Ricky Cohen1,2, Anat Gesser-Edelsburg1,3, Arvind Singhal4,5, Shmuel Benenson6, Allon E Moses6. 1. School of Public Health, University of Haifa, Haifa, Israel. 2. The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel. 3. The Health and Risk Communication Research Center, University of Haifa, Haifa, Israel. 4. Department of Communication, The University of Texas at El Paso, El Paso, Texas, United States of America. 5. School of Business and Social Sciences, Inland University of Applied Sciences, Hamar, Norway. 6. Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
Abstract
BACKGROUND: Although a wide range of intervention programs and methods have been implemented to increase health professionals' (HPs) adherence with infection prevention and control (IPC) guidelines and decrease the incidence of healthcare associated infections (HAIs), a significant discrepancy remains between the guidelines and their implementation in practice. OBJECTIVES: This study proposes an applied tool based on the integrated theoretical framework of the positive deviance (PD) approach for developing more effective interventions to mitigate this discrepancy. METHODS: A qualitative study guided by the PD approach based on data from two sources: (1) in-depth archival analysis of systematic review articles, and (2) integration and synthesis of findings based on an extensive empirical study we conducted, involving 250 HPs (nurses, physicians, support staff and cleaning staff) from three governmental hospitals in Israel, over 35 months (January 2017 to November 2020). RESULTS: The barriers faced by HPs were classified into four main categories: (1) individual-motivational, (2) social-cultural, (3) organizational, and (4) work environment and resource-centered. For each barrier, we constructed a set of questions based on the PD approach. For each question, we adapted and applied methodological tools (e.g., in-depth interviews, focus groups, social network maps, video clips and simulations) to help solve the problem. CONCLUSION: Translating a theory-based approach into an applied tool that offers step-by-step actions can help researchers and practitioners adopt and implement the approach within intervention programs to mitigate barriers.
BACKGROUND: Although a wide range of intervention programs and methods have been implemented to increase health professionals' (HPs) adherence with infection prevention and control (IPC) guidelines and decrease the incidence of healthcare associated infections (HAIs), a significant discrepancy remains between the guidelines and their implementation in practice. OBJECTIVES: This study proposes an applied tool based on the integrated theoretical framework of the positive deviance (PD) approach for developing more effective interventions to mitigate this discrepancy. METHODS: A qualitative study guided by the PD approach based on data from two sources: (1) in-depth archival analysis of systematic review articles, and (2) integration and synthesis of findings based on an extensive empirical study we conducted, involving 250 HPs (nurses, physicians, support staff and cleaning staff) from three governmental hospitals in Israel, over 35 months (January 2017 to November 2020). RESULTS: The barriers faced by HPs were classified into four main categories: (1) individual-motivational, (2) social-cultural, (3) organizational, and (4) work environment and resource-centered. For each barrier, we constructed a set of questions based on the PD approach. For each question, we adapted and applied methodological tools (e.g., in-depth interviews, focus groups, social network maps, video clips and simulations) to help solve the problem. CONCLUSION: Translating a theory-based approach into an applied tool that offers step-by-step actions can help researchers and practitioners adopt and implement the approach within intervention programs to mitigate barriers.
Authors: Alexandre R Marra; Danilo Teixeira Noritomi; Adilson J Westheimer Cavalcante; Thiago Zinsly Sampaio Camargo; Renata Puzzo Bortoleto; Marcelino Souza Durao Junior; Anucha Apisarnthanarak; Claudia Laselva; Walace de Souza Pimentel; Leonardo Jose Rolim Ferraz; Maria Fátima dos Santos Cardoso; Elivane da Silva Victor; Oscar Fernando Pavão dos Santos; Miguel Cendoroglo Neto; Michael B Edmond Journal: Am J Infect Control Date: 2013-08-21 Impact factor: 2.918
Authors: Rajiv Jain; Stephen M Kralovic; Martin E Evans; Meredith Ambrose; Loretta A Simbartl; D Scott Obrosky; Marta L Render; Ron W Freyberg; John A Jernigan; Robert R Muder; LaToya J Miller; Gary A Roselle Journal: N Engl J Med Date: 2011-04-14 Impact factor: 91.245