Infection Control in Optometric Practice: Evaluating the Impact of Guidelines on Knowledge, Attitude and Practice Behaviours.

Abstract

Infection control (IC) is central to safe optometric care, yet little is known about optometrists' knowledge, attitudes and practice behaviours (KAP) in this domain. This study aimed to assess the IC-related KAP of Australian optometrists and to evaluate whether engagement with newly released IC guidelines could improve these measures. This study comprised two components: a cross-sectional survey of Australian optometrists' IC-related KAP (part A) and a pre-post intervention study assessing the impact of IC guidelines (part B). The survey, distributed in early 2021, included demographic items, KAP measures and explored perceived barriers to best practice and preferred educational resources. Knowledge was assessed using multiple-choice and true/false questions, while attitudes and behaviours were analysed using Rasch-scaled measures. Participants consenting to follow-up were randomised into control or intervention groups. The intervention group received updated IC guidelines before repeating the survey; the control group repeated the survey prior to guideline exposure. A total of 302 valid responses were analysed in part A. Respondents demonstrated moderate knowledge (mean 58%), supportive attitudes (median 79/100) and reported enacting IC behaviours in practice (median 64/100), although notable gaps were identified in areas such as tonometer disinfection and infectious disease exclusion periods. Barriers included insufficient time (47%), workplace support (29%) and equipment access (28%). Trusted sources of IC information were Optometry Australia, government advice and clinical guidelines. In part B (n = 73), the intervention group demonstrated significant improvements in knowledge (p < 0.01) and attitude (p = 0.02) compared with controls, although the attitude change was not clinically meaningful. No significant changes were observed in self-reported behaviours. Engagement with IC guidelines significantly improved knowledge among Australian optometrists but did not translate into behaviour change. Findings highlight the need for multifaceted, theory-informed implementation strategies that address environmental and motivational barriers, alongside provision of trusted resources, to embed evidence-based IC practices in optometry.