• Kimberly Raines and Kelsey Rosen.
• Kimberly Raines, AGACNP-BC, MSN, BSN, RN, CCRN, is a medical critical care fellow at the Carolina Healthcare System, Charlotte, North Carolina, and School of Nursing, University of Pennsylvania, Philadelphia. Kelsey Rosen, AGACNP-BC, MSN, BSN, RN, is a trauma surgery and critical care medicine fellow at the George Washington University Hospital, and School of Nursing, University of Pennsylvania, Philadelphia.
• Dimens Crit Care Nurs. 2016 Mar 1; 35 (2): 84-91.

BackgroundThis literature review examined the current research of evidence-based standards to evaluate the effectiveness of daily bathing with 2% chlorhexidine gluconate (CHG; manufactured by Sage Products Inc) compared with traditional non-antimicrobial bathing on reducing the incidence of nosocomial infections in the critically ill population.Objective/AimThe objective of this article is 3-fold: first, to provide a background on the increased susceptibility to pathogens that have become endemic in many intensive care units; second, to challenge health care providers to question current practice and consider additional ways to ensure safety and better outcomes in the critically ill population; and third, to provide health care providers with clinical evidence to avoid infection control failures.MethodTo determine whether published standards for daily patient bathing exist, a search was conducted of bibliographic databases for articles published within the last 5 years (2010-2015). Ultimately, 3 large multicenter cluster randomized controlled studies were chosen to compare the outcomes of daily bathing with 2% CHG cloths with those of daily bathing with non-antimicrobial cloths.ResultsThe side-by-side comparison of the studies revealed similar outcomes, but with variations in study design. Climo et al (2013) and Milestone et al (2013) recommended the implementation of daily bathing with 2% CHG washcloths as a strategy to decrease nosocomial infections in the critically ill population. Huang et al (2013) recommended universal decolonization as the most effective method to decrease nosocomial infections.DiscussionThe analysis of the 3 primary studies revealed similar findings that support the recommendation for the implementation of daily bathing with 2% CHG in the critically ill population. Further research will inform clinicians on the susceptibility of bacteria to CHG and the probability of creating microbial resistance.

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