Internal Validity And Its Effect On Students ' Attitudes On Elective And Inherent Hand Washing

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(including reverse coded items) to measure HCPs’ attitudes regarding elective and inherent hand washing. Longtin, Sax, Allegranzi, Hugonnet, and Pittet (2009) did not describe the Likert scale used to measure participants’ beliefs and perceptions of their participation to increase HCPs’ HH adherence. Validity Polit and Beck (2012) define validity as “a quality criterion referring to the degree to which inferences made in a study are accurate and well-founded; in measurement, the degree to which an instrument measures what it is intended to measure” (p. 745). Internal Validity Polit and Beck (2012) define internal validity as “the degree to which it can be inferred that the experimental intervention (independent variable), rather than the uncontrolled, extraneous factors, is responsible for the observed effects “(p. 731). A common threat to internal validity was failure to control or rule out confounding or extraneous variables. For example, Liu, Liang, Wu, and Chuang (2014) and Ellingson et al. (2014) found understaffing and workload correlated to HH nonadherence. Factors such as changes in related institutional policies and procedures or local public health trends may affect results. For example, Vernaz et al.’s (2008) study occurred at same time as another HAI initiave. Although nine studies included self report which may not be a reliable measurement leading to statistical regression. However, seven of these studies validated self report with direct observation.

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