Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Ross, Ratchneewan

Committee Member

Shumaker, Shannon

Author's Keywords

CHG; application time; antisepsis; skin prep; SSI; prevention



Background: Surgical site infections (SSIs) are the most common cause of a surgical complication and account for 38% of all hospital acquired infections (HAI). The cost of caring for SSIs in the United States can range from $3.5-$10 billion annually.

Purpose: The purpose of this DNP Quality Improvement (QI) initiative was to improve preoperative staff’s knowledge and application of the Food and Drug Administration (FDA) approved 3-minute application scrub time for the 2% CHG cloths and reduce SSIs for an acute care hospital located in Louisville, Kentucky.

Methods: Quality improvement was initiated using the Plan, Do, Study, Act (PDSA) model to provide preoperational 2% CHG cloth education to preoperative staff. Participants included 11 varying preoperative staff members made up of nurses and nursing assistants.

Intervention: The intervention was an education program on 2% CHG cloths.

Measures and Data Analysis: A 6-item 2% CHG cloth application knowledge questionnaire was used to evaluate participants’ knowledge pre-and post-intervention. Paired t-tests were applied to analyze the differences between the total pre-test and post-test mean scores. Rates of SSIs before and after the intervention were compared using percentage change.

Results: Using paired t-test, results showed that participants (n=11) had a significantly lower pre-test mean score (4.45 0.82) of 2% CHG cloth knowledge than post-test mean score (5.45 0.52) (t=4.28, p<0.001).

Conclusion: This 2% CHG cloth education initiative helped to increase preoperative staff knowledge and led to a decrease in the organization’s SSIs.

Key Words: Preoperative, chlorhexidine gluconate, CHG, cloth, wipes, application time, antisepsis, skin prep, surgery, surgical site infection, SSI prevention

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