Development and psychometric properties of an instrument to evaluate missed nursing care in home care: A validation study.

OBJECTIVE: To develop and validate a questionnaire to evaluate missed nursing care (MNC) in a home care setting. DESIGN: A new instrument was developed and tested performing a preliminary analysis of a multicenter cross-sectional study in Italy. Reporting was performed according to COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines. SAMPLE: Eight hundred out of a total of 2549 home care nurses enrolled in AIDOMUS-IT were considered for the validation of the Missed Nursing Care in Home Care (MNC_HC). MEASUREMENTS: The MNC_HC instrument was developed by a panel of experts and underwent content and face validation. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. RESULTS: EFA revealed a one-factor solution, explaining 56% of the total variance for MNC_HC. CFA confirmed excellent structural validity, with a one-factor model showing an exceptional fit (χ2 (27) = 141.39, p < .001, RMSEA = 0.04, SRMR = 0.04, CFI = 0.99, TLI = 0.99, factor loadings > 0.5). MNC_HC also demonstrated high reliability (Cronbach's α = 0.92). The activity with the highest rate of missed care was the documentation of nursing care (77%), while activities related to nursing techniques (e.g., injections, dressings, etc.) were reported to be missed less (33.63%). CONCLUSIONS: MNC_HC is a quick-filling, valid, reliable, and psychometrically sound instrument for measuring MNC in home care useful for future research.

The impact of gender on the nursing figure and nurses' interprofessional relationships: A multimethod study.

AIMS: To identify the current presence of stereotypes about the nursing profession in Italy and to understand how gendered processes and modalities are regulated and expressed in the physician-nurse dyad, and the implications for professional identity and autonomy. DESIGN: Qualitative multimethod design. METHODS: Forty-five interviews were conducted with nurses and physicians. The collected qualitative data underwent automatic textual data analysis using a multidimensional exploratory approach and a gender framework analysis. RESULTS: In Italy, nurses' roles are still associated with gender stereotypes stemming from the predominant male culture, which affects sexual and gender identity, the division of labor, and access to career paths. This leads to disadvantages in the nursing profession, which is heavily dominated by women. CONCLUSION: Biological differences between sexes generate an unconscious yet shared symbolic gender order composed of negative stereotypes that influence nurses' professional roles and activities. They follow behaviors that enter the work routine and institutionalize organizational processes. These effects are also seen in the asymmetric, limited, and reciprocal interprofessional relationships between male physicians and female nurses, where the former hinders the latter's professional autonomy and access to top positions. IMPLICATIONS FOR THE PROFESSION: This survey raises awareness of gender issues and stimulates reflection. It also enables health and nursing organizations to take action to raise gender awareness and education by countering the image of a non-autonomous profession. The analysis of gender processes allows us to identify interventions that can counteract forms of oppression in the work environment that lead to the emergence of nursing as a non-autonomous profession.

The Usefulness of Virtual Reality in Symptom Management during Chemotherapy in Lung Cancer Patients: A Quasi-Experimental Study.

Background: Virtual reality (VR) emerges as a promising non-pharmacological intervention for managing symptoms and providing distraction during chemotherapy. This study aims to assess VR's effectiveness on cancer-related symptoms, vital signs, and the patients' perception of chemotherapy in lung cancer patients. Methods: A quasi-experimental study was conducted on 100 patients. Participants were allocated into an intervention group (n = 55), which experienced immersive VR, and a comparison group (n = 45), which received usual care. Data were collected through questionnaires and checklists, including feedback on the VR experience, pain, vital signs, and common cancer symptoms, assessed through the Edmonton Symptom Assessment Scale. Results: VR had a significant impact on reducing the perception of chemotherapy length. Patients reported high levels of satisfaction and tolerability. No adverse events were observed. VR did not have significant influence on pain intensity or vital signs. The only exceptions were oxygen saturation, where a significant difference (p = 0.02) was reported, and the perception of chemotherapy duration. Conclusions: As a non-pharmacological intervention, VR proves to be beneficial in minimizing the perceived length of chemotherapy sessions for lung cancer patients, enhancing their overall treatment experience. The intervention was found to be a safe, feasible, and well-accepted distraction technique. Future research should explore VR's potential effects on a wider range of symptoms and evaluate its impact on long-term outcomes.

Workload of home care nurses: Italian adaptation, validity, and reliability of the National Aeronautics and Space Administration Task Load Index questionnaire.

The aim of this study was to adapt the National Aeronautics and Space Administration Task Load Index (NASA-TLX) to the home care setting and translate and validate it in Italian. An online questionnaire containing the Italian version of the NASA-TLX adapted to the home care setting was administered to home care nurses to measure workload. Content Validity Index, Exploratory, and Confirmatory Factor Analyses were used to measure the psychometric characteristics of the modified NASA-TLX. The modified Italian version of NASA-TLX_HC-IT showed good psychometric characteristics in measuring the workload of home care nurses, with excellent fit indices. The reliability, calculated with Cronbach's alpha, was 0.73, indicating adequate reliability. A negative correlation between workload and job satisfaction among home care nurses, as well as a positive association between high workload and intention to leave the workplace, was verified. The modified Italian version of the NASA-TLX_HC-IT was confirmed to be a valid and reliable instrument to measure workload in home care nursing. Furthermore, the correlation between workload and the intention to leave the workplace among home care nurses was an important result that community nursing managers should consider preventing the shortage of home care nurses.

Community health services in European literature: A systematic review of their features, outcomes, and nursing contribution to care.

BACKGROUND: To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored. INTRODUCTION: Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing-related determinants of outcomes. METHODS: A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856). RESULTS: Twenty-three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services' effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long-term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated. DISCUSSION: Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models. CONCLUSIONS AND IMPLICATIONS FOR HEALTH POLICY: Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.

Exploring Burnout among Nursing Students in Bangalore: A t-Distributed Stochastic Neighbor Embedding Analysis and Hierarchical Clustering in Cross-Sectional Data.

This study explores burnout among nursing students in Bangalore, India, focusing on Exhaustion and Disengagement scores. A cross-sectional design was applied using the Oldenburg Burnout Inventory modified for nursing students, collecting data using a survey that was conducted between October and December 2023. The sample consisted of 237 female nursing students from the Bachelor of Science in Nursing program at Bangalore College of Nursing, South India. The study integrated the t-distributed Stochastic Neighbor Embedding (t-SNE) procedure for data simplification into three t-SNE components, used in a hierarchical clustering analysis, which identified distinct student profiles: "High-Intensity Study Group" and "Altruistic Aspirants". While burnout scores were generally high, students with high study hours ("High-Intensity Study Group") reported greater Exhaustion, with a mean score of 26.78 (SD = 5.26), compared to those in the "Altruistic Aspirants" group, who reported a mean score of 25.00 (SD = 4.48), demonstrating significant differences (p-value = 0.005). Conversely, those motivated by altruism ("Altruistic Aspirants") showed higher Disengagement, with a mean score of 19.78 (SD = 5.08), in contrast to "High-Intensity Study Group", which reported a lower mean of 17.84 (SD = 4.74) (p-value = 0.002). This segmentation suggests that burnout manifests differently depending on the students' academic load and intrinsic motivations. This study underscores the need for targeted interventions that address specific factors characterizing the clusters and provide information for designing future research and interventions. This study was not registered.

Empowering Nurse Health Education: Linguistic and Cultural Validation of the Nurse Health Education Competence Instrument (NHECI) in the Italian Context.

BACKGROUND: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context. METHODS: Following Beaton et al.'s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. RESULTS: The Italian version demonstrates a good internal consistency and stability, making it suitable for assessing nursing students during clinical internships and practicing nurses. The availability of Italian tools promotes healthcare research, ensuring patient-centric care. CONCLUSIONS: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

An Observational Cross-Sectional Analysis of the Correlation between Clinical Competencies and Clinical Reasoning among Italian Registered Nurses.

Ability, knowledge, aptitude, and skill are the terms identified in the literature as the attributes of the concept of clinical competence. This implies that in order to act competently in their own context, the nurse must be able to make decisions which mainly depend on the ability to put clinical reasoning into practice. However, the evaluation of clinical reasoning in the various clinical-care activities of nursing competence is a necessary operation to prevent routine attitudes. From the perspective of an assessment of nursing competences, the aim of this study is to validate the relationship between the degree of competence recognized in a specific clinical setting and the amount of clinical reasoning executed by nurses. The study design was a cross-sectional observational design, following the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) of observational studies. Both the Italian Nurse Competence Scale and the Nurse Clinical Reasoning Scale were used. The data was collected between 25 January and 5 March 2022. Four hundred twenty-four clinical nurses participated by completing and returning the questionnaires. The instruments underwent assessment to ensure internal consistency and test-retest reliability. Their validity was tested with the validity of known content, construct, and groups. This is supported by statistically significant correlations between the different variables examined and the scores of the different dimensions of the Italian Nurse Competence Scale and the Italian Nurse Clinical Reasoning Scale. The data collected showed an excellent average level of competencies and clinical reasoning, M = range of 72.24 and 63.93, respectively. In addition, we observed satisfactory scores across all dimensions of I-NCS (significance range: 0.000-0.014) and I-NCRS (significance range: 0.000-0.004). The understanding and development of clinical reasoning has also brought out new aspects that require further research. This study provides a fresh perspective on the correlation between clinical competences and clinical reasoning, representing a novel attempt to analyze their relationship.

Decoding Nursing Job Demands: A Multicenter Cross-Sectional Descriptive Study Assessing Nursing Workload in Hospital Medical-Surgical Wards.

Background: Nursing workload is largely studied but poorly explored under physical, mental, and emotional dimensions. Currently, only a limited number of variables have been linked to nursing workload and work contexts. Purpose: The study aimed to investigate whether it is feasible to identify variables that consistently correlate with nursing workload and others that are specific to the context. Methods: We employed a descriptive correlational analysis and a cross-sectional design. Data were collected through a survey distributed to registered nurses working across Italy, at the conclusion of randomly assigned morning or afternoon shifts. Results: We received 456 surveys from 195 shifts, collected from nurses in four public and two private hospitals. Commonly associated variables with nursing workload dimensions included patient complexity of care, admission/discharge or transfer, informing patients/relatives, contacting physicians, and unscheduled activities. Variables categorized as setting-specific were patient isolation and specialties, nurse-to-patient ratio, adequacy of staff in the shift, peer collaboration, healthcare documentation, educating others, and medical urgency. Conclusions: In summary, certain variables consistently correlate with nursing workload across settings, while others are specific to the context of care. It is imperative for nurses and nurse managers to measure the nursing workload in various dimensions, enabling the prompt implementation of improvement actions.

Working conditions, missed care and patient experience in home care nursing in Italy: An observational study.

INTRODUCTION: The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described. OBJECTIVES: To describe the characteristics of nurses and care recipients involved in home care. METHODS: A descriptive cross-sectional study conducted in 18 Italian Regions. Between April and October 2023, data from nurses and patients involved in home care were collected through two surveys. Psychosocial conditions in workplaces, missed care, and care experiences were assessed using validated tools. Descriptive statistics and Pearson's correlations were performed. RESULTS: A total of 46 local healthcare units were included in this study, with a total of 2549 nurses and 4709 care recipients. Nurses (mean age 46.60; 79.48% female; 44.68% regional nursing diploma as the highest qualification) reported good working conditions (42.37; SD = 12.25; range = 0-100) and a high mean number of missed care activities (5.11; SD = 3.19; range 0-9). Most nurses (83.41%) reported high levels of job satisfaction, while 20.28% intended to leave their job. Patients (mean age 75.18; 57.57% female; 36.95% primary school), on the other hand, rated positively the care they had received (8.23; range = 0-10). CONCLUSIONS: Despite the perception of critical issues at work and some missed care, satisfaction in nurses and patients was high. These data constitute a preliminary snapshot of the studied phenomena, which will be investigated through more in-depth analyses.

Factors Influencing Generation Z Bachelor of Nursing Students' Decision to Choose Nursing as a Career: A Pilot Study.

Introduction: Despite nurses representing the largest healthcare professional group, the number is not enough for global health coverage. Understanding Generation Z students' intrinsic and extrinsic motivations, internal and external influences, and beliefs in choosing nursing education is crucial. This knowledge empowers universities to enhance nursing program enrollment through targeted promotion and recruitment strategies. Objective: The aim was to understand why Italian students of Generation Z choose the Nursing Degree Course. Methods: In this pilot study, a cross-sectional design was used. A survey with closed and open answers analyzing demographics, opinions, and motivations among new enrolled nursing students was administered on the first day of the Bachelor of Nursing Degree course. Descriptive statistics were used. Quantitative data were analyzed with Chi-square and ANOVA tests and qualitative data underwent content analysis and coding. Correlation analysis explored relationships between qualitative and quantitative results. Results: Forty first-year students (85% female, average age 22) completed the questionnaire. The choice of the degree pathway, as the first or second option, is influenced by intrinsic and extrinsic motivations, the student's opinions, and family and social influences. Significant positive and negative associations were evidenced. Negative factors affecting choice included location and the responsibility for nursing care, while positive factors included role models, family advice, passion, curiosity for healthcare, the desire to help others, and family influences on decision-making. Conclusions: Among Italian generation Z students, the choice of the nursing degree pathway is influenced by social models, family advice, passion, the desire to help others, and curiosity. Universities should be more proactive in their recruitment and promotion efforts, transforming these events into vibrant meeting points for professionals from diverse nursing specialties. They should also implement robust information policies that highlight career possibilities spanning clinical practice, management, education, and research areas within the field.

Self-Perceived Clinical Competence of Nurses in Different Working Experiences: A Cross-Sectional Study.

BACKGROUND: Competence is an essential concept for measuring nurses' performance in terms of effectiveness and quality. To this end, our analysis highlighted the process of acquiring competencies, their self-evaluation into clinical practice, and how their proficiency levels change throughout the nursing career. In detail, this research explored nurses' perceived level of competence and the factors that influence it in different contexts. METHODS: A cross-sectional survey using a structured questionnaire to assess the nursing participants' perception of their competencies in different clinical settings was accomplished. RESULTS: A descriptive and bivariate analysis was performed on 431 nurses. Most respondents assessed their level of competence to be higher than their roles required. The Kruskal-Wallis test confirmed that nursing experience was a relevant factor influencing nursing competencies. CONCLUSIONS: We suggest improving the competence of practicing nurses, using experience as a measurable effect of their development.

Describing the readiness for interprofessional education among university students attending healthcare programs: insights from a monocentric cross-sectional study.

BACKGROUND AND AIM: Readiness for interprofessional education (IPE) was recognized by international authorities as a key approach for educating students attending healthcare programs. Thus far, there are no descriptions of readiness for IPE in the Albanian context. For this reason, this study aimed to describe readiness for IPE, assessed by measuring "teamwork and collaboration" and "positive professional identity, roles, and responsibilities" among students attending healthcare programs in an Italian-speaking university based in Albania, and describe the correlations between readiness for IPE and the characteristics of the respondents. METHODS: This study had a descriptive observational design, a cross-sectional data collection, and a convenience sampling procedure performed in a single centre. The study was accomplished between April 2020 and June 2021, involving 688 students, 38.2% of the entire population of students attending healthcare programs in the context of the investigation. RESULTS: The teamwork and collaboration mean score was 4.40 (standard deviation = 0.56), and no differences were found between programs (p-value=0.159). The positive professional identity, roles, and responsibilities mean score was 4.33 (standard deviation = 0.64) with no differences between programs (p-value=0.340). Females attending nursing or midwifery reported higher positive professional identity, roles, and responsibilities scores (p-value=0.020), and females in dentistry reported higher teamwork and collaboration scores than males (p-value=0.045). CONCLUSIONS: Future research should evaluate readiness for IPE longitudinally to ascertain its trajectories over time and analyze any potential individual- or organizational-level variables that may impact IPE and sex-related differences regarding factors influencing IPE.

Assessment of the Psychometric Characteristics of the Italian Version of the Nurse Manager Actions Scale.

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses' autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items' scalability as well as the scale's validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar-Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar-Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage.

An Observational Cross-Sectional Study on the Correlation between Professional Competencies and Self-Efficacy in Albanian Registered Nurses.

(1) Background: The assessment and application of registered nurses' professional skills are essential to providing quality and safe care. Self-efficacy can positively affect the professional competence of registered nurses. This study analysed professional competence and its association with self-efficacy among registered nurses. (2) Methods: A cross-sectional observational study was conducted. The sampling was conventional. The data collection took place through the Albanian version of the Nurse Professional Competence Scale Short Form (A-NPCS-SF), which was used to assess their professional skills, and the Albanian version of the Nursing Profession Self-Efficacy Scale (A-NPSES), which was used to assess their self-efficacy. The study was based on a convenience sample of 985 registered nurses from the 12 Albanian provinces. (3) Results: The Cronbach alpha value for the A-NPCS-SF scale was 0.947, while for the A-NPSES scale, it was 0.875, proving both scales to be reliable. Self-efficacy does not play an essential role in the development of the professional competence of registered nurses since our survey found only one dimension correlates with these two elements. (4) Conclusions: The results of our analysis have instead highlighted the importance of a close relationship between job satisfaction and the development of professional skills.

Translation, validation and psychometric properties of the Albanian version of the Nurses Professional Competence Scale Short form.

BACKGROUND AND AIM: The primary aim of this study was the translation and psychometric validation of the Albanian Nurse Professional Competence Scale Short Form (A-NPCS-SF) for further application in Albanian healthcare settings. METHODS: The multiphase design used to develop the A-NPCS-SF comprised (1) cultural and linguistic validation, (2) content and face validity, and (3) construct validity. RESULTS: The A-NPCS-SF showed adequate content validity. Confirmatory factor analysis supported the six-factor structure of the A-NPCS-SF to explain the data obtained from the nurses. CONCLUSIONS: The A-NPCS-SF showed evidence of validity and reliability in measuring four professional competencies. Having an appropriate scale in Albanian for professional competence self-assessment by nurses constitutes an essential step in measuring these competencies.  (www.actabiomedica.it).

Development and Validation of the Nursing Care and Religious Diversity Scale (NCRDS).

(1) Background: In response to the impact of religious intervention on health outcomes and the importance of documenting how nurses experience the spiritual need of 392 hospitalized patients, it is vital to provide the nursing profession with instruments to evaluate these spiritual aspects. This study describes the development and validation of the Nursing Care and Religious Diversity Scale (NCRDS); (2) Methods: A two-step design was used for NCRDS translation and psychometric validation. The tool design was developed in the first step, while the psychometric characteristics were tested in the second step. An inductive study was conducted to test the validity and reliability of the NCRDS tool. The overall sample consisted of 317 nurses; (3) Results: The final instrument comprised 25 items in five dimensions. The construct validity indicated five dimensions. The face and content validity were adequate. Test-retest reliability displayed good stability, and internal consistency (Cronbach's α) was acceptable (0.83); (4) Conclusions: Initial testing of the NCRDS suggested that it is a valid and reliable instrument to evaluate individuals in religious diversity, with five dimensions for evaluating the meaning of spirituality and individual belief, the religious healthcare environment, educational adequacy, spiritual and religious needs, and religious plurality.

Psychometric Properties of the Italian Version of the Leader Member Exchange Scale (LMX-7): A Validation Study.

For decades, scholars have studied leader-member exchange (LMX) relationships to understand and explain the effects of leadership on follower attitudes and performance outcomes within work settings. One available instrument to measure these aspects is the LMX-7 scale. This measurement has been widely used in empirical studies, but its psychometric properties have been poorly explored. The aim of this study was to test the psychometric characteristics (content, structural and construct validity, and reliability) of the Italian version of the LMX-7 scale and to support its cultural adaptation. We used a cross-sectional multi-center design. The forward-backward translation process was used to develop the Italian version of the scale. The scale was administered through an online survey to 837 nurses and nurse managers working in different settings. The factorial structure was tested using both exploratory and confirmatory factor analyses (EFA and CFA), and reliability was evaluated using Cronbach's alpha. For the construct validity, we used hypothesis testing and differentiation by known groups. The Italian version of the LMX-7 scale presented one dimension. All the psychometric tests performed confirmed its validity and suggested its usefulness for future research.

Psychometric Evaluation of the Nurse Clinical Reasoning Scale (NCRS): A Validation Study Among Italian Nurses.

Background and Purpose: Clinical reasoning for nurses is considered a valuable component of clinical nursing competencies, but there are few tools to ascertain this. This study tested the Italian Nurses Clinical Reasoning Scale (I-NCRS) psychometric properties based on Levett-Jones' theoretical clinical reasoning model. Methods: Content, face, and construct characteristics were ascertained for their validity. The study had a two-phase design: (a) content and face validity and (b) construct validity. Results: Three factors emerged from the factorial analysis of our reference sample: nursing problems of health, nursing information of health, and nursing assessment of health. Conclusions: The scale represents a valuable tool for the self-assessment of the clinical reasoning skills of nurses. I-NCRS showed evidence of validity and reliability, being also useful for assessing clinical reasoning for educational and research purposes among Italian nurses.

Evaluation of Standard Precautions Compliance Instruments: A Systematic Review Using COSMIN Methodology.

BACKGROUND: Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals' compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. METHODS: We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. RESULTS: Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. CONCLUSIONS: The available instruments that measure healthcare professionals' compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.