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Wiping Catheter-Associated Urinary Tract Infections Away With Chlorhexidine Gluconate
Latasha Williams1, Felicia Collins1, Cynthia Hall-Thomas2
1Rehabilitation Services, ECU Health Medical Center, Greenville, NC, USA.
Insights
Using 2% chlorhexidine gluconate (CHG) during bathing and indwelling catheter care prevented catheter-associated urinary tract infections (CAUTIs). The 4% CHG intervention resulted in two CAUTIs, while the 2% CHG intervention showed zero CAUTIs.
Area of Science:
- Infection Control
- Patient Safety
- Healthcare Quality Improvement
Background:
- Catheter-associated urinary tract infections (CAUTIs) pose a significant financial and clinical burden in healthcare settings.
- Limited research exists on the efficacy of chlorhexidine gluconate (CHG) for preventing CAUTIs, particularly with indwelling (Foley) catheters outside of intensive care units.
- Preventative strategies for CAUTIs can yield substantial benefits for patients and healthcare organizations.
Purpose of the Study:
- To evaluate the effectiveness of 2% versus 4% chlorhexidine gluconate (CHG) in reducing CAUTI occurrences in patients with indwelling catheters.
- To assess the impact of integrating FDA-approved CHG products into bathing and indwelling catheter care protocols.
- To address the gap in research regarding CHG use for indwelling catheter care in inpatient rehabilitation settings.
Main Methods:
- A quality improvement project was implemented in an inpatient rehabilitation facility.
- Patients requiring indwelling catheters received either 2% or 4% CHG during bathing and catheter care.
- CAUTI occurrences were monitored and compared between the two intervention groups.
Main Results:
- The unit utilizing 2% CHG for bathing and indwelling catheter care observed zero CAUTIs.
- The unit utilizing 4% CHG reported two CAUTIs during the study period.
- Identified CAUTI associations included chronic renal calculi, bowel care management issues, and staff knowledge deficits.
Conclusions:
- The use of 2% chlorhexidine gluconate (CHG) in bathing and indwelling catheter care appears effective in preventing catheter-associated urinary tract infections (CAUTIs).
- Further investigation is warranted to understand the contributing factors to CAUTIs, including patient comorbidities and staff education.
- Implementing targeted CHG protocols can enhance patient safety and reduce healthcare-associated infection rates.
Abstract:
Catheter-associated urinary tract infections (CAUTIs) continue to be a concern in health care. According to the Agency on Healthcare Research and Quality, the cost associated with a single CAUTI is estimated to be $13,793 on average but can be as high as $29,743. Decreasing CAUTIs through preventative strategies will benefit both the patient and the healthcare organization. There were limited studies utilizing 2% and 4% chlorhexidine gluconate (CHG) as an intervention for CAUTI prevention. There was also an insufficient research about indwelling catheters, also known as a Foley catheters, and use of CHG during bathing and indwelling catheter care outside intensive care and CHG benefits relating to indwelling catheter care. To address this issue, we developed and implemented a quality improvement project in an inpatient rehabilitation facility for patients requiring indwelling catheters by integrating Food and Drug Administration-approved CHG products to determine the effectiveness of using 2% versus 4% CHG during bathing and indwelling catheter care to decrease CAUTI occurrences. We observed two CAUTIs for the unit using 4% CHG and zero CAUTIs using the 2% CHG. CAUTIs were associated with chronic renal calculi, missed opportunities with bowel care management, and knowledge deficits of supplemental staff members.
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