Published
I work in a large MSICU in a teaching hospital, and our "head" infectious disease physician implemented the CHD baths about a year ago. Every new patient, no matter if they are coming from surgery, or from the street gets an "ICU bath" with the CHD. Our nurse educators have large amounts of research corroborating the efficacy of the CHD baths with regards to a decrease in central infection/foley/etc..It is a simple nursing act with low risk and substantial benifits!
Of course I did not mean to openly give the email without permission and then it could be shared privately. I have no problems with a lit search as previously stated but it is always helpful not to have to re-do the search if someone has that information available and is able to share it. I will just do a goggle search for companies and the chlorohexidene. I was just trying to get an idea of how common it is. Thanks all those who replied.
The link provides a great article regarding the implementation and efficacy of the CHD baths in critical care.
http://www.turner-white.com/memberfile.php?PubCode=jcom_nov09_bloodstream.pdf
I have to say I am torn regarding the evidence regarding the efficacy of chlor hex bag baths. From a nursing perspective regarding time and efficiency I love the product however I am yet to find more than 2 well designed studies conducted in ICU and even neither of those are not blinded RCTs. There are a number of before and after studies however most of these are confounded by failure to report hand hygiene studies and/or compliance with VAP or CRBSI bundles. In addition environmental hygiene is rarely if ever described. There are currently 9 studies registered with the clinical trials site and none of these are RCTs although one is a cluster randomised study. No results as yet.
I am doing a systematic review at the moment and will be finished before long. As I am at home I dont have my citations on me but will post them next week.
What I cant fathom is why a blinded RCT is not being done? There are a number of US institutions where VAP and CRBSI bundles have been in place for a number of years so undertaking one in these settings should account for the confounding variables. The company produces both medicated and non-medicated cloths so should be able to come to the party with product especially as a blinded study would put the matter to rest both in the mind of the purist EBP crowd and the money men. Of course an RCT might not be the answer BUT please do a better designed prospective before and after or cross over study!
So would I want them on my family if they were in ICU, you betcha.
Would I fall on the side of mandating them for patients who are not colonised with resistant bugs - No
But if I had a problem with resistant bugs in my unit - Emphatically :up:YES!
greetings from OZ and thank heaven there are universal nursing problems!
nightshift82
86 Posts
I work in a community hospital, Cardiac Intensive Care (mix of MICU/occ SICU and Cardiac(PCI)) rare if any trauma and no open heart. Our nurse manager who took away our packaged bag baths over a year ago due to ?cost
(using basins and washcloths again). Now she would like to try the 2% chlohexidene bath packs because we have had recent >>> in our central line infections..hmmmm:confused:. She read a study that showed a significant