Researchers: Anat Gesser-Edelsburg¹, Lior Lowenstein , Asher Salmon , Dan Shteinberg

Background: The phenomenon of nosocomial infections acquired in hospitals in Israel and around the world is considered one of the most critical and studied problems in public health. But despite the accumulated knowledge and implementation of diverse strategies, compliance with infection-preventing actions remains low, infection rates are high, and there is still a gap between recommendations and implementation on the ground. To bridge that gap we utilize the Positive Deviance (PD) approach to prevent HAIs in Israel.

Objectives: To identify, map and classify unique infection prevention practices of individual PD staff members in specific areas and sectors in three hospitals: Hadassah Ein Kerem, Bnei Zion and Rambam, and through them to find solutions for “gray areas;” (2) to estimate and validate the proposed PD practices using the infection control units; (3) to disseminate and integrate the PD practices among hospital staff; (4) to check the impact of the PD practices on behavior change of hospital staff to maintain infection prevention rules; (5) to check the impact of the PD practices on the reduction of HAI rates from durable bacteria and CLABSI.

Method: Mixed research methods.

Findings: 132 personal interviews, observations and videos were made with staff members from different sectors in the hospitals. They yielded 50 unique practices that do not exist in the accepted HAI prevention guidelines.

Conclusions: The unique PD approach identifies creative solutions by hospital staff based on existing resources and can overcome barriers and motivate the entire staff to cooperate.

Recommendations: Staff from HAI prevention units in all three hospitals who participated in the study can use this approach in order to create across-the-board change in other departments, while sharing and disseminating the knowledge and PD practices between the different hospitals.

Research end date: 03/2020