't expect to have the same infection control policies in a nursing home as you have in ICU.
    ♪♫ in my ♥ likes this.
  5. 0
    Quote from morte
    Perhaps if the handwashing was better, it would not be necessary?
    Perhaps...

    However, hand hygiene has been a front-burner topic for many years; one could argue that, barring introduction of some disruptive technology, it's matured and is not likely to improve substantially from where it presently is...

    And yet the problem with MDROs, CLABSI, CAUTI, etc is increasing all the time.

    Twenty percent is not dramatic but it's not small... it's incremental.
  6. 0
    we have heard/seen here on AN. that short staffing has lessened hand washing....and 20% sounds like a lot, but that is 20% of less than 1% of patient days....as i said 23% of small (actuallyvery small) is very, perhaps even very very, small.

    ptive technology, it's matured and is not likely to improve substantially from where it presently is...

    And yet the problem with MDROs, CLABSI, CAUTI, etc is increasing all the time.

    Twenty percent is not dramatic but it's not small... it's incremental.[/QUOTE]
  7. 1
    One of the advantages that CHG has over regular soap and water (besides its bactericidal properties) is that it continues to inhibit bacteria for hours after application (residual action).

    Also, I believe 23% is actually a huge reduction. In another thread, we discussed VTE risk where "high risk" meant 6% chance of developing VTE. Suddenly quality watchers and hospitals everywhere see it as monumentally important to start prophylactically treating everyone under the sun for VTE because of a little 6% chance. That's because it's cheaper to throw around heparin and TEDs than deal with the consequences of a handful of people with a new clot. I imagine same goes for a little pink soap versus a multi-drug resistant infection.
    GrnTea likes this.
  8. 1
    I'll add that we shouldn't be using CHG wipes on the face/mucous membranes and should use moisturizers (as they did in the study).

    Quote from morte
    Try googling antibacterial+soap+super+bugs......
    You brought up the worry, the burden of proof is on you.


    I am aware of some research for 2007 and 2008 that looked at quaternary ammonia compounds like triclosan found in consumer antibacterial soaps had no advantage over normal soap. A few studies covered the worry you brought up. These studies were low power studies and mostly statistical insignificant. The results of these studies often had no meaningful results but the authors remained concerned largely based on theory combined with the argument that biocides don’t have a proven need or even proven effectiveness in the home. The opposite is the case in the hospital. There is both a proven effect and a proven need for these biocides. Therefor, we should not recoil in fear of possibilities of CHG being a theoretical progenitor or promoter of "super bugs" when it is nothing like the home use QAC biocides that you probably heard referenced in some story on CNN 5 years ago.
    GrnTea likes this.
  9. 0
    actually someone else brought it up. I googled, gave you the words I googled, figured you could do that much...I don't watch TV, s
    Quote from SummitRN
    I'll add that we shouldn't be using CHG wipes on the face/mucous membranes and should use moisturizers (as they did in the study).


    You brought up the worry, the burden of proof is on you.


    I am aware of some research for 2007 and 2008 that looked at quaternary ammonia compounds like triclosan found in consumer antibacterial soaps had no advantage over normal soap. A few studies covered the worry you brought up. These studies were low power studies and mostly statistical insignificant. The results of these studies often had no meaningful results but the authors remained concerned largely based on theory combined with the argument that biocides don’t have a proven need or even proven effectiveness in the home. The opposite is the case in the hospital. There is both a proven effect and a proven need for these biocides. Therefor, we should not recoil in fear of possibilities of CHG being a theoretical progenitor or promoter of "super bugs" when it is nothing like the home use QAC biocides that you probably heard referenced in some story on CNN 5 years ago.
    Last edit by Esme12 on Mar 8, '13
  10. 0
    23% sounds huge, but you have to look at what it is 23% of.....less than 1%!
    Quote from Vespertinas
    One of the advantages that CHG has over regular soap and water (besides its bactericidal properties) is that it continues to inhibit bacteria for hours after application (residual action).

    Also, I believe 23% is actually a huge reduction. In another thread, we discussed VTE risk where "high risk" meant 6% chance of developing VTE. Suddenly quality watchers and hospitals everywhere see it as monumentally important to start prophylactically treating everyone under the sun for VTE because of a little 6% chance. That's because it's cheaper to throw around heparin and TEDs than deal with the consequences of a handful of people with a new clot. I imagine same goes for a little pink soap versus a multi-drug resistant infection.


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