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Lommi M, De Benedictis A, Porcelli B, Raffaele B, Latina R, Montini G, Tolentino Diaz MY, Guarente L, De Maria M, Ricci S, Giovanniello D, Rocco G, Stievano A, Sabatino L, Notarnicola I, Gualandi R, Tartaglini D, Ivziku D. Evaluation of Standard Precautions Compliance Instruments: A Systematic Review Using COSMIN Methodology. Healthcare (Basel) 2023; 11:healthcare11101408. [PMID: 37239700 DOI: 10.3390/healthcare11101408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/26/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals' compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. METHODS We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. RESULTS Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. CONCLUSIONS The available instruments that measure healthcare professionals' compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.
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Affiliation(s)
- Marzia Lommi
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Anna De Benedictis
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Barbara Porcelli
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Barbara Raffaele
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Roberto Latina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90128 Palermo, Italy
| | - Graziella Montini
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | | | - Luca Guarente
- Department of Biomedicine and Prevetion, University Tor Vergata, 00133 Rome, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevetion, University Tor Vergata, 00133 Rome, Italy
| | - Simona Ricci
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Dominique Giovanniello
- Department of Traslational Medical Sciences, University of Campania "Luigi Vanvitelli", 81100 Caserta, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
- Department of Nursing, Catholic University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Alessandro Stievano
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Laura Sabatino
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
| | - Ippolito Notarnicola
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
| | - Raffaella Gualandi
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Daniela Tartaglini
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Dhurata Ivziku
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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Hammoud S, Amer F, Lohner S, Kocsis B. Patient education on infection control: A systematic review. Am J Infect Control 2020; 48:1506-1515. [PMID: 32512081 DOI: 10.1016/j.ajic.2020.05.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Lately, suggestions have been emphasizing the importance of engaging patients and family members in infection control (IC) through participation and education after showing that patients and family members can aid in preventing the transmission of health care-associated infections. However, assessing patient education on IC measures in hospitals is poorly investigated. PURPOSE To identify all available studies in the literature that assessed hospitalized patients' education on IC measures. METHODS PubMed, Embase, and CINAHL were searched from inception till May 6, 2020 without restrictions. We used Strengthening the Reporting of Observational Studies in Epidemiology tool for assessing the reporting quality of each eligible study. MAIN FINDINGS Of the 6,740 identified papers, 25 were eligible for inclusion. Education on health care-associated infections was investigated in 8 studies, education on central line-associated bloodstream infections in 1, education on surgical site infections in 2, education on hand hygiene in 12, education on isolation rationale, precautions, usage of personal protective equipment in 3, and education on respiratory hygiene in 1. In general, a low percentage of patient education on IC was found in most of the included papers. CONCLUSIONS The low percentage of patient education on IC in hospitals highlights the need for additional emphasis on patient involvement in IC. Further studies are needed to assess patient education on several IC measures and to explore the education of family members as well.
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Samur M, Seren Intepeler S, Lam SC. Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey. Int J Nurs Pract 2020; 26:e12839. [PMID: 32304177 DOI: 10.1111/ijn.12839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022]
Abstract
AIMS To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses. BACKGROUND Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams. METHODS This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016. RESULTS Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest. CONCLUSION The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.
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Affiliation(s)
- Menevse Samur
- Nursing Management Department, Nursing Faculty, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Seyda Seren Intepeler
- Nursing Management Department, Nursing Faculty, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Burnett E. Effective infection prevention and control: the nurse's role. Nurs Stand 2018; 33:68-72. [PMID: 29972291 DOI: 10.7748/ns.2018.e11171] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
Healthcare-associated infections and antimicrobial resistance are significant threats to public health. As resistant organisms continue to emerge and evolve, and antimicrobial agents become less effective, infection prevention and control remains a vital aspect of maintaining public health, particularly among vulnerable patient groups such as older people and young children. Because of the increasing complexity of healthcare treatments and interventions, patients are becoming increasingly susceptible to healthcare-associated infections and resistant organisms. This article outlines some of the challenges that nurses may experience in ensuring effective infection prevention and control, and how these can be addressed.
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Affiliation(s)
- Emma Burnett
- School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland
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Moralejo D, El Dib R, Prata RA, Barretti P, Corrêa I. Improving adherence to Standard Precautions for the control of health care-associated infections. Cochrane Database Syst Rev 2018; 2:CD010768. [PMID: 29481693 PMCID: PMC6491237 DOI: 10.1002/14651858.cd010768.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Standard Precautions' refers to a system of actions, such as using personal protective equipment or adhering to safe handling of needles, that healthcare workers take to reduce the spread of germs in healthcare settings such as hospitals and nursing homes. OBJECTIVES To assess the effectiveness of interventions that target healthcare workers to improve adherence to Standard Precautions in patient care. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, two other databases, and two trials registers. We applied no language restrictions. The date of the most recent search was 14 February 2017. SELECTION CRITERIA We included randomised trials of individuals, cluster-randomised trials, non-randomised trials, controlled before-after studies, and interrupted time-series studies that evaluated any intervention to improve adherence to Standard Precautions by any healthcare worker with responsibility for patient care in any hospital, long-term care or community setting, or artificial setting, such as a classroom or a learning laboratory. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results, extracted data from eligible trials, and assessed risk of bias for each included study, using standard methodological procedures expected by Cochrane. Because of substantial heterogeneity among interventions and outcome measures, meta-analysis was not warranted. We used the GRADE approach to assess certainty of evidence and have presented results narratively in 'Summary of findings' tables. MAIN RESULTS We included eight studies with a total of 673 participants; three studies were conducted in Asia, two in Europe, two in North America, and one in Australia. Five studies were randomised trials, two were cluster-randomised trials, and one was a non-randomised trial. Three studies compared different educational approaches versus no education, one study compared education with visualisation of respiratory particle dispersion versus education alone, two studies compared education with additional infection control support versus no intervention, one study compared peer evaluation versus no intervention, and one study evaluated use of a checklist and coloured cues. We considered all studies to be at high risk of bias with different risks. All eight studies used different measures to assess healthcare workers' adherence to Standard Precautions. Three studies also assessed healthcare workers' knowledge, and one measured rates of colonisation with methicillin-resistant Staphylococcus aureus (MRSA) among residents and staff of long-term care facilities. Because of heterogeneity in interventions and outcome measures, we did not conduct a meta-analysis.Education may slightly improve both healthcare workers' adherence to Standard Precautions (three studies; four centres) and their level of knowledge (two studies; three centres; low certainty of evidence for both outcomes).Education with visualisation of respiratory particle dispersion probably improves healthcare workers' use of facial protection but probably leads to little or no difference in knowledge (one study; 20 nurses; moderate certainty of evidence for both outcomes).Education with additional infection control support may slightly improve healthcare workers' adherence to Standard Precautions (two studies; 44 long-term care facilities; low certainty of evidence) but probably leads to little or no difference in rates of health care-associated colonisation with MRSA (one study; 32 long-term care facilities; moderate certainty of evidence).Peer evaluation probably improves healthcare workers' adherence to Standard Precautions (one study; one hospital; moderate certainty of evidence).Checklists and coloured cues probably improve healthcare workers' adherence to Standard Precautions (one study; one hospital; moderate certainty of evidence). AUTHORS' CONCLUSIONS Considerable variation in interventions and in outcome measures used, along with high risk of bias and variability in the certainty of evidence, makes it difficult to draw conclusions about effectiveness of the interventions. This review underlines the need to conduct more robust studies evaluating similar types of interventions and using similar outcome measures.
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Affiliation(s)
- Donna Moralejo
- Memorial UniversitySchool of NursingH2916, Health Sciences Centre300 Prince Philip DriveSt. John'sNewfoundlandCanadaA1B 3V6
| | - Regina El Dib
- Institute of Science and Technology, UNESP ‐ Univ Estadual PaulistaDepartment of Biosciences and Oral DiagnosisSão José dos CamposSPBrazil
| | - Rafaela A Prata
- Department of Nursing, UNESP ‐ Univ Estadual PaulistaBotucatuBrazil
| | - Pasqual Barretti
- Botucatu Medical School, UNESP ‐ Univ Estadual PaulistaClinical MedicineDistrito de Rubião Junior, s/nBotucatuSão PauloBrazil18618‐900
| | - Ione Corrêa
- Department of Nursing, UNESP ‐ Univ Estadual PaulistaBotucatuBrazil
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Sousa ÁFLD, Queiroz AAFLN, Oliveira LBD, Moura MEB, Batista OMA, Andrade DD. Social representations of biosecurity in nursing: occupational health and preventive care. Rev Bras Enferm 2017; 69:864-871. [PMID: 27783728 DOI: 10.1590/0034-7167-2015-0114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/27/2016] [Indexed: 02/08/2023] Open
Abstract
Objective: to understand the biosecurity social representations by primary care nursing professionals and analyze how they articulate with quality of care. Methods: exploratory and qualitative research based on social representation theory. The study participants were 36 nursing workers from primary health care in a state capital in the Northeast region of Brazil. The data were analyzed by descending hierarchical classification. Results: five classes were obtained: occupational accidents suffered by professionals; occupational exposure to biological agents; biosecurity management in primary health care; the importance of personal protective equipment; and infection control and biosecurity. Conclusion: the different positions taken by the professionals seem to be based on a field of social representations related to the concept of biosecurity, namely exposure to accidents and risks to which they are exposed. However, occupational accidents are reported as inherent to the practice.
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Affiliation(s)
- Álvaro Francisco Lopes de Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação em Enfermagem Fundamental. Ribeirão Preto-SP, Brasil
| | | | - Layze Braz de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação em Enfermagem Fundamental. Ribeirão Preto-SP, Brasil
| | - Maria Eliete Batista Moura
- Universidade Federal do Piauí, Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Teresina-PI, Brasil
| | - Odinéa Maria Amorim Batista
- Universidade Federal do Piauí, Centro de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Teresina-PI, Brasil
| | - Denise de Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação em Enfermagem Fundamental. Ribeirão Preto-SP, Brasil
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Pereira FMV, Lam SC, Gir E. Cultural Adaptation and Reliability of the Compliance with Standard Precautions Scale (CSPS) for Nurses in Brazil. Rev Lat Am Enfermagem 2017; 25:e2850. [PMID: 28301030 PMCID: PMC5363326 DOI: 10.1590/1518-8345.1204.2850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/26/2016] [Indexed: 11/30/2022] Open
Abstract
Objective: this study aimed to carry of the cultural adaptation and to evaluate the reliability of the Compliance with Standard Precautions Scale (CSPS) for nurses in Brazil. Method: the adaptation process entailed translation, consensus among judges, back-translation, semantic validation and pretest. The reliability was evaluated by internal consistency (Cronbach alpha) and stability (test-retest). The instrument was administered to a sample group of 300 nurses who worked in a large hospital located in the city of São Paulo/SP, Brazil. Results: through the semantic validation, the items from the scale were considered understandable and deemed important for the nurse´s clinical practice. The CSPS Brazilian Portuguese version (CSPS-PB) revealed excellent interpretability. The Cronbach`s alpha was 0.61 and the intraclass correlation coefficient was 0.85. Conclusion: the initial study showed that CSPS-PB is appropriate to assess compliance with standard precautions among nurses in Brazil. The reliability was considered acceptable. Furhter study is necessary to evaluate its comprehensive psychometric properties.
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Affiliation(s)
| | - Simon Ching Lam
- PhD, Associate Professor, Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China
| | - Elucir Gir
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Colet PC, Cruz JP, Alotaibi KA, Colet MKA, Islam SMS. Compliance with standard precautions among baccalaureate nursing students in a Saudi university: A self-report study. J Infect Public Health 2016; 10:421-430. [PMID: 27425794 DOI: 10.1016/j.jiph.2016.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/23/2016] [Accepted: 06/24/2016] [Indexed: 12/23/2022] Open
Abstract
Meticulous observance of standard infection control precautions by health care providers is strongly recommended for every patient encounter. Assessment of nursing students' compliance should be carried out regularly in order to ensure adherence to protocols. Thus, this study was conducted to assess self-reported compliance with standard precautions among baccalaureates in nursing students in a Saudi university. A convenience sample of 236 nursing students was surveyed in this cross-sectional, self-reported study, using the Compliance with Standard Precaution Scale Arabic version (CSPS-A). Independent t-test and one-way analyses of variance (ANOVA) were performed to examine the differences on compliance. A multiple regression analysis was performed to identify the factors affecting compliance. The overall compliance rate was 61.0%. The students reported highest compliance in disposing used sharp instruments and other sharp objects into sharps-only boxes, while the lowest compliance rate in using water only for hand washing. Significant differences in compliance were observed when respondents were grouped according to their demographic characteristics. Cultivating a supportive culture of adherence to infection control precautions among nursing students is of paramount importance. The clinical environment should be supportive of a culture where strict compliance with the control and prevention of infection is of prime importance.
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Affiliation(s)
- Paolo C Colet
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Saudi Arabia
| | - Jonas P Cruz
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Saudi Arabia.
| | - Khalaf A Alotaibi
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Saudi Arabia
| | - Maverick K A Colet
- College of Physical and Respiratory Therapy, Lorma Colleges, Philippines
| | - Sheikh M S Islam
- Non-Communicable Diseases Initiative, International Center for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Bangladesh; Diabetes Research, University of Munich, Germany; NCD, Bangladesh University of Health Science Postdoc Research, Bangladesh; The George Institute for Global Health, University of Sydney, Australia
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Valle ARMDC, Andrade DD, Sousa ÁFLD, Carvalho PRMD. Prevenção e controle das infecções no domicílio: desafios e implicações para enfermagem. ACTA PAUL ENFERM 2016. [DOI: 10.1590/1982-0194201600033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Resumo Objetivo Identificar as competências teóricas do enfermeiro para atuação na prevenção e controle das infecções em atenção domiciliar a partir da opinião de especialistas. Métodos Estudo quase-experimental baseado na Técnica Delphi, realizado em Unidades Básicas de Saúde de uma capital do Nordeste brasileiro e Universidades de quatro regiões do País. Participaram 19 enfermeiros atuantes nas equipes da Estratégia Saúde da Família e 15 pesquisadores recrutados pelo método snow-ball. Resultados A partir da avaliação e consenso dos participantes, elaborou-se uma lista de competências, que permitiram analisar aspectos conceituais, procedimentais e contextuais quanto à prevenção da infecção no ambiente domiciliar. Conclusão As práticas de prevenção e controle das infecções na Atenção Domiciliar são competências teóricas reconhecidas pelos enfermeiros, contudo as bases teóricas necessitam de revisões e adaptações no âmbito assistencial e do ensino. As categorias elencadas configuram-se em um instrumento de futuras análises e de reflexão no controle das infecções no ambiente domiciliar.
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Michinov E, Buffet-Bataillon S, Chudy C, Constant A, Merle V, Astagneau P. Sociocognitive determinants of self-reported compliance with standard precautions: Development and preliminary testing of a questionnaire with French health care workers. Am J Infect Control 2016; 44:14-9. [PMID: 26422181 DOI: 10.1016/j.ajic.2015.07.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/29/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Inconsistent compliance of health care workers with standard precautions has already been documented. The objective of this study was to develop a questionnaire to investigate the sociocognitive determinants of compliance with standard precautions based on the theory of planned behavior. METHODS To construct the Standard Precautions Questionnaire (SPQ), items were selected using a systematic review of literature and semistructured interviews with 54 health care workers. Thirty-five items were selected for a draft questionnaire. These questionnaires were sent to 649 health care workers in 3 medical specialties (pediatrics, geriatrics, and intensive care) in a French University hospital. A total of 331 valid questionnaires were analyzed. RESULTS Factor analysis yielded a final 7-factor solution with an explained variance of 66.51%, with 24 items. The 7 dimensions were the following: attitude toward standard precautions, social influence facilitating organization, exemplary behavior of colleagues, organizational constraints, individual constraints, and intention to perform standard precautions. Some differences were observed between medical specialties on attitude toward standard precautions, social influence, and individual constraints. CONCLUSION The SPQ met the conditions of reliability and validity in accordance with psychometric demands and could be used to evaluate attitudes and intention to perform standard precautions among medical and nursing staff.
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