Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

(^226) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Library, and Google Scholar databases. Literature pertaining to basin bathing,
CHG (chlorhexidine) bath wipes, plain bath wipes, and associated outcomes
were included. A title and abstract review eliminated a number of studies based
on exclusion criteria, and the total number of studies included in the evidence
review was 41.
Level of Evidence Number of
Articles
Quality A Quality B
Level I 4 1 3
Level II 18 5 13
Level III 5 2 3
Level IV 0 0 0
Level V 14 1 13
Total 41
The majority of studies and EBP projects included in the literature review were
Level II and Level V and B-quality ratings, according to the JHNEBP Model.
The evidence indicated that bath basin bacterial contamination places patients
who use basins at an increased risk for HAIs, including CAUTIs. Additionally, the
removal of reusable bath basins can reduce patient exposure to harmful organ-
isms, and the use of bathing alternatives, like CHG wipes and plain bath wipes,
should be further investigated. Though the use of CHG and CHG wipes has been
found to be effective in reducing central line associated bloodstream infections
(CLABSIs) and surgical site infections (SSIs), no significant reduction in CAUTI
rates when CHG wipes or CHG bathing protocols are implemented has been
demonstrated. The evidence does support the use of plain wipe bathing to aid in
the prevention of CAUTIs with little additional cost and high patient and staff
satisfaction. For that reason, the removal of bath basins and the initiation of