Interventions
infection, gram-negative, ®
ADVERSE EVENTS, INFECTION, ADVERSE EVENT
Each ICU was randomly assigned to one of three bathing regimes: daily patient bathing with non-antiseptic soap and water (control, routine care), daily bathing with 2% chlorhexidine-impregnated cloths (Sage 2% Chlorhexidine Gluconate (CHG)) or 0.08% octenidine disposable wash mitts (Octenisan® by Schülke). Chlorhexidine gluconate is a cationic biguanide compound with strong activity against gram-positive and weaker activity against gram-negative bacteria [All ICUs received standard operating protocols (SOP), and education material on infection control and daily bathing procedures (printed material and short videos on step-by-step instructions for bathing and frequently asked questions (FAQs) as downloads) according to their group allocation. Posters and information leaflets were provided to inform patients, patient’s legal representatives, and visitors on participation of the ICU in the trial. All ICUs were encouraged to perform patient bathing at least once a day by trained nurses, to continue all medical interventions including catheter care according to their hygiene plans and standard operating protocols. In the intervention groups, antiseptic products were applied according to manufacturer’s instructions, one (if necessary, more) package(s) of antiseptic products was recommended per patient and day, and on-site trainings were provided by employees of Stryker for chlorhexidine-impregnated cloths and by employees of Schülke for octenidine-impregnated wash mitts.Details on interventions can be found elsewhere [Treating physicians and the ICU personnel were responsible for local quality management including on-site implementation of routine care and interventions as well as the management of adverse events. ICUs identified at least two individuals (from the hygiene and/or ICU team) in charge for conducting the CLIP-ID trial on their ward. Adverse events and consumption of decolonisation products were reported monthly to the CLIP-ID study management team. All ICUs were obliged to provide feedback and participate in surveys on infection prevention measures of their wards before and at the end of the intervention period.The full study protocol including all documentation forms and surveys can be found elsewhere [