Demonstrating Efficacy of CHG Bathing Treatment for Inpatient Adult Hematopoietic Stem Cell Transplant Recipients Improves Daily Compliance Among Staff.

Topic Significance & Study Purpose/Background/Rationale Daily chlorhexidine gluconate (CHG) bathing is recommended as a method to decrease blood stream infections (BSI) in intensive care units; this strategy may also be effective in hematopoietic stem cell transplant (HSCT) units. Methods, Intervention, & Analysis CHG bathing treatment was initiated in the Adult HSCT unit as standard clinical care in January 2017. Patients admitted for HSCT and recovery from January 2016 through August 2018 were reviewed. Patients transferred from outside hospitals or units were excluded. Patients were grouped by frequency of documented CHG bathing treatment: (1) no CHG (includes patients before CHG implementation and patients with no CHG even after implementation); (2) <50% of admission days; (3) 50-75% of admission days; or (4) >75% of admission days. CHG treatment frequency was evaluated until discharge, transfer off unit, or BSI, whichever came first. BSI was defined as either ≥2 positive blood cultures or a single positive blood culture within 24 hours of meeting ≥1 SIRS criteria. A chi square test for trend was performed to evaluate the association between CHG frequency and BSI. Findings & Interpretation One hundred eighty-six inpatients met inclusion criteria (n=79 pre-CHG implementation, 107 post-CHG). BSI developed in 28% of patients with no CHG treatment, 20% with <50% CHG treatment, 10% with 50-75% CHG treatment, and 0% with >75% CHG treatment (Table 1). Increased CHG treatment frequency was significantly associated with decreased BSI (p = 0.0028). Discussion & Implications In this retrospective study, CHG bathing treatment was associated with significantly reduced BSI in adult HSCT inpatients. After preliminary data were shared among staff, compliance with daily CHG treatment (>75% of admission days) has increased 7.2-fold in 2018 compared to 2017. Efforts are ongoing to increase compliance by collaborating with hospital informatics to facilitate CHG treatment reminders and improve accuracy of documentation through incorporating CHG bathing orders into the electronic medical record. [ABSTRACT FROM AUTHOR]