This crossectional study assessed the self-reported compliance with SPs and the factors associated with it among nursing students. Findings of the current study showed that 56.3% with 95%CI (51.4,60.9) of the study participants were compliant with standard precautions.
The finding of this study is in line with studies conducted in Hong Kong 53.5% (27),in Croatia 58.4% (14) and in Saudi Arabia 60.1%, and 56.8% (12, 24) and in Nigeria 57.3 (31). Even though there is a difference in socioeconomic status and level of health sector development, the possible reason for the similarity might be the use of a similar tool and study design.
The finding was lower than studies conducted in South Korea 79.74% (32), 85% in Malaysia (33), Saudi Arabia 61%, and 84.8% (23, 34). The possible reason might be the difference in a hospital setting, sampling techniques, study population characteristics, the availability and accessibility of safety materials (clinical environment), curriculum, and socioeconomic differences. For example, in South Korea sampling techniques were convenient and included only final year nursing students. Additionally, there might be differences in teachers' close monitoring and following up of students during their clinical practices.
However, The result of this study was higher than a study conducted in South Korea 50.5% (13) and in Egypt, 15% of them had good compliance (35). This difference might be the study conducted in South Korea is in a single setting where the current study is a multicenter study and in Egypt sampling technique and sample size difference.
In this study the maximum compliance was on putting used sharp articles into sharps boxes. which is consistence with studies conducted in South Korea (19) and Whereas the lowest compliance in this study was disposing sharps box only when it is full, which is consistent with studies conducted in Croatia (20) and Saudi Arabia (30, 31).
Study participants with good knowledge were found to be 2.52 times more likely to comply with standard precautions as compared to nursing students with poor knowledge (AOR = 2.519, 95% CI = 1.609–3.943). This finding is consistent with the study done in Melanesia (36), China (17) and Iran (37), and Nigeria (38). The possible explanation could be, knowledge is a pre-requisite to appropriate behavioral change and a very important element for behavior change(39). This is also supported by literature that lack of knowledge is the major reason for non-compliance to standard precautions measures (40). So having good knowledge helps to implement standard precautions measures properly as recommended. On the other hand, the finding of the current study Contradicts with the studies in the Philippines (41), Malaysia (33), and South Korea (32) showed that no association between knowledge and compliance.
In the current study participants who had training or seminar related to standard precautions were found to be 1.52 times more likely to be compliant with standard precautions than those who had not taken any training or seminar in the last six months (AOR = 1.518, 95% CI = 1.008–2.288). The current result is consistent with previous literatures in Hong Kong, Saudi Arabia, and Jordan showed that individuals with proper training and education seminar-workshop in infection control are more compliant (17, 23, 24, 42). This might be justified as the fact that training and seminars can sensitize the knowledge of nursing students make them to comply with standard precaution measures. Which also supported by CDC recommendations that training is required for all health care providers to maintain competency and ensure that infection prevention policies and procedures are understood and followed (1).
Participants who perceived workplace climate as safe were found to be 2.15 times more likely to be compliant with standard precautions than those who perceived the workplace as unsafe (AOR = 2.147, 95% CI = 1.242–3.7121). This finding is consistent with the studies conducted in South Korea revealed that the higher the perception of a safe environment for standard precautions results the higher compliance with IPC practices (30, 32). The possible explanation could be well equipped and a safe environment is mandatory to accomplish tasks according to recommendations. Since Safe workplace climate is the shared perception of management for safety support and feedback regarding infection prevention and control in hospitals, including a supportive work environment as well as adequate infrastructure and resources(43). So the health facilities' infection prevention climate needs to be improved to increase students’ compliance with standard precautions.