Positive deviance: Concept analysis using the evolutionary approach of Rodgers

Methodology
By Josiane Létourneau, Marie Alderson, Chantal Caux, Lucie Richard
English

Positive deviance is a relatively new concept in healthcare. Since 2006, it has been applied to infection control in order to increase awareness of good hand hygiene practices. This article focuses on presenting analytical results of this concept using the evolutionary approach of Rodgers based on the philosophical postulate that concepts are dynamic and change with time. A census of the writings in nursing, medicine, and psychology was carried out in order to produce these results. By going through the CINAHL, MEDLINE and PsycINFO databases using “positive deviance” as a keyword for the time period of 1975 to May 2012, and in accordance with Rodgers’s method, ninety articles were retained (thirty per discipline per discipline). The analysis enables us to notice that positive deviance, described as an individual characteristic at first, is now used as a behavioral changing approach in both nursing and medicine. At the end of the analysis and beyond this article, positive deviance will be used in order to study the practice of nurses who adhere to hand hygiene practices despite limiting constraints within hospitals. We will then be able to continue the development of this concept in order to bring it, as Rodgers recommends, beyond analysis. It would then constitute an important contribution to good nursing practices in the field of infection control and prevention.

Key words

  • positive deviance
  • evolutionary concept analysis
  • hand hygiene
  • nursing
  • nosocomial infections
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