Clostridium difficile knowledge in healthcare workers: conclusions in the absence of broader evaluation

A validated, knowledge-based questionnaire tool could provide the means for identification of risk factors associated with poor levels of knowledge, assist in targeting educational interventions, and provide measurable data on the impact of educational interventions.

Unfortunately, Aroori et al. failed to examine if data resulting from the questionnaire could discriminate populations with known differing levels of knowledge or if conclusions were valid in repeated sampling of healthcare worker populations elsewhere. Additionally, the questionnaire provides no clear conclusion/definition of what is an adequate level of knowledge, i.e. does anything less than 100% correct response deem a healthcare worker as possessing a lack of knowledge?

Previously, we assessed methicillin resistant Staphylococcus aureus knowledge in healthcare workers, both in a surgical trainee¹ and wider healthcare worker population in repeated sampling. We found questionnaire statements on policy could be UK-region specific and that knowledge levels needed to be judged against a broader healthcare worker population context. In addition, even populations with assumed high levels of knowledge (infection control nurses) did not achieve 100% correct answers.²

Until further validation, it is difficult to support the conclusions that the study findings are indeed ‘valid’ in reference to a presumed ‘significant lack of knowledge’ in wider consultant and nursing staff populations.³ This questionnaire can only ultimately comment on a local population, sampled at a specific time, and does not adequately define an appropriate level of knowledge.