title: Instruments for evaluating compliance with infection control practices and factors that affect it: an integrative review.
abstract: OBJECTIVE
  To search for instruments to measure compliance with infection control practices and to report on which dimensions and contents the instruments evaluate, their psychometric characteristics, compliance and factors influencing compliance.
  
  
  BACKGROUND
  Low compliance with infection control practices has been reported among healthcare professionals around the world over the years. Existing data concerning health professionals' compliance with standard precautions are based on measuring instruments.
  
  
  METHODS
  Integrative review.
  
  
  METHODS
  The descriptors were identified and used separately and in combination to search in the following databases: Lilacs, PubMed (MEDLINE), ISI Web of Knowledge, Scopus and CINAHL. The selected articles complied with inclusion and exclusion criteria.
  
  
  RESULTS
  Twenty-three studies were analysed, resulting in the identification of 18 instruments. No instrument addressed all compliance topics, and the most commonly addressed topics were the use of personal protective equipment, hand hygiene and safe practices in the handling of cutting material. Most authors explored content validity and some performed reliability analysis by means of Cronbach's alpha and test-retest. Countries in the sample have different human development indices, and countries with medium and low human development indices show less compliance. Some variables were strong predictors of compliance: training, perceptions of safe environment, perception of obstacles to comply with standard precautions and knowledge.
  
  
  CONCLUSIONS
  Compliance is below the recommended levels. Health professionals seem to be selective in following standard precautions. Significant influences include institutional management and psychosocial variables, which deserve further study.
  
  
  CONCLUSIONS
  Health managers and government policies and interventions should pay greater attention to this subject.
authors.affiliation: Department of Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Marília Duarte
authors.initials: MD
authors.lastname: Valim
authors.forename: Maria H Palucci
authors.initials: MH
authors.lastname: Marziale
authors.forename: Miguel
authors.initials: M
authors.lastname: Richart-Martínez
authors.forename: Ángela
authors.initials: Á
authors.lastname: Sanjuan-Quiles
mesh_terms: D001291:Attitude of Health Personnel; D019985:Benchmarking; D019983:Guideline Adherence; D006801:Humans; D017053:Infection Control / Q000592:standards*; D015397:Program Evaluation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: compliance; healthcare worker; infection control; occupational health; review; standard precaution; universal precaution