Predictors and Barriers to Standard Precaution Adherence Among Nurses in Jordan: A Multisectoral Cross‐Sectional Study
Omar Moh’d Alzyoud, Khalil Yousef, Ghadeer Al-Dweik, Abedalmajeed Shajrawi, Wegdan Bani-Issa, Nabeel Al-Yateem, Fatma Refaat Ahmed, Loai Abusharour, Vidya Seshan, Heba KhalilBackground
Nurses are at a heightened risk of healthcare‐associated infections due to continuous exposure to patients and invasive procedures. Adherence to Standard Precautions (SP) is the cornerstone of infection prevention; however, evidence consistently demonstrates suboptimal and variable compliance across clinical settings. This study aimed to assess SP adherence among nurses in Jordan and identify associated demographic, institutional, and perceived barrier factors.
Methods
A descriptive cross‐sectional study was conducted among 300 nurses recruited through convenience sampling from four hospitals, one from each of the public, military, private, and educational sectors. Data were collected using the validated Arabic version of the Infection Control Practices Tool, a self‐report measure. Statistical analyses included descriptive statistics, chi‐squared tests, point‐biserial correlations, and multiple linear regression.
Results
Adherence to SP was mixed across practices: while hand hygiene and glove use were consistently high, important gaps remained in mask use, gowning, and avoidance of needle recapping. According to the original instrument’s percentile‐based thresholds, 61% of participants were classified in the high‐adherence category and 39% in the weak‐adherence category; because these thresholds are not clinically validated safety benchmarks and adherence was self‐reported, the overall findings are interpreted as reflecting moderate‐to‐high self‐reported adherence with important practice gaps. Higher self‐reported adherence was significantly associated with working in intensive care and surgical units and with prior training in bivariate analyses ( p < 0.05), although training was not independently associated with adherence in the multivariable model. Multiple regression analysis among participants with complete data for all model variables ( n = 281) identified the sampled hospital/sector, category unit type, availability of an SP manual, and hepatitis B vaccination as factors associated with adherence, explaining 37.1% of the variance in adherence scores ( R 2 = 0.371, p < 0.001). Time constraints (35%), lack of personal protective equipment (21%), and workload (19%) were the most frequently reported perceived barriers.
Conclusion
Nurses in this Jordanian multisectoral sample reported moderate‐to‐high self‐reported adherence to SP overall, but critical gaps persist in specific practices. Organizational and system‐level factors were associated with adherence. Because adherence was self‐reported, actual compliance may be lower than reported, and hospital‐type differences may reflect the individual sampled hospitals rather than sector‐wide differences. Targeted interventions addressing resource availability, workload, and context‐specific training may help strengthen compliance and enhance patient and staff safety.