1. A multicenter study using positive deviance for improving hand hygiene compliance
- Author
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Marcelino Souza Durão Junior, Thiago Zinsly Sampaio Camargo, Miguel Cendoroglo Neto, Oscar Fernando Pavão dos Santos, Maria Fátima dos Santos Cardoso, Renata Puzzo Bortoleto, Anucha Apisarnthanarak, Adilson J. Westheimer Cavalcante, Michael B. Edmond, Claudia Regina Laselva, Danilo Teixeira Noritomi, Alexandre R. Marra, Walace de Souza Pimentel, Leonardo José Rolim Ferraz, and Elivane da Silva Victor
- Subjects
Cross Infection ,medicine.medical_specialty ,Pediatrics ,Epidemiology ,business.industry ,Health Policy ,Incidence (epidemiology) ,media_common.quotation_subject ,Significant difference ,Public Health, Environmental and Occupational Health ,Tertiary care ,Hospitals ,Infectious Diseases ,Multicenter study ,Hygiene ,Internal medicine ,Intensive care ,medicine ,Humans ,Hand Hygiene ,Guideline Adherence ,Positive deviance ,business ,media_common - Abstract
Positive deviance (PD) can be a strategy for the improvement of hand hygiene (HH) compliance.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.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).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.
- Published
- 2013
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