- Volume 14 Issue 11
DOI QR Code
The Effects of Bed Baths with 2% Chlorhexidine on the Incidence of Methicillin-resistant Staphylococcus aureus and Blood Stream Infection in Intensive Care Units
2% 클로르헥시딘 침상목욕 간호가 중환자실 입원환자의 메티실린 내성 황색포도상구균과 혈류감염 발생에 미치는 효과
- Received : 2014.07.31
- Accepted : 2014.10.03
- Published : 2014.11.28
The purpose of this study was to identify the effects of bed baths with 2% chlorhexidine on the incidence of Methicillin-resistant Staphylococcus aureus (MRSA) and blood stream infection (BSI) and to suggest guidelines on the therapeutic bed baths using skin cleaner. This study was designed to compare the incidence of MRSA and BSI of the experimental group(n=188) who received the bed baths with 2% chlorhexidine with the incidence of MRSA and BSI of the control group(n=199) who received the existing bed baths with soap and skin cleaner. A research design used in the study was a randomized control group posttest-only design. The experimental group had 6.7% decrease in MRSA acquisition than the control group (7.4% vs 14.1%, p=.036). The experimental group was decreased in the incidence density of MRSA than the control group (9.32 cases per 1,000 patient-days at risk of experimental group vs 15.44 cases per 1,000 patient-days at risk of control group; p=.099). The experimental group had 4.5% decrease in the rate of BSI than the control group (0.5% vs 5.0%, p=.011). The experimental group was decreased in the incidence density of BSI than the control group (0.67 cases per 1,000 patient-days at risk of experimental group vs 5.52 cases per 1,000 patient-days at risk of control group; p=.052). These finding indicated that bed baths with 2% chlorhexidine is an effective nursing intervention to decrease the incidence of MRSA and BSI.
Baths;Chlorhexidine;MRSA;Infection;Intensive Care Units
Supported by : 한국성서대학교
- 김진화, 중환자실 환자에서 발생한 원발성 혈류감염의 위험요인, 카톨릭대학교 석사학위논문, 2007.
- J. M. Boyce, B. Cookson, K. Christiansen, S. Hori, J. Vuopio-Varkila, and S. Kocagoz, "Methicillin-resistant Staphylococcus aureus," The Lancet Infectious Disease, Vol.5, pp.653-663, 2005. https://doi.org/10.1016/S1473-3099(05)70243-7
- 대한병원감염관리학회, 병원감염관리, 한미의학, 2006.
- C. Ani, S. Farshidpanah, A. Bellinghausen Stewart, and H. B. Nguyen, "Variations in Organism-Specific Severe Sepsis Mortality in the United States: 1999-2008," Critical Care Medicine, 16(Published Ahead-of-print), 2014(9).
- 최승매, 정재심, 황동희, 우준희, "접촉주의 강화 및 적극적 감시 배양 적용에 따른 중환자실에서 Methicillin-resistant Staphylococcus aureus 감소 효과", 대한병원감염관리학회, 제15권, 제2호, pp.112-119, 2010(12).
- Martin-Loeches, E. Diaz, and J. Valles, "Risks for multidrug-resistant pathogens in the ICU," Current Opinion in Critical Care, Vol.20, No.5, pp.516-24, 2014. https://doi.org/10.1097/MCC.0000000000000124
- 김기숙, 김순덕, 지선미, 이제숙, "일개 종합병원 중환자실에서의 병원성 혈류감염에 관한 연구", 한국역학회, 제29권, 제1호, pp.70-79, 2007.
- 대한중환자의학회, 중환자의학, 군자출판사, 2006.
- S. C. Bleasdale, W. E. Trick, I. M. Gonzalez, R. D. Lyles, M. K. Hayden, and R. A. Weinstein, "Effectiveness of Chlorhexidine Bathing to Reduce Catheter-Associated Bloodstream Infections in Medical Intensive Care Unit Patients," Archives of Internal Medicine, Vol.167, No.19, pp.2073-2079, 2007. https://doi.org/10.1001/archinte.167.19.2073
- J. K. Popovich, B. Hota, R. Hayes, R. A. Weinstein, and M. K. Hayden, "Effectiveness of Routine Patient Cleansing with Chlorhexidine Gluconate for Infection Prevention in the Medical Intensive Care Unit," Infection Control and Hospital Epidemiology, Vol.30, No.10, pp.959-963, 2009(10). https://doi.org/10.1086/605925
- M. W. Climo, K. A. Sepkowitz, G. Zuccotti, V. J. Fraser, D. K. Warren, and T. M. Perl, "The effect of daily bathing with chlor hexidine on the acquisition of methicillin-resistant staphylococcus aureus, vanco mycin-resistant enterococcus, and health care associated bloodstream infections: result of a quasiexperimental multicenter trial," Critical Care Medicine, Vol.37, No.6, pp.1858-1865, 2009. https://doi.org/10.1097/CCM.0b013e31819ffe6d
- J. S. Garner, W. R. Javis, T. G. Emori, T. C. Horan, and J. M. Hughes, "CDC Definition for Nosocominal Infections," American Journal of Infection Control, Vol.16, pp.28-40, 1988. https://doi.org/10.1016/0196-6553(88)90072-7
- J. Powers, J. Peed, L. Burns, and M. Ziemba-Davis, "Chlorhexidine bathing and microbial contamination in patients' bath basins," American Journal of Critical Care, Vol.21, No.5, pp.338-342, 2012. https://doi.org/10.4037/ajcc2012242
- N. P. O'Grady, M. Alexander, L. A. Burns, E. P. Dellinger, J. Garland, and S. O. Heard, Healthcare Infection Control Practices Advisory Committee, "Guidelines for the prevention of intravascular catheter-related infections, 2011," American Journal of Infection Control, Vol.39, No.4, pp.1-34, 2011. https://doi.org/10.1016/j.ajic.2010.05.024
- Department of Health and Human Services. "Guideline for the Prevention of Intra vascular Catheter-Related Bloodstream Infections(Final Issue Riview). Atlanta: Centers for Disease Control and Prevention," 2010, May.
- J. D. Siegel, E. Rhinehart, M. Jackson, and L. Chiarello, Health Care Infection Control Practices Advisory Committee, "2007 Guideline for Isolation Precautions: Preventing Transmission of Infections Agents in Healthcare Settings," American Journal of Infection Control, Vol.35, No.10, pp.65-164, 2007.
- Centers for Disease Control and Prevention, "National Healthcare Safety Network(NHSN) report; Data summary for 2006 through 2008, issued December 2009. Atlanta, Georgia.9," 2009.
- 최정실, 연정화, "회음부 간호시 클로르헥시딘과 생리식염수 적용에 따른 유치도뇨관 관련 요로감염 발생률 비교", 기본간호학회지, 제19권, 제2호, pp.223-232, 2012. https://doi.org/10.7739/jkafn.2012.19.2.223
- G. Ridenour, R. Lampen, J. Federspiel, S. Kritchevsky, E. Wong, and M. Climo, "Selective Use of Intranasal Mupirocin and Chlorhexidine Bathing and the Incidence of Methicillin-Resistant Staphylococcus aureus Colonization and Infection Among Intensive Care Unit Patients," Infection Control and Hospital Epidemiology, Vol.28, No.10, pp.1155-1161, 2007(10). https://doi.org/10.1086/520102
- M. A. Viray, J. C. Morley, C. M. Coopersmith, M. H. Kollef, V. J. Fraser, and D. K. Warren, "Daily bathing with chlorhexi -dine-based soap and the prevention of Staphylococcus aureus transmission and infection," Infection Control and Hospital Epidemiology, Vol.35, No.3, pp.243-250, 2014. https://doi.org/10.1086/675292
- M. W. Climo, D. S. Yokoe, D. K. Warren, T. M. Perl, M. Bolon, and L. A. Herwaldt, "Effect of daily chlorhexidine bathing on hospital-acquired infection," The New England Journal of Medicine, Vol.368, No.6, pp.533-542, 2013. https://doi.org/10.1056/NEJMoa1113849
- L. S. Munoz-Price, B. Hota, A. Stemer, and R. A. Weinstein, "Prevention of Blood stream Infections by Use of Daily Chlorhexidine Baths for Patients at a Long-Term Acute Care Hospital," Infection Control and Hospital Epidemiology, Vol.30, No.11, pp.1031-1035, 2009(11). https://doi.org/10.1086/644751
- H. L. Evans, T. H. Dellit, J. Chan, A. B. Nathens, R. V. Maier, and J. Cuschieri, "Effect of Chlorhexidine Whole-Body Bathing on Hospital Acquired Infections Among Trauma Patients," Archives of Surgery, Vol.145, No.3, pp.240-246, 2010. https://doi.org/10.1001/archsurg.2010.5
- Korean Society for Nosocomial Infection Control, "Korean nosocomial infections surveillance system(KONIS)," Retrived July 2009 through June 2010, from http;//konis.cdc.go kr, 2011.
- 유소연, 중환자실에서 발생한 중심정맥 카테터 관련 혈류 감염의 위험요인과 의료비용, 카톨릭대학교 석사학위논문, 2009.
- L. Pereira, T. Chipato, A. Mashu, V. Mushangwe, S. Rusakaniko, and S. BangdiwalaI, "Randomized study of vaginal and neonetal cleansing with 1% chlorhexidine," International Journal of Genaecology and Obstetrics, Vol.112, No.3, pp.234-238, 2011(3). https://doi.org/10.1016/j.ijgo.2010.09.009