Development of a scale for nursing practices for the prevention of surgical site infection

Background: Surgical site infections are still a problem despite advances in sterilisation methods, surgical techniques and antibiotic prophylaxis. There is a need for measurement tools with confirmed validity and reliability to assist nurses to control and prevent surgical site infections, as nurses have the most contact with patients. Method: This descriptive cross-sectional study, with methodology in accordance with STROBE guidelines, was carried out in three phases. In the first phase, a draft scale consisting of 38 items was prepared. In the second phase, the draft scale was reviewed by ten experts and applied to 70 nurses in a pilot study. Three items were removed based on the expert evaluation and two more items were removed after analysis of the data from the pilot study, leaving the final scale with 33 items. In the third phase, the 33-item scale was applied to 320 nurses working in university hospitals and teaching and research hospitals. The reliability and validity of the scale were evaluated by data analysis and a test–retest analysis was carried out on 30 nurses. Results: The 33-item Nursing practices for the prevention of surgical site infections (NPPSSI) scale, with items scored using a 5-point Likert-type scale, was found through factor analysis to include two sub-dimensions – ‘asepsis-related practices’ and ‘patient-related practices’. Cronbach’s alpha was 0.88 for the scale as a whole, 0.87 for the ‘asepsis-related practices’ sub-dimension and 0.86 for the ‘patient-related practices’ sub-dimension. The mean total score was 187.43 ± 54.14 and the mean subscale scores were 107.21 ± 37.23 for asepsis-related practices and 80.22 ± 16.91 for patient-related practices. Conclusion: As a result of analysis and evaluation, the reliability and validity of the NPPSSI scale were confirmed. This scale can be used to determine nursing practices in the surgical area and to prevent surgical site infections.