Using Visual Management to Improve Compliance with Chlorhexidine Gluconate Bathing and Nasal Decolonization
Recommended Citation
Ruby A, Chami E, Musgrove H, Ma X, McLenon J, Gnam G. Using Visual Management to Improve Compliance with Chlorhexidine Gluconate Bathing and Nasal Decolonization. Jt Comm J Qual Patient Saf. 2026;52(11):660-664.
Document Type
Article
Publication Date
11-1-2026
Publication Title
Joint Commission journal on quality and patient safety
Keywords
Humans, Chlorhexidine, Baths, Anti-Infective Agents, Local, Guideline Adherence, Adherence Interventions, Methicillin-Resistant Staphylococcus aureus, Cross Infection, Staphylococcal Infections
Abstract
BACKGROUND: Visual management tools are designed to drive desired behaviors and support consistent performance. When tailored to specific practice areas, these tools become more relevant for staff.
METHODS: Visual management tools were designed and implemented for this project to standardize nursing handoff communication and improve administration of 2% chlorhexidine gluconate (CHG)-impregnated wipe bathing and prophylactic alcohol-based nasal decolonization swabs. Supply locations were standardized across the hospital, and a wipeable sticker was added to patient whiteboards, which served as a visual reminder, prompting discussion of CHG bathing and nasal decolonization administration status during nursing handoff.
RESULTS: Compliance with nursing documentation of chlorhexidine gluconate bathing (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.57-1.76, p < 0.001) and nasal decolonization (OR 1.86, 95% CI 1.81-1.93, p < 0.001) improved postimplementation (October 2023-April 2024 vs. October 2024-April 2025). Improvements were also noted in central line-associated bloodstream infection (rate ratio [RR] 0.47, 95% CI 0.28-0.76, p = 0.003) and methicillin-resistant Staphylococcus aureus bacteremia (RR 0.80, 95% CI 0.20-3.01, p = 0.74) rates when comparing preimplementation and postimplementation data.
CONCLUSION: This project demonstrates that visual management tools may help to improve nursing handoff communication, and CHG bathing and nasal decolonization administration and documentation.
Medical Subject Headings
Humans; Chlorhexidine; Baths; Anti-Infective Agents, Local; Guideline Adherence; Adherence Interventions; Methicillin-Resistant Staphylococcus aureus; Cross Infection; Staphylococcal Infections
PubMed ID
42586927
ePublication
ePub ahead of print
Volume
52
Issue
11
First Page
660
Last Page
664
