Changing personnel behavior to promote quality care practices in an intensive care unit

Dominic Cooper¹, Keith Farmery², Martin Johnson³, Christine Harper³, Fiona L Clarke³, Phillip Holton⁴, Susan Wilson⁵, Paul Rayson⁶, Hugh Bence⁶

¹Department of Applied Health Sciences, Indiana University, Bloomington, IN, USA; ²Consultant in Clinical Governance and Risk Management to Co Durham and Tees Valley Strategic Health Authority, Stockton on Tees, UK; ³James Cook University Hospital, Intensive Care Unit, Middlesbrough, UK; ⁴Co Durham and Tees Valley Strategic Health Authority, Stockton on Tees, UK; ⁵Primary Care Community Nursing, North Tees Primary Care Trust, Stockton on Tees, UK; ⁶Hunstman Petrochemicals (UK) Ltd, Redcar, Teesside, UK

Abstract: The delivery of safe high quality patient care is a major issue in clinical settings. However, the implementation of evidence-based practice and educational interventions are not always effective at improving performance. A staff-led behavioral management process was implemented in a large single-site acute (secondary and tertiary) hospital in the North of England for 26 weeks. A quasi-experimental, repeated-measures, within-groups design was used. Measurement focused on quality care behaviors (ie, documentation, charting, hand washing). The results demonstrate the efficacy of a staff-led behavioral management approach for improving quality-care practices. Significant behavioral change (F [6, 19] = 5.37, p < 0.01) was observed. Correspondingly, statistically significant (t-test [t] = 3.49, df = 25, p < 0.01) reductions in methicillin-resistant Staphylococcus aureus (MRSA) were obtained. Discussion focuses on implementation issues.

Keywords: behavioral management, hospital-acquired infection, goal-setting, feedback, employee involvement, methicillin-resistant Staphylococcus aureus (MRSA)