Running head: EVIDENCE REGARDING A NURSING INTERVENTION

Evidence Regarding a Nursing Intervention

Observed at Surgical Intensive Care Unit
Bonnie K. Wright
BridgeValley Community and Technical College: Nursing

EVIDENCE REGARDING A NURSING INTERVENTION

Abstract
During the observation at Charleston Area Medical Center (CAMC) I was on a unit called
surgical intensive care unit (SICU); all the nurses practiced nursing interventions that do not
require an order from a physician. The nursing interventions play a huge role in patient care,
simple tasks each shift can make a big difference on how long the patient is admitted to the
hospital. One nursing intervention that was observed is the use of chlorhexidine gluconate wipes
to replace bed baths when the patient in admitted in an intensive care unit (ICU).

EVIDENCE REGARDING A NURSING INTERVENTION

Evidence Regarding a Nursing Intervention

Observed at Surgical Intensive Care Unit
Nursing interventions play a huge role in patient care, and if the interventions are not
implemented each shift then the patient could be at risk for infection and decline in health.
Chlorhexidine impregnated wipes used for bathing a patient in the ICU have been proven to
reduce the likelihood of the patient developing an infection. The wipes are bactericidal, virucidal,
and fungicidal, and can be used multiple times a day but the area around the eyes, and perineum
should be avoided (Does Chlorhexidine Bathing Prevent, 2015). At the SICU each patient gets a
chlorhexidine bath at least once a day, it is usually provided by the nursing assistant or registered
nurse. The wipes are put in a warming system so the patient has minimal discomfort.
There was a study conducted in four different ICUs located in Thailand, 241 patients
received soap and water baths and 241 patients received the chlorhexidine bath daily. The
patients using soap (non-antimicrobial) and water were able to bath twice a day and use lotion
and other moisturizing products. The patients using the chlorhexidine wipes were only allowed
to use six wipes once a day and was not allowed to use skin moisturizers. The study was
conducted over a two-year period and was found the patients receiving the soap and water bath
did not have longer hospital stays nor did the patients acquire an infection while hospitalized.
About two percent of patients did have a skin reaction to the chlorhexidine wipes (Effectiveness
of Chlorhexidine Wipes, 2015).

EVIDENCE REGARDING A NURSING INTERVENTION

In the evidence based practice article the patients using soap and water were given two
baths a day; in the SICU unless needed a patient only receives a bath once a day. Chlorhexidine
wipes in the SICU can be used multiple times a day as needed and the patient is not limited to a
certain number of cloths used during cleaning. The article mentions that they studied four ICUs,
this does not mean the patient came from surgery; at CAMC SICU the patients are coming from
surgery and were given a chlorhexidine bath before surgery. For the study they needed the
patients informed consent and the testing could be more accurate because the patients that
participated were compliant with the terms of the study (Effectiveness of Chlorhexidine Wipes,
2015).
It can be difficult to incorporate evidence based practice into nursing care. A big
challenge can be patient compliance, patients have the right to refuse and if something new is
implemented the patient may not feel comfortable complying to the new changes. Healthcare
workers may not implement the change due to lack of knowledge or they have been practicing in
their career a long time and like to implement their interventions the original way (The
Challenges of Implementing Evidence Based Practice, 2011).
Whether patients use soap and water or chlorhexidine wipes for their daily bath, they
have both been proven to reduce the risk for infection. Chlorhexidine wipes have been proven to
decrease the amount of time it takes to bathe the patient, instead of the three steps it takes to bath
a patient with soap and water it only takes one step to clean a patient with a chlorhexidine wipe.
This allows a patient that has more difficulty with range of motion and mobility to not be as tired
after their daily bath (Effectiveness of Chlorhexidine Wipes, 2015).

EVIDENCE REGARDING A NURSING INTERVENTION

References
Barclay, L. 2015. Does Chlorhexidine Bathing Prevent Infections in ICU Patients? Found on
9/7/16 at http://www.medscape.org/viewarticle/843969
Boonyasiri, A. 2015. The Society for Healthcare Epidemiology of America. Effectiveness of
Chlorhexidine Wipes for the Prevention of Multidrug-Resistant Bacterial Colonization
and Hospital-Acquired Infections in Intensive Care Unit Patients: A Randomized Trial in
Thailand. Found on 9/7/16 at https://www.cambridge.org/core/journals/infection-control
Farley, A. 2011. The Challenges of Implementing Evidence Based Practice: Ethical
Considerations in Practice, Education, Policy, and Research. Found on 9/7/16 at
http://www.socwork.net/sws/article/view/76/335