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Shielding little warriors: enhancing hygiene with chlorhexidine bathing in paediatric oncology - a quality

Rashmisnata Barman1, Amrita Talukdar2, L Shangnung3

  • 1Department of Microbiology, Dr B Borooah Cancer Institute, Room No. 120, OPD Building, Guwahati, Assam, India. drrashmisnata16nabl@gmail.com.

BMC Health Services Research
|May 21, 2026
PubMed

Insights

Daily chlorhexidine gluconate (CHG) bathing significantly improved infection control compliance in pediatric oncology patients. A quality improvement project boosted adherence from 27% to 64%, demonstrating a scalable, low-cost intervention.

Area of Science:

  • Infection Control
  • Pediatric Oncology
  • Quality Improvement

Background:

  • Pediatric oncology patients face high risks of healthcare-associated infections (HAIs), especially central line-associated bloodstream infections (CLABSIs), due to compromised immunity and central venous catheter (CVC) use.
  • Daily bathing with chlorhexidine gluconate (CHG) effectively reduces skin colonization by multidrug-resistant organisms (MDROs), but compliance is often low.

Purpose of the Study:

  • To assess the feasibility and impact of a quality improvement project (QIP) aimed at increasing daily CHG bathing compliance among pediatric oncology inpatients.
  • To address suboptimal adherence to CHG bathing protocols in a resource-constrained tertiary cancer center in Northeast India, where baseline compliance was only 27%.

Main Methods:

  • A multidisciplinary quality improvement project (QIP) utilized A3 methodology for root cause analysis and intervention development.
  • Interventions included creating a standard operating procedure (SOP), providing structured training, improving infrastructure, and enhancing logistical support over six months (October 2024 - February 2025).
  • Compliance was monitored through daily audits and run charts.

Main Results:

  • Mean weekly CHG bathing compliance increased from a baseline of 27% to 64% by February 2025.
  • The achieved compliance rate exceeded the project target of 60%.

Conclusions:

  • A structured, multi-faceted QIP can substantially improve and sustain adherence to CHG bathing protocols in resource-limited pediatric oncology settings.
  • Daily CHG bathing is a cost-effective and scalable intervention for enhancing infection control.
  • Engaging stakeholders and addressing systemic barriers are crucial for successful implementation and sustained adherence.
Abstract

Keywords:
Central line-associated bloodstream infectionsChlorhexidine gluconateInfection controlMultidrug-resistant organismsPaediatric oncologyQuality improvement

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