Chlorhexidine gluconate bathing: Patient perceptions, practices, and barriers at a tertiary care center

Vanhoozer, Ginger; Bs, Ian Lovern; Masroor, Nadia; Abbas, Salma; Doll, Michelle; Cooper, Kaila; Stevens, Michael P.; Bearman, Gonzalo

doi:10.1016/j.ajic.2018.08.002

Cited by 10 publications

(6 citation statements)

References 7 publications

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“…Inpatients often need to establish intravascular catheters to treat critically ill and severe diseases such as cancer chemotherapy, parenteral nutrition, hemodialysis, long-term intravenous antibiotics and organ transplantation, etc. (25, 26). In the United States, more than 5 million inpatients require central venous access each year (27).…”

Section: Discussionmentioning

confidence: 99%

The Effects of Chlorhexidine Dressing on Health Care-Associated Infection in Hospitalized Patients: A Meta-Analysis

Wang¹,

Xie²,

Wang³

et al. 2019

ijph

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Background: To assess the effects of chlorhexidine dressing on health care-associated infection in hospitalized patients. Methods: We searched for English-language published randomized controlled trials (RCTs) in Cochrane Library, EMBASE and PubMed between January 1998 and January 2018. We used meta-analysis to calculate the risk ratios (RRs) and 95% confidence intervals (CIs) of the data, and using the I2 assessment to summarize the heterogeneity of RCTs and the funnel plot and Egger regression test to evaluate publication bias. Results: A total of 13 RCTs were included in our meta-analysis, including 7555 patients and 11,931 catheters. The effects of chlorhexidine dressing on the incidence of catheter-related bloodstream infections (CRBSIs) were reported in 13 RCTs, and the incidence of CRBSIs were 1.3% (80/6160) in the chlorhexidine group and 2.5% (145/5771) in the control group. We used a forest plot to determine the risk ratio (RR) of chlorhexidine dressing on the incidence of CRBSIs, and our results showed that chlorhexidine dressing significantly reduced the incidence of CRBSIs (RR 0.55, 95% CI 0.39-0.77, P<0.001). Moreover, we also analyzed the effects of chlorhexidine dressing on the incidence of catheter colonization and catheter-related infections (CRIs), and our forest plot results showed that chlorhexidine dressing significantly reduced the incidence of catheter colonization (RR 0.52, 95% CI 0.40-0.67, P<0.001) and the incidence of CRIs (RR 0.43, 95% CI 0.28-0.66, P<0.001) in hospitalized patients. Conclusion: The use of chlorhexidine dressings for hospitalized patients significantly reduce the incidence of CRBSIs, catheter colonization and CRIs.

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Section: Discussionmentioning

confidence: 99%

The Effects of Chlorhexidine Dressing on Health Care-Associated Infection in Hospitalized Patients: A Meta-Analysis

Wang¹,

Xie²,

Wang³

et al. 2019

ijph

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“…Others 95 (19), ( 24) 21 ( 17), ( 19) 3 ( 18), ( 20) 29 ( 20), ( 24) 3 ( 14), ( 21) 38 ( 20), ( 28) 1 ( 14), (20) 0 1, 1 with limited evidence such as perioperative chlorhexidine bathing pose a perception barrier. [26][27][28] We, therefore, implemented the abovementioned monitoring instrument of OR hygiene protocol, staff training, and consultations with the infectious disease department demonstrating that 80% compliance rate was first reached after 2 years. This underlines the importance of continuous monitoring and training as reported by previous studies.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary Infection Prevention and Control Bundle in Neurosurgical Patients: Results of a Prospective Cohort Study

Koch¹,

Saydan

Schwab

et al. 2023

Neurosurgery

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BACKGROUND: Surgical site infections (SSIs) account for one of the most common causes of nosocomial infections. Bundle approaches for infection prevention and control do not capture the full complexity of neurosurgical interventions. OBJECTIVE: To study the efficacy of an interdisciplinary infection prevention and control bundle (IPCB) in neurosurgery. METHODS: This was a prospective, single-center, observational study, analyzing 3 periods: before (2014), during (2017), and after (2019) full implementation of IPCB. IPCB included the following infection prevention measures: preoperative decolonization, patient engagement, operating room (OR) hygiene protocol, and pre-, peri-, and postoperative standard operating procedures (SOPs) while infection control measures included intraoperative sonication, blood culture inoculation, and interdisciplinary SSI management. All neurosurgical patients being readmitted to the hospital for SSIs within 90 days after receiving index surgery were included in the trial (403/9305). RESULTS: Implementation of IPCB resulted in more frequently succeeded pathogen isolation in patients with SSI (2014: 138 isolates in 105 (83%) patients with SSI, 2017: 169 isolates in 124 (91%) patients with SSI, and 2019: 199 isolates in 136 (97%) patients with SSI; P < .001). Proportion of gram-positive SSI and virulence was declining (P = .041, P = .007). The number of repeated revision surgeries decreased from 26 (20%) in 2014 and 31 (23%) in 2017 to 18 (13%) in 2019 (P = .085). Significantly, fewer patients experienced sepsis in response to SSI (2014: 12%, 2017: 10%, and 2019: 3.6%, P = .035). In-hospital mortality rate was declining from 12 (9.4%) in 2014 to 9 (6.6%) in 2017 to 5 (3.6%) in 2019 (P = .148). CONCLUSION: Introducing an interdisciplinary IPCB in neurosurgery leads to a significant reduction of sepsis and decreased in-hospital mortality while a pathogen switch toward gram-negative bacteria was observed. Minimizing diagnostic gap of pathogen detection toward a more efficient anti-infective treatment may be the main reason for the substantial decrease in morbidity and mortality.

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“…These can result in patient refusal of treatments. [13][14][15][16] However, these are surmountable barriers that can often be overcome with patient education. 15 Increasing knowledge and comfort in discussing the benefits and potential side effects of CHG bathing treatments with patients/ families may be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Central Line–Associated Bloodstream Infections and Advanced Practice Providers: Identifying Opportunities for Prevention Efforts

Mudd¹,

Slater²,

Curless³

2022

The Journal for Nurse Practitioners

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Chlorhexidine gluconate bathing: Patient perceptions, practices, and barriers at a tertiary care center

Cited by 10 publications

References 7 publications

The Effects of Chlorhexidine Dressing on Health Care-Associated Infection in Hospitalized Patients: A Meta-Analysis

The Effects of Chlorhexidine Dressing on Health Care-Associated Infection in Hospitalized Patients: A Meta-Analysis

Interdisciplinary Infection Prevention and Control Bundle in Neurosurgical Patients: Results of a Prospective Cohort Study

Central Line–Associated Bloodstream Infections and Advanced Practice Providers: Identifying Opportunities for Prevention Efforts

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