Health care workers were willing to use the patient safety event reporting system, which yielded a broad range of patient safety data. Patient safety events are multifaceted and often have multiple causal factors. Application of a causal classification model for patient safety event coding in the intensive care and preoperative and postoperative care units is feasible and facilitates local communication of important event-related information.

This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Discuss current research on chlorhexidine gluconate (CHG) bathing 2. Compare use of CHG-impregnated washcloths with CHG solution dissolved in bath water 3. Describe the effects of CHG bathing on methicillin-resistant Staphylococcus aureus BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is a virulent organism causing substantial morbidity and mortality in intensive care units. Chlorhexidine gluconate, a topical antiseptic solution, is effective against a wide spectrum of gram-positive and gram-negative bacteria, including MRSA. OBJECTIVES To examine the impact of a bathing protocol using chlorhexidine gluconate and bath basin management on MRSA acquisition in 5 adult intensive care units and to examine the cost differences between chlorhexidine bathing by using the bath-basin method versus using prepackaged chlorhexidineimpregnated washcloths. METHODS The protocol used a 4-oz bottle of 4% chlorhexidine gluconate soap in a bath basin of warm water. Patients in 3 intensive care units underwent active surveillance for MRSA acquisition; patients in 2 other units were monitored for a new positive culture for MRSA at any site 48 hours after admission. RESULTS Before the protocol, 132 patients acquired MRSA in 34 333 patient days (rate ratio, 3.84). Afterwards, 109 patients acquired MRSA in 41 376 patient days (rate ratio, 2.63). The rate ratio difference is 1.46 (95% CI, 1.12-1.90; P = .003). The chlorhexidine soap and bath basin method cost $3.18 as compared with $5.52 for chlorhexidine-impregnated wipes (74% higher). CONCLUSIONS The chlorhexidine bathing protocol is easy to implement, cost-effective, and led to decreased unit-acquired MRSA rates in a variety of adult intensive care units. (Critical Care Nurse. 2014;34[5] Reduction and elimination of hospital-acquired infections requires a multipronged approach. Hand hygiene is the primary strategy to reduce hospital-acquired infections and prevent transmission of resistant microbes between patients.5 Rapid reporting of culture results allows the health care team to initiate timely contact isolation precautions that help reduce the spread of infection once a resistant organism is identified. A multidisciplinary critical care team partnership with infection prevention specialists can facilitate these evidence-based prevention strategies. The increase in MRSA prevalence in the community and the high level of mortality associated with MRSA (3.62 deaths per 100000 population in the United States) 1 require clinicians to continuously explore measures to prevent MRSA acquisition in critically ill patients. MRSA colonization can be a source of fear, anxiety, and uncertainty for patients.6-8 Therefore, prevention of hospital-acquired MRSA is an important nursing intervention. Chlorhexidine gluconate (CHG), a topical antiseptic solution, is effective against a wide spectrum of grampositive and...

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