Factors Influencing Adherence to Standard Precautions Scale: A psychometric validation

Bouchoucha, Stéphane L.; Moore, Kathleen A.

In an integrative review, Valim, Marziale, Richart-Martínez, and Sanjuan-Quiles (2014) identified 18 measures designed to evaluate levels of compliance and adherence (terms they used interchangeably) with infection control practices. They emphasized that most of those measures assessed adherence/non-adherence rates, and recommended that "further research [to] assess the variables that influence adherence to SP" (p. 1516). Attempts to date to determine the reasons for non-adherence to SP among health-care workers have typically used only single items (Lam, 2014; Rabaud et al., 2000; Valim, Marziale, Richart-Martínez, & Sanjuan-Quiles, 2014) or observational and anecdotal accounts. These latter accounts indicate that a lack of knowledge, lack of or inadequate supplies, time pressure, confidence in their own skills, the organizational climate, and forgetfulness are among the factors that staff have cited as their reasons for non-adherence (Efstathiou, Papastavrou, Raftopoulos, & Merkouris, 2011b; Hills & Wilkes, 2003; Reda, Fisseha, Mengistie, & Vandeweerd, 2010) . Furthermore, Efstathiou et al. (2011b) highlighted that most studies discussing non-adherence to Standard Precautions "studied only one or limited aspects of SP, mainly hand hygiene" (p. 2). Some attempts to broaden the range of factors argued to assess adherence to SP can be found in the work of Osborne (2003) and Cheung et al. (2015) ; however, neither study provided detailed items nor any psychometric data beyond Cronbach's alpha. It is important, therefore, to develop and psychometrically validate a scale that systematically assesses a range of factors influencing adherence or non-adherence to SP. The aim of the present study was to develop and validate such a scale. We report on two studies designed to achieve this aim.