2% chlorhexidine gluconate to reduce or prevent nosocomial infections

The survey was distributed among 600 hospitals, which included non-federal hospitals as well as Veterans affairs hospitals. The study concluded that the chlorhexidine was both as a barrier precaution in the form of chlorhexidine gluconate in the central venous line insertions and chlorhexidine impregnated dressings was increasingly used in the healthcare facilities under the survey. Another study was condusted by Jefferson, Kassakian, Machan, Mermel and Parenteau(2011), which corroborated a study by Vernon et al. (2006) on the use of chlorhexidine in patient bathing for the reduction of Vancomycin-resistant Enterococci. Both of the studies produced results indicating that the use of dressings impregnated with 2% chlorhexidine gluconate as an intervention method was effective in reducing Vancomycin-resistant Enterococci colonization and other forms of colonization as well.

The authors concluded that the reason there was no difference in the test groups was because of the fact that the majority of the colonizing organisms in the hospital's intensive care units were gram-negative bacilli. This is corroborated by other studies that show gram- negative bacilli are characterized by higher minimum inhibiting concentrations of chlorhexidine compared to pathogens that are gram positive pathogens. In addition to this, gram-negative pathogens are usually recovered from the perianal area which implies they originate from the gastrointestinal tract where chlorhexidine would not have an effect on colonization (Wang & Layon, 2017). Ultimately, all the literature point to the positive impact that 2% chlorhexidine-impregnated cloths have on preventing or at least reducing nosocomial infections with literature positing an alternative conclusion providing reasoning for the difference.

References Table Citation Type of Study Design Type Framework/Theory Setting Key Concepts/Variables Findings Hierarchy of Evidence Level Afonso E, Blot K, Blot S. Dependent Variable: The rate of nosocomial infections. Controlled Variable: This meta-analysis provides evidence that the use of CHG washcloths prevents HABSI in ICUs. The impact of CHG washcloth bathing appeared to be primarily due to its prevention of CLABSI. This effect was beneficial and comparable for CLABSI in all four studies. Level 1 A. Concepts: Independent Variable: application of chlorhexidine wipes Dependent Variable: bacterial colonization and hospital-acquired infections Controlled Variable: hygiene standards and protocols in the hospital. The effectiveness of 2% chlorhexidine-impregnated washcloths for the prevention of MDR gram-negative bacteria colonization and hospital-acquired infection in adult patients in ICU was not proven.

Level 3 Citation Study Design Type Framework/Theory Setting Key Concepts/Variables Findings Hierarchy of Evidence Level Hofer, T. P. , Krein, S. Concepts: Independent Variable: Prevention practices Dependent Variable: hospital acquired infections Controlled Variable:n/a Since 2005, key practices to prevent CLABSI, VAP and CAUTI such as the use of Chlorhexidine were on the increase and this has caused a decrease in hospital associated infections. Level 3 Wang, E. , & Layon, A. Chlorhexidine gluconate use to prevent hospital acquired infections—a useful tool, not a panacea. Annals Of Translational Medicine, 5(1), 14-14. Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Arch Intern Med. DOI: 10. 1001/archinte. 306 PMID: 16476870 Type of Study: Randomized control trials.