Effect Of Bath Wıth Chlorexıdıne On Protectıon Of Skın Integrıty And Preventıon Of Hospıtal Infectıon

The study is planned to be carried out between September 2022 and September 2023 in the 15-bed pediatric intensive care unit of Sarıyer Hamidiye Etfal Hospital. Sample size was determined by power analysis. Based on the percentage measurement values of the methods to be studied in the literature review, the total sample size was found to be n=68, with an effect size of 0.8 (cohen), a power of 90%, and a margin of error of 0.05, using the G-POWER program. The sample of the study was determined as 68 children, 34 of whom were bathed with 2% Chlorhexidine soap and 34 children who were bathed with water and soap. The randomization of the groups will be determined by drawing lots.

The pediatric intensive care unit works in two shifts, 08-17 and 16-08. During the research, the researcher will be in the clinic during the procedure, bathroom applications will be made by the research nurse in the 08-17 shift and recorded in the data collection form. A blood culture will be taken at the first hospitalization for each child who meets the acceptance and exclusion criteria of the study hospitalized in the pediatric intensive care unit, and their names will be written on closed papers by randomization drawing method and randomly thrown into the lanterns representing the control and intervention groups prepared beforehand. process will be started. Those with negative culture results at their first admission to the clinic will be included in the study.

It is known that healthcare-associated infections occur within 48 to 72 hours of hospitalization. For this reason, for both groups included in the study, necessary blood tests and cultures will be taken at their first admission to the clinic in order to evaluate the effects of the products to be used in the care process on health care-associated infections. During the application, children will be monitored daily by suspecting any systemic inflammatory response syndrome (such as fever, vomiting, diarrhea) in terms of healthcare-associated infections, and in case of any symptoms, their examinations will be repeated and recorded in the data collection form.

For the control and intervention groups, daily bathing will be done during the patient's stay in the clinic, skin evaluation will be made with the Northempton Pediatric Skin Evaluation Scale before the application, and the application process will begin for the pediatric patients whose scale score is between low and medium level and will be evaluated daily after the application. If a change is noted in the Northempton Pediatric Skin Rating Scale skin score during daily evaluations, the evaluations will continue within the intervals specified in the form of the scale, and the study will be terminated for children whose scale score is evaluated in the high-risk group. In addition, the evaluation of skin integrity will be recorded daily on the data collection form immediately after each application (dryness, redness, deterioration of skin integrity/peeling). Immediately after each application and 6 hours after the FCM-2 Skin Oil and Moisture Meter (With this device, the fat and moisture ratios of any part of the body can be determined and the measurements are concluded with high precision. Measuring range; 0%...99.9% RH) device. skin moisture values will be measured from three different regions, namely forearm, lateral upper leg and abdomen (2 cm above the umbilicus) and recorded daily in the data collection form.

Reproductive findings of healthcare-associated infections will be determined by evaluating the results of the samples sent to Sarıyer Hamidiye Etfal Training and Research Hospital laboratory.