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  1. 1. TEMPLATE DESIGN © 2008 The purpose of this project is to determine the effectiveness in decreasing illness in the medical surgical setting upon using chlorhexidine wipes. Our investigation compared several research studies that discussed the use of chlorhexidine wipes. The majority of the findings discovered that the use of chlorhexidine wipes decreased the spread of infection, decreasing the risk for illness. According to research published by Infection Control and Hospital Epidemiology, it was found that bathing patients daily with chlorhexidine wipes instead of the traditional soap and water method decreased the acquisition of MRSA (Viray et al., 2014). The determination of these findings is important to anyone working in the healthcare setting to better ensure the safety of patients. Utilizing chlorhexidine wipes can increase the patients’ safety by decreasing the spread of infection. After obtaining this knowledge about chlorhexidine wipes, one would question why anyone would not want to use them. ABSTRACT CLINICAL PROBLEM/SIGNIFICANCE CLINICAL QUESTION LITERATURE REVIEW Description of Evidence Based Practice WIPE AWAY YOUR WORRIES: AN INVESTIGATION OF THE EFFECTIVENESS OF CHLORHEXADINE BATHING KARLY BROOKS, PAIGE DICKEY, MARI GRAY, CHOURTNEY HAHN Mentor: Ginger Holloway MSN, R.N., and Lisa Johnson BSN, R.N. IMPLICATIONS FOR MEDICAL SURGICAL NURSING PRACTICE REFERENCESWill medical surgical patients bathing daily with chlorhexidine wipes decrease hospital acquired illness? Our research question addresses the Joint Commission patient safety goal of preventing infection (Joint Commission on Accreditation of Healthcare Organizations [JCAHO], 2013). Hines, A. G., Nuss, S., Rupp, M. E., Lyden, E., Tyner, K., & Hewlett, A. (2015). Chlorhexidine bathing of hospitalized patients: beliefs and practices of nurses and patient care technicians, and potential barriers to compliance. Infection Control & Hospital Epidemiology, 36(8), 993-994. doi: 10.1017/ice.2015.92 Noto, M. J., Domenico, H. J., Byrne, D. W., Talbot, T., Rice, T. W. ... Wheeler, A. P. (2015). Chlorhexidine bathing and health care-associated infections: a randomized clinical trial. Journal of the American Medical Association, 313(4), 369-378. doi:10.1001/jama.2014.18400 O’Quinn, L., Geigle, G., Baker, R., Baker, S., Beckman, E. … Workman, L. (2013). Cincinnati Children’s Hospital Medical Center. Best evidence statement (BESt). Daily bathing of children in critical care settings with chlorhexidine gluconate. Retrieved from content.aspx?id=47066&search=chlorhexidine. Podgorny, K., & Kuhmar, S. (2013). The Joint Commission's implementation guide for NPSG.07.05.01 on surgical site infections: The SSI change project. Retrieved November 1, 2015 from Rupp, M. E., Cavalieri, R. J., Lyden, E., Kucera, J., Martin, M., Fitzgerald, T. ... Vanschooneveld, T. C. (2012). Effect of hospital-wide chlorhexidine patient bathing on healthcare-associated infections. Infection Control & Hospital Epidemiology, 33(11), 1094-1100. doi:10.1086/668024 The Joint Commission on Accreditation of Healthcare Organizations. (2015). 2015 Hospital National Patient Safety Goals (NPSG.07.05.01). Retrieved from Viray, M. A., Morley, J. C., Coopersmith, C. M., Kollef, M. H., Fraser, V. J., & Warren, D. K. (2014). Daily bathing with chlorhexidine-based soap and the prevention of Staphylococcus aureus transmission and infection. Infection Control & Hospital Epidemiology, 35(3), 243-250. doi: 10.1086/675292 Wensen, C., Quan, C., Songqin, L., Huifen, L., & Weihong, Z. (2015). Impact of daily bathing with chlorhexidine gluconate on ventilator associated pneumonia in intensive care units: a meta-analysis. Journal Of Thoracic Disease, 7(4), 746-753. doi:10.3978/j.issn. 2072-1439.2015.04.21 Hospital Acquired Infections [Online Image]. (2015). Retrieved November 3, 2015 from A literature review was completed using several different key-words such as: chlorhexidine, bathing, infection, daily bathing, and protocol. Results from our literature review are featured below: When comparing bathing with chlorhexidine-based soap and traditional bathing methods in ICU patients, chlorhexadine based was more effective in reducing acquisition of MRSA (Viray et al., 2014). Strictly adhering to chlorhexidine bathing methods reduces the likelihood of C. difficile infection (Rupp et al., 2012). Daily bathing with chlorhexidine did not reduce the incidence of healthcare-associated infections including CLABSIs, CAUTIs, VAP, or C difficile. Daily bathing of critically ill patients with chlorhexidine is not recommended (Noto, et al., 2015). A meta-analysis of a variety of studies determined that daily bathing with 2% chlorhexadine gluconate wipes in patients with ventilators reduces the risk of ventilator associated pneumonia by 27% in ICU settings (Wensen, Quan, Songqin, Huifen, & Weihong, 2015). There is potential for reduced risk for infection if more thorough nursing education were provided in order to promote adherence to chlorhexidine bathing practices (Hines et. al., 2015). According to, bloodstream infection acquisition can be reduced by daily chlorhexidine bathing (O’Quinn et. al, 2013). Despite the amount of healing that takes place in a hospital, a hospital is a dangerous place, oozing with infection. Many clients come into the hospital with one condition and acquire another during the duration of their stay. Can a particular intervention be implemented to reduce the number of hospital-acquired infection? Our research focused on whether or not daily bathing with chlorhexidine wipes would reduce the amount of hospital-acquired infections in the adult care setting. Although our research is limited to the adult care setting, this information could be applied in all hospital settings. During observation in our clinical setting, we determined that our chlorhexidine wipe bathing intervention was only utilized with pre-operative patients. When reviewing evidence-based articles, we determined that some facilities do utilize chlorhexidine wipes on a frequent basis in order to reduce the likelihood of hospital-acquired infection. The occurrence of C. difficile and MRSA were greatly reduced in a variety of facilities when chlorhexidine bathing was utilized. In order to reduce hospital-acquired illness, it is recommended that nurses frequently utilize chlorhexidine wipes in the hospital. Every nurse should be cognizant that even minor actions can make a big difference when it comes to infection control. Using chlorhexidine to provide bathing promotes the safety and well being of patients. Daily bathing of children in critical care settings with chlorhexidine gluconate guideline: •Patients should receive a daily bath using 2% chlorhexidine gluconate to reduce the risk of bloodstream infection (O’Quinn et. al, 2013). •The wipes should be used on patients with intact skin (O’Quinn et. al, 2013). •Recommendation adherence will require stocking of CHG-impregnated washcloths on the inpatient critical care units and education to nursing staff that provide care in the critical care units (O’Quinn et. al, 2013). •Education to patients and families will also be required to support family centered care (O’Quinn et. al, 2013). By placing emphasis on using chlorhexidine wipes for daily bathing in all medical surgical nursing locations, nurses could decrease the risk for hospital-acquired infections and therefore increase patient safety. By assuming nurses are compliant in implementing this research, this bathing intervention has the potential to significantly reduce mortality rates and limit healthcare spending wasted on caring for hospital-acquired illnesses. Our findings would be effective if used around the globe, as hospital-acquired infections are such a pressing concern. This specific implication should not only be recognized in medical surgical floors but throughout healthcare facilities.