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Title: A multicenter study using positive deviance for improving hand hygiene compliance
Authors: Marra, Alexandre R. [UNIFESP]
Noritomi, Danilo Teixeira
Westheimer Cavalcante, Adilson J.
Sampaio Camargo, Thiago Zinsly
Bortoleto, Renata Puzzo
Durao Junior, Marcelino Souza [UNIFESP]
Apisarnthanarak, Anucha
Laselva, Claudia
Pimentel, Walace de Souza [UNIFESP]
Rolim Ferraz, Leonardo Jose
Santos Cardoso, Maria Fatima dos
Victor, Elivane da Silva
Pavao dos Santos, Oscar Fernando [UNIFESP]
Cendoroglo Neto, Miguel [UNIFESP]
Edmond, Michael B.
Positive Deviance Hand Hyg Study G
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
Keywords: Safety patient
Health care-associated infection
Issue Date: 1-Nov-2013
Publisher: Elsevier B.V.
Citation: American Journal of Infection Control. New York: Mosby-Elsevier, v. 41, n. 11, p. 984-988, 2013.
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.
ISSN: 0196-6553
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