Chlorhexidine Bathing of Hospitalized Patients: Beliefs & Practices of Nurses and Patient Care Technicians, and Potential Barriers to Compliance
Bathing hospitalized patients daily with chlorhexidine gluconate (CHG) has been adopted by many institutions as a measure to reduce healthcare-associated infections. Although nursing policy states that CHG is to be used for all inpatient bathing in our institution, compliance rates vary significantly between units. This quality improvement project sought to assess beliefs, practices and potential barriers that influence nurses and patient care technicians (PCT) and may impact compliance rates with daily CHG bathing.
An 11 question survey was distributed via e-mail to all inpatient nurses and PCTs at an academic medical center with 621 licensed beds. Paper copies of the survey were distributed to the units with poor response rates.
A total of 401 surveys were returned, representing approximately 39% of the nurse and PCT work force. Eighty-eight percent of the respondents correctly identified that CHG is to be used instead of regular soap for all inpatient bathing as part of our institution’s nursing policy. Patient refusal and lack of time were indicated as the major barriers to daily bathing of patients (74% and 62% of respondents, respectively). A larger proportion of PCTs indicated that CHG bathing was very/extremely important to the care and outcomes of their patients compared to nurses (73.1% vs. 60.7%, p= .0493), and that CHG bathing had high/essential priority (78.7% vs. 49.5%, p=<.0001). A larger proportion of PCTs identified patient reluctance/refusal as a barrier to daily bathing compared to nurses (87.5% vs. 70.3%, p=.0007), and lack of supply availability as a barrier to daily bathing (14.6% vs. 5.6%, p=.0076). A larger proportion of nurses identified lack of patient care support as a barrier to daily bathing compared to PCTs (47% vs. 31.3%, p=.0064).
CHG bathing compliance rates are likely impacted by multiple factors, including the beliefs and attitudes of the nursing staff, as well as perceived or true barriers. Recognition of these issues is of utmost importance in order to influence practice. Results from this project will be utilized to create targeted educational interventions in an attempt to increase compliance with CHG bathing.
A. Green Hines,
M. E. Rupp, Mölnlycke Health Care: Research Contractor, Research support
E. Lyden, None
K. Tyner, None
A. Hewlett, None