AUTHOR BIOGRAPHIES
Tanisha Davis, DNP, RN, Quality, Allegheny Health Network
Tanisha Davis (tanisha.davis@ahn.org) is a registered nurse and U.S. Navy veteran with over 25 years of healthcare experience and has specialized as a quality improvement leader for the last 11 years. She completed her baccalaureate at Florida State University, her master’s degree at University of Pittsburgh, and doctor of nursing practice at Capella University.
*Corresponding author
Susanne Wittmann, MSHSA, BSN, RN, Nursing, Allegheny Health Network
Susanne Wittmann received her Bachelor of Science in nursing from the University of Pittsburgh and a Master of Science in health service administration from the University of St. Francis in Joliet, Illinois. She has over 30 years of nursing experience in a variety of roles, including patient care, management, education, and quality in a four-time Magnet-recognized acute care hospital.
Beth A. Prairie, MD, MPH, Chief Medical Officer, Allegheny Health Network
Beth A. Prairie is board certified in both obstetrics and gynecology and preventive medicine. Dr. Prairie has more than 15 years of experience working in process improvement in hospitals and public health departments. Currently, she serves as the chief medical officer for West Penn Hospital in Pittsburgh, Pennsylvania. Dr. Prairie completed her medical degree at the University of New Mexico School of Medicine and her residency training with a Master of Public Health at Dartmouth Hitchcock Medical Center in New Hampshire.
Nancy Dugan, MSN, RN, Infection Prevention, Allegheny Health Network
Nancy Dugan, a registered nurse and infection preventionist, has 23 years of experience in both acute care and critical care settings. She holds a Certificate of Infection Control from the Certification Board of Infection Control and Epidemiology, Inc. She completed her Bachelor of Science from the University of Pittsburgh and Master of Science from Carlow University.
Patricia Reiser, BSN, RN, Vascular Access Team, Allegheny Health Network
Patricia Reiser completed her Bachelor of Science in nursing through Capella University. She has over 40 years of nursing experience, primarily in oncology nursing in both the inpatient and outpatient setting. In addition, she has completed vascular access training and education through the Infusion Nurses Society and Association for Vascular Access over 25 years ago.
Leah Goclano, MHA, BS, Infection Prevention, Allegheny Health Network
Leah Goclano is a microbiologist and infection preventionist with over 13 years of experience. She completed both her Bachelor of Science in microbiology and her Master of Health Administration from the University of Pittsburgh.
Rose Dziobak, RN, Vascular Access Team, Allegheny Health Network
Rose Dziobak graduated from West Penn Hospital School of Nursing in Pittsburgh, Pennsylvania. She has 44 years of nursing experience, 22 of which have been with the vascular access team. Over the years, she has seen how a CLABSI can negatively impact patients and their recovery.
Abstract
Background
Chlorhexidine gluconate (CHG) bathing has proven to reduce central line–associated bloodstream infections (CLABSI) in hospitalized patients. The aim of this study is to evaluate whether the implementation of a compliance monitoring process for CHG bathing and strict hand hygiene as part of the traditional CLABSI prevention bundle will reduce the overall hospital CLABSI standardized infection ratio (SIR).
Methods
A quasi-experimental study was conducted in intensive care and non-intensive care inpatient hospital units in an urban 361-bed teaching hospital in Western Pennsylvania. The pre-intervention period consisted of January–August 2021, the intervention period consisted of September–November 2021, and the post-intervention and sustainability period consisted of December 2021–June 2022. A compliance monitoring process for the initiation of a daily bath using a 4% CHG solution and strict hand hygiene surveillance was implemented as part of the standard CLABSI prevention bundle (which includes standardized insertion checklists and processes, daily necessity assessment, dressing change and integrity standards, five moments hand hygiene standards, CHG disk [Biopatch], end caps [Curos], and care of tubing).
Outcomes
A statistically significant increase in hand hygiene (p=<0.001) and in CHG bathing compliance (p=0.014) helped reduce the overall hospital CLABSI SIR from 1.45 to 0.82, standing for an overall 43.4% decrease. Cost reduction was statistically significant (p=0.011) and was an estimated $1.4 million dollars in savings for the hospital.
Next Steps
Incorporate the compliance monitoring component for CHG bathing and hand hygiene as part of the best strategy for CLABSI bundle prevention within the healthcare system.
