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

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)

Acknowledgements

The management team and personnel of PX Ltd's Teesside Operations are gratefully acknowledged for their generous contribution to the initial funding stages of this project. The major contribution provided by Huntsman Petrochemicals (UK) Ltd in terms of time and access to their staff and Teesside facilities to support this pilot is also gratefully acknowledged.

Indeed, the partnership between industry (Huntsman Petrochemicals [UK] Ltd and PX Ltd, Teesside), academe (Indiana University, IN, USA) and the NHS has provided a model example of how widely different parties can work together for the benefit of all.