- •A targeted intervention to improve patient understanding and use of CHG washes.
- •71% (n = 129) of participants used CHG the recommended two times.
- •Information received from the preadmissions nurses was highly rated.
- •Inconsistent information across the hospital remained an issue.
Despite a lack of consensus around which type of preoperative wash is most effect in preventing surgical site infection, their use in clinical practice remains common. Chlorhexidine gluconate (CHG) is widely used however a previous study indicated issues with patient understanding and use of CHG. In response an intervention was developed which aimed to improve patient understanding and compliance with CHG.
A patient information sheet and a standardised script to guide preadmission phone calls were developed to improve the delivery of information to patients at the study hospital. These interventions were implemented for four months with adult surgical inpatients. A cross-sectional survey was then conducted to assess the effectiveness of the intervention.
A 75% (n = 226) response rate was attained. The majority of participants (86%, n = 189) used CHG prior to their surgical procedure and of these 71% (n = 129) used CHG the recommended two times. The quality of information received from the preadmissions nurses was rated more highly than information delivered by other hospital staff. Openended questions revealed key issues including lack of information, time and access issues, and inconsistencies in CHG use.
The value of standardised calls and information sheets was evident in participants who reported receiving these measures. A moderate increase was seen from the original study in the number of participants who used CHG washes the recommended two times. However, issues remained with inconsistent information across the hospital. Clinicians need to draw on high quality, contemporary research to inform clinical practice.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Infection, Disease & Health
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- To bathe or not to bathe with chlorhexidine gluconate: is it time to take a stand for preadmission bathing and cleansing?.AORN J. 2015; 101: 529-538
- Preoperative bathing of the surgical site with chlorhexidine for infection prevention: systematic review with meta-analysis.Am J Infect Contr. 2017; 45: 343-349
- A fresh look at preoperative body washing.J Infect Prev. 2012; 13: 11-15
- Does perioperative skin preparation reduce surgical site infection?.Laryngoscope. 2018; 128: 1987-1989
- Preoperative chlorhexidine shower or bath for prevention of surgical site infection: a meta-analysis.Am J Infect Contr. 2013; 41: 167-173
- Pre-operative bathing or showering with skin antiseptics to prevent surgical site infection.Cochrane Database Syst Rev. 2012;
- Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.Cochrane Database Syst Rev. 2006; 19
- Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.Cochrane Database Syst Rev. 2015; 20
- Preventing surgical- site infections in nasal carriers of staphylococcus aureus.N Engl J Med. 2010; 362: 9-17
- Care bundle to prevent methicillin-resistant staphylococcus aureus sternal wound infection after off-pump coronary artery bypass.Am J Infect Contr. 2014; 42: 562-564
- Active surveillance screening of MRSA and eradication of the carrier state decreases surgical-site infections caused by MRSA.J Am Coll Surg. 2009; 208: 981-986
- Preoperative screening/decolonization for staphylococcus aureus to prevent orthopaedic surgical site infection: prospective cohort study with 2-year follow-up.J Arthroplast. 2011; 26: 1501-1507
- Effect of a preoperative decontamination protocol on surgical site infections in patients undergoing elective orthopedic surgery with hardware implantation.JAMA Surg. 2015; 150: 390-395
- Implementation of an infection prevention bundle and increased physician awareness improves surgical outcomes and reduces costs associated with spine surgery.J Neurosurg Spine. 2018; 29: 108-114
- Systematic review of a patient care bundle in reducing staphylococcal infections in cardiac and orthopaedic surgery.ANZ J Surg. 2017; 87: 239-246
- National statement on ethical conduct in human research.Australian Government, CanberraMay 2015
- Handbook of health survey methods. Hoboken, New Jersey.2014
Published online: July 23, 2019
Accepted: June 10, 2019
Received in revised form: June 10, 2019
Received: April 22, 2019
© 2019 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.