The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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The Effects of Bed Baths with 2% Chlorhexidine on the Incidence of Methicillin-resistant Staphylococcus aureus and Blood Stream Infection in Intensive Care Units

2% 클로르헥시딘 침상목욕 간호가 중환자실 입원환자의 메티실린 내성 황색포도상구균과 혈류감염 발생에 미치는 효과

  • Received : 2014.07.31
  • Accepted : 2014.10.03
  • Published : 2014.11.28
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Abstract

The purpose of this study was to identify the effects of bed baths with 2% chlorhexidine on the incidence of Methicillin-resistant Staphylococcus aureus (MRSA) and blood stream infection (BSI) and to suggest guidelines on the therapeutic bed baths using skin cleaner. This study was designed to compare the incidence of MRSA and BSI of the experimental group(n=188) who received the bed baths with 2% chlorhexidine with the incidence of MRSA and BSI of the control group(n=199) who received the existing bed baths with soap and skin cleaner. A research design used in the study was a randomized control group posttest-only design. The experimental group had 6.7% decrease in MRSA acquisition than the control group (7.4% vs 14.1%, p=.036). The experimental group was decreased in the incidence density of MRSA than the control group (9.32 cases per 1,000 patient-days at risk of experimental group vs 15.44 cases per 1,000 patient-days at risk of control group; p=.099). The experimental group had 4.5% decrease in the rate of BSI than the control group (0.5% vs 5.0%, p=.011). The experimental group was decreased in the incidence density of BSI than the control group (0.67 cases per 1,000 patient-days at risk of experimental group vs 5.52 cases per 1,000 patient-days at risk of control group; p=.052). These finding indicated that bed baths with 2% chlorhexidine is an effective nursing intervention to decrease the incidence of MRSA and BSI.

본 연구의 목적은 2% 클로르헥시딘 침상목욕 간호가 중환자실 입원환자의 MRSA (Methicillin-resistant Staphylococcus aureus) 발생률과 BSI (blood stream infection) 발생률에 미치는 효과를 검증하고 치료적인 침상목욕 방법을 제시하기 위함이다. 본 연구의 대상자는 서울에 소재한 1개 상급 종합병원의 내 외과계중환자실에 2010년 11월 1일부터 2011년 8월 15일까지 입실한 환자 전수로 하였으며, 실험군 188명, 대조군 199명으로 총 387명이었다. 2% 클로르헥시딘(MICROSHIELD $2^{(R)}$, 존슨앤존슨, 뉴질랜드) 침상목욕 간호를 실시한 실험군의 MRSA 발생률은 7.4%로 일반 비누와 액상 세정제를 사용하여 침상목욕 간호를 실시한 대조군의 MRSA 발생률 14.1%보다 유의하게 낮았다(p=.036). 실험군의 재원일수 1,000일당 MRSA 발생건수는 9.32건으로 대조군의 재원일수 1,000일당 발생건수 15.44건보다 낮았다(p=.099). 2% 클로르헥시딘 침상목욕 간호를 실시한 실험군의 BSI 발생률은 0.5%로 일반 비누와 액상 세정제를 사용하여 침상목욕 간호를 실시한 대조군의 BSI 발생률 5.0%보다 유의하게 낮았다(p=.011). 실험군의 재원일수 1,000일당 BSI 발생건수가 0.67건으로 대조군의 재원일수 1,000일당 발생건수 5.52건에 비해 낮게 나타났다(p=.052). 따라서 2% 클로르헥시딘 침상목욕 간호를 치료적 간호중재로 간호실무에 적극적으로 활용할 것을 제안한다.

Keywords

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