Chlorhexidine (CHG) Bathing to Prevent Healthcare-Linked Infections

What is CHG bathing?

Chlorhexidine gluconate (CHG) is a cleaning product that kills germs. Daily baths with CHG reduce the spread of infections in hospitals. CHG baths are especially helpful in intensive care units (ICUs).

For several reasons, patients staying in the ICU have a high risk of getting a new infection. These patients are often very ill. They may have more than one health condition. That makes them more likely to get an infection. ICU patients are also likely to need medical devices, such as urinary catheters and ventilators. These things can increase the risk for infection. Plus, many ICUs contain bacteria that have become resistant to many antibiotic medicines. These bacteria may not respond to standard antibiotics. They can cause infections that are very hard to treat.

These types of infections cause major symptoms in many ICU patients each year. They may even cause death. To help prevent them, hospitals practice many precautions. These precautions now include daily bathing with CHG for every person staying in the ICU.

During CHG bathing, a nurse cleans you with a washcloth. The washcloth has been infused with CHG. These baths often take place after a normal soap and water sponge bath. They take place each day, as long as you stay in the ICU. You might also need a CHG bath in other medical situations as well.

Why might I need CHG bathing?

Many experts now recommend daily CHG bathing for all people getting care in the ICU. That is because the risk for infection is so high. Bathing with CHG seems to work better at preventing infections than bathing with just soap and water.

Daily CHG bathing generally lowers your risk of getting an infection in the hospital. You are less likely to get sick from a germ that is very hard to treat. One example is methicillin-resistant Staphylococcus aureus (MRSA). CHG bathing can also help prevent other types of infections, such as:

• Vancomycin-resistant Enterococcus (VRE)

• Infections from central venous catheters

• Infections at surgical sites

• Infections from ventilator use

Experts are less certain how helpful daily CHG baths are for patients outside the ICU. Many people are at risk of getting a new infection while in the hospital. This risk is not as high as the risk for people staying in the ICU. If you are at high risk for infection, your healthcare provider might advise daily CHG bathing for you, even if you are not in the ICU.

In some cases, you might do CHG bathing yourself at home. For example, your healthcare provider might advise using a CHG skin cleanser if you have a MRSA infection. CHG bathing might also be advised before you have surgery to reduce the chance for infection. In some centers, patients who screen positive for MRSA need to bathe with CHG before elective surgeries.

What are the risks of CHG bathing?

It is rare to have problems with CHG bathing. Some possible side effects of the practice are:

• Skin rash (usually mild)

• Allergic reaction

• Skin dryness with lengthy use (the most common side effect)

• Irritation of mucous membranes

Your risks may differ depending on your age, your health conditions, and other factors. CHG baths might not be right for you if you have serious skin problems, irritation, or burns. Talk with your healthcare provider about all your concerns. CHG bathing is generally not used in babies younger than 2 months old.

CHG bathing may pose another long-term risk to healthcare facilities. Over time, heavy use of CHG bathing in ICUs may promote the growth of bacteria that are resistant to the treatment.

How do I get ready for CHG bathing?

You shouldn't need to do much to prepare for CHG bathing. Your nurse can gather all the needed supplies. Ask any questions that you have about the process and the reasons for it.

What happens during CHG bathing?

The exact method of CHG bathing may differ somewhat from hospital to hospital and among different healthcare providers. Your medical team can let you know exactly what to expect. As an example, you might expect the following:

• Your nurse will help you remove your clothes and any medical attachments, such as ECG leads, if this is possible.

• Your nurse will do the bath using freshly washed hands and new gloves.

• If this is your first bath, the nurse might give you a sponge bath with soap and water to clean you thoroughly. When you are dry, the CHG bath will begin.

• Often the nurse will use a special CHG-infused washcloth. Your nurse will use these washcloths to massage you all over your body, except your face. It should feel much like a normal sponge bath. (Your nurse will clean your face with soap and water instead.)

• Don't swallow CHG. Keep CHG out of your eyes, ears, nose, and mouth.

• Ask your care team for instructions on use in your genital and rectal areas.

• Based on instructions from your healthcare provider and recommendations from the manufacturer of CHG, certain areas of your body may not be bathed with the solution

Many hospitals now don't use a basin to do these baths. Basins may become contaminated with germs.

What happens after CHG bathing?

Typically, you will air dry for a few minutes after having your bath. Your nurse will apply any needed lotions. Someone will help you put your clothes back on. Any medical devices that have been removed will be reattached.

You will probably have one of these baths per day. You can ask your nursing staff when you can normally expect this bath.

Let your healthcare provider know right away if the bath feels uncomfortable or if you develop dry skin or a rash. You may need to use extra lotion after your CHG bath. In rare cases, some people have a true allergic reaction. If that happens, you may need to stop having CHG bathing.

CHG bathing is not a substitute for other ways of controlling infection in the hospital. It also can't prevent infection all the time. But regular CHG baths may reduce the risk that you or a loved one will get a new infection. That may shorten your hospital stay and increase your chance of a good outcome.

Next steps

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