Monitoring adherence to standard precautions

Background: Health care workers (HCWs) do not consistently follow Standard Precautions (SP). This is a serious problem because inadequate compliance i s associated with increased blood exposure thus predisposing HCWs to bloodb orne pathogen transmission. Methods: The primary goal of this study was to identify institutional facto rs associated with adequacy of HCW training to monitor coworkers' adherence to SP. Surveys were sent to ail community hospital infection control pract itioners (ICPs) in Iowa and Virginia. ICPs indicated on a 5-point Likert sc ale, ranging from strongly disagree to strongly agree, their assessment of HCW training adequacy. Data from another statewide survey of HCWs in Iowa w ere assessed to validate this outcome measure. Multiple logistic regression models were developed to identify predictors of assessed training adequacy . independent variables included methods of education, training, approaches to SP compliance assessment, provision of SP reinforcement by clinical lea ders, and organizational data. Results: A total of 149 institutions (62%) participated. Models of training program adequacy varied across occupations. Management commitment to SP tr aining programs, leadership support, frequency-bf providing bloodborne path ogen information, and safety climate were important institutional predictor s of assessed adequacy of training. Thr outcome was validated by demonstrat ing an association between the ICPs' assessment of HCW training and workers who reported having sufficient information to comply with SP (P < .05). Conclusions: Institutional safety climate, leadership support. and frequenc y of education play an important role in HCWs' training adequacy to monitor coworkers' adherence to SP. Occupational groups should be considered indep endently when strategies are developed to increase compliance interventions based on modifiable factors identified by this study may reduce bloodborne pathogen exposure among HCWs.