It has been a very busy week back on the consult service so my blogging has been light.Chlorhexidine (CHG) bathing decreases multi-drug resistant organisms acquisition and decreases hospital acquired bloodstream infection rates, particularly in ICUs.
But having a bathing policy for CHG bathing and actually implementing it with high reliability are two different matters. The other day I met with nurse leadership at my institution to underscore the need for heightened implementation of CHG bathing.
Requiring mandatory, web-based training and re-training on bathing is the next step in raising awareness.
Option to measure CHG bathing include:
- Choosing not to assess CHG bathing: Not likely the best option
- Performing direct patient observation of CHG bathing: not practical, privacy concerns
- Performing skin calorimetry assessment of CHG residue post bath, as done in research protocols: not feasible
- Requiring electronic medical record (EMR) structured documentation with audit and feedback- bingo!
It may not be sexy and it may not be the most reliable (documentation does not confirm that bathing was done accurately) but a may be a satisfactory albeit imperfect way of measuring patient CHG bathing.
This is exactly what we will continue to do, communicating the EMR mined bathing automated reports back to unit and hospital leadership on a monthly basis.
Not surprisingly, CHG bathing practice and documentation is improving.
