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Institution reports low compliance rate for daily chlorhexidine bathing
Most nurses and primary care technicians knew that chlorhexidine gluconate rather than regular soap should be used daily for bathing hospitalized patients, yet the overall adherence rate was low, according to data drawn from a Nebraska hospital.
Researchers sought to determine the attitudes, awareness levels, practices and potential barriers pertaining to chlorhexidine gluconate (CHG) bathing protocol among nurses and patient care technicians (PCTs) at Nebraska Medicine. An online survey, sent to all 673 nurses and 297 PCTs at the center, evaluated the knowledge, practices and beliefs of these providers regarding CHG bathing and bathing in general. Respondents also were asked what would increase their adherence to CHG bathing. Overall compliance for using the antibacterial treatment was low (63%).
The response rate was 41%, and 88% of respondents demonstrated awareness that CHG should be used rather than regular soap in all patient bathing. Practitioners with more than 5 years’ experience were more likely to correctly identify this information vs. less-experienced employees (92% vs. 84%; P = .016).
More respondents suggested that bathing in general was very or extremely important to patient care and improved outcomes than those who stated the same for CHG bathing (85% vs. 63%; kappa = 0.27). CHG bathing was cited as very or extremely important to patient care and outcomes by a greater proportion of PCTs than nurses (73% vs. 61%; P = .0493), and more PCTs considered CHG bathing to be a high or essential priority (79% vs. 50%; P < .0001).
The most prominent obstacles to daily bathing of patients were patient refusal (74%) and lack of time (62%). PCTs cited patient reticence or refusal as an obstacle to daily bathing more frequently than nurses (88% vs. 70%; P = .0007).
Conversely, more nurses specified a lack of patient care support as a barrier to daily bathing (47% vs. 31%; P = .0064).
The respondents most frequently suggested patient or family education (78%) and increased support staff assistance (58%) as a means to improve CHG bathing compliance. According to the researchers, these findings shed light on some of the practitioner-level barriers to CHG bathing.
“Results from this quality improvement project will be utilized to create targeted educational interventions in an attempt to increase compliance with CHG bathing at our institution,” the researchers wrote. – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.