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Motivating healthcare professionals (nurses, nurse assistants, physicians) to integrate new practices for preventing healthcare-associated infections into the care continuum: turning Positive Deviance into positive norms

机译:激励医疗保健专业人士(护士,护士助理,医生),以整合预防医疗保健相关感染进入护理连续体的新实践:将积极的偏差转化为积极的规范

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The literature examining healthcare-associated infections (HAI) points to two main problems in conforming to infection prevention and control (IPC) guidelines among healthcare professionals (HP). One is the discrepancy between HPs’ behavioral intentions and their implementation in practice. The other refers to how HPs maintain these practices after the intervention stage ends. The method proposed in this study seeks to address both these issues by using the Positive Deviance (PD) approach to focus on the dissemination stage of interventions. The study seeks to offer a method for disseminating 27 PD practices to 135 HPs, among them nurses, nurse assistants and physicians, so as to help them maintain IPC guidelines, offer feedback on the dissemination process and examine the impact of the dissemination stage on changes in their behavior. The theoretical model underlying this qualitative research was the Recognition-Primed Decision (RPD) model, which we implemented in the field of healthcare-associated infections (HAIs). Moreover, we used the Discovery & Action Dialogue (DAD) and Think Aloud (TA) techniques to describe the methodological development of simulations for HPs. Feedback from the HP demonstrators underwent content analysis, while descriptive statistics were used to characterize behavioral changes. HPs’ information processing regarding infection prevention shifts from peripheral/automatic processing to intuition and analytical/central processing, turning PD practices into positive norms. The HPs personally experienced finding a solution and made repeated corrections until they overcame the barriers. Most of the HPs (69.4%) reported that the practices were fully implemented, together with additional practices. Implementation of the dissemination stage indicates that in order for HPs to integrate and assimilate practices that are not in the official guidelines, merely observing simulations is not sufficient. Rather, each staff member must personally carry out the procedures.
机译:审查医疗保健相关感染(海)的文献指出了符合医疗专业人士(HP)的感染预防和控制(IPC)指南的两个主要问题。一个是HPS行为意图与其在实践中的实施之间的差异。另一个是指干预阶段结束后如何维持这些实践。本研究中提出的方法旨在通过使用积极的偏差(PD)方法关注干预措施的传播阶段来解决这些问题。该研究旨在提供一种将27个PD实践传播到135 HPS的方法,包括护士,护士助理和医生,以帮助他们维持IPC指南,提供有关传播过程的反馈,并检查传播阶段对变化的影响在他们的行为。这种定性研究的理论模型是认可 - 突出的决定(RPD)模型,我们在医疗保健相关感染(HAI)领域中实施。此外,我们使用了发现和行动对话(爸爸)并大声思考(TA)技术来描述HPS模拟的方法。 HP示威者的反馈接受了内容分析,而描述性统计用于表征行为变化。 HPS的信息处理关于感染预防从外围/自动处理转移到直觉和分析/中央处理,将PD实践转化为正值。 HPS亲自经历了解决方案并进行重复的校正,直到它们克服障碍。大多数HPS(69.4%)报告说,该实践与其他措施一起全面实施。传播阶段的实施表明,为了使HPS整合和同化不在官方指南的做法,仅仅观察模拟是不够的。相反,每个工作人员必须亲自进行程序。

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