Lin Shu-Cing, Lin Chair-Hua, Yu Chin-Ching
Graduate Institute of Nursing, Central Taiwan University of Science and Technology, Taiwan, ROC.
Department of Nursing, Changhua Christian Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2017 Aug;64(4):71-78. doi: 10.6224/JN.000056.
Central catheters are used primarily in ICU settings. Bloodstream infections in the central line of central catheters have been shown to cause longer hospital stays for patients and result in higher medical costs.
The present study applies a systematic review and meta-analysis to assess the effect of a 2% chlorhexidine (CHG) bed-bath on the risk of central line-associated bloodstream infections (CLABSI).
The Public Health Resource Unit of England issued the Critical Appraisal Skills Programme and evaluated the standardized crucial appraisal tools from the Joanna Briggs Institute that are used to assess methodological quality. The present study identified 6 studies that met the criteria from a keyword search that included: CHG and soap-water for bed-bath experiment. The experiment used RevMan 5 software to conduct the meta- analysis.
The results support the homogeneity (p = .002, I = 64%) of the sample. Comprehensive effectiveness was 0.45 (95% CI [0.35, 0.58], p < .001). The CHG bed-bath intervention was shown to effectively reduce CLABSI.
CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The meta-analysis indicated that bed-bath with CHG reduces the incidence of CLABSI. We recommend that center catheter bundle care be applied in ICUs in combination with CHG bed-bath in order to reduce the risk of CLABSI.
中心静脉导管主要用于重症监护病房。中心静脉导管相关血流感染已被证明会导致患者住院时间延长，并增加医疗成本。
本研究采用系统评价和荟萃分析来评估2%氯己定（CHG）擦浴对中心静脉导管相关血流感染（CLABSI）风险的影响。
英国公共卫生资源单位发布了关键评估技能计划，并评估了乔安娜·布里格斯研究所用于评估方法学质量的标准化关键评估工具。本研究通过关键词搜索确定了6项符合标准的研究，关键词包括：CHG与肥皂水擦浴实验。实验使用RevMan 5软件进行荟萃分析。
结果支持样本的同质性（p = 0.002，I = 64%）。综合效应值为0.45（95%置信区间[0.35, 0.58]，p < 0.001）。CHG擦浴干预被证明能有效降低CLABSI。
结论/实践意义：荟萃分析表明，CHG擦浴可降低CLABSI的发生率。我们建议在重症监护病房将中心导管集束护理与CHG擦浴相结合，以降低CLABSI的风险。
