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C H G
B A T H I N G
ter team already had pre-op educational classes in place for all hip and knee patients twice a month, there was no need to reinvent the wheel. Our classes had primarily focused on educating patients about the procedure and what to expect post-op. Now we began to really focus on the prevention aspect, too.
The Project JOINTS program is now a national project and anybody can register on the IHI website (www.ihi.org) and gain access to helpful educational material. If you're just now thinking about initiating a preop bathing or showering protocol, I recommend starting small. Begin providing bathing or showering instruction to a small group of your highest-risk patients. You may want to start with one kind of surgery, like knees or shoulders. Choose a subset of some sort and make sure you have the process down before you spread it to other service lines.
For those just starting, the IHI recommends selecting 2 patients, discussing the value of CHG bathing before surgery and asking if they'll help you with a process improvement. Doing so gives them an opportunity to have input into their care, and you can point out that they may help improve the care of others. Give them a copy of the patient CHG checklist (available on the IHI website) to complete and bring back before surgery. Then, before surgery, follow up with the patient or patent's family to assess compliance and ask for suggestions.
Budgeting help
We got a significant boost in our efforts when our joint center coordinator was able to include the CHG wipes in her fiscal year budget. That meant we didn't have to rely on patients to find and buy their own. Instead, we handed them out during classes or mailed them, along with instructions, to patients who either were coming back for a revision or to have a second knee done. We learned, incidentally, that we needed to get them in the mail as early as possible. There were
