A multicenter study using positive deviance for improving hand hygiene compliance.

Abstract

BACKGROUND:

Positive deviance (PD) can be a strategy for the improvement of hand hygiene (HH) compliance.

METHODS:

This study was conducted in 8 intensive care units and 1 ward at 7 tertiary care, private, and public hospitals. Phase 1 was a 3-month baseline period (from August to October 2011) in which HH counts were performed by observers using iPods (iScrub program). From November 2011 to July 2012, phase 2, a PD intervention was performed in all the participating centers. We evaluated the consumption of HH products (alcohol gel and chlorhexidine) and the incidence density of health care-associated infections.

RESULTS:

There was a total of 5,791 HH observations in the preintervention phase and 11,724 HH observations in the intervention phase (PD). A statistically significant difference was found in overall HH compliance with 46.5% in the preintervention phase and 62.0% in the PD phase (P < .001). There was a statistically significant reduction in the incidence of density of device-associated infections per 1,000 patient-days and also in the median of length of stay between the preintervention phase and the PD phase (13.2 vs 7.5 per 1,000 patient-days, respectively, P = .039; and 11.0 vs 6.8 days, respectively, P < .001, respectively).

CONCLUSION:

PD demonstrated great promise for improving HH in multiple inpatient settings and was associated with a decrease in the median length of stay and the incidence of device-associated HAIs.

• Authors: Alexandre R Marra, Danilo Teixeira Noritomi, Adilson J Westheimer Cavalcante, Thiago Zinsly Sampaio Camargo, Renata Puzzo Bortoleto, Marcelino Souza Durao Junior, Anucha Apisarnthanarak, Claudia Laselva, Walace de Souza Pimentel, Leonardo Jose Rolim Ferraz, Maria Fátima dos Santos Cardoso, Elivane da Silva Victor, Oscar Fernando Pavão dos Santos, Miguel Cendoroglo Neto, Michael B Edmond, Positive Deviance For Hand Hygiene Study Group
• Journal: American journal of infection control (Am J Infect Control) Vol. 41 Issue 11 Pg. 984-8 (Nov 2013) ISSN: 1527-3296 [Electronic] United States
• PMID: 23973423 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Topics

• Cross Infection (epidemiology, prevention & control)
• Guideline Adherence
• Hand Hygiene
• Hospitals
• Humans