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.