UC Irvine

Purpose: To improve daily chlorhexidine gluconate (CHG) bathing rates among hospitalized adults with central venous catheters (CVCs) by implementing a standardized patient education pamphlet and education process. Background: Hospital-acquired infections (HAIs), including central line-associated bloodstream infections (CLABSIs), contribute to increased morbidity, length of stay, and healthcare costs. Daily CHG bathing is an evidence-based strategy for CLABSI prevention; however, patient refusal remains a major barrier to adherence. Engaging patients and families through standardized education may improve compliance with CHG bathing protocols. Methods: This project was conducted on a post-surgical acute care unit at an academic hospital in Northern California. The intervention consisted of (1) a standardized patient education toolkit (handout, self-bathing instructional diagram, and wall signage) and (2) a structured education process delivered by trained champions. Patients appropriate for self-bathing were observed during their initial bath, while others received assisted bathing at arranged times. Weekly reinforcement was provided for patients with a CVC’s length of stay greater than 7 days. Champions documented interventions using standardized templates, and data were securely stored and analyzed using a project site-approved Excel tool. Central line maintenance bundle (CLMB) audits were used to collect data on CHG bathing compliance. Descriptive statistics were used to analyze CVC types, patient mobility level, education length, and self-bathing eligibility. Results: A total of 32 eligible patients were included over the 9-week implementation period. Monthly CLMB audits demonstrated a marked improvement in daily CHG bathing rates in which pre-intervention rates were 57% and 54% in the two months prior, compared to 90% and 72% during the two-month intervention period. Implementation outcomes included participation from 9 project champions and 100% adherence to the presence of wall signage and education pamphlets in all patient rooms. Implications and Conclusion: A structured CHG education process with standardized materials is a feasible and effective strategy to enhance bathing compliance and support infection prevention efforts. Engaging patients and families as active participants in care, alongside targeted workflow adaptations, can improve implementation success. Future efforts should expand family involvement, extend device-specific education to other high-risk populations, and evaluate patient-driven engagement measures to further strengthen outcomes.