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choose CHG soap was because they felt it was too harsh on the skin for daily use, hypersensitivity, or that the soap did not clean as well as ordinary soap and water. Some of the nursing staff did not see a plausible reason to use CHG soap since it was not utilized after the patient leaves the ICU setting. The staff was more reluctant to CHG soap because they reported that their hospital had low HAI rates compared to other hospitals in the area (Musuuza, Roberts, Carayon, & Safdar, 2017).
RESEARCH CRITIQUES AND PICOT7Lastly, the nursing staff's perception on adding CHG daily bathing to their order sets was evaluated. As a result of the interviews, the staff had mixed views about this intervention. Some believed if the CHG daily baths was incorporated as an order set that they would feel obligated to carry out this nursing task. Others were against the order sets and stated they felt it would clutter their order sets that are already crowded. It was discussed with the nursing staff that CHG soap could be scanned as part of the of medication schedule, but some of the nursing staff reported that it would not increase compliance because nurses may just scan the soap and leave itat the bedside (Musuuza, Roberts, Carayon, & Safdar, 2017). Quantitative StudyBackground of StudyHealthcare-associated infections are associated with high morbidity and mortality rates aswell as substantial excess in costs that are no longer being covered by Medicaid or Medicare (Climo et al., 2013). According to Climo et al. (2013), hospital-acquired bloodstream infections in the intensive care unit (ICU) can be significantly reduced with targeted interventions that include chlorhexidine-containing products. Numerous studies have proven that the risk of infection is decreased during central venous catheter insertions with the standardization of insertion-site antisepsis; however it remains controversial if patient bathing with chlorhexidine gluconate can prevent healthcare-associated infections (Climo et al., 2013). Since chlorhexidine gluconate is an effective antiseptic agent against organisms such as S. aureus and enterococcus species, it has residual antibacterial properties that can reduce the microbial burden on patient's skin (Climo et al., 2013). The studies performed with daily bathing using chlorhexidine-impregnated cloths reduced the acquistion rate of VRE bacteremia by 66% amongst patients (Climo et al., 2013).
RESEARCH CRITIQUES AND PICOT8Unfortunately, the previous studies were observational and performed in six ICUs that were primarily based at a single center which limited the general applicability of results. The purpose of this study was to broaden the research by utilizing multiple healthcare centers and a randomized trial method to evaluate the effectiveness of chlorhexidine bathing in high risk patients (Climo et al., 2013). A quantitative approach to this study was appropriate because the variables (patients) can be described objectively in numbers, meanwhile confidentiality is maintained. A research question that this study was designed to answer was: “Is chlorhexidine