Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

If you need an accessible version of this item please contact JSTOR User Support

Positive Deviance: A New Strategy for Improving Hand Hygiene Compliance

Alexandre R. Marra , MD, Luciana Reis Guastelli , RN, Carla Manuela Pereira de Araújo , RN, Jorge L. Saraiva dos Santos , RN, Luiz Carlos R. Lamblet , RN, Moacyr Silva Jr , MD, Gisele de Lima , PharmD, Ruy Guilherme Rodrigues Cal , MD, Ângela Tavares Paes , PhD, Miguel Cendoroglo Neto , MD, Luciana Barbosa , PharmD, Michael B. Edmond , MD, MPH, MPA and Oscar Fernando Pavão dos Santos , MD
Infection Control and Hospital Epidemiology
Vol. 31, No. 1 (January 2010), pp. 12-20
DOI: 10.1086/649224
Stable URL: http://www.jstor.org/stable/10.1086/649224
Page Count: 9
  • More info
  • Cite this Item
Item Type
Article
References
If you need an accessible version of this item please contact JSTOR User Support
Positive Deviance: A New Strategy for Improving Hand Hygiene Compliance
Preview not available

Abstract

Objective.  To evaluate the effectiveness of a positive deviance strategy for the improvement of hand hygiene compliance in 2 adult step‐down units. Design.  A 9‐month, controlled trial comparing the effect of positive deviance on compliance with hand hygiene. Setting.  Two 20‐bed step‐down units at a tertiary care private hospital. Methods.  The first phase of our study was a 3‐month baseline period (from April to June 2008) in which hand hygiene episodes were counted by use of electronic handwashing counters. From July to September 2008 (ie, the second phase), a positive deviance strategy was implemented in the east unit; the west unit was the control unit. During the period from October to December 2008 (ie, the third phase), positive deviance was applied in both units. Results.  During the first phase, there was no statistically significant difference between the 2 step‐down units in the number of episodes of hand hygiene per 1,000 patient‐days or in the incidence density of healthcare‐associated infections (HAIs) per 1,000 patient‐days. During the second phase, there were 62,000 hand hygiene episodes per 1,000 patient‐days in the east unit and 33,570 hand hygiene episodes per 1,000 patient‐days in the west unit ( \documentclass{aastex} \usepackage{amsbsy} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{bm} \usepackage{mathrsfs} \usepackage{pifont} \usepackage{stmaryrd} \usepackage{textcomp} \usepackage{portland,xspace} \usepackage{amsmath,amsxtra} \usepackage[OT2,OT1]{fontenc} \newcommand\cyr{ \renewcommand\rmdefault{wncyr} \renewcommand\sfdefault{wncyss} \renewcommand\encodingdefault{OT2} \normalfont \selectfont} \DeclareTextFontCommand{\textcyr}{\cyr} \pagestyle{empty} \DeclareMathSizes{10}{9}{7}{6} \begin{document} \landscape $P< .01$ \end{document} ). The incidence density of HAIs per 1,000 patient‐days was 6.5 in the east unit and 12.7 in the west unit ( \documentclass{aastex} \usepackage{amsbsy} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{bm} \usepackage{mathrsfs} \usepackage{pifont} \usepackage{stmaryrd} \usepackage{textcomp} \usepackage{portland,xspace} \usepackage{amsmath,amsxtra} \usepackage[OT2,OT1]{fontenc} \newcommand\cyr{ \renewcommand\rmdefault{wncyr} \renewcommand\sfdefault{wncyss} \renewcommand\encodingdefault{OT2} \normalfont \selectfont} \DeclareTextFontCommand{\textcyr}{\cyr} \pagestyle{empty} \DeclareMathSizes{10}{9}{7}{6} \begin{document} \landscape $P=.04$ \end{document} ). During the third phase, there was no statistically significant difference in hand hygiene episodes per 1,000 patient‐days ( \documentclass{aastex} \usepackage{amsbsy} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{bm} \usepackage{mathrsfs} \usepackage{pifont} \usepackage{stmaryrd} \usepackage{textcomp} \usepackage{portland,xspace} \usepackage{amsmath,amsxtra} \usepackage[OT2,OT1]{fontenc} \newcommand\cyr{ \renewcommand\rmdefault{wncyr} \renewcommand\sfdefault{wncyss} \renewcommand\encodingdefault{OT2} \normalfont \selectfont} \DeclareTextFontCommand{\textcyr}{\cyr} \pagestyle{empty} \DeclareMathSizes{10}{9}{7}{6} \begin{document} \landscape $P=.16$ \end{document} ) or in incidence density of HAIs per 1,000 patient‐days. Conclusion.  A positive deviance strategy yielded a significant improvement in hand hygiene, which was associated with a decrease in the overall incidence of HAIs.

Page Thumbnails