Last year, Ron wrote about the concept of positive deviance and how the concept can be applied in healthcare settings in order to improve quality of care. A study published in the February issue of the American Journal of Infection Control found that a positive deviance strategy on hand hygiene led to higher hand hygiene compliance and lower infection rates.
Researchers observed hand hygiene compliance using electronic handwashing counters, recording both the frequency of usage of alcohol gel dispensers and the total volume of dispensed alcohol gel during the study period. The positive deviance strategy for hand hygiene involved bi-monthly meetings with healthcare workers (HCWs) to discuss best practices. These sessions were led by positive deviants identified initially by the nurse managers and they were HCWs who were highly motivated to improve hand hygiene through new ideas. Positive deviants employed various methods to engage other HCWs during the meeting including the use of motivational techniques and videos.
During the 3 month study period, the total volume of alcohol gel dispensed per month was more than double the volume dispensed before the study began. Hospital acquired infection rates were also lower during the study period than before the study began. This study shows that positive deviance is an effective strategy for hand hygiene compliance and when used appropriately, can lead to much improved hand hygiene results.
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