Positive deviance as a strategy to prevent CLABSI in intensive care

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Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care”  Oliveira et al (2017).

Abstract:

OBJECTIVE: To describe the application of positive deviance as a strategy to prevent and control bloodstream infections.

METHOD: An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design.

RESULTS: In 90 days, 188 actions were observed, of these, 36.70% (n=69) were related to catheter dressing. In 81.15% (n=56) of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing.

CONCLUSION: Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care.

OBJETIVO: Descrever a aplicação do Positive Deviance como estratégia na prevenção e no controle da infecção de corrente sanguínea.

MÉTODO: Estudo de intervenção realizado na Unidade de Terapia Intensiva de um hospital universitário, com os membros das equipes de enfermagem e médica, de junho a dezembro de 2014. Foram aplicados os quatro passos da metodologia Positive Deviance: Definir, Determinar, Descobrir e Desenhar.

RESULTADOS: Em 90 dias 188 ações foram observadas, destas, 36,70% (n=69) estavam relacionadas aos curativos dos cateteres. Em 81,15% (n=56) desses curativos, o uso da haste flexível estéril para realização da antissepsia do local de inserção do cateter e de sua placa de fixação foi a ação de maior adesão.

CONCLUSÃO: O Positive Deviance auxiliou na implementação de propostas de melhorias de processo de trabalho e no desenvolvimento da equipe para os problemas identificados no cuidado com o cateter venoso central.

Full Text English Full Text Portuguese

Reference:

Oliveira, F.T., Ferreira, M.M., Araújo, S.T., Bessa, A.T., Moraes, A.C. and Stipp, M.A. (2017) Positive deviance as a strategy to prevent and control bloodstream infections in intensive care. Revista da Escola de Enfermagem da U S P. April 3rd. [Article in English, Portuguese].

doi: 10.1590/S1980-220X2016182303212.

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