Universal to standard precautions in disease prevention: Preliminary development of compliance scale for clinical nursing

Simon C. Lam

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)


Background: The Center for Disease Control and Prevention revised the infection control practice from Universal Precautions to Standard Precautions in 1996. Although the practice of Standard Precautions has been implemented for almost 15 years in clinical settings, recent local research still adopts the Universal Precautions Scale to measure the compliance with the current infection control practice of general frontline nursing staff and students. Despite the scale's sound psychometric properties, that its items may not be sensitive and comprehensive enough to reflect the current compliance of frontline staff to Standard Precautions is questionable. Aim: The present study aims to develop a Compliance with Standard Precautions Scale (CSPS) for use by the general frontline nurses and nursing students in clinical settings. Methods: The current study employed a recognized instrumentation design. In addition, a preliminary assessment of reliability and validity was described. The CSPS was developed through the modification of the Universal Precautions Scale through five steps: reviewing the infection control guidelines, modifying the items of the Universal Precautions Scale, examining the relevance and adequacy of new items by an expert panel, verifying the linguistic and grammatical issues, and examining the understandability of the items and acceptability of the entire instrument by stakeholders. Internal consistency was examined using Cronbach's alpha statistic. Results: The original 15-item Universal Precautions Scale was revised to the 20-item CSPS, in which 13 items were revised in wording and concept, 2 items were deleted, and 7 items were added. The 20-item new scale obtained the overall content validity index of 0.90, and 100% understandability and acceptability in face validity, and Cronbach's alpha of 0.73. Conclusion: With the explicit justification on each generated item and the satisfactory results of the psychometric testing, the CSPS is a preliminary reliable and valid instrument in measuring the compliance with Standard Precautions of frontline nurses and nursing students in clinical settings.

Original languageEnglish
Pages (from-to)1533-1539
Number of pages7
JournalInternational Journal of Nursing Studies
Issue number12
Publication statusPublished - Dec 2011


  • Clinical nursing
  • Infection control
  • Psychometric testing
  • Scale development
  • Standard precautions


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