Using Visual Management to Improve Compliance with Chlorhexidine Gluconate Bathing and Nasal Decolonization.

BACKGROUND: Visual management tools are designed to drive desired behaviors and support consistent performance. When tailored to specific practice areas, these tools become more relevant for staff. METHODS: Visual management tools were designed and implemented for this project to standardize nursing handoff communication and improve administration of 2% chlorhexidine gluconate (CHG)-impregnated wipe bathing and prophylactic alcohol-based nasal decolonization swabs. Supply locations were standardized across the hospital, and a wipeable sticker was added to patient whiteboards, which served as a visual reminder, prompting discussion of CHG bathing and nasal decolonization administration status during nursing handoff. RESULTS: Compliance with nursing documentation of chlorhexidine gluconate bathing (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.57-1.76, p < 0.001) and nasal decolonization (OR 1.86, 95% CI 1.81-1.93, p < 0.001) improved postimplementation (October 2023-April 2024 vs. October 2024-April 2025). Improvements were also noted in central line-associated bloodstream infection (rate ratio [RR] 0.47, 95% CI 0.28-0.76, p = 0.003) and methicillin-resistant Staphylococcus aureus bacteremia (RR 0.80, 95% CI 0.20-3.01, p = 0.74) rates when comparing preimplementation and postimplementation data. CONCLUSION: This project demonstrates that visual management tools may help to improve nursing handoff communication, and CHG bathing and nasal decolonization administration and documentation.