Universal ICU Decolonization: An Enhanced Protocol
Appendix F. Chlorhexidine Bathing Skills Assessment
Table of Contents
Please record your observations when monitoring a patient being bathed with CHG.
Observed CHG Bathing Practices
Please circle your answer:
Y N Cleanses entire neck area well including skin folds and around lines.
Y N Massages skin firmly with CHG cloth to ensure adequate cleansing.
Y N States rationale for not using soap below jaw line at any time.
Y N Uses all six cloths and more if needed.
Y N Cleans armpit and back of knee well.
Y N Cleans in between toes and fingers.
Y N Cleans between all folds in perineal and gluteal area.
Y N Wipes occlusive and semi-permeable dressing with CHG cloth.
Y N Cleans tubing, lines, and drains closest to body (after emptying drains).
Y N Bathing is completed with no skin below jaw line missed.
Y N N/A Uses CHG on superficial wounds, rash, and stage 1 & 2 decubitus ulcers.
Y N N/A Uses on closed surgical wounds.
Y N Allows to air dry/does not wipe off CHG.
Y N CHG bathing documented.
Queries to Bathing Assistant/Nurse
1. Do you ever use soap in conjunction with a CHG bathing cloth? If so, when?
2. Do you reapply CHG after an episode of incontinence?
3. If a patient needs freshening up/second bath, do you use CHG cloths or a different product?
4. Are you comfortable applying CHG to superficial wounds?
5. Are you comfortable applying CHG to stage 1 & 2 decubitus ulcers?
6. Are you comfortable applying CHG to closed surgical wounds?
7. Do you ever wipe off the CHG after bathing?
Page originally created September 2013