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

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Title
Positive deviance in infection prevention and control: A systematic literature review
Abstract
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 infec- tions 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.
Publication
Infection Control & Hospital Epidemiology
Date
2020
Citation
Alzunitan, M. A., Edmond, M. B., Alsuhaibani, M., Samuelson, R., Schweizer, M. L., & Marra, A. R. (2020). Positive deviance in infection prevention and control: A systematic literature review. Infection Control & Hospital Epidemiology. https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/positive-deviance-in-infection-prevention-and-control-a-systematic-literature-review/6359ADB7FF4EF5D7369062AD657BA47F