Document Type
DNP Project
Publication Date
5-2022
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Sylvie Rosenbloom, DNP, APRN, FNP-BC, CDCES
Practice Mentor
Alex Xelas, MSN, RN, CIC
Abstract
Introduction
Patients admitted to hospitals are at risk for developing Healthcare-acquired Infections (HAIs). Evidence suggests that these infections, including Central Line Associated Infections (CLABSIs), increase the cost of patient care and have a negative impact on patient outcomes. Daily chlorhexidine (CHG) bathing has been identified to help decrease HAIs in the hospital for patients in the Intensive Care Unit (ICU), those with Multi-drug Resistant Organisms (MDROs), and/or patients with a Central Venous Catheter (CVC).
Purpose
The purpose of this project is to implement an intervention to assess and improve CHG bathing adherence for hospitalized patients. Patients targeted include those at risk for developing an HAI, specifically patients in the ICU, those with an MDRO, and patients with a CVC. Methods to improve adherence include staff education, automatic electronic orders, and electronic medical record (EMR) reminders to assigned staff.
Interventions and Setting
This project developed a monitoring system to assess CHG bathing adherence. The project provided staff education on CHG bathing and made changes to the EMR, promoting CHG bathing adherence. EMR changes included automatic CHG bathing orders and daily pop-up reminders for assigned staff. This project took place at a nonprofit community Hospital in a suburb of NY in the ICU and other inpatient units. Pre-intervention data was collected from April 2021 through June 2021. Education and EMR changes began July 1st, 2021, and post-intervention data was collected from July 2021 through September 2021. This project is IRB exempt and approved as a quality improvement (QI) project.
Evaluation
The project was evaluated based on CHG bathing adherence pre and post intervention. CHG bathing increased from 76% to 85% for the ICU, 54% to 65% for CVC, and 29% to 46% for patients with MDROs. There was an overall increase in CHG bathing adherence post intervention.
Discussion
This project suggests that CHG bathing education and electronic reminders may help to improve CHG bathing adherence for hospital patients in the ICU, with CVCs, and with MDROs. Project details will be disseminated to support ongoing monitoring of CHG bathing adherence and future projects.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Benedetto, M. (2022). Increasing adherence of CHG bathing: An evidence-based practice quality improvement project [Unpublished DNP project]. Sacred Heart University.
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.