Use of Positive Deviance and Electronic Data Collection in a Hospital Hand Hygiene Program

Bren, Virginia; Anderson, Julie E.; Gillett, Kirstie; Grassel, Kelly; Swendseid, Lanette; Hansen, Shannon

doi:10.1016/j.ajic.2015.04.155

Cited by 1 publication

(8 citation statements)

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“…1), 14 articles met the inclusion criteria and were included in the systematic review (Table 1). [22][23][24][25][26][27][28][29][30][31][32][33][34][35] All studies were observational, quasi-experimental (before-and-after intervention) studies. [22][23][24][25][26][27][28][29][30][31][32][33][34][35] Of the 11 studies that reported the type of healthcare setting, [22][23][24][25][26][29][30][31][32]34,35 3 studies (27%) had at least 1 academic medical center included.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…[22][23][24][25][26][27][28][29][30][31][32][33][34][35] All studies were observational, quasi-experimental (before-and-after intervention) studies. [22][23][24][25][26][27][28][29][30][31][32][33][34][35] Of the 11 studies that reported the type of healthcare setting, [22][23][24][25][26][29][30][31][32]34,35 3 studies (27%) had at least 1 academic medical center included. 30,32,35 A quarter of the studies (3 of 11, 27%) were conducted in the Veterans' Affairs (VA) Health Care System.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…22,24,25 Few studies (3 of 12, 25%) were multicenter 25,27,32 ; the number of involved centers was 165 (range, 5-153 per study). [22][23][24][25][26][27][28][29][30][31][32][33][34][35] The United States (6 of 14, 43%) and Brazil (4 of 14, 29%) had the most studies among the 6 countries represented. Only 2 studies were published after 2015.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…34,35 The median duration of an intervention was 28 months (range, 9-144 months). [22][23][24][25][26][27][28][29][30][31][32][33][34][35] Regarding the quality assessment of included studies, 4 studies (4 of 14, 29%) scored poorly (<14 of 28 possible), 27,28,30,33 whereas 3 studies (21%) scored between 19 and 23 (good). 16,32,35 The median score was 16 (range, .…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Most of the studies that evaluated the effect of positive deviance on HH implemented it as a single intervention (6 of 8, 75%). 23,26,29,30,32,33 All of these noted that there was an improvement in HH compliance by direct observation or indirect measures (calculating product usage, or by electronic monitoring of sink or alcohol gel dispenser use), 37,38 yet the results of only 2 studies achieved statistical significance. 16,32 Half of the studies (4 of 8) mentioned direct HH observation differences or rates.…”

Section: Hand Hygienementioning

confidence: 99%

See 4 more Smart Citations

Positive deviance in infection prevention and control: A systematic literature review

Alzunitan

Edmond

Alsuhaibani

et al. 2020

Infect. Control Hosp. Epidemiol.

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Background: Healthcare-associated infections (HAIs) remain a major challenge. Various strategies have been tried to prevent or control HAIs. Positive deviance, a strategy that has been used in the last decade, is based on the observation that a few at-risk individuals follow uncommon, useful practices and that, consequently, they experience better outcomes than their peers who share similar risks. We performed a systematic literature review to measure the impact of positive deviance in controlling HAIs. Methods: A systematic search strategy was used to search PubMed, CINAHL, Scopus, and Embase through May 2020 for studies evaluating positive deviance as a single intervention or as part of an initiative to prevent or control healthcare-associated infections. The risk of bias was evaluated using the Downs and Black score. Results: Of 542 articles potentially eligible for review, 14 articles were included for further analysis. All studies were observational, quasi-experimental (before-and-after intervention) studies. Hand hygiene was the outcome in 8 studies (57%), and an improvement was observed in association with implementation of positive deviance as a single intervention in all of them. Overall HAI rates were measured in 5 studies (36%), and positive deviance was associated with an observed reduction in 4 (80%) of them. Methicillin-resistant Staphylococcus aureus infections were evaluated in 5 studies (36%), and positive deviance containing bundles were successful in all of them. Conclusions: Positive deviance may be an effective strategy to improve hand hygiene and control HAIs. Further studies are needed to confirm this effect.

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