Chlorhexidine Bath Procedures to Increase CLABSI Maintenance Bundle Compliance and Decrease CLABSI and CLAMBI Incidence Rates.

Abstract Chlorhexidine Bath Procedures to Increase CLABSI Maintenance Bundle Compliance and Decrease CLABSI and CLAMBI Incidence Rates. Purpose The purpose of the quality improvement (QI) project was to increase the Chlorhexidine (CHG) bath compliance, to decrease Central Line-Associated Bloodstream Infections (CLABSI and Central Line-Associated Mucosal Barrier Injury Infections (CLAMBI) rates in a transplant oncology unit. Background CLABSI and CLAMBI are hospital-acquired infections causing morbidity and mortality worldwide. A project targeting CHG bath compliance was developed to address the increased rates of these infections at a 32-bed transplant oncology unit at a hospital in Dallas, Texas. Methodology Two simulation-based videos were created on the importance of CHG baths and demonstration of CHG wipe application at bedside and administered to the registered nurses (RNs) and patient care technicians (PCTs) in the unit. A pre-and post-intervention quiz was used to assess knowledge. Post-intervention data were collected through daily audits and monthly infectious disease reports on CHG bath compliance, CLABSI, and CLAMBI incidence. The Plan-Do-Study-Act (PDSA) model was used to guide the project. Results Forty-four RNs and PCTs participated in the project. The post-implementation data showed 95% reduction in CLAMBI rate, 100 % decrease in CLABSI rates, and an increase in daily CHG bath compliance from 57% to 84.2%. The pre-quiz was completed by 23 participants and 18 completed the post-quiz. Post-quiz results showed improvement: 89% participants scored 100%, and 11% scored between 90–99%. Implications This project supports the reinforcement of CHG bath compliance in decreasing CLABSI and CLAMBI incidence rates. Future efforts should focus on the education and reinforcement of the entire CLABSI bundle compliance. Key words: Chlorhexidine, CLABSI, CLAMBI, compliance, bundle, bloodstream infection.