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C H G
B A T H I N G
FLORA PLAN Nearly all hip and knee patients at Greater
Baltimore Medical Center bathe with CHG for 3 days before surgery.
SOAPS AND WIPES DONE RIGHT
Pre-Op Showering Tips
Pre-op showering or bathing for 3 days with chlorhexidine gluconate (CHG) soap or wipes is part of the Institute for Healthcare Improvement's (IHI) "Enhanced Surgical Site Infection Prevention Bundle" for hip and knee arthroplasty providers. Here are some of the IHI's recommendations, if you're interested in implementing the practice:
• Tailor the implementation process to your setting. Determine where most pre-operative assessments currently take place, because that's the optimal time to discuss CHG soap or wipes with patients.
• Consider whether it's feasible to give CHG soap or wipes to all patients during their pre-operative assessments. If not, tell patients specifically where they can get them and about how much they'll cost. (Weigh costs from both the patient perspective and the facility perspective. It might make economic sense to provide the materials.)
• Develop a guide or quick reference for staff, to ensure that patients always get the same message and understand why 3 days of CHG showering/bathing is important.
• Provide instructions to the patient or family. Tell them to wash the whole body from the neck down and to avoid getting soap in eyes, ears, nose, or mouth; to concentrate on the area to be operated on; not to wash genital areas with CHG soap; and not to use lotions or moisturizers afterward.
• To promote compliance, consider offering patients either soap or wipes. Some patients prefer wipes, but others prefer showering and want the soap.
• Develop a simple form that patients can use to track the number of days they've bathed or showered with CHG and tell them to bring it with them on the day of surgery.
— Jim Burger
