Implementation Strategies to Improve Evidence-Based Bathing Practices in a Neuro ICU.
Date
2019-04
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Abstract
Background
Evidence supports daily bathing using chlorhexidine gluconate (CHG) cloths to decrease preventable hospital-acquired central line-associated bloodstream infections (CLABSIs). However, implementation of this practice is inconsistent. Using multifaceted strategies to promote implementation is supported in the literature, yet there is a gap in knowing which strategies are most successful.Purpose
Using the Grol and Wensing Model of Implementation as a guide, the purpose of this study was to determine whether using tailored, multifaceted strategies would improve implementation of daily CHG bathing and decrease CLABSIs in a large neuro ICU.Methods
An observational pre-/postdesign was used.Results
Following implementation, infection rates decreased (P = .031). Statistically significant improvements were also seen across all process measures: bathing documentation, nursing knowledge, and perceived importance of CHG bathing.Conclusions
This study assists in closing the research-practice gap by using tailored, multifaceted implementation strategies to increase use of evidence-based nursing care for infection prevention practices.Type
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Reynolds, Staci Sue, Chris Sova, Bridget McNalty, Suzanne Lambert and Bradi Granger (2019). Implementation Strategies to Improve Evidence-Based Bathing Practices in a Neuro ICU. Journal of nursing care quality, 34(2). pp. 133–138. 10.1097/ncq.0000000000000347 Retrieved from https://hdl.handle.net/10161/26931.
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Scholars@Duke

Staci Reynolds
Dr. Staci Reynolds is a Clinical Professor at Duke University School of Nursing (DUSON). At DUSON, Dr. Reynolds primarily teaches in the DNP program. Previously, she clinically served as a Clinical Nurse Specialist (CNS) at Duke University Hospital within the neuroscience inpatient units and Infection Prevention and Hospital Epidemiology department. In January 2023, Dr. Reynolds was appointed the Editor-in-Chief of the Journal of Nursing Care Quality. Before coming to DUSON, she was a neurocritical care nurse and a neuroscience CNS at Indiana University Health Methodist Hospital.
Dr. Reynolds received a baccalaureate degree in nursing science from Indiana University (IU) School of Nursing in Indianapolis, Indiana. She earned a Master’s degree as a Clinical Nurse Specialist at IU in 2011, and completed her PhD at IU in May 2016. Dr. Reynolds’ current scholarship interests include evidence-based practice implementation and evaluation, and she is an expert in quality improvement.

Bradi Bartrug Granger
Dr. Bradi Granger is a Research Professor at Duke University School of Nursing, Director of the Duke Heart Center Nursing Research Program, and adjunct faculty at the University of Gothenburg, Sweden. She is also a core faculty at the Duke-Margolis Center for Health Policy. Dr. Granger received her doctorate in nursing from the University of North Carolina at Chapel Hill, her MSN from Duke University, and her BSN from the University of Tennessee at Knoxville.
Dr. Granger has extensive clinical experience in cardiovascular nursing, and her clinical work as a Clinical Nurse Specialist has been dedicated to overcoming barriers to the use and conduct of research in the service setting through the development of pragmatic tools that change the way nurses learn about, apply, and conduct nursing science. She has developed an innovative model for clinical inquiry and research in the hospital setting, which has been adopted in clinical settings across the U.S. and abroad. Dr. Granger is an active member of the Council for the Advancement of Nursing Science, the American Association of Critical Care Nurses, the American Heart Association, and the European Society for Patient Adherence, Compliance, and Persistence.
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