A systematic review of knowledge assessment instruments for isolation precautions among health care personnel

Health care personnel (HCP) knowledge of isolation precautions (IPs) is essential for preventing health care-associated infections. HCP adherence to IP guidelines remains suboptimal worldwide, often due to knowledge gaps. Post-COVID-19 challenges highlight the need for standardized tools. This study systematically reviews IP knowledge instruments.

Following PRISMA guidelines, 5 databases were searched for studies published between 2007 and 2024. Eligible studies used instruments with more than 10 items covering Centers for Disease Control and Prevention-recommended domains. Instruments were evaluated for content coverage, psychometric properties, and methodological quality.

Twenty-seven studies met inclusion criteria. All instruments assessed standard precautions, while transmission-based precautions and fundamental elements were under-represented. A total of 608 items were identified, most focusing on personal protective equipment and hand hygiene. Response formats and scoring systems varied widely, with inconsistent benchmarks. Knowledge of transmission-based precautions was consistently lower than standard precautions. Only 14 studies (51.9%) reported both validity and reliability, indicating limited psychometric rigor. Few studies were high quality, though those published after 2020 showed modest improvement.

Current HCP IP knowledge instruments show significant variation, incomplete scope, and limited validation. Standardized tools with balanced coverage and stronger psychometric evaluation are needed to support education, enable comparability, and guide interventions in diverse health care settings.