Exploring facilitators and barriers to daily chlorhexidine gluconate bathing in adult patients undergoing hematopoietic stem cell transplantation.

Abstract

Hematopoietic cell transplantation (HCT) is a promising treatment for hematologic malignancies, but intensive conditioning leads to immunosuppression and susceptibility to healthcare-associated infections (HAI). Despite standard prevention measures, bloodstream infections (BSI) impact a significant percentage of immunocompromised HCT patients. Incidence of BSI can be mitigated by chlorhexidine gluconate (CHG) bathing-an underutilized infection-prevention strategy. Gaining HCT recipients' perceptions on CHG bathing can inform strategies to improve adherence and enhance patient outcomes.

Purpose: This study explored patients' perceived facilitators, barriers, and education/knowledge related to CHG bathing and thus addresses the gap in implementation for immunocompromised HCT patients.

Methods: This study used a qualitative description approach to explore patients' perceived facilitators, barriers, and knowledge of CHG bathing. Fourteen HCT recipients (mean 51 ± 16 years) completed semi-structured interviews. Data were analyzed using a rapid qualitative analysis approach to identify themes.

Results: Participants identified facilitators to using CHG wipes including ease of use, comfort, and staff assistance, along with barriers including wait time, discomfort, and physical challenges. Patient education themes encompassed patient understanding of CHG purpose, perceived ease in learning/application, inconsistent instruction, and inconsistent procedures.

Conclusion: CHG bathing is a valuable infection prevention strategy for HCT patients. Participants' perspectives highlight the importance of addressing practical challenges and improving education to enhance adherence. This study contributes insights from HCT recipients, emphasizing the need for patient-centered interventions to reduce HAI and improve overall patient care.