Decolonization Bathing Routine Reduces Infections and Resistant Organisms in Nursing Homes

Strategic Insights -

A groundbreaking study has found that nursing homes using a chlorhexidine bathing routine to clean the skin and nose with over-the-counter antiseptic solutions can prevent serious infections and reduce the amount of antibiotic-resistant organisms in the nursing home, such as methicillin-resistant Staphylococcus aureus (MRSA). The study, published in the New England Journal of Medicine, found that residents in nursing homes using the decolonization bathing routine were less likely to be transferred to the hospital due to infections, and also saw significant reductions in the overall prevalence of multidrug-resistant organisms (MDROs).

Key Takeaways:

  • The study, funded by the Agency for Healthcare Research and Quality (AHRQ), included nearly 14,000 residents in 28 nursing homes in California and found that decolonization bathing reduced hospital transfers due to infections by 2 residents per month.
  • Nursing homes that used decolonization also saw significant reductions in the overall prevalence of MDROs, including MRSA, vancomycin-resistant Enterococci, and other resistant bacteria.
  • No change in MDRO prevalence was detected in residents who lived in nursing homes that used routine bathing.
  • The study's findings suggest that changing to an antiseptic soap and cleaning the nose with iodophor is a highly effective way to prevent dangerous infections in nursing homes.
  • Adherence to the decolonization bathing routine didn't need to be perfect to prevent hospitalization and resistant organisms: 87 percent of nursing home staff used the antiseptic soap as intended and 67 percent used the nasal swab as intended.
  • The study's senior investigator, Susan S. Huang, M.D., M.P.H., of the Division of Infectious Diseases, University of California Irvine School of Medicine, stated that "compared with other healthcare strategies, this is a relatively simple win for nursing homes, and we hope nursing homes will want to adopt it."

Statistics:

  • Nearly 14,000 residents were included in the study.
  • 2 residents per month avoided transfers to the hospital due to infections in nursing homes using decolonization bathing.
  • Nursing homes that used decolonization also saw significant reductions in hospital transfers for other causes.
  • 87 percent of nursing home staff used the antiseptic soap as intended.
  • 67 percent of nursing home staff used the nasal swab as intended.
  • Each year, 3 million healthcare-associated infections (HAIs) such as MRSA, bloodstream infections, and urinary tract infections occur in U.S. nursing homes, causing 150,000 hospital admissions and 350,000 deaths.
  • More than 1 million people reside in one of the Nation's 15,000 nursing homes on any given day.

Sources:

  • AHRQ. (2023, October 10). New Study Finds Decolonization Bathing Routine Reduces Infections and Resistant Organisms in Nursing Homes. https://www.ahrq.gov/news/newsroom/press-releases/chlorhexidine-bathing.html
  • New England Journal of Medicine. (2023, October 10). Nursing Home Decolonization for Infection and Hospitalization Prevention. https://www.nejm.org/doi/full/10.1056/NEJMoa2215254