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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/d4j_pdi12-crbsi-bestpractices.pdf
May 17, 2016 - Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
2 Tool D.4j
Maximal Barrier … • Apply maximal barrier precautions.
• Use chlorhexidine skin prep unless contraindicated. … central line cart, at a minimum, should
include all of the following9,10:
Supplies for maximal barrier … Recommended Practice: Maximal Barrier Precautions and Skin Preparation
• Prepare skin:
o Prepare … skin with chlorhexidine skin antiseptic, if not contraindicated, by first breaking
the central core.
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www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7c.html
October 01, 2014 - Skin inspected daily
c. … Barrier cream applied if moisture issues identified
h. … Skin inspected daily
d. … Barrier cream applied if moisture issues identified
i. … Determine how comprehensive the initial skin assessment was.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4y_combo_nqi03-bsi-bestpractices.pdf
May 17, 2016 - Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
2 Tool D.4y
Maximal Barrier … • Apply maximal barrier precautions.
Use chlorhexidine skin prep unless contraindicated. … Recommended Practice: Maximal Barrier Precautions and Skin Preparation
• Prepare skin:
○ Prepare … skin with chlorhexidine skin antiseptic, if not contraindicated, by first breaking
the central core. … antiseptic
• Maximal barrier precautions
• Central line catheters
Communication
• Education on
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www.ahrq.gov/hai/universal-icu-decolonization/universal-icu-ape3.html
September 01, 2013 - Only use CHG-compatible lotions and/or barrier products.
Dispose of all cloths in the trash. … Apply CHG compatible barrier.
Repeat throughout the day, as needed. … After bathing skin, clean 6 inches of tubes/Foley nearest patient. … Skin may feel sticky for a few minutes. Do NOT wipe off. Allow to air dry.
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www.ahrq.gov/hai/tools/surgery/modules/implementation/ssi-bundle-slides.html
October 01, 2020 - Standardization of skin preparation.
Capitalize on frontline wisdom:
CUSP. … tools:
Glucose control audit tool (Word, 1.67 MB)
Normothermia audit tool (Word, 1.59 MB)
Skin … barrier uses a table with space to record following information: Barrier, Likelihood score, Severity … the effects of that barrier. … Skin preparation.
SSI investigation.
Antibiotic.
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www.ahrq.gov/es/hai/universal-icu-decolonization/universal-icu-ape3.html
September 01, 2013 - Only use CHG-compatible lotions and/or barrier products.
Dispose of all cloths in the trash. … Apply CHG compatible barrier.
Repeat throughout the day, as needed. … After bathing skin, clean 6 inches of tubes/Foley nearest patient. … Skin may feel sticky for a few minutes. Do NOT wipe off. Allow to air dry.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module3/putoolkit_module3_tools.docx
April 02, 2025 - Skin Moisture
Touch the skin to see if the skin is wet or dry, or has the right balance of moisture. … Then let the skin go.
If the skin quickly returns to place, this is a normal skin turgor finding. … Moisture
Constantly Moist
· Skin assessment and inspection q shift.
· Use moisture barrier ointments … toileting after meals or rectal tubes if appropriate.
· Consider low air loss bed
Moist
· Use moisture barrier … training and toileting after meals.
· Consider low air loss bed
Occasionally Moist
· Use moisture barrier
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/062-protocol-training-decolonization-with-chg.pptx
October 01, 2024 - Pay extra attention to neck, joints, and all skin folds.
Lift skin folds to clean with CHG. … Apply CHG-compatible barrier protection, if needed.
Use only barrier products compatible with CHG. … If additional bathing is required during the day, clean with CHG, and reapply CHG-compatible barrier … Once applied to skin, CHG binds to skin proteins and will not stain sheets. … DO massage CHG firmly onto skin.
DO pay special attention to neck, joints, and skin folds.
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www.ahrq.gov/hai/tools/surgery/guide-surg-comp.html
December 01, 2017 - Surgical Skin Preparation Audit Tool ( Word , 1.57 MB)
This tool will help your team understand how … appropriately you are preparing the skin for incision. … Additional Resources
Barrier Identification and Mitigation Tool ( Word , 1.73 MB)
Understand where … The Barrier Identification and Mitigation (BIM) Tool was designed to help your safety program team systematically
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www.ahrq.gov/hai/cusp/clabsi-final-companion/clabsicomp5b.html
January 01, 2013 - units consistently used the following CLABSI reduction steps over time: hand hygiene, chlorhexidine skin … preparation, full-barrier precautions during line insertion, avoidance of femoral site for placement … More than 80 percent of units consistently used hand hygiene, chlorhexidine skin preparation, full-barrier
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module1/putoolkit_module1_tools.docx
March 01, 2013 - activities
Other
Specific products - floor stock or formulary items
PH balanced skin … cleanser
Skin creams (for dry skin)
Moisture barrier creams
Skin protectant wipes
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/001-clabsi-prevention-webinar-slides.pptx
October 01, 2024 - Do not wipe or blow dry the skin. … Allow skin preparation to completely dry before puncturing the skin. … CHG skin preparations are preferred. … Precautions33-36
Use maximal sterile barrier precautions when placing a central line. … Effect of different sterile barrier precautions and central venous catheter dressing on the skin colonization
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb.pdf
April 02, 2025 - ■ Moldable barrier or caulking strips can be used to fill in skin creases or scars. … ■ Use only alcohol-free skin sealant, a plasticizing agent applied to the skin to create a barrier … – Apply skin barrier powder to “weepy” areas prior to pouching. … – Protect peristomal skin from effluent with an occlusive barrier ointment. … ■ Fungal infections: can occur in the warm, moist environment beneath the barrier and erode
skin
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www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/nursing-protocols/nursing-chg-bed-bathing.docx
March 01, 2022 - Ensure that cloths are applied to skin by firm massage to ensure the binding of CHG to skin proteins. … If needed, use CHG-compatible barrier protection products for barrier protection (contact product manufacturers … NOTE: Once CHG is applied to the skin, it binds skin proteins and will not rub off onto bedding. … Wet skin with water. Turn off water or stand out of water stream. … This will go away once skin completely dries.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/nursing-protocols/nursing-chg-bed-bathing.pdf
March 01, 2022 - Ensure that cloths are applied to skin by firm
massage to ensure the binding of CHG to skin proteins … If needed, use CHG-compatible barrier protection products for barrier
protection (contact product manufacturers … NOTE: Once CHG is
applied to the skin, it binds skin proteins and will not rub off onto bedding. … CHG works better than soap and water to deeply
cleanse the skin. … This will go away
once skin completely dries.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/nursing-protocols/nursing-chg-basin-bathing.docx
March 01, 2022 - Ensure that wipes are applied to skin by firm massage to ensure the binding of CHG to skin proteins. … Then, clean skin with wipes soaked with CHG. … If needed, use CHG-compatible barrier protection products for barrier protection (contact product manufacturers … NOTE: Once CHG is applied to the skin, it binds to skin proteins and will not rub off onto bedding. … Wet skin with water. Turn off water or stand out of water stream.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/nursing-protocols/nursing-chg-basin-bathing.pdf
March 01, 2022 - Ensure that wipes are applied to skin by firm
massage to ensure the binding of CHG to skin proteins. … Then, clean skin
with wipes soaked with CHG. … If needed, use CHG-compatible barrier protection products
for barrier protection (contact product manufacturers … • Allow skin to dry naturally – do not wipe off. … NOTE: Once CHG is applied to the skin, it binds to skin proteins and will not rub off
onto bedding.
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www.ahrq.gov/hai/cauti-tools/impl-guide/implementation-guide-appendix-j.html
October 01, 2015 - Skin Care in the Incontinent Patient
Appendix O. CAUTI Event Report Template
Appendix P. … Use skin barrier creams.
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www.ahrq.gov/hai/tools/surgery/modules/implementation/ssi-bundle-fac-notes.html
October 01, 2020 - care when it comes to concerns such as glucose (Word, 1.67 MB), normothermia (Word, 1.59 MB), skin … Different preoperative skin preparation products have different procedures. … One indicates a barrier is unlikely to occur; five indicates a barrier is very likely to occur. … of that barrier. … If your goal is to ensure that all providers perform appropriate preoperative skin preparation, then
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www.ahrq.gov/hai/universal-icu-decolonization/universal-icu-apd.html
September 01, 2013 - CHG removes bacteria from the skin during bathing. … Cloths should be used to bathe the skin with firm massage. … bacteria from skin. … Then clean skin with CHG cloths. Use CHG-compatible barrier products if needed. … Skin may feel sticky for a few minutes after application.
Do not rinse with water or wipe off.