ORCID ID
Graduation Date
Winter 12-20-2024
Document Type
Thesis
Degree Name
Master of Science (MS)
Programs
Medical Sciences Interdepartmental Area
First Advisor
Mark Rupp, MD
Second Advisor
Roslyn Mannon, MD
Third Advisor
Trevor Van Schooneveld, MD
Fourth Advisor
Kelly Cawcutt, MD MS
MeSH Headings
Epidemiology
Abstract
Bathing intensive care unit (ICU) patients with chlorhexidine gluconate (CHG) decreases hospital acquired infections (HAIs). The optimal method of CHG bathing remains undefined. Prospective cluster crossover study comparing CHG daily bathing with 2% CHG impregnated cloths versus 4% CHG solution. In phase 1, from January 2020 through March 2020, one ICU utilized 2% cloths, while the other ICU utilized 4% solution. After an interruption caused by the COVID-19 pandemic, in phase 2, from July 2020 through September 2020, the unit CHG bathing assignments were reversed. Swabs were performed three times per week from patients’ arms and legs to measure skin microbial colonization and CHG concentration. Other outcomes included HAIs, adverse reactions, and skin tolerability.
411 assessments occurred after baths with 2% cloth, 425 assessments after baths with 4% solution, and 54 assessments after no bath. Average microbial colonization was 691 (interquartile range 0, 30) colony forming unit per square centimeter (CFU/cm2 ) for patients bathed with 2% cloths, 1,627 (0, 265) CFUs/cm2 for 4% solution, and 8,519 (10, 1130) CFUs/cm2 for patients who did not have a CHG bath (P<0.001). Average CHG skin concentration (parts per million) was 1300.4 (100, 2000) for 2% cloths, 307.2 (30, 200) for 4% solution, and 32.8 (0, 20) for patients without a recorded CHG bath. Both CHG bathing methods were well-tolerated. Although underpowered, no difference in HAI were noted between groups. Either CHG bathing method resulted in a significant decreased in microbial skin colonization with a greater CHG concentration and fewer organisms associated with 2% CHG cloths.
Recommended Citation
Hankins, Richard J., "Prospective, Crossover, Comparative Study of Two Methods of Chlorhexidine Bathing" (2024). Theses & Dissertations. 899.
https://digitalcommons.unmc.edu/etd/899
Comments
2024 Copyright, the authors