Authors (including presenting author) :
Lai SK (1,2), Siu L (1,2)
Affiliation :
Department of Medicine and Geriatrics (1), Ruttonjee & Tang Shiu Kin Hospitals (2), Hong Kong East Cluster
Keyword 1: :
Bathing Workflow
Keyword 2: :
MDROs Patient
Introduction :
Patients with Multidrug-Resistant Organisms (MDROs) are at higher risk for healthcare-associated infections and potential cross-transmission. In the Special Accommodation Ward (SAW), temporary ward amalgamation with other units whether due to renovation or operational needs, has introduced complexities in patient care routines. Specifically, MDRO patients have experienced inconsistent bathing schedules, unclear staff prioritization, documentation gaps. With the growing number of MDRO cases and the corresponding rise in bathing workload, a standardized, streamlined workflow for scheduling and performing baths became urgently needed to ensure consistent infection control standards in alignment with Hospital Authority (HA) guidelines.
Objectives :
The primary goals of this project were to: (1) standardize the bathing workflow for MDRO patients to ensure baths every three days, and (2) administer daily chlorhexidine gluconate (CHG) baths for Methicillin-resistant Staphylococcus Aureus (MRSA) patients with bacteremia for five consecutive days. Additionally, the project aimed to improve nursing compliance, improve documentation accuracy, and prioritize patient safety.
Methodology :
This ward-based Continuous Quality Improvement (CQI) project utilized the Plan-Do-Study-Act (PDSA) framework to implement key interventions. These interventions included adherence to a standardized MDRO bathing protocol and checklist; conducting staff education sessions focusing on infection control guidelines, hand hygiene, and the appropriate use of personal protective equipment (PPE); introducing a visual bathing schedule (Appendix I) to prioritize MDRO patients; and employing single-use disposable bathing supplies such as washcloths, towels, and appropriate antimicrobial cleaning agents. Compliance and documentation were systematically monitored via regular audits, along with feedback from nursing staff.
Result & Outcome :
Following the implementation of these strategies, there was a marked improvement in compliance with the designated bathing frequencies for both MDRO and MRSA patients. The visual bathing schedule significantly reduced the occurrence of missed or delayed baths, while nursing documentation became markedly more complete and clearer. Nursing staff reported enhanced clarity in workflow and accountability for patient care, and patients expressed increased comfort and understanding regarding their bathing arrangements.
