Table of Evidence: Pre-Op Bathing Practice with Chlorhexedine



Citation/AuthorsTitleType of Article & SampleLevel & Quality of EvidenceOutcomes MeasuredFindingsChlebicki, M.P., Safdar, N., O’Horo, J.C., & Maki, D.G. (2013). American Journal of Infection Control, 41, 167-173. doi: 10.1016/j.ajic.2012.02.014Preoperative chlorhexidine shower or bath for prevention of surgical site infection: A meta-analysis.Meta-Analysis1-indicating the use of preoperative chlorhexidine baths not showing any reduction in the rates of post operative surgical site infections compared to bathing with regular bath soaps and/or taking more than one bath-reduces bacterial colonization of the skin which in turn, decreases the incidence of surgical site infections and the transmission of antibiotic-resistant pathogensEdmiston, C.E., Okoli, O., Graham, M.B., Sinski, S., Seabrook, G. (2010), AORN Journal, 92(5), 509-518. doi: 10.1016/j.aorn.2010.01.020Evidence for using Chlorhexidine gluconate preoperative cleansing to reduce the risk of surgical site infection.Literature review4Chlorhexidine has to remain on the skin for a specified time, approximately three minutesDebaun, B. (May 2008). AORN Journal, 87 (5),925-933.Evaluation of the antimicrobial properties of an alcohol-free 2% chlorhexidine gluconate solution.RCT1prophylactic antibiotic pre-surgical baths has proven to be an effective measure Hakkarainen, T., Patchen Dellinger, E., Evans, H.L., Farjah, F., Farrokhi, E., Steele, S.R., Thirlby, R., Flum, D.R. (2014). American College of Surgeons, 218 (3), 336-344. doi:10.1016/j.jamcollsurg.2013.11.parative effectiveness of skin antiseptic agents in reducing surgical site Infections: A report from the Washington State Surgical Care and Outcomes Assessment Program.Case Report4chlorhexidine has to remain on the skin for a specified time, approximately two-three minutesSpruce, L. (May 2014). AORN Journal, 99 (5). 601- 608. doi: 10.1016/j.aorn.2014.02.002.Back to Basics: Preventing surgical Site Infection.Cross sectional study3infection control of surgical site infection rates Ecolab (2014). Recommended Practices for CHG skin cleansing for patients: Skin wound and general skin cleansingUsing ChlorhexidineGluconate (CHG) toReduce Bacteria on the SkinExpert Opinion5effectiveness increaseswith continued use. CHG-containingproducts provide substantial persistentactivity, resulting in significantly reducedbacterial counts for up to 11 hoursCenters for Disease Control and Prevention. Infection Controland Hospital Epidemiology 20, no. 4 (1999): 247-278. Available at: .“Guideline for Prevention of Surgical Site Infection, 1999.”Case controlled trial2CHG rapidly kills transient and residentmicroorganisms on the skin and iseffective against Gram-positive andGram-negative bacteria, includingmethicillin-resistant StaphylococcusAORN “2014 Edition; Recommended Practices for PreoperativePatient Skin AntisepsisPerioperative Standards and Recommended Practices”,Case Report5two showers with CHG prior to surgery, supported by studies thatsuggest CHG’s antimicrobial properties are cumulativeThe Joint Commission’s Implementation Guide for NPSG.07.05.01 on (2013): 1-48.Surgical Site Infections: The SSI Change Project”Case Report5skin cleansing as part of an overall strategyto help prevent surgical site infectionsKleinpelRM, Munro CL, Giuliano KK.2008Health Care–Associated Infections: Evidence-Based StrategiesBook 3-4Patient Safety and Quality: An Evidence-Based Handbook for NursesChapter 42. (pdf)World Health Organization (2004)Practice GuidelinesBook3-4Practice Guidelines for infection control in health care facilities Chapter 41. (pdf)Duffy, Harris, Gade, Sehulster, Newhouse, O’Connel, Noble-Wang, Rao, Balajee, Chiller (2014)Mucormyscosis outbreak associated with hospital illness Case Controlled study2Pediatric Infectious diseases preventable with linen change. Environmental care settings. Nosocomial infection prevention. Hospital bed linen are vehicles for contamination and spread of infection. 11 month periodPediatric Infectious Disease journalFijan & Turk (2012)Hospital Textiles, Are They a Possible Vehicle for Healthcare-Associated Infections?Literature Review5Journal of Environmental Research and Public HealthCenters for Disease Control(2003, 2016 rev.)Environmental infection controlExpert Opinion4Practice guidelines, revised after ebola virus outbreak on importance of bed linen change to prevent recontamination of patient. Children’s Hospitals’ Solutions for Patient Safety (2015)SSI Bundle ElementsConsensus, systematic review4Bratzler DW1, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA; American Society of Health-System Pharmacists; Infectious Disease Society of America; Surgical Infection Society; Society for Healthcare Epidemiology of America.. American Journal of Health-System Pharmacy February 1, 2013 vol. 70 no. 3 195-283SSI prevention presurgical bathingConsensus, systematic review4Clinical practice guidelines for antimicrobial prophylaxis in surgery ................
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