Chlorhexidine Gluconate Impregnated Waterless Bath System for the Reduction of Blood Stream Infections in the BMT Population

Title: Chlorhexidine Gluconate Impregnated Waterless Bath System for the Reduction of Blood Stream Infections in the BMT Population

Robin McFarland Rosselet, MS, RN, CNP, AOCN; Misty Lamprecht, MS, RN, CNS, AOCN

Objectives:  The primary objective was to determine whether blood and marrow transplant (BMT) patients bathed daily with chlorhexidine gluconate (CHG)  waterless bath system have lower incidence of  skin flora associated (i.e. Staphylococcus epidermis, Staphylococcus aureus) central line associated blood stream infections (CLABSI) and total CLABSIs compared to patients bathed with the standard CHG soap and water method.

Background: Patients undergoing BMT are immunocompromised hosts whose leading cause of death during the transplant process is infection.  Multiple studies have presented solid evidence that hospital water systems and bath basins are the source of serious waterborne nosocomial infection and exposure comes from showering and bathing. A number of studies in the medical intensive care units have shown a significant reduction in hospital acquired CLABSIs after implementing the use of CHG waterless bath system.

Methods:  This project was an innovative, evidence based intervention to decrease CLABSI rates (5.2/1000 catheter days) through the use of a CHG impregnated waterless bath system for daily hygiene.  It included (N=281; 3451 catheter days) historical controls who showered using CHG soap and water bathing during their admission for BMT versus (N=290; 3838 catheter days) patients bathed with CHG waterless bath system. Data for both groups was extracted from a BMT program database.   Outcome measures included incidence of total CLABSI and skin flora associated CLABSI.

Results:   BMT patients bathed with CHG waterless bath intervention had significantly fewer CLABSI associated with skin flora (Staphylococcus epidermis & Staphylococcus aureus) (p <0.05). Overall CLABSI rate were reduced from 5.2/1000 catheter days to 4.1/1000 catheter days which did not reach statistical significant but showed an important downward trend.

Conclusions: Daily bathing of patients with CHG waterless bath system significantly decreased CLABSI, associated with skin flora.  It is an easy, time-efficient, cost-effective intervention to decrease these infections in patients undergoing a BMT.