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Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study.

Publication ,  Journal Article
Rhee, Y; Hayden, MK; Schoeny, M; Baker, AW; Baker, MA; Gohil, S; Rhee, C; Talati, NJ; Warren, DK; Welbel, S; Lolans, K; Bahadori, B; Bell, PB ...
Published in: Infect Control Hosp Epidemiol
September 2023

OBJECTIVE: To assess whether measurement and feedback of chlorhexidine gluconate (CHG) skin concentrations can improve CHG bathing practice across multiple intensive care units (ICUs). DESIGN: A before-and-after quality improvement study measuring patient CHG skin concentrations during 6 point-prevalence surveys (3 surveys each during baseline and intervention periods). SETTING: The study was conducted across 7 geographically diverse ICUs with routine CHG bathing. PARTICIPANTS: Adult patients in the medical ICU. METHODS: CHG skin concentrations were measured at the neck, axilla, and inguinal region using a semiquantitative colorimetric assay. Aggregate unit-level CHG skin concentration measurements from the baseline period and each intervention period survey were reported back to ICU leadership, which then used routine education and quality improvement activities to improve CHG bathing practice. We used multilevel linear models to assess the impact of intervention on CHG skin concentrations. RESULTS: We enrolled 681 (93%) of 736 eligible patients; 92% received a CHG bath prior to survey. At baseline, CHG skin concentrations were lowest on the neck, compared to axillary or inguinal regions (P < .001). CHG was not detected on 33% of necks, 19% of axillae, and 18% of inguinal regions (P < .001 for differences in body sites). During the intervention period, ICUs that used CHG-impregnated cloths had a 3-fold increase in patient CHG skin concentrations as compared to baseline (P < .001). CONCLUSIONS: Routine CHG bathing performance in the ICU varied across multiple hospitals. Measurement and feedback of CHG skin concentrations can be an important tool to improve CHG bathing practice.

Duke Scholars

Published In

Infect Control Hosp Epidemiol

DOI

EISSN

1559-6834

Publication Date

September 2023

Volume

44

Issue

9

Start / End Page

1375 / 1380

Location

United States

Related Subject Headings

  • Intensive Care Units
  • Humans
  • Feedback
  • Epidemiology
  • Critical Care
  • Chlorhexidine
  • Adult
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
 

Citation

APA
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ICMJE
MLA
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Rhee, Y., Hayden, M. K., Schoeny, M., Baker, A. W., Baker, M. A., Gohil, S., … CDC Prevention Epicenters Program, . (2023). Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study. Infect Control Hosp Epidemiol, 44(9), 1375–1380. https://doi.org/10.1017/ice.2023.177
Rhee, Yoona, Mary K. Hayden, Michael Schoeny, Arthur W. Baker, Meghan A. Baker, Shruti Gohil, Chanu Rhee, et al. “Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study.Infect Control Hosp Epidemiol 44, no. 9 (September 2023): 1375–80. https://doi.org/10.1017/ice.2023.177.
Rhee Y, Hayden MK, Schoeny M, Baker AW, Baker MA, Gohil S, et al. Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study. Infect Control Hosp Epidemiol. 2023 Sep;44(9):1375–80.
Rhee, Yoona, et al. “Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study.Infect Control Hosp Epidemiol, vol. 44, no. 9, Sept. 2023, pp. 1375–80. Pubmed, doi:10.1017/ice.2023.177.
Rhee Y, Hayden MK, Schoeny M, Baker AW, Baker MA, Gohil S, Rhee C, Talati NJ, Warren DK, Welbel S, Lolans K, Bahadori B, Bell PB, Bravo H, Dangana T, Fukuda C, Habrock Bach T, Nelson A, Simms AT, Tolomeo P, Wolf R, Yelin R, Lin MY, CDC Prevention Epicenters Program. Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study. Infect Control Hosp Epidemiol. 2023 Sep;44(9):1375–1380.
Journal cover image

Published In

Infect Control Hosp Epidemiol

DOI

EISSN

1559-6834

Publication Date

September 2023

Volume

44

Issue

9

Start / End Page

1375 / 1380

Location

United States

Related Subject Headings

  • Intensive Care Units
  • Humans
  • Feedback
  • Epidemiology
  • Critical Care
  • Chlorhexidine
  • Adult
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences