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Positive deviance: Using a nurse call system to evaluate hand hygiene practices

Authors :
Oscar Fernando Pavão dos Santos
Rita de Cássia Ribeiro de Macedo
Alexandre R. Marra
Edson Américo Sant'Ana
Miguel Cendoroglo
Eloísa Martins Oliveira Jacob
Antonio Ferreira de Souza
Priscila Gonçalves
Vanessa Pio da Silva
Michael B. Edmond
Source :
American Journal of Infection Control. 40:946-950
Publication Year :
2012
Publisher :
Elsevier BV, 2012.

Abstract

Background Many approaches have been taken to increase compliance with hand hygiene by health care professionals. We evaluated a nurse call system used as a tool in a positive deviance (PD) approach to improving compliance. Methods We conducted a quasi-experimental study between September 2008 and December 2010 in 2 step-down units (SDUs). The consumption of alcohol-based sanitizers for hand hygiene was monitored by electronic handwash counters installed in each room as of January 2009. The number of nurse visits to patient rooms was measured by the nurse call system, which provides information on each instance of nursing care provided to the patients. Results The use of alcohol hand rubs was increased in both units after implementation of the PD approach, with higher rates sustained for more than 2 years. The rate of device-related infections showed a decreasing trend, especially for catheter-associated urinary infection in the east SDU. In both units, the ratio of alcohol hand rub uses to nurse visits was >2.5, indicating increased use of alcohol rubs, especially in the east SDU, which had a ratio of 3 for 2010. Conclusions The PD approach to hand hygiene produced increased compliance, as measured by increased consumption of alcohol hand sanitizer, an improved ratio of alcohol hand rub uses to nurse visits, and a reduced rate of device-related infections, with results sustained over 2 years.

Details

ISSN :
01966553
Volume :
40
Database :
OpenAIRE
Journal :
American Journal of Infection Control
Accession number :
edsair.doi.dedup.....c00c953e29b450c01f387e94d18bdb64
Full Text :
https://doi.org/10.1016/j.ajic.2011.11.015