Treatment in the Hospital with CHG (4% Chlorhexidine Gluconate) Foam

Preventing infections during your child’s hospital stay is very important to us. Using CHG is one way to help prevent infections.

CHG foam is an antiseptic product that is even more effective than using regular soap for cleaning the skin. Studies have shown that CHG decreases the risk for certain infections.

Do not use CHG if your child:

• Is allergic to chlorhexidine gluconate. There are several forms of CHG. Please ask the medical team if one will be safe for your child.

• Is an infant less than 2 months old (less than 48 weeks gestational or corrected age)

• Has severe skin conditions or skin burns

• Receives thiotepa or total body irradiation. They cannot use CHG during and for 24 hours after treatment.

• Has an unrepaired open spinal defect (for example, myelomeningocele).

If your child has sensitive skin or any skin problems, or if you have any questions, please ask your healthcare team for other antiseptic treatment options.

Who should use CHG foam?

• Your child must be 2 months old (greater than 48 weeks gestational or corrected age) to use the CHG foam unless directed by your child’s healthcare provider.

• All patients with central lines.

• All patients scheduled for certain types of surgery/central line placement

How often should CHG foam be used?

• If your child has a central line, routine hygiene with CHG is performed at least every 24 hours. In addition, if a soap and water bath or shampoo is performed at any other time, CHG should be repeated within one hour.

• The night before and the day of surgery for certain procedures.

• The morning of central line placement.

Instructions for CHG foam treatment with cloths:

You can perform the treatment or assist the nurse in giving your child the CHG treatment. After reading the instructions below, please contact your child’s nurse with any questions.

1. A daily soap and water bath and shampoo is recommended. If you choose to perform a soap and water bath or shampoo, you must do a CHG treatment afterwards.

2. After a soap and water bath or shampoo, do not apply lotions, creams, powder or other skin products to your child’s skin. Let the skin completely dry and cool.

3. Open the package of disposable cloths and fill package with warm water, use enough to soak each cloth.

4. Reseal the package and massage pack to make sure all cloths are wet.

5. Use the instructions below to decide:

   • The number of cloths to use (based on your child’s weight).

   • The order and body site to clean and rinse.

6. Reopen the package and pull out one cloth. Apply CHG foam to the cloth or child’s skin. Cover the skin with the CHG foam, add more as needed.

7. Use a circular and back and forth motion with friction/light pressure to apply the CHG foam to your child’s skin. Start at your child’s chin and work your way down the body. Follow the chart below. Do not use the CHG foam on the head or face.

8. Rinse the CHG foam from your child’s skin using a new cloth following the instructions below. Allow your child’s skin to air dry before dressing into clean pajamas.

9. After you have used the CHG foam, do not apply lotions, moisturizers, deodorants, or powders. If you need to apply a product, only approved CHG compatible products may be used. The CHG works best when left on clean, dry skin.

10. Put clean sheets and pillowcases on your child’s bed each day when they use CHG.

11. If there is redness or itching that does not go away after 10 minutes, rinse off and stop using the CHG foam. Call your child’s healthcare provider if you have any questions.

Instructions for children less than 22 lb or 10 kg

4 clothes: 2 CHG cloths and 2 rinse cloths

Cloth 1: CHG chest, both arms*, back, neck

Cloth 2: Rinse chest, both arms*, back, neck

Cloth 3: CHG both legs*, buttocks, groin area* Do NOT use CHG cloth on inner labial folds, tip of penis or anus

Cloth 4: Rinse both legs*, buttocks, groin area*

* Armpit, the back of the knees, and the groin area typically have the most bacteria. Clean these areas last with the cloth being used in that body area.

Instructions for children 22-66lbs or 10-30 kg

Requires 8 cloths: 4 CHG cloths and 4 rinse cloths

Cloth 1: CHG chest, both arms*, neck

Cloth 2: Rinse chest, both arms*, neck

Cloth 3: CHG both legs*

Cloth 4: Rinse both legs*

Cloth 5: CHG groin area *Do NOT use CHG cloth on inner labial folds, tip of penis or anus

Cloth 6: Rinse groin area*

Cloth 7: CHG back, buttocks ,

Cloth 8: CHG back, buttocks

* Armpit, the back of the knees, and the groin area typically have the most bacteria. Clean these areas last with the cloth being used in that body area.

Instructions for children who weigh greater than 66lbs or 30 kg

Requires 10 cloths: 6 CHG cloths and 4 rinse cloths

Pictures adapted with permission from Children’s Hospital and Clinics of Minnesota

Cloth 1: CHG chest, both arms*, neck

Cloth 2: Rinse chest, both arms*, neck,

Cloth 3: CHG right leg*

Cloth 4: CHG left leg*

Cloth 5: Rinse-use rinse cloth 5 for both legs*

Cloth 6: CHG groin area *Do NOT use CHG cloth on inner labial folds, tip of penis or anus

Cloth 7: Rinse groin area*

Cloth 8: CHG back

Cloth 9: CHG buttocks

Cloth 10: Rinse-use rinse cloth 10 for back and buttocks

* Armpit, the back of the knees, and the groin area typically have the most bacteria. Clean these areas last with the cloth being used in that body area.

Instructions for a CHG foam shower:

After reading the instructions below, please contact your child’s nurse with any questions.

1. A daily soap and water bath and shampoo is recommended. If you choose to perform a soap and water bath or shampoo, you must do a CHG treatment afterwards.

2. After a soap and water shower or shampoo, make sure your child’s body is thoroughly rinsed of any soap or shampoo on the body.

3. Move away from the water stream. Apply the CHG foam onto the skin using a clean, wet washcloth. Gently wash all body surfaces below the chin with the CHG foam. Do not use the CHG foam on the head or face.

4. Step back into the water stream to thoroughly rinse the CHG foam from your child’s body.

5. Dry your child’s skin with a clean towel before dressing into clean clothes.

6. After you have used the CHG foam, do not apply lotions, moisturizers, deodorants, or powders. If you need to apply a product, only approved CHG compatible products may be used. The CHG works best when left on clean, dry skin.

7. Put clean sheets and pillowcases on your child’s bed each day when then use CHG. If there is redness or itching that does not go away after 10 minutes, rinse off and stop using the CHG foam. Call your child’s healthcare provider if you have any questions.

For questions or concerns, contact a member of your child’s healthcare team.

 

Reviewed May 2024 by Stephen Noll, BSN, RN, CCRN, Catherine Murtaugh, BSN, RN, CPHQ