Positive deviance: a new strategy for improving hand hygiene compliance

Area of Science:

• Healthcare Improvement
• Infection Prevention
• Clinical Practice Research

Background:

• Hand hygiene compliance is critical for preventing healthcare-associated infections (HAIs).
• Traditional methods may not always achieve optimal compliance rates.
• Innovative strategies are needed to enhance adherence to hand hygiene protocols.

Purpose of the Study:

• To assess the effectiveness of a positive deviance strategy in improving hand hygiene compliance.
• To determine the impact of enhanced hand hygiene on HAI incidence.
• To evaluate the strategy's applicability in adult step-down units.

Main Methods:

• A 9-month controlled trial was conducted in two adult step-down units.
• A positive deviance strategy was implemented, comparing intervention and control units.
• Hand hygiene episodes and HAI incidence were monitored using electronic counters and surveillance.

Main Results:

• The positive deviance strategy led to a significant increase in hand hygiene episodes per 1,000 patient-days in the intervention unit.
• A statistically significant decrease in the incidence density of HAIs was observed in the unit where the strategy was applied.
• No significant differences were found during the baseline and final phases when the strategy was applied to both units or neither.

Conclusions:

• A positive deviance strategy can effectively improve hand hygiene compliance in clinical settings.
• Enhanced hand hygiene adherence is associated with a reduction in the overall incidence of HAIs.
• The positive deviance approach offers a promising method for infection control.