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

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• 作者：Alex ; re 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 F谩tima dos Santos Cardoso ; Elivane da Silva Victor ; Oscar Fern ; o Pav茫o dos Santos ; Miguel Cendoroglo Neto ; Michael B. Edmond ; Positive Deviance For H ; Hygiene Study Group
• 关键词：Safety patient ; Health care-associated infection
• 刊名：American Journal of Infection Control
• 出版年：November, 2013
• 年：2013
• 卷：41
• 期：11
• 页码：984-988
• 全文大小：298 K

文摘

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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聽= .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.