Infection prevention
close adherence to guidelines, both clinically and financially. Currently, infection prevention and control
practices are not uniformly standardised across the NHS, resulting in significant variability and unclear outcomes in reporting among Trusts. A combination of clear consistent infection prevention guidelines and standardised data collection methods will inform healthcare systems, including SSI teams and procurement colleagues, of the return investment certain products such as CHG wash can deliver. While some best-practice case studies are available, there remains a considerable need for high- quality research studies to fully demonstrate the benefits of CHG bathing to healthcare systems.
The benefits of CHG bathing Within a wider care bundle for infection prevention, pre-operative antiseptic skin preparation using CHG full body washing has emerged as a crucial strategy in the fight against HCAIs across the UK. CHG solutions are approved as antiseptic skin
cleansers to reduce germs on the skin that may cause infection. They are not intended to treat or prevent any specific disease or infection as a standalone therapy, but may serve as part of a comprehensive infection prevention bundle. CHG reduces the density of microorganisms on the skin by binding to the negatively charged bacterial cell walls, causing bacterial cell death. Unlike soap and water preoperative washes, patients offered whole body washes are reported to have less adverse skin conditions, fewer complications and are less likely to be
readmitted to hospital.11,12 This offers nurses a
highly effective means of ensuring that patients can recover from surgery with a minimised risk of infection. Crucially, the effectiveness of such measures hinges on the diligent adherence of healthcare personnel to rigorous pre-operative cleansing protocols. For instance, while the use of CHG bathing is well established as an efficacious and effective method for the prevention of HCAIs and specifically SSIs, its true impact over time is determined by consistent delivery of care. Compliance to an infection prevention protocol, which includes CHG bathing, as well as consistent and effective delivery of the appropriate bathing technique, is critical for success. Numerous NHS Trusts have successfully implemented daily CHG washes, yielding lower
rates of HCAIs and tangible improvements in patient outcomes.
Case Studies Kettering General Hospital, UK: Some NHS hospitals have adopted daily CHG bathing as a protocol for all patients as a ‘house-wide’ practice, both in and outside the ICU setting. The benefits of daily CHG bathing for all patients as part of a broader, horizontal approach have been demonstrated by the reduction of HCAI across a facility and subsequent financial savings that the protocol can contribute to in the longer term. For instance, Kettering General Hospital has used CHG bathing for over two decades. During that time, the hospital expanded its staff training to educate more on the importance of CHG bathing and the application of the solution. Kettering has also increased its testing for MRSA and carried out the full-body CHG washing on those who tested positive with the bacteria. The hospital then began ‘early full-body washing’, whereby all patients were washed regardless, as opposed to waiting for a positive MRSA test. The hospital has now been MRSA bacteraemia free for over five years, which can be attributed to the regular use of CHG bathing.13
Royal Brompton and Harefield hospitals, UK: The Royal Brompton Hospital advocates for the use of a four percent CHG body wash. The solution has been shown to help reduce the risk of infection when used before procedures and operations. CHG bathing has removed microorganisms from patient’s skin, ensuring skin protection long after application. Its prolonged antimicrobial effect prevents re- accumulation of microorganisms.14
University Hospital of Perugia, Italy: The University Hospital of Perugia conducted a study involving 449 individuals using 4% CHG
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