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Background <p>Paediatric oncology patients are highly susceptible to healthcare-associated infections (HAIs), particularly central line-associated bloodstream infections (CLABSIs), due to immunosuppression and frequent central venous catheter (CVC) use. Daily bathing with chlorhexidine gluconate (CHG) has demonstrated efficacy in reducing skin colonization by multidrug-resistant organisms (MDROs), yet compliance remains suboptimal in many settings.</p> Local Problem <p>At our tertiary cancer centre in Northeast India, baseline compliance with daily CHG bathing among paediatric oncology inpatients was 27%, despite institutional guidelines recommending routine use.</p> Methods <p>A multidisciplinary quality improvement project (QIP) was implemented using A3 methodology. Root cause analysis identified key barriers to compliance. Targeted interventions were deployed over a six-month period from October 2024 to February 2025, supported by EQUIP India under the National Cancer Grid. Compliance was tracked using daily audits and run charts.</p> Results <p>Interventions included developing a standard operating procedure (SOP), structured training for staff and caregivers, infrastructure improvements, and enhanced logistical support. Following implementation, mean weekly chlorhexidine gluconate (CHG) bathing compliance improved from a baseline of 27% to 64% by February 2025, exceeding the project target of 60%.</p> Conclusions <p>A structured, multi-faceted QIP can significantly improve and sustain adherence to CHG bathing protocols in a resource-constrained pediatric oncology setting. Daily chlorhexidine gluconate (CHG) bathing is a low-cost, scalable intervention that enhances infection control. Stakeholder engagement and addressing systemic barriers are critical for success.</p>

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Shielding little warriors: enhancing hygiene with chlorhexidine bathing in paediatric oncology – a quality improvement initiative

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Rashmisnata Barman,
  • Amrita Talukdar,
  • L. Shangnung,
  • Munlima Hazarika,
  • Bibhuti Bhusan Borthakur,
  • Sarbani Ghosh Laskar

摘要

Background

Paediatric oncology patients are highly susceptible to healthcare-associated infections (HAIs), particularly central line-associated bloodstream infections (CLABSIs), due to immunosuppression and frequent central venous catheter (CVC) use. Daily bathing with chlorhexidine gluconate (CHG) has demonstrated efficacy in reducing skin colonization by multidrug-resistant organisms (MDROs), yet compliance remains suboptimal in many settings.

Local Problem

At our tertiary cancer centre in Northeast India, baseline compliance with daily CHG bathing among paediatric oncology inpatients was 27%, despite institutional guidelines recommending routine use.

Methods

A multidisciplinary quality improvement project (QIP) was implemented using A3 methodology. Root cause analysis identified key barriers to compliance. Targeted interventions were deployed over a six-month period from October 2024 to February 2025, supported by EQUIP India under the National Cancer Grid. Compliance was tracked using daily audits and run charts.

Results

Interventions included developing a standard operating procedure (SOP), structured training for staff and caregivers, infrastructure improvements, and enhanced logistical support. Following implementation, mean weekly chlorhexidine gluconate (CHG) bathing compliance improved from a baseline of 27% to 64% by February 2025, exceeding the project target of 60%.

Conclusions

A structured, multi-faceted QIP can significantly improve and sustain adherence to CHG bathing protocols in a resource-constrained pediatric oncology setting. Daily chlorhexidine gluconate (CHG) bathing is a low-cost, scalable intervention that enhances infection control. Stakeholder engagement and addressing systemic barriers are critical for success.