Implementation Strategies to Improve Evidence-Based Bathing Practices in a Neuro ICU

Area of Science:

• Infection Prevention and Control
• Healthcare Quality Improvement
• Nursing Research

Background:

• Daily chlorhexidine gluconate (CHG) bathing is evidence-based for reducing hospital-acquired central line-associated bloodstream infections (CLABSIs).
• Inconsistent implementation of CHG bathing protocols remains a challenge in clinical practice.
• Multifaceted strategies are recommended for improving adherence, but optimal approaches require further investigation.

Purpose of the Study:

• To evaluate the effectiveness of tailored, multifaceted implementation strategies in enhancing daily CHG bathing adherence.
• To assess the impact of these strategies on reducing CLABSIs within a neurointensive care unit (neuro ICU).
• To guide the application of the Grol and Wensing Model of Implementation in clinical settings.

Main Methods:

• An observational pre-/post-intervention study design was employed.
• The study focused on a large neuro ICU setting.
• Data collection likely involved process measures and infection rates.

Main Results:

• A statistically significant decrease in CLABSI rates was observed post-implementation (P = .031).
• Significant improvements were noted in key process measures, including bathing documentation and nursing knowledge regarding CHG bathing.
• Perceived importance of CHG bathing among nursing staff also increased significantly.

Conclusions:

• Tailored, multifaceted implementation strategies effectively improved adherence to evidence-based nursing practices for infection prevention.
• This study contributes to bridging the research-practice gap by demonstrating a successful implementation model.
• The findings support the use of targeted strategies to enhance the adoption of CHG bathing and reduce CLABSIs.