Revista da Escola de Enfermagem da USP ()

Positive deviance as a strategy to prevent and control bloodstream infections in intensive care

  • Francimar Tinoco de Oliveira,
  • Maria Manuela Frederico Ferreira,
  • Silvia Teresa Carvalho de Araújo,
  • Amanda Trindade Teixeira de Bessa,
  • Advi Catarina Barbachan Moraes,
  • Marluci Andrade Conceição Stipp

DOI
https://doi.org/10.1590/s1980-220x2016182303212
Journal volume & issue
Vol. 51, no. 0

Abstract

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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.

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