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Real-time intervention to increase daily chlorhexidine bathing and reduce central line-associated bloodstream
Brad A Krier1, Pawan Bhandari2, Ashley M Brooks1
1Infection Prevention and Control, Mayo Clinic Health System - Southwest Minnesota Region, Mankato, MN, USA.
Background:
After an increase of central line-associated bloodstream infections (CLABSIs) at our community hospital in 2021, a case-control study suggested that patients with CLABSIs were 3.0 times more likely to have missed daily chlorhexidine gluconate (CHG) bathing than patients without CLABSIs.
Objective:
To increase the rate of daily CHG bathing in hospitalized patients with central lines and subsequently reduce the number of CLABSIs.
Methods:
Our pre-post intervention was launched on September 2022 and consisted of enhancements to the electronic health record (EHR) to simplify the identification of overdue CHG bathing instances to increase compliance, and therefore decrease the CLABSI rate at our hospital. A workflow was implemented Monday-Friday utilizing these EHR enhancements for active surveillance to engage frontline nursing staff and address gaps in care in real time.
Results:
After the initiative was implemented, adherence to daily CHG bathing increased from 94.9% to 95.3%, with a considerable disparity between weekdays (97.6%) and weekends (89.3%). After weekend data were excluded, the post-intervention increase in the adherence rate was statistically significant (p = .003).
Discussion:
This initiative underscored the importance of involving health care informatics partners and showed how technology can bridge gaps in health care quality. Outreach and reminders effectively improved CHG bathing adherence by emphasizing the importance of consistent communication and follow-up.
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