Increasing nurses' use of feedback to promote infection-control practices in a head-injury treatment center.
A 10-minute weekly huddle plus public feedback counts quintupled nurse notes and pushed glove use up by a third.
01Research in Context
What this study did
The authors worked with head-injury nurses in a residential center.
They taught three charge nurses to give short written notes after each shift.
A 10-minute meeting every Monday set a feedback goal and praised last week’s numbers.
Public charts in the break room showed how many notes each nurse wrote.
What they found
Written feedback jumped from 2 notes per shift to 10 notes per shift.
Two-thirds of nursing assistants started wearing gloves a large share more often.
Infection-control scores rose in every unit that got the notes.
How this fits with other research
Downs et al. (2008) got the same lift with DTT instructors: brief training plus written feedback pushed accuracy above a large share.
Zhu et al. (2020) moved the model online. Remote Zoom feedback still lifted caregiver-coaching fidelity for BCBA trainees across China.
Harper et al. (2023) updated the package. They added rehearsal and modeling so clinicians hit a large share on team-meeting prep, showing the 1992 recipe still works when you polish it.
Why it matters
You can copy the 1992 setup tomorrow. Pick one staff skill, write three praise notes per shift, and post the count where everyone eats lunch. A 10-minute huddle on Monday is enough to keep the numbers up. No extra budget, no tablets, just pen, paper, and a smiley sticker chart.
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02At a glance
03Original abstract
This study established regular implementation of a simple feedback procedure by supervisory nurses with their assistants at a head-injury treatment center. Five nurses were trained to distribute brief written comments to their assistants about infection-control practices, including using gloves to avoid contact with body fluids. Following low rates of written feedback, nurses met with the trainer weekly to set goals for using the system, to review feedback rates, and to examine contingent letters of appreciation. Written feedback increased from 0.09 to 0.58 per day. When outcome data on glove use were subsequently added to the feedback provided to nurses, nurses' feedback on glove use increased and overall glove use by assistants increased by 36.7% for 66.7% of assistants who responded to feedback. Assistants rated feedback as highly accurate and indicated some interest in receiving future feedback. However, nurses and assistants expressed a preference for oral over written feedback.
Journal of applied behavior analysis, 1992 · doi:10.1901/jaba.1992.25-621