Project PROTECT: Protecting Nursing Homes From Infections and Hospitalization

University of California, Irvine13,952 enrolled

Overview

This is a cluster-randomized trial of nursing homes to assess whether decolonization with routine chlorhexidine bathing and periodic use of nasal antiseptics can reduce hospitalizations associated with infections, antibiotic utilization, and multi-drug resistant organism (MDRO) prevalence. The comparator arm will be routine bathing care.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

13,952

Conditions

Hospitalization Infection

Interventions

Chlorhexidine gluconate (CHG)DRUG

2% no-rinse chlorhexidine gluconate (CHG) for bed bathing and 4% rinse-off CHG showering. Bathing frequency will be per routine plus admission bathing.

Iodophor (10% povidone-iodine)DRUG

Nasal decolonization using topical 10% povidone-iodine nasal swabs will be applied to all residents on admission for 5 days twice daily plus every other week Monday-Friday using a twice daily regimen.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria Nursing homes will be eligible to participate if they meet the following criteria: * Licensed nursing home in Orange County or Southern Los Angeles County serving adults * Minimal use of chlorhexidine bathing\* * Minimal use of nasal decolonization\* \*Minimal use defined as \<15% of residents receiving at least one chlorhexidine bath or nasal decolonization treatment during their nursing home stay. Exclusion Criteria Nursing homes will not be eligible to participate if they meet the following criteria: * Facilities routinely using decolonization * Dedicated psychiatric nursing homes * Facilities with a resident population with \>=20% combative patients * Pediatric facilities Note: in any participating nursing home, residents with active end-of-life comfort care only measures are excluded

Locations (28)

Outcomes

Primary Outcomes

Hospital Transfers Due to Infection

Probability that a transfer to a hospital is due to an infection

Time frame: 18 months

Secondary Outcomes

All Hospital Transfers

Probability that a discharge is to a hospital

Time frame: 18 months

Data from ClinicalTrials.gov

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Buena Vista Care Center