Authors (including presenting author) :
Ng KUG(1), Lau KH(1), Li HL(1), Ng PY(1), Cheng KL(1), Lee KP(1), Leung YF(2)
Affiliation :
(1)Infection Control Team, Caritas Medical Centre (2)Central Nursing Division, Caritas Medical Centre
Keyword 2: :
Multidrug-resistant organisms
Keyword 4: :
Decontamination
Keyword 5: :
Chlorhexidine
Introduction :
Multidrug-resistant organisms (MDROs) present significant challenges in healthcare, resulting in increased patient morbidity, extended hospital stays, and higher healthcare costs. Effective infection control is essential for safeguarding patient health and preventing the spread of these pathogens. In June 2024, the Hospital Authority advised a single chlorhexidine (CHG) bath as a decontamination therapy for newly admitted Residential Care Homes for the Elderly (RCHE) residents. In response to a concerning upsurge in MRSA bacteremia cases at Caritas Medical Centre (CMC), the Central Bed Bath Team was formed in accordance with the KWC MDRO Reduction Program. Launched on May 28, 2025, the team’s mission is to provide CHG baths to eligible RCHE patients upon admission. Ordinarily, ward staff administer 1-2 baths per day. However, with the Central Bed Bath Team in place, the overall capacity to conduct CHG baths in CMC has increased to approximately 20 baths per day, significantly enhancing patient care and timely decontamination for newly admitted residents.
Objectives :
-Administer effective CHG baths to reduce skin bacteria load in newly admitted RCHE patients. -Improve patient safety and satisfaction through enhanced hygiene practices.
Methodology :
The Central Bed Bath Team consists of infection control nurses and trained patient care assistants (PCAs), operating Monday to Friday from 9 AM to 5 PM. Each day, the infection control nurse generates a list of eligible patients for CHG bathing. The PCAs coordinate with the ward in charge to determine appropriate cases and communicate completed baths to ward staff. To ensure effective implementation of the CHG bathing protocol, the team developed training packages for the PCAs. These include educational materials on infection control practices, proper CHG bathing techniques, and the importance of maintaining hygiene standards. Additionally, the team will conduct regular audits on napkin changing and bed bathing to assess compliance with infection control measures. Team members will evaluate the workflow regularly, using feedback for necessary adjustments.
Result & Outcome :
The introduction of CHG bathing has led to a significant reduction in MRSA bacteremia cases, indicating the effectiveness of the decontamination therapy. The hospital acquired MRSA bacteremia rate decreased from 0.119 / 1000 acute patient days in the period of Dec 2024 to May 2025 to 0.060 / 1000 acute patient days in the period of Jun 2025 to Nov 2025. The percentage change in rate was -49.7% but the exact p-value (two-tailed, using Fisher’s/conditional binomial) was ≈ 0.114. Although the 49.7% reduction is clinically meaningful, it did not reach statistical significance, likely owing to the limited number of events. Nevertheless, the Central Bed Bath Team was associated with reduced ward staff workload and notable improvements in patient care. In the long term, the team expects to maintain lower rates of MRSA bacteremia, further Improving hygiene practices and promoting patient satisfaction, thus allowing ward staff to focus on other critical care responsibilities.
