762: Impact of Chlorhexidine Gluconate Bathing on Catheter-Associated Urinary Tract Infections in the Icu

Introduction: Catheter-associated urinary tract infections (CAUTIs) are a significant source of morbidity in intensive care units (ICUs). This study evaluates the impact of bathing compliance utilizing a 4% chlorhexidine gluconate (CHG) product on CAUTI incidence across two 16-bed ICUs with differing Foley catheter utilization and infection outcomes. The Standardized Utilization Ratio (SUR) measures the ratio of observed to predicted device use, while the Standardized Infection Ratio (SIR) reflects the ratio of observed to predicted healthcare-associated infections (CAUTI). Methods: A retrospective comparative analysis was performed on two ICUs within the same institution. Each unit had 16 beds and evaluated 1,000 patients during calendar year 2024. CHG bathing compliance, Foley catheter utilization (SUR), and CAUTI incidence (SIR) were collected and analyzed. ICU 1 and ICU 2 were compared using descriptive statistics and p-values for statistical significance (threshold: p < 0.05). Our Foley utilization protocol is as follows: Remove the Foley catheter and place a Foley removal order on all patients except those who are (1) post-GU procedure, (2) prone position, (3) have chronic Foley use (changed regularly), or (4) require replacement only if intermittent straight catheterization is needed more than 3 times in 24 hours. Daily CHG application was performed using a foaming pump dispensed onto a damp washcloth or directly onto the patient’s skin, followed by rinsing with a second damp washcloth after appropriate contact time. Perineal cleansing was conducted using the same technique, and Foley catheters along with other tubes and drains were wiped with CHG foam. Results: ICU 1 had a lower Foley catheter utilization (SUR: 0.48 vs 0.8, p = 0.001) and CHG bathing compliance rate (85% vs 92 %, p = 0.001) compared to ICU 2. Despite increased catheter use, ICU 2 achieved a SIR of 0, indicating no CAUTIs, while ICU 1 had a SIR of 0.55 (p = 0.0001). Conclusions: Higher CHG bathing compliance was significantly associated with lower CAUTIs, even in the context of greater Foley catheter utilization. These results emphasize the importance of high CHG bathing adherence and Foley care protocols in reducing infection rates in patients who require a Foley in the ICU.