title: Monitoring adherence to Standard Precautions.
abstract: BACKGROUND
  Health care workers (HCWs) do not consistently follow Standard Precautions (SP). This is a serious problem because inadequate compliance is associated with increased blood exposure thus predisposing HCWs to bloodborne pathogen transmission.
  
  
  METHODS
  The primary goal of this study was to identify institutional factors associated with adequacy of HCW training to monitor coworkers' adherence to SP. Surveys were sent to all community hospital infection control practitioners (ICPs) in Iowa and Virginia. ICPs indicated on a 5-point Likert scale, ranging from strongly disagree to strongly agree, their assessment of HCW training adequacy. Data from another statewide survey of HCWs in Iowa were 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 leaders, and organizational data.
  
  
  RESULTS
  A total of 149 institutions (62%) participated. Models of training program adequacy varied across occupations. Management commitment to SP training programs, leadership support, frequency of providing bloodborne pathogen information, and safety climate were important institutional predictors of assessed adequacy of training. The outcome was validated by demonstrating 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 frequency of education play an important role in HCWs' training adequacy to monitor coworkers' adherence to SP. Occupational groups should be considered independently when strategies are developed to increase compliance. Interventions based on modifiable factors identified by this study may reduce bloodborne pathogen exposure among HCWs.
authors.affiliation: Department of Internal Medicine, The University of Iowa College of Medicine, Iowa City, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: McCoy
authors.forename: S E
authors.initials: SE
authors.lastname: Beekmann
authors.forename: K J
authors.initials: KJ
authors.lastname: Ferguson
authors.forename: T E
authors.initials: TE
authors.lastname: Vaughn
authors.forename: J C
authors.initials: JC
authors.lastname: Torner
authors.forename: R F
authors.initials: RF
authors.lastname: Woolson
authors.forename: B N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D017848:Blood-Borne Pathogens; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006282:Health Personnel / Q000193:education / Q000592:standards*; D006801:Humans; D017053:Infection Control; D007318:Inservice Training; D007484:Iowa; D008297:Male; D008962:Models, Theoretical; D016273:Occupational Exposure / Q000517:prevention & control*; D015203:Reproducibility of Results; D012307:Risk Factors; D014481:United States; D016635:Universal Precautions / Q000706:statistics & numerical data*; D014768:Virginia