Reduction in patient refusal of CHG bathing.

• Daily chlorhexidine gluconate (CHG) bathing can reduce patient's infection risk. • Patient refusal of CHG bathing is noted to be a major barrier to compliance. • Iterative Plan-Do-Study-Act cycles were implemented to target patient refusals. • After 6 months, patient refusal of CHG bathing and CLA...

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Publicado en:American Journal of Infection Control Vol. 51; no. 9; pp. 1034 - 1038
Autores principales: Destine, Yvette, Capes, Kellie, Reynolds, Staci S.
Formato: research Journal Article
Publicado: Elsevier B.V. Sep2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2023
      vid: 51
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      pub: Elsevier B.V.
      place: New York, New York
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        170085136
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        10.1016/j.ajic.2023.01.007
        170085136
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        atl: Reduction in patient refusal of CHG bathing.
      aug:
        au:
          Destine, Yvette
          Capes, Kellie
          Reynolds, Staci S.
        affil: Duke Regional Hospital, Durham, NC
      sug:
        subj:
          Treatment Refusal Prevention and Control
          Patient Compliance
          Catheter-Related Bloodstream Infections
          Nursing Staff, Hospital Psychosocial Factors
          Nursing Knowledge
          Outcomes (Health Care)
          Human
          Quality Improvement
          Program Implementation
      ab: • Daily chlorhexidine gluconate (CHG) bathing can reduce patient's infection risk. • Patient refusal of CHG bathing is noted to be a major barrier to compliance. • Iterative Plan-Do-Study-Act cycles were implemented to target patient refusals. • After 6 months, patient refusal of CHG bathing and CLABSI rates decreased. Daily chlorhexidine gluconate (CHG) bathing is a well-supported intervention to reduce patient's risk of central line associated bloodstream infection (CLABSI); however, compliance with this practice is suboptimal. One major barrier is patient refusals of CHG bathing. The purpose of this project was to implement tailored interventions to mitigate this barrier. The specific aims were to reduce patient refusals, increase compliance with CHG bathing, and evaluate CLABSI rates and nursing staff's knowledge of CHG bathing. Iterative Plan-Do-Study-Act (PDSA) cycles were implemented over the course of 6 months. Run charts were used to identify signals of improvement. Interventions included printed educational flyers for staff and patients, educational sessions, an electronic learning module, and a "badge buddy." We saw a reduction in the median percentage of patient refusals documented, from 23% to 8% after the PDSA cycles. Documentation compliance with CHG bathing increased only slightly from 46% to 47%. CLABSI rates decreased 6% from 0.69 to 0.65. Using interventions tailored to the clinical setting can impact patient outcomes. Other health care systems should consider implementing PDSA cycles to improve evidence-based practices. Using PDSA cycles can result in a reduction in patient refusal documentation, and may slightly improve CHG bathing compliance and CLABSI rates.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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