Becker's Clinical Quality & Infection Control

23 Executive Briefing Preventing Patient Infections: Common CHG Bathing Questions, Answered S urgical site infections, central line-associated bloodstream infections, catheter-associated urinary tract infections and ventilator-associated pneumonia — what do they have in common? Beyond being harmful and costly healthcare-associated infections, they are also similar in that bundled approaches using chlorhexidine gluconate can help prevent them. Chlorhexidine gluconate, or CHG, is a chemical with broad-spectrum antimicrobial properties. Increasingly, studies have found that, as part of a bundle, daily use of CHG is tied to decreases in rates of the aforementioned infections. For instance, a study presented at the annual conference of the Association for Professionals in Infection Control and Epidemiology found daily bathing with CHG for pediatric patients cut bloodstream infections by 59 percent. Additionally, studies have found that bathing with CHG can help reduce methicillin-resistant Staphylococcus aureus and Clostridium difficile infections. But for CHG bathing to work effectively, the product must be applied properly every time. That's where hospital and staff patient education comes in, according to Ann Meyer, the clinical manager for antiseptics at Mölnlycke Health Care. Ms. Meyer spends time traveling to hospitals talking with staff about their processes and helping them incorporate CHG bathing into their protocols. During her time in the field working with managers and front-line workers alike, Ms. Meyer has fielded many questions regarding CHG in general and also about HIBICLENS, Mölnlycke Health Care's 4 percent CHG soap product. Below are some of the common questions or misconceptions she has encountered during her time working with hospitals. Isn't killing all of the flora on a patient harmful? It is true that CHG will kill off normal, usually harmless, flora from a patient's skin. But, as Ms. Meyer puts it, "Why wouldn't you want it dead?" For instance, many patients are colonized with Staphylococcus aureus, which is generally not a problem. But when a patient goes into a high-risk situation like a surgery or the intensive care unit, flora usually found on the body could cause an infection, Ms. Meyer says. Additionally, the harmless flora killed by the CHG solution will grow back in time. Her motto is, "Bathe the patient in the hospital, protect them in the hospital, then send them home and let it [the flora] all grow back." Aren't we developing more resistant bacteria by using CHG? Antibiotic resistance is a hot topic in healthcare today, making many front-line clinicians and managers alike more concerned with how they can contribute to slowing down the spread of antibiotic resistance. But Ms. Meyer says CHG use shouldn't be tied to the issue of antibiotic resistance. "CHG works differently than an antibiotic; it has a different mechanism of action 1 ," Ms. Meyer explains. There has been little evidence of bacteria developing resistance to clinical concentrations of CHG (4 percent and 2 percent). Sponsored by:

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