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Use of a 1-piece chlorhexidine gluconate transparent dressing on critically ill patients
Barbara Pfaff1, Teresa Heithaus, Madeline Emanuelsen
1Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, USA.
Background:
New transparent dressings with chlorhexidine gluconate in the dressing are available.
Objectives:
To compare the effectiveness of a new 1-piece occlusive dressing that incorporates chlorhexidine gluconate with that of a dressing plus a chlorhexidine gluconate patch in maintaining the low rate of catheter-related bloodstream infections in the intensive care unit and to evaluate nurses' satisfaction with and cost of the new dressing.
Methods:
A quality improvement observational study was done in an adult medical-surgical intensive care unit. All patients with a central venous catheter had initial and/or subsequent dressing changes done with the new dressing. The central catheter bundle elements of the Institute for Healthcare Improvement were followed. Patients were monitored for catheter-related bloodstream infections, and the rate of infection was calculated.
Results:
During the study period of 1881 device days, the infection rate was 0.051 per 1000 device days, compared with a rate of 0.052 in 2008. Nurses preferred the new dressing. Cost savings were $3807.
Conclusion:
A low rate of catheter-related bloodstream infections can be maintained, nurses' satisfaction achieved, and cost savings realized with the new dressing.
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