Use of 2 Chlorhexidine Wipes for Bathing Treatment

Use of 2% Chlorhexidine Wipes for Bathing Treatment PURPOSE: TO PREVENT COLONIZATION OF MULTI-DRUG RESISTANT ORGANISMS

Purpose of the training: q. To provide a brief summary of 2% CHG bathing treatment Disclaimer: the authors of this training do not endorse any particular manufacturer’s CHG product.

Definitions For the purposes of this training: ◦ A patient is either a hospitalized patient OR a resident in a long term care facility ◦ CHG treatment is referred to as application of 2% Chlorhexidine from an impregnated wipe by any of the following methods: ◦ a full bed bath ◦ a partial bath ◦ an application of 2% CHG wipes following a bath or shower

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General principles of CHG treatment q. Determine 2% CHG bathing treatment frequency per your facility’s recommendation üSome facilities use CHG daily, while others use less frequently (e. g. , every other day). q Patient may first take a bath or shower prior to application of the CHG q Ensure skin is dry before administering the CHG treatment q Remember to change gloves after wiping the groin and buttocks area with CHG üPrevents cross contamination of potential pathogens to other parts of the body q. DO NOT use CHG impregnated wipes on: q. Face q. Large or deep wounds q. New surgical wounds q. Check current evidence for routine use of CHG during perineal care

The CHG treatment process Gather your supplies prior to entering the patient’s room. üThe CHG wipes can be kept in a warmer. üAnticipate the number of wipes needed for your patient – each individual package holds 3 sets of 2 wipes, stock accordingly.

The CHG bathing treatment process Explain the purpose of the CHG treatment to your patient. Proceed with “wiping” the body in any manner you are accustomed to for cleansing the body üApply CHG BELOW the jawline only (not used on the face or hair) üAreas commonly missed are between the fingers and toes, and the six inches closest to the patient’s body when wiping a drainage tube

Apply wipe firmly to all skin surfaces DO NOT RINSE OFF – let the liquid air dry (it may feel sticky for up to 5 minutes while drying) If a shower or tub bath is preferred, complete as usual, dry off, and then use the wipes to cover the body areas as if bathing with the wipes. Use a new cloth for each numbered area. DO NOT USE on the face or the head. USE on all other body areas. Discard used wipes in the trash, not in the toilet.

Some final thoughts from actual users of the CHG bathing treatment q. Patients typically report a feeling of “stickiness” from the CHG wipe treatment üIt takes approximately 5 minutes for the CHG to dry üMoisturizers are included within the product. Skin will feel soft throughout the day q The patient may be dressed immediately following the CHG treatment üThe active CHG binds with cells quickly, the remaining dampness of the product is from the added moisturizers üTo prevent skin dryness with CHG bathing treatment, routinely apply a facility-approved compatible lotion to the patient’s skin after the product dries q. If patients develop skin irritations from the CHG treatment, discuss options with healthcare team üSkin allergic reactions are rare, discontinuing product may be necessary q. Keep the CHG wipes (not used) during the treatment in the packets to prevent cooling quickly üDO NOT microwave heat the packages

References Climo, M. W. , Yokoe, D. S. , Warren, D. K. et al. (2013). Effect of daily chlorhexidine bathing on hospital-acquired infection. New England Journal of Medicine, 368, 533 – 542. Popovich, KJ. J. , Hota, B. , Hayes, R. , Weinstein, R. A. , Hayden, M. K. (2009). Effectiveness of routine patient cleansing with chlorhexidine gluconate for infection prevention in the medical intensive care unit. Infection Control & Hospital Epidemiology, 30, 959 – 963. Rhee, Y. , Palmer, L. , Okamoto, K. , Gemunden, S. , Hammouda, K. , Kemble, S. , . . . Hayden, M. K. (2018). Differential effects of chlorhexidine skin cleansing methods on residual chlorhexidine skin concentrations and bacterial recovery. Infection Control & Hospital Epidemiology, 39, (4), 405 – 411.