Daily bathing of pediatric patients with disposable cloths containing 2% chlorhexidine gluconate (CHG) reduced central line-associated bloodstream infections (CLABSIs) by 59% and saved approximately $300,000 in one hospital over a six-month period, according to a study presented recently in Nashville at the annual APIC conference.
Infection preventionists examined the impact of implementing a daily CHG bathing protocol for all pediatric patients at Riley Hospital for Children at Indiana University Health in Indianapolis. Previously, the hospital used CHG for daily bathing to reduce CLABSIs in the hematology/oncology unit with marked success. This prompted the team to consider implementation of this practice hospital-wide, regardless of whether patients had central line catheters.
The infection prevention team worked with nursing staff, parents, and hospital leadership to develop a comprehensive educational program to adopt daily CHG bathing for all patients, and to strengthen adherence to a bundle of prevention practices already in place for patients with central lines. In addition to daily bathing with CHG-impregnated wipes, the strategies included daily linen changes, assessment of central line dressings, appropriate technique for giving medications, and regular tubing and cap changes on the lines.
“Our executive suite and unit managers made sure all staff understood that this was a priority,” said Adam N. Karcz, MPH, CPH, CIC, an IP at Riley Hospital. “By educating everyone on the care team — including parents — and standardizing bathing procedures, we were able to dramatically reduce infections and save healthcare dollars in just six months.”
Bathing compliance increased from 45% to 81% during the six-month study period. During the control period — six months prior to implementation —the 269-bed hospital had 22 CLABSIs. During the implementation period the number dropped to nine CLABSIs. The hospital also experienced a 56% percent drop in the number of MRSA infections during this time period. The reduction in healthcare-associated infections during the implementation period represents a potential cost savings of $297,999, Karcz said. n