Chlorhexidine gluconate bathing: does it decrease hospital-acquired infections?

As pay for performance becomes more prevalent, hospitals struggle to improve processes, especially those for preventing hospitalacquired infections (HAIs). Many hospital programs seek out evidence-based “best practices” to keep patients safe from deadly and costly HAIs. Critical care nurses have begun examining even the most rudimentary tasks, such as bathing patients, and the processes inherently associated with them. It has been suggested that a bathing procedure that focuses on decolonization may decrease HAI rates. This procedure routinely includes administration of a nasal antibacterial agent and then bathing patients with a solution of 2% to 4% chlorhexidine gluconate, each for a series of days. It has also been suggested that bath basins may be a source of bacterial transmission. Further, use of a bath basin may lead to contamination of other items such as the sink for hand washing. These suggestions bring into focus several important steps that nurses must take to help keep patients safe from HAIs, although we cannot assume that these few steps are the complete answer for prevention. The Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America have developed a compendium of recommendations to prevent transmission of multidrug-resistant organisms and HAIs in acute care hospitals. The idea is that if procedures outlined in the compendium are performed, HAIs such as ventilator-associated A regular feature of the American Journal of Critical Care, Clinical Evidence Review unveils available scientific evidence to answer questions faced in contemporary clinical practice. It is intended to support, refute, or shed light on health care practices where little evidence exists. To send an eLetter or to contribute to an online discussion about this article, visit www.ajcconline.org and click “Respond to This Article” on either the full-text or PDF view of the article. We welcome letters regarding this feature and encourage the submission of questions for future review.