None listed
Conditions
Brief summary
The aim of this study is to evaluate the impact of a change to universal patient decolonization in ICU based on emerging evidence. Universal decolonization is the therapeutic administration of bathing with a chlorhexidine impregnated cloth daily to all ICU patients with the goal of decreasing hospital-acquired bloodstream infections and the acquisition of multidrug resistant organisms. Recent studies have shown that such administration of daily chlorhexidine bathing to ICU patients is more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection from any pathogen. In response to these findings there is now consensus among ICU specialists, infectious diseases specialists and the Pharmacy Department that a policy of universal decolonization should be implemented in the Austin ICU beginning in early 2014. Bathing will be completed according to manufacturer instructions. In brief, washcloths will be used in sequential order to rinse all body surfaces with the exception of the face during bathing with the 2% chlorhexidine-impregnated cloths in order to avoid exposure of the mucous membranes to the eyes and mouth. A manufacturer-produced video will be used to instruct nurses on the application of these cloths. Such washing will be applied within 4-6 hours of admission and, thereafter, daily at practically convenient times and at intervals no greater than 24 hours. Our primary outcome is the incidence of ICU acquired blood stream infections during the observation period. All relevant data on patient characteristics, diagnoses and illness severity will continue to be collected as is routine in ICU. All microbiological data will continue to be collected as is routine or clinically indicated in ICU.
Interventions
For a period of 12-months, at admission, and daily thereafter until discharge from ICU, critically ill patients admitted to the intensive care unit will have bathing performed using 2% chlorhexidine-impregnated washcloths.
Specifically, bathing will be completed according to manufacturer instructions. In brief, washcloths will be used in sequential order to rinse all body surfaces with the exception of the face during bathing with the 2% chlorhexidine-impregnated cloths in order to avoid exposu
For a period of 12-months, at admission, and daily thereafter until discharge from ICU, critically ill patients admitted to the intensive care unit will have bathing performed using 2% chlorhexidine-impregnated washcloths. Specifically, bathing will be completed according to manufacturer instructions. In brief, washcloths will be used in sequential order to rinse all body surfaces with the exception of the face during bathing with the 2% chlorhexidine-impregnated cloths in order to avoid exposure of the mucous membranes to the eyes and mouth. A manufacturer-produced video will be used to instruct nurses on the application of these cloths. Such washing will be applied within 4-6 hours of admission and, thereafter, daily at practically convenient times and at intervals no greater than 24 hours. The adherence to the use of the 2% chlorhexidine-impregnated washcloths will be performed by medical record audit of medication use.
Sponsors
Austin Health
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Healthy volunteers
No
Inclusion criteria
All patients admitted to the Austin Hospital ICU will be eligible for this audit.
Exclusion criteria
Nil
Outcome results
None listed