Daily Chlorhexidine Gluconate Bathing Reduces CLABSI Rates

Administration of bortezomib using Palindrome dialysis catheter access
Administration of bortezomib using Palindrome dialysis catheter access

SAN ANTONIO, Tex.–Daily chlorhexidine gluconate (CHG) bathing on all patients with ports and tunneled catheters decreased the rates of central line bloodstream infections (CLABSI) on an inpatient oncology unit, a study presented at the ONS 41st Annual Congress has shown.1

“CLABSI is a preventable adverse event that affects quality of life, causes economic burden on the patient and health care system, and may even result in death,” said Helen Jackson, MSN, APRN-CNS, GCNS-BC, a clinical nurse specialist at Nebraska Methodist Hospital in Omaha. “Prevention of CLABSI should be a front-line focus for any oncology unit.

In 2013 and the beginning of 2014, the oncology unit at Nebraska Methodist Hospital implemented many evidence-based interventions, including: the use of alcohol permeated caps; a 2-person blood draw process; the use of neutral displaced injection caps; and the creation of an IV team to access all ports and do all dressing changes.

Then in August 2014, daily CHG bathing of all patients with ports and tunneled catheters was implemented. Two nursing assistants were recruited to champion CHG bathing and staff participated in individual meetings to discuss the change. The transition ultimately took approximately 3 months to become daily practice for all nursing staff on the oncology unit.

Since the implementation of daily CHG bathing, there have only been 5 CLABSI. Of those, 1 was a PICC, 1 was gut epithelial disruption and translocation, 1 was associated oropharyngeal translocation, 1 was gram-positive staphylococcus, and 1 was associated with yeast/mold. There have been no CLABSI on the oncology unit as of April 15, 2016.

Because of the positive outcome, this practice was adopted throughout the hospital for all central lines.

REFERENCE

1. Jackson H. Chlorhexidine gluconate (CHG) bathing for port and tunneled catheter patients. Oral presentation at: 2016 Oncology Nursing Society Annual Congress; April 28-May 1, 2016; San Antonio, TX.

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