Hello my name is brandi jenkins and i’m a registered nurse here at lancaster general i’m also one of the nurse managers who is a part of the infection control committee this is dr. contra the chief of infectious disease here at likes to general and we would like to take the next couple minutes to explain to you the importance of chlorhexidine or chg bathing in the
Hospital setting corrects the bathing is one of the most important things you can do for your patient to eliminate infection risk the cdc estimates that about 1 in 20 patients that were admitted to a hospital will develop a hospital associated infection and the source of the infections are the skin surface of the patient and the skin service of the healthcare
Worker by and large by using chlorhexidine you greatly reduced that log of bacteria that exists on the skin’s surface and in so doing reduce to this to your patient because we are so integral in decreasing infections here at the hospital because of chd bleeding we must make sure that we’re all doing it the exact same way and in the next few minutes i will show
You exactly how to bathe the patient here at links to your general and this will be the standard for patient bathing with chg in order to give a chg back you will need the following items a clean pink basin which if it’s not if you’re uncertain about the cleanliness of the basin then you can clean it out again when it’s an a s3 wife which i’ll show you later hand
Sanitizer two sets of gloves you’ll need both the pump portion and the chc portion of the soap you will need at the very least nine washcloths some towels i grabbed about three obviously a clean gown and sheets and another blue pad okay so once you’re ready with all your supplies you’re going to make sure that you clean your hands and place on your glove there is
Assembly required for the foam chd so you just take the top off and you can discard that and then screw the pump top on once you have your water in your basin you’re ready to go okay so first you’ll start by putting all of your washcloths into the basin with the water and then you’ll instruct the patient what you’re going to do obviously you’ve probably done that
A little bit before here too so mr. smith my name is brandy i’m just here to give you your bath this is a special chd bath that’s going to help with preventing infections here while you’re in the hospital the more we use it the better and you’ll probably be dealing with this for the rest of your stay here in the hospital we’d like to first start with your face so
No thg goes on the face when i wring out your washcloth and using to the glopped method so you put part of it over your hand goes underneath and then back on top you can hold it there you just fold it over start washing their eyes again this is not with any phd in and around their ears and then you discard that washcloth so next what you’re going to do is expose
Their arms mr. smith i’m just going to expose your arm here so we can clean it and place a towel underneath the arm you’re only doing one extremity exposed at a time in order to keep the patient as warm as possible and then you’re going to take the soap and place it right on the patient so this phone’s ad you blink it down there and using the gloved method of
The washcloth spread the soap around on the patient’s arm not forget paying special attention to their hand obviously this is the most frequent portion of the body that touches the environment now perfectly the soap is to stay on the skin for about a minute however we all know that patients get cold so as long as you’ve covered everything and you think that this
You know you’ve least made it to the 30-second mark you take your washcloth and you turn it inside out and wipe the patient down and discard that washcloth you then dab the patient dry with the towel and you would do the same with the other arm after the other arm is finished can move on to the chest and abdomen taking concern to keep the patient as covered
As possible using the soap directly on the skin and the gloves method moving the chd around on the chest and abdomen and then using the non chg portion of the wash rag to wipe it off and a towel to dab it dry technically the chg does not rinse off and that is on purpose this patients skin might remain a little tacky but just notice that ch g is staying on there
For at least 24 hours and will continue to work okay once you finish with the arms and the chest you can put the new gown on the top of the patient again as to keep them as warm as possible so after you put the new gown on the top of the patient you can expose one of the legs for this patient specifically has a back on the bottom of this foot and it’s recommended
That with any device such as a foley or something like a back that you phase or wash the first six inches of the tubing coming from the patient so we’ll take the ch d and put it on the patient just as we did before using the glove method you move a phd around on the patient not going to hurt the back dressing by getting it a little wet but should be careful and
Then down the tubing about six inches clipping the washcloth inside out again taking the ch d off of the patient or the foam i should say because the safety does stay on the patient and then drying the patient with the towel do the same steps on the other leg so as far as perry care goes if the patient has a foley catheter you need to use the regular soap not the
Ch g and that can be found on the protocol for the ch 2 bathing so you expose the carrier area and place the ch d soap on the patient again using the flows method you’re going to start with that meatus if the patient is uncircumcised you’ll have to pull that the foreskin and wash around the native and then the rest of the scrotum with the female you would start
In the middle always using down strokes and then this is the only time you use a separate washcloth sometimes a separate washcloth out of the bin to rinse the patient and it’s how to drive again if the patient is uncircumcised you would need to gently replace the foreskin back to its butt pull your clean gown down and then discard your gloves and we’re going to
Turn the patient okay so when you have the patient turned and you have your new gloves on you’re going to put the ch d on the patient’s back sorry mr. smith this might be chilly and bottom again using this bluff method read the phd around the patient’s back and lower back and as long as the patient can stand the coolness try to keep it on there for about a minute
Use the clean side of the washcloth and rinse it off dry and then the chc silk on the rest of the for any i’m in a very top of the legs keeping the glove method going to work from clean to dirty spreading it around and again getting a different washcloths to do the reasoning having the patient dry and then you can roll the sheets off of the bed the dirty sheets
Tuck them under and following you and place the clean sheets on the patient tuck them under and then roll the patient back over to finish the back so when you’re finished with the water you dump it on the sink i like to draw the basin out just a bit first before i wipe it down to get the excess water out of there if yourself some af3 wipe remembering that you’re
Getting enough as3 wipes to keep the entire inside of the basin wet for three minutes so you may need more than one wait a little bit are several different nightstands within the hospital each of them have drawers labeled specifically for different things so you’ll see the one drawer labeled bath basin you take a clean towel and place it in the bottom of the depth
Of the drawer and then take your clean bath basin and place it upside down in the drawer so when you’re ready to document you go into flow sheets and pull up the daily cares portion of the flow sheets go down to hygiene care click on that and go into the hygiene care flow sheet row bath chg and you’re done one of the main reasons that patients don’t receive a chg
Bath in the hospital is because they refused and we’re certain that maybe this is just because they don’t understand what’s going on and what chg is so it’s important to reinstruct them and we educate them on how ct bathing can help reduce their chances of getting an infection here in the hospital even if you can just wash their hands up to their elbows maybe so
That they can see that it’s not the soaps not so bad and it’s not so irritating it is really anything is better than nothing
Transcribed from video
CHG Bathing By Jessica Klinkner