A multicenter study using positive deviance for improving hand hygiene compliance

A multicenter study using positive deviance for improving hand hygiene compliance

Author Marra, Alexandre R. Autor UNIFESP Google Scholar
Noritomi, Danilo Teixeira Google Scholar
Westheimer Cavalcante, Adilson J. Google Scholar
Sampaio Camargo, Thiago Zinsly Google Scholar
Bortoleto, Renata Puzzo Google Scholar
Durao Junior, Marcelino Souza Autor UNIFESP Google Scholar
Apisarnthanarak, Anucha Google Scholar
Laselva, Claudia Google Scholar
Pimentel, Walace de Souza Autor UNIFESP Google Scholar
Rolim Ferraz, Leonardo Jose Google Scholar
Santos Cardoso, Maria Fatima dos Google Scholar
Victor, Elivane da Silva Google Scholar
Pavao dos Santos, Oscar Fernando Autor UNIFESP Google Scholar
Cendoroglo Neto, Miguel Autor UNIFESP Google Scholar
Edmond, Michael B. Google Scholar
Positive Deviance Hand Hyg Study G Google Scholar
Institution Hosp Israelita Albert Einstein
Universidade Federal de São Paulo (UNIFESP)
Hosp Paulistano
Hosp Heliopolis
Hosp Municipal Dr Moyses Deutsch MBoi Mirim
Thammasat Univ Hosp
Hosp Brigadeiro
Virginia Commonwealth Univ
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. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Keywords Safety patient
Health care-associated infection
Language English
Sponsor GOJO Latin America
Date 2013-11-01
Published in American Journal of Infection Control. New York: Mosby-Elsevier, v. 41, n. 11, p. 984-988, 2013.
ISSN 0196-6553 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 984-988
Origin http://dx.doi.org/10.1016/j.ajic.2013.05.013
Access rights Closed access
Type Article
Web of Science ID WOS:000326241700008
URI http://repositorio.unifesp.br/handle/11600/36933

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