Using Positive Deviance in the prevention and control of MRSA infections in a Colombian hospital: A time-series analysis

Autores organización

• Tamy Goretty Trujillo Escobar

  Autor

• 

  Javier Antonio Escobar Perez

  Autor

Autores

• Escobar N.M.O.
• Márquez I.A.V.
• Quiroga J.A.
• González F.
• Aguilar M.I.G.

Unidades de investigación

• Laboratorio de Genética Molecular Bacteriana

  

  Investigador

  Javier Antonio Escobar Perez

Resumen

Positive Deviance (PD) is a process to achieve a social and cultural change. This strategy has been used for the control of methicillin-resistant Staphylococcus aureus (MRSA) infection in some health institutions in the United States, but has rarely been adopted in institutions from developing countries where resources are limited. We describe our experience of PD in the control of healthcare-associated infections (HAIs) due to MRSA in a Colombian hospital with the aim of reducing HAI rates through a cultural change in processes. A time-series study was conducted based on the MRSA-HAI rate and the number of months with zero MRSA infections before and after application of PD (2001-2012). On comparing the pre-intervention and intervention periods, the mean overall rates of MRSA-HAI was 0·62 and 0·36, respectively (P = 0·0005); the number of months with zero MRSA-HAIs were 3/70 and 12/74 (odds ratio 0·264, 95% confidence interval 0·078-0·897); the percentage of MRSA-HAIs was 53·2% and 41·0%. These results are consistent with other published data. Implementation of PD was associated with a significant reduction of MRSA-HAIs, it did not involve high costs and the changes have been lasting. Copyright © Cambridge University Press 2017.

Keywords

• Adult; Behavior Therapy; Colombia; Cross Infection; Disease Transmission, Infectious; Guideline Adherence; Humans; Infant; Infant, Newborn; Infection Control; Methicillin-Resistant Staphylococcus aureus; Staphylococcal Infections; Article; Colombia; cultural anthropology; developing country; healthcare associated infection; infection control; infection prevention; methicillin resistant Staphylococcus aureus infection; nonhuman; time series analysis; adult; behavior therapy; cross infection; disease transmission; human; infant; infection control; isolation and purification; methicillin resistant Staphylococcus aureus; microbiology; newborn; prevention and control; procedures; protocol compliance; Staphylococcal Infections