Can daily bathing with chlorhexidine reduce hospital aquired infection?

Effect of Daily Chlorhexidine Bathing on Hospital-Aquired Infection

The Article:

Effect of Daily Chlorhexidine Bathing on Hospital-Aquired Infection [http://www.ncbi.nlm.nih.gov/pubmed/23388005]

Big Idea:

Can using chlorhexidine impregnated cloths to bed bath patients reduce rates of Multi-Drug Resistant Organism (MDRO) acquisition and bloodstream infection rates in hospitals?

Evidence:

Observational studies (looking at populations uncontrolled by researchers) suggest that chlorhexidine bathing reduces multidrug-resistant organisms (MDROs) aquisition and blood stream infections. This study conducted a cluster-randomized trial (they split up organizations and specific units to intervention [chlorhexidine] and control [nonantimicrobial cloth] groups. They worked with 6 organizations using their intensive care and bone marrow transplant units to see if they could identify any difference in MDRO aquisition and bloodstream infection rates.

Quotable:

  • (Althought it was from another study) “Bleasdale et al. found that daily bathing with 2% chlorhexidine–impregated washcloths reduced the incidence of primary bloodstream infections by 60%.”
  •  Effect of Daily Chlorhexidine Bathing on Hospital-Aquired Infection
  • “The overall rate of MRSA or VRE acquisition was 23% lower during the intervention period”
  • “hospital-acquired bloodstream infections was 28% lower during the intervention”
  • “central-catheter–associated bloodstream infections was 53% lower during the intervention period than”
  • “31% lower rate of primary bloodstream infections during the intervention period”

So What?

This paper adds to the evidence that chlorhexidine bathing can reduce rate of MDROs aquisition and bloodstream infections. The study reported 2.0% had skin reactions, which was less than the 3.4% of patients who had skin reactions to the control product, 85% of these reactions were classified as mild to moderate reactions and were considered unrelated to the bathing intervention. Bed bathing is a regular part of nursing care, and a frequent activity for patients. Making this a potentially important transition for hospitals to make to reduce the rate of MDRO aquition and blood stream infections. This intervention could prevent increase length of stay and adverse events to patients.

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