An intervention to improve patient understanding and use of preoperative chlorhexidine washes

Despite a lack of consensus around which type of preoperative wash is most effect in preventing surgical site infection, their use in clinical practice remains common. Chlorhexidine gluconate (CHG) is widely used however a previous study indicated issues with patient understanding and use of CHG. In response an intervention was developed which aimed to improve patient understanding and compliance with CHG.

A patient information sheet and a standardised script to guide preadmission phone calls were developed to improve the delivery of information to patients at the study hospital. These interventions were implemented for four months with adult surgical inpatients. A cross-sectional survey was then conducted to assess the effectiveness of the intervention.

A 75% (n = 226) response rate was attained. The majority of participants (86%, n = 189) used CHG prior to their surgical procedure and of these 71% (n = 129) used CHG the recommended two times. The quality of information received from the preadmissions nurses was rated more highly than information delivered by other hospital staff. Openended questions revealed key issues including lack of information, time and access issues, and inconsistencies in CHG use.

The value of standardised calls and information sheets was evident in participants who reported receiving these measures. A moderate increase was seen from the original study in the number of participants who used CHG washes the recommended two times. However, issues remained with inconsistent information across the hospital. Clinicians need to draw on high quality, contemporary research to inform clinical practice.