Positive deviance : concept analysis using the evolutionary approach of Rodgers

Positive deviance is a relatively new concept in healthcare. Since 2006, it has been applied to infection control in order to increase the awareness to good hand hygiene practices. This article focus on presenting analytical results of this concept using the evolutionary approach of Rodgers based on the philosophical postulate that concepts are dynamical and changing with time. For doing so, a census of the writings in nursing, medicine and psychology was carried out. By going through the CINAHL, Medline and PsycINFO databases using positive deviance as a keyword for the time period: 1975 to May 2012, and in accordance with the method of Rodgers, ninety articles were retained (30 per discipline). The analysis enables one to notice that positive deviance described as an individual characteristic at first, is now used as a behavioral changing approach in nursing and medicine as well. At the end of the analysis and apart from this article, positive deviance will be used in order to study the practice of nurses that adheres to hand hygiene despite limiting constraints within hospital. We will then be able to continue the development of this concept in order to bring it, as Rodgers recommends, beyond the analysis. It would then be an important contribution to good nursing practices in the field of infection control and prevention.