The use of chlorhexidine gluconate wipes for patient hygiene may lower central line-associated bloodstream infection rates among patients with cancer, according to the results of a study presented at the Oncology Nursing Society Annual Congress.
Central line-associated bloodstream infections (CLABSI) can lead to treatment delays and sepsis-related death in patients with cancer. Thus, prevention of infection is crucial in this immunocompromised population.
“We made chlorhexidine gluconate [CHG] wipes common practice,” Lauri Brunton, RN, OCN, of University of California Davis Medical Center, told HemOnc Today. “We will continue to monitor infection rates but as of March, we had no infections. I recommend and can confirm that literature regarding CHG efficacy is valid, and CHG wipes can lower infection rates.”
Brunton and colleagues used evidence-based practices to lower CLABSI rates in a hematology/oncology stem cell transplant unit because they were above the National Healthcare Safety Network 2% benchmark.
To lower CLABSI rates, researchers examined hand hygiene, environmental cleaning and patient bathing. They determined hand hygiene and environmental hygiene compliance was acceptable and directed their attention to patient bathing practices, which were inconsistent.
Based on a literature review, Brunton and colleagues implemented the use of 2% CHG wipes for all patients and discontinued the use of wash basins with soap and water for bathing.
Nurses and physicians were educated about the efficacy and importance of using CHG wipes for patient bathing. Nurses also educated patients and reinforced that education using technique posters in each room.
Infection rates dropped in the quarter following CHG wipe implementation. Temporary line infections went from 7.09% to 1.63%, and permanent line infection rates fell from 3.7% to 3.13%.
Early third quarter results also showed preventable CLABSI — which is not related to mucosal barrier injury — decreased from an infection rate of 3.5% in quarters 1 and 2 to 0%.
“Due to heavy patient volume, simple infection prevention techniques can be left unaddressed and that goes for all healthcare providers with patient-interaction,” Brunton said. “We wanted to make a change that was evidence-based which meant washing the bed and high-touch areas twice per shift and using CHG wipes.” – by Nick Andrews
Readings & Resources (click to view)
Brunton L, et al. Presented at: ONS Annual Congress; April 28-May 1, 2016; San Antonio, Texas.