Positive deviance: A program for sustained improvement in hand hygiene compliance - 06/08/11
, Luciana Reis Guastelli, RN a, Carla Manuela Pereira de Araújo, RN a, Jorge L. Saraiva dos Santos, RN a, Miguel Almeida O. Filho, RN a, Claudia Vallone Silva, RN b, Julia Yaeko Kawagoe, RN b, Miguel Cendoroglo Neto, MD c, Oscar Fernando Pavão dos Santos, MD a, Michael B. Edmond, MD, MPH, MPA d
Address correspondence to Alexandre R. Marra, MD, Av Albert Einstein, 627/701, Intensive Care Unit, 5th floor, Morumbi, São Paulo, Brazil 05651-901.Abstract |
Background |
There is a paucity of data evaluating whether positive deviance (PD) can sustain improvement in hand hygiene compliance.
Methods |
An observational study comparing the effect of PD on compliance with hand hygiene was conducted in two 20-bed step-down units (SDUs) at a private tertiary care hospital. In a 3-month baseline period (April-June 2008), hand hygiene counts were performed by electronic handwashing counters. Between July 1, 2008, and November 30, 2009, (East SDU) and between September 30, 2008, and December 2009 (West SDU), PD was applied in both units.
Results |
There was more than a 2-fold difference in the number of alcohol gel aliquots dispensed per month from April 2008 (before PD) to November 2009 (last month in PD) in the East SDU. There was also a 2-fold difference in the number of alcohol gel aliquots dispensed per month from September 2008 (before PD) to December 2009 (last month in PD) in the West SDU. The difference in the rate of health care‒associated infections (HAIs) between the baseline period and 2009 was statistically significant in the East SDU (5.8 vs 2.8 per 1,000 device-days; P = .008) and in the West SDU (3.7 vs 1.7 per 1,000 device-days; P = .023).
Conclusions |
PD was responsible for a sustained improvement in hand hygiene in the inpatient setting and was associated with a decrease in the incidence of device-associated HAIs.
Le texte complet de cet article est disponible en PDF.Key Words : Step-down unit, sustainability, alcohol gel, positive deviance strategy, observational study, epidemiology
Plan
| Conflicts of interest: None to report. |
Vol 39 - N° 1
P. 1-5 - février 2011 Retour au numéro
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