title: A tool to assess knowledge, attitude and behavior of Indonesian health care workers regarding infection control.
abstract: OBJECTIVE
  to investigate knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire and to evaluate the use of the questionnaire as a tool.
  
  
  METHODS
  we investigated knowledge, attitude and behaviour toward infection control in two teaching hospitals on the island of Java by means of a questionnaire to identify problem areas, barriers and facilitators. The target was to include at least 50% of all health care workers (physicians, nurses, assistant nurses and infection control nurses) in each hospital, department and profession. Differences between demographic variables and scores for individual questions and groups of questions were compared using the chi-square statistic and analysis of variance and Spearman's rho was used to test for correlations between knowledge, attitude, self-reported behaviour and perceived obstacles.
  
  
  RESULTS
  more than half of the health care workers of the participating departments completed the questionnaire. Of the 1036 respondents (44% nurses, 37% physicians and 19% assistant nurses), 34% were vaccinated against hepatitis B, 77% had experienced needle stick accidents and 93% had been instructed about infection control. The mean of the correct answers to the knowledge questions was 44%; of the answers to the attitude questions 67% were in agreement with the correct attitude; obstacles to compliance with infection control guidelines were perceived in 30% of the questions and the mean self-reported compliance was 63%. Safe handling of sharps, hand hygiene and the use of personal protective equipment were identified as the most important aspects for interventions. Significant positive correlations were found between knowledge, attitude, self-reported behaviour and perceived obstacles.
  
  
  CONCLUSIONS
  the questionnaire in conjunction with site visits and interviews was a valuable strategy to identify trouble spots in the hospitals and to determine barriers to facilitators of change that should be taken into account when planning interventions. Successful interventions should cover hospital management, the infection control team, as well as the health care workers on the wards.
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: D O
authors.initials: DO
authors.lastname: Duerink
authors.forename: U
authors.initials: U
authors.lastname: Hadi
authors.forename: E S
authors.initials: ES
authors.lastname: Lestari
authors.forename: Djoko
authors.initials: D
authors.lastname: Roeshadi
authors.forename: Hendro
authors.initials: H
authors.lastname: Wahyono
authors.forename: N J D
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: R G
authors.initials: RG
authors.lastname: Van der Meulen
authors.forename: P J
authors.initials: PJ
authors.lastname: Van den Broek
mesh_terms: D001291:Attitude of Health Personnel; D019983:Guideline Adherence / Q000706:statistics & numerical data; D063373:Hand Hygiene / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006509:Hepatitis B / Q000517:prevention & control; D006801:Humans; D007214:Indonesia; D017053:Infection Control / Q000592:standards*; D016602:Needlestick Injuries / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011482:Protective Devices; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data