Reduction in patient refusal of CHG bathing

Area of Science:

• Healthcare Improvement
• Infection Prevention
• Patient Safety

Background:

• Daily chlorhexidine gluconate (CHG) bathing is effective in reducing central line-associated bloodstream infections (CLABSI).
• Suboptimal compliance with CHG bathing is often due to patient refusals.
• Targeted interventions are needed to address barriers to CHG bathing compliance.

Purpose of the Study:

• To implement tailored interventions to reduce patient refusals of CHG bathing.
• To increase compliance with CHG bathing protocols.
• To evaluate the impact on CLABSI rates and nursing staff knowledge.

Main Methods:

• Iterative Plan-Do-Study-Act (PDSA) cycles were employed over six months.
• Interventions included educational materials for staff and patients, learning modules, and visual aids.
• Run charts were utilized to monitor improvement signals.

Main Results:

• Patient refusals of CHG bathing decreased from a median of 23% to 8%.
• Documentation compliance with CHG bathing showed a slight increase from 46% to 47%.
• CLABSI rates experienced a marginal decrease of 6%, from 0.69 to 0.65.

Conclusions:

• Tailored interventions within clinical settings can positively influence patient outcomes.
• Plan-Do-Study-Act (PDSA) cycles are effective in reducing patient refusals of CHG bathing.
• PDSA cycles may offer a pathway to improve CHG bathing compliance and reduce CLABSI rates.