Appendix E: Chlorhexidine Antiseptic Body Cleaning

(Adopted from LRMC Policy)

Policy: The chlorhexidine antiseptic body cleaning wash cloths will be used on all intensive care unit patients unless a patient declines or has any known sensitivities to ingredients.

Purpose: To reduce the risk of hospital associated infection by decreasing bacterial colonization that can cause skin infection.

Applicability: The antiseptic body cleaning wash cloths policy is applicable to all healthcare workers assigned to provide bedside bathing to patients in the medical facility.

Responsibility: It is the responsibility of the nursing managers to ensure that this policy is implemented correctly and consistently.

Exclusion: Avoid facial area, open wounds, and areas of 2nd or 3rd degree burned skin.

PROCEDURE

1. When the patient arrives to the unit first bathe patient with soap/water add 30 cc of Hibiclens 4 % to the basin and bathe patient to remove all visible dirt.
   - Wait 6 hours after initial bath and bathe patient with antiseptic body cleaning washcloths once a day.
   - Warming the antiseptic body cleaning washcloths (if warmer not available).
   - Warm package in the dedicated microwave settings: 1000 watts for 30 seconds.
   - Consult package for complete indications, ingredients, and warnings.
2. Bathing a patient with antiseptic body cleaning washcloths

- Wash hands prior to the procedure and don a pair of gloves and a gown.
- Explain the procedure to the patient.
- Ensure the patient has privacy. Have patient remove gown or assist in the removal as needed. Use a towel or sheet to cover the patient appropriately.
- Peel back the label on the package and test the temperature by touching the top washcloth. Remember, gloves diminish sensitivity to heat. If temperature is acceptable, proceed to the next step.
- Remove #1 washcloth.
  - Test washcloth to back of patient’s hand or inside wrist/forearm area.
  - Ask patient if the temperature is acceptable.
    - If acceptable, proceed with next step.
    - If NOT acceptable, STOP the procedure until temperature is acceptable to the patient.
    - Continue to monitor patient’s comfort level with the temperature as the bath progresses.

- For incontinence care, clean using terrycloth towels, soap and water, followed by wiping the involved skin with as many chlorhexidine cloths as necessary.
- Apply clean gown, reposition and cover the patient.
- Discard all disposables as general waste. NOTE: Do not flush antiseptic body cleaning washcloths in the toilet!
- Document procedure in progress notes.

Table 1. Wash cloth sequence

5. What To Do

Do use chlorhexidine (CHG) baths in place of daily bathing with soap and water.

Do massage firmly into skin to bind skin proteins and prevent bacteria for 24 hours.

Only use CHG-compatible lotions.

Use over superficial wounds, including stages 1 and 2 decubitus ulcers.

6. What NOT To Do

Do NOT use above jaw line.

Do NOT rinse or wipe off CHG. Let air dry.

Do NOT flush CHG cloths (discard in trash, not toilet or commode)

Do NOT include patients who are allergic to CHG.