Sreeramoju Pranavi
Division of Medicine-Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, Texas.
Open Forum Infect Dis. 2019 Feb 2;6(2):ofy348. doi: 10.1093/ofid/ofy348. eCollection 2019 Feb.
Reducing healthcare-associated infections often requires the use of both technical and adaptive strategies. The experiences of Semmelweis and Nightingale teach us the importance of social adaptation of technical interventions. Because most infection prevention interventions require widespread participation by healthcare personnel, it is helpful for infectious diseases physicians to learn principles of diffusion of innovations theory and apply them to influence different groups. Comprehensive unit-based program has been successful in reducing device-associated infections. Positive deviance as a socioadaptive approach may be promising. These and other approaches such as social network analysis, relational coordination, link nurses, and stop the line policies need to be further evaluated in future studies. Future research on socioadaptive interventions needs to focus on developing tools and strategies for diagnosing local context and study how these interventions might influence culture of safety. Strategies to sustain momentum of improvement efforts in different healthcare settings need to be refined and further developed through additional research.
减少医疗保健相关感染通常需要同时运用技术策略和适应性策略。塞麦尔维斯和南丁格尔的经历让我们认识到技术干预进行社会适应的重要性。由于大多数感染预防干预措施都需要医护人员的广泛参与，传染病医生了解创新扩散理论的原则并将其应用于影响不同群体是很有帮助的。基于综合病房的项目在减少与设备相关的感染方面取得了成功。积极偏差作为一种社会适应方法可能很有前景。这些方法以及其他方法，如社会网络分析、关系协调、联络护士和停止生产线政策，需要在未来的研究中进一步评估。未来关于社会适应干预的研究需要专注于开发用于诊断当地情况的工具和策略，并研究这些干预措施如何影响安全文化。需要通过更多研究来完善和进一步发展在不同医疗环境中维持改进努力势头的策略。
