Construction and validation of instrument to assess the quality of infection control programs

Alvim, André Luiz Silva; Gazzinelli, Andrea; Couto, Bráulio Roberto Gonçalves Marinho

doi:10.1590/1983-1447.2021.20200135

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Original Article • Rev. Gaúcha Enferm. 42 • 2021 • https://doi.org/10.1590/1983-1447.2021.20200135 copy

Construction and validation of instrument to assess the quality of infection control programs

Construcción y validación del instrumento para evaluar la calidad de los programas de control de infecciones

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To build and validate an instrument to assess hospital infection control programs.

Method:

Methodological study that was developed in seven stages. The instrument items were categorized into the structure, process and result components. 10 expert judges participated, who evaluated the psychometric properties and validated the content using the Likert scale. The pre-test was carried out with 98 health professionals, from April to July 2018. For reliability analysis, Cronbach's alpha test was used.

Results:

Regarding the content validity index, the score made by expert judges ranged from 0.777 to 1.00, with mean of 0.902 (± 0.076). The Cronbach's alpha test showed good internal consistency of the items (0.82).

Conclusion:

An instrument to assess hospital infection control programs was developed and validated, which showed good reliability and can be efficiently used at national level.

Keywords:
Validation study; Cross infection; Health services research; Infection control

Participants	Equivalent or absolutely equivalent items*	Non-equivalent items	Content Validity Index (CVI)
Expert Judge 01	36	0	1.00
Expert Judge 02	30	6	0.833
Expert Judge 03	34	2	0.944
Expert Judge 04	34	2	0.944
Expert Judge 05	31	5	0.861
Expert Judge 06	31	5	0.861
Expert Judge 07	29	7	0.805
Expert Judge 08	32	4	0.888
Expert Judge 09	36	0	1.00
Expert Judge 10	34	2	0.944
Mean	32	3	0.908
Standard deviation	3	2.3	0.064

Item description	Scale mean, if item was excluded	Scale variance, if item was excluded	Corrected correlation between item and total	Alpha, if the item was excluded
Question 1	23.83	24.866	0.422	0.808
Question 2	23.27	26.005	0.278	0.813
Question 3	23.25	25.762	0.398	0.810
Question 4	23.68	24.236	0.519	0.803
Question 5	23.16	26.948	0.094	0.817
Question 6	23.51	26.181	0.129	0.820
Question 7	23.20	26.623	0.162	0.816
Question 8	23.25	25.802	0.368	0.811
Question 9	23.22	26.633	0.132	0.817
Question 10	23.25	26.262	0.219	0.815
Question 11	23.31	25.825	0.293	0.813
Question 12	23.29	25.677	0.354	0.811
Question 13	23.26	25.452	0.464	0.808
Question 14	23.89	25.635	0.276	0.813
Question 15	23.38	24.715	0.514	0.805
Question 16	23.93	25.641	0.293	0.813
Question 17	23.25	26.067	0.281	0.813
Question 18	23.54	24.888	0.394	0.809
Question 19	23.22	25.872	0.426	0.810
Question 20	23.56	24.903	0.385	0.809
Question 21	23.73	24.713	0.424	0.808
Question 22	23.58	24.069	0.56	0.802
Question 23	23.47	24.375	0.528	0.803
Question 24	23.40	24.738	0.487	0.806
Question 25	23.45	27.223	-0.080	0.827
Question 26	23.43	26.194	0.141	0.819
Question 27	23.58	25.874	0.183	0.818
Question 28	23.27	25.81	0.337	0.812
Question 29	23.62	25.494	0.257	0.815
Question 30	23.35	24.902	0.493	0.806
Question 31	23.51	26.535	0.057	0.822
Question 32	23.62	25.529	0.250	0.815
Question 33	23.25	26.842	0.039	0.819
Question 34	23.27	26.005	0.278	0.813
Question 35	23.58	24.069	0.560	0.802
Question 36	23.16	26.948	0.094	0.817

Structure
(1) Does your region have a Central Public Health Laboratory (CPHL)?	Yes	Partially	No
(2) Does your institution have its own microbiology laboratory or a third party?	Yes	Partially	No
(3) Is there basic sanitation in your health service region?	Yes	Partially	No
(4) Do you consider that there is adequate ventilation in your institution?	Yes	Partially	No
(5) Does your work institution periodically monitor water quality?	Yes	Partially	No
(6) Does your work institution periodically monitor air quality?	Yes	Partially	No
(7) Does your institution have a HICC and HICS structured in accordance with current legislation?	Yes	Partially	No
(8) Does the structure of your institution contribute to hand hygiene effectively?	Yes	Partially	No
(9) Are there sinks and/or dispensers for alcohol and/or liquid soap at all service points?	Yes	Partially	No
(10) Does your institution have a Health Solid Waste Management Program (HSWMP) described and validated?	Yes	Partially	No
(11) Is there an overcrowding of patients in your work institution?	Yes	Partially	No
(12) Do you consider that the health professionals that compose the multidisciplinary team are overloaded?	Yes	Partially	No
(13) Does your institution have at least 1 (one) meter of bed spacing between patients?	Yes	Partially	No
(14) Do you consider that your institution has an adequate structure to serve patients during an epidemic or pandemic?	Yes	Partially	No
(15) Does your institution adopt cohort isolation for patients under specific precautions?	Yes	Partially	No
Process
(16) The patient safety protocols are implemented at the institution?	Yes	Partially	No
(17) Does HICS know and validate the cleaning and disinfection protocols for surfaces?	Yes	Partially	No
(18) Does your institution perform cleaning, preparation, sterilization, disinfection and storage of health products?	Yes	Partially	No
(19) Do HICS professionals develop protocols based on scientific evidence?	Yes	Partially	No
(20) Do stakeholders (strategic public) participate in the elaboration of HICS protocols and guidelines?	Yes	Partially	No
(21) What criterion does HICS adopt for surveillance of HAIs?	ANVISA	NHSN	Other/ none
(22) What surveillance method does HICS adopt?	Prospective	Transversal	Retrospective
(23) Does your institution monitor the use of antibiotics through an Antimicrobial Use Management Program?	Yes	Partially	No
(24) Has your institution implemented protocols on standard, contact, droplet and aerosol precautions?	Yes	Partially	No
(25) Does your institution implement the multimodal strategy for improving hand hygiene?	Yes	Partially	No
(26) Does your institution have other multimodal strategies related to the prevention and control of HAIs?	Yes	Partially	No
(27) Do medical professionals actively participate in the training defined by HICS?	Yes	Partially	No
(28) Does the nursing team actively participate in the training defined by the HICS?	Yes	Partially	No
(29) Does the physiotherapy team actively participate in the training defined by HICS?	Yes	Partially	No
(30) Do administrative professionals and the management team receive training from HICS?	Yes	Partially	No
(31) Does HICS conduct sectoral audits periodically in the assistance sectors?	Yes	Partially	No
Result
(32) Does the HICS identify outbreaks in a timely manner through infectious indicators and establish control measures?	Yes	Partially	No
(33) Are the results of the bundles disclosed to your institution for the prevention and control of HAIs?	Yes	Partially	No
(34) Does the HICS carry out a survey of the Health Care Related Infection indicators and disclose it widely to the entire institution?	Yes	Partially	No
(35) Does the HICS prioritize problems based on the Health Care Related Infection indicators?	Yes	Partially	No
(36) Do HICS professionals periodically provide feedback on infectious indicators to the multidisciplinary team?	Yes	Partially	No

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
André Luiz Silva Alvim Email: andrealvim1@hotmail.com