ArticleBMC health services research2026
Shielding little warriors: enhancing hygiene with chlorhexidine bathing in paediatric oncology - a quality improvement initiative.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPaediatric 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.
methodsA 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.
resultsInterventions 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%.
conclusionsA 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.
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