Using Positive Deviance in the prevention and control of MRSA infections in a Colombian hospital: a time-series...

Area of Science:

• Infectious Disease Epidemiology
• Healthcare Management
• Public Health Interventions

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings globally.
• Limited resources in developing countries often hinder the adoption of effective infection control strategies.
• Positive Deviance (PD) offers a novel approach to drive social and cultural change for infection control.

Purpose of the Study:

• To evaluate the effectiveness of the Positive Deviance (PD) approach in reducing MRSA healthcare-associated infections (HAIs) in a Colombian hospital.
• To assess the feasibility and sustainability of implementing PD in a resource-limited setting.
• To achieve a cultural shift in processes to lower HAI rates.

Main Methods:

• A time-series study design was employed, analyzing MRSA-HAI rates from 2001 to 2012.
• Data collection included MRSA-HAI rates and the number of months with zero MRSA infections.
• Comparison of pre-intervention and intervention periods to assess the impact of PD implementation.

Main Results:

• The mean MRSA-HAI rate decreased from 0.62 to 0.36 (P = 0.0005) post-intervention.
• The number of months with zero MRSA-HAIs increased significantly (from 3/70 to 12/74), with an odds ratio of 0.264.
• The percentage of MRSA-HAIs decreased from 53.2% to 41.0%.

Conclusions:

• Implementation of the Positive Deviance (PD) strategy was associated with a significant reduction in MRSA-HAIs.
• The PD approach proved to be a cost-effective intervention with lasting effects on infection control.
• PD is a viable and sustainable strategy for controlling MRSA infections in resource-limited healthcare settings.