Bosakowski, Jolie B, BSN, RN

Hartman, Jaclyn C, BSN, RN

McCartney, Sarah F, BSN, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingCHG Bathing in the ICU Setting: Educating Stafffor Increased ComplianceJolie B. Bosakowski BSN, RNLehigh Valley Health Network, jolie_b.bosakowski@lvhn.orgJaclyn C. Hartman BSN, RNLehigh Valley Health Network, jaclyn_c.hartman@lvhn.orgSarah F. McCartney BSN, RNLehigh Valley Health Network, sarah_f.mccartney@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtBosakowski, J. Hartman, J. McCartney, S. (2016, Oct). CHG Bathing in the ICU Setting: Educating Staff for Increased Compliance. Posterpresented at LVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA.© 2016 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaCHG Bathing in the ICU Setting: Educating Staff for Increased Compliance• ICU patients are at an increased risk of infection due touse of empiric antibiotics, preexisting disease, use ofmechanical ventilation, central lines/drains, and attimes prolonged use of urinary catheters and invasivemonitoring equipment. (Dereli, Ozayar, Degerli, Sahin,& Koç, 2013).• A study found that 16.2% of patients developed ahealthcare associated infection in 2010  (Dereli,Ozayar, Degerli, Sahin, & Koç, 2013)• Bathing with Chlorhexidine Gluconate (CHG)impregnated wipes reduces the risk of blood streaminfection in ICU patients compared to more traditionalmethods of bathing. (Shah, Schwartz, Luna, & Cullen,2016).• Chlorhexidine will stay on the skin as an antimicrobialfor up to 24 hours, reducing the risk of infection.(Popovich et al., 2012).• Use of CHG wipes is part of the LVHN policy andprocedure for proper bathing of ICU patients. (LehighValley Hospital, 2013).• Opportunities for improvement were identified in theCardiac Intensive Care Unit (CICU) with utilization ofCHG wipes for daily bathing of patients.• Utilization of CHG wipes for bathing  was audited for 3nights before any education intervention wasperformed.– On night 1, 14% of baths were done according topolicy and procedure using CHG wipes.– On night 2, 16% of baths included CHG wipes.– On night 3, 50% of baths were provided usingCHG wipes• A pre-education survey was distributed to the unit toassess the knowledge of the bathing policy.• After the data was collected, education provided andsigns were posted to remind staff which wipes to useand when.• Another survey was distributed and compliance wasaudited again after education.• Pre-education auditing data was impacted by thestaff’s awareness of it occurring.In licensed and unlicensed critical care staff, does education on the use of chlorhexidine gluconate wipes for daily baths compared to current practice increase compliance with using CHG wipes for daily bathing?Jolie Bosakowski, BSN, RN, Jaclyn Hartman, BSN, RN, & Sarah McCartney, BSN,  RNBACKGROUND / INTRODUCTIONPICO QUESTIONRESULTSCONCLUSIONSBarriers• The greatest knowledge deficit ascertained  was whichwipes should be used for bathing  and how many should beused for each bath .• The second most common knowledge deficit was whichareas of the body not to bath with the CHG wipes.• This project shows that with education on proper ICUbathing, more baths are completed according to policy andprocedure.IMPLEMENTATIONSurvey Results0102030405060708090100How Often Should We BathePatients?What Kind of Bath WipesShould Be Used on a Patientin the ICU?How Many Packages of CHGwipes are usually required forbathing?What Areas Should You AvoidBathing with CHG Wipes?QuestionsPercentage Answered CorrectlyPre-Education Post-Education •The graph above shows the results of the survey answers before and after education.Usage of Different Wipes02468101214161820May June July AugustMonthNumber of Boxes UsedCHG WipesComfort WipesThis graph reflects  the increased use of CHG wipes and decreased use of Comfort Wipes on the CICU over 4 months.•Compliance was audited again for 3 nights followingthe education on the unit.• On night 1, 60% of the baths  were done usingCHG wipes, 66% of the baths on night 2, and 72% of baths on night 3.References•Dereli, N., Ozayar, E., Degerli, S., Sahin, S., & Koç, F. (2013). Three-Year Evaluation of  Nosocomial Infection Rates of the ICU. Brazilian Journal of Anesthesiology, 63(1), 73-84. doi:10.1016/s0034-7094(13)70199-5)•Lehigh Valley Health Network (2013). SAGE CHLORHEXIDINE GLUCONTATE WIPES®- Also Known As CHG WIPES Used in Conjunction with SAGE COMFORT™ PERSONAL CLEANSING WASHCLOTHS. Patient Care Manual. Lehigh Valley Health Network, Allentown, PA.•Popovich, K. J., Lyles, R., Hayes, R., Hota, B., Trick, W., Weinstein, R. A., & Hayden, M. K. (2012). Relationship between Chlorhexidine Gluconate Skin Concentration and Microbial Density on the Skin of Critically Ill Patients Bathed Daily with Chlorhexidine Gluconate. Infection Control & Hospital Epidemiology•Shah, H. N., Schwartz, J. L., Luna, G., & Cullen, D. L. (2016). Bathing With 2% Chlorhexidine Gluconate. Critical Care Nursing Quarterly

CHG Bathing in the ICU Setting: Educating Staff for Increased Compliance

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1713&context=patient-care-services-nursing

CHG Bathing in the ICU Setting: Educating Staff for Increased Compliance

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