Does a one hour educational class improve compliance of chlorhexidine gluconate baths prior to operation?

Abstract

Background: Surgical site infections (SSIs) continue to be a major contributor to morbidity and mortality post-operatively. One of the treatments used to prevent such infections is chlorhexidine gluconate (CHG) baths prior to surgery. An obstacle to using CHG as a pre operative preventative measure to infection has been the low patient compliance rates. Our study aimed to analyze whether an educational class explaining the proper usage of CHG prior to the surgery date will improve patient compliance.
Methods: We evaluated two different groups. One group consisted of patients who were scheduled for total joint arthroplasty (TJA) and attended an educational class in addition to receiving the standard preoperative protocol explaining the proper application of CHG. A second group consisted of subjects undergoing any other type of surgery but was not offered the additional educational class.
Results: Subjects undergoing TJA had a higher compliance rate than all other surgeries (95.8% and 77.8% respectively; p < .001). Interestingly, throughout time, the effectiveness of the educational class to improve compliance also improved (from 90.9% in the first month to 100% in the final month; p < .001).
Discussion: The addition of an educational class to the standard preoperative educational protocol significantly improved patient compliance to the preoperative application of CHG in TJA Patients, and increasingly so overtime. This suggests the importance of proper patient education in the prevention of costly comorbidities such as infection.
Conclusions: The use of instructional classes may be useful for improving compliance to patient protocols prior to undergoing surgery. Further research is needed to fully assess the benefits of educational classes and their correlation to patient compliance.