title: Infection control practice in the operating room: staff adherence to existing policies in a developing country.
abstract: BACKGROUND
  Infection control interventions are important for containing surgery-related infections. For this reason, the modern operating room (OR) should have well-developed infection control policies. The efficacy of these policies depends on how well the OR staff adhere to them. There is a lack of available data documenting adherence to infection control policies.
  
  
  OBJECTIVE
  To evaluate OR staff adherence to existing infection control policies in Jamaica.
  
  
  METHODS
  We administered a questionnaire to all OR staff to assess their training, knowledge of local infection control protocols, and practice with regard to 8 randomly selected guidelines. Adherence to each guideline was rated with fixed-choice items on a 4-point Likert scale. The sum of points determined the adherence score. Two respondent groups were defined: adherent (score > 26) and nonadherent (score ≤ 26). We evaluated the relationship between respondent group and age, sex, occupational rank, and time since completion of basic medical training. We used χ(2) and Fisher exact tests to assess associations and t tests to compare means between variables of interest.
  
  
  RESULTS
  The sample comprised 132 participants (90 physicians and 42 nurses) with a mean age of 36 (standard deviation ± 9.5) years. Overall, 40.1% were adherent to existing protocols. There was no significant association between the distribution of adherence scores and sex (p = 0.319), time since completion of basic training (p = 0.595), occupational rank (p = 0.461), or age (p = 0.949).Overall, 19% felt their knowledge of infection control practices was inadequate. Those with working knowledge of infection control practices attained it mostly through informal communication (80.4%) and self-directed research (62.6%).
  
  
  CONCLUSIONS
  New approaches to the problem of nonadherence to infection control guidelines are needed in the Caribbean. Several unique cultural, financial, and environmental factors influence adherence in this region, in contrast to conditions in developed countries.
authors.affiliation: Lecturer in the Department of Surgery at the University of West Indies in Port of Spain, Trinidad and Tobago. E-mail: socawich@hotmail.com.
authors.forename: Shamir O
authors.initials: SO
authors.lastname: Cawich
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Tennant
authors.forename: Clarence D
authors.initials: CD
authors.lastname: McGaw
authors.forename: Hyacinth
authors.initials: H
authors.lastname: Harding
authors.forename: Christine A
authors.initials: CA
authors.lastname: Walters
authors.forename: Ivor W
authors.initials: IW
authors.lastname: Crandon
mesh_terms: D000328:Adult; D002983:Clinical Competence; D002985:Clinical Protocols; D003428:Cross Infection; D003906:Developing Countries; D005260:Female; D019983:Guideline Adherence; D006291:Health Policy; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards*; D057226:Information Seeking Behavior; D007563:Jamaica; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009873:Operating Rooms / Q000592:standards*; D010820:Physicians; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires