Daily CHG bathing protocol for pediatric patients reduces bloodstream infections by 59%: Study

Daily bathing of pediatric patients with disposable cloths containing 2 percent chlorhexidine gluconate (CHG) reduced central line-associated bloodstream infections (CLABSIs) by 59 percent and saved approximately $300,000 in one hospital over a six-month period, according to a new study.

The study, to be presented on Saturday, June 27, at the 42nd Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC), examined the impact of implementing a daily CHG bathing protocol for all pediatric patients at Riley Hospital for Children at Indiana University Health.

CHG is an antimicrobial that kills germs on a patient's skin for a prolonged period of time.

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.

A central line catheter is a tube placed in a large vein of a patient's neck or chest to give fluid, blood, or medication. It can be an entryway for germs to get inside the body.

"We took great care to ensure successful implementation of the new bathing regimen," said Adam N. Karcz, MPH, CPH, CIC, infection preventionist, Riley Hospital for Children at Indiana University Health in Indianapolis. "Our executive suite and unit managers made sure all staff understood that this was a priority. 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 percent to 81 percent 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 methicillin-resistant Staphylococcus aureus (MRSA) infections during this time period. The reduction in healthcare-associated infections during the implementation period represents a potential cost savings of $297,999.

Source: Association for Professionals in Infection Control