Title : Improving compliance of Chlorhexidine Gluconate (CHG) bathing through team-based communication strategies
Abstract:
Background: Hospital-acquired infections (HAIs), including central line-associated bloodstream infections (CLABSIs), remain a significant source of patient harm. Daily chlorhexidine gluconate (CHG) bathing is an evidence-based intervention shown to reduce infection risk; however, inconsistent practice and documentation limit its effectiveness in acute care settings.
Purpose: This quality improvement project aimed to increase the reliability of CHG bathing for eligible hospitalized patients on an adult internal medicine unit at a large academic medical center.
Methods: A multidisciplinary team led by a Clinical Resource Nurse implemented a series of Plan-Do-Study-Act (PDSA) cycles to improve CHG bathing compliance. Interventions included staff education, standardization of workflow, improved supply accessibility, visual reminders, and audit-and-feedback processes. Compliance data were tracked through routine audits, with a target reliability rate of ≥90%.
Results: CHG bathing compliance improved substantially following implementation of targeted interventions, with sustained gains observed over time. Increased staff awareness, improved access to supplies, and ongoing feedback were key drivers of success. Enhanced documentation accuracy also contributed to more reliable measurement of practice.
Conclusion: Improving reliability of evidence-based infection prevention practices such as CHG bathing can reduce patient risk and enhance quality of care. This project demonstrates how structured quality improvement methods and frontline nursing engagement can lead to sustainable practice change. Future work will focus on expanding this approach to other units and exploring the impact on infection outcomes.
