Medicolegal knowledge and observed personal protective equipment compliance among hospital laboratory staff in Boyolali, Indonesia: a cross-sectional study

Abstract

Background. Compliance with personal protective equipment (PPE) in hospital laboratories is often incomplete. Whether staff knowledge of the legal consequences of unsafe practice is associated with observed PPE use has not been examined in Indonesian laboratories.

Objective. To examine the association between medicolegal knowledge of occupational safety and health and observed PPE compliance among hospital laboratory staff.

Methods. This single-centre cross-sectional study was conducted at a private secondary hospital in Boyolali, Indonesia, over three months in 2024. A random sample of 120 of 150 laboratory staff completed the 25-item Medicolegal Implication Knowledge Scale (MIKS). Auditors covertly observed gloves, mask, coat and closed shoes in 10 shifts per participant. Full tier-1 bundle compliance was correct use of all four items in at least 80% of shifts. Associations were tested with chi-square or Fisher exact tests and logistic regression.

Results. Full tier-1 bundle compliance was 60.0% (72/120). It was 80.0% (48/60) among staff with high MIKS scores and 40.0% (24/60) among those with low scores (crude odds ratio 6.00, 95% CI 2.68–13.42). After adjustment, high MIKS score (adjusted odds ratio 3.36, 95% CI 1.48–7.64) and female sex (adjusted odds ratio 2.72, 95% CI 1.35–5.48) were associated with higher odds of compliance. Eye protection was the least-used audited item (35.0% compliant) and gloves the most used (85.0%).

Conclusion. In this hospital, higher medicolegal knowledge was associated with higher observed PPE compliance. The design cannot show that legal education improves compliance. Interventional studies and attention to eye protection are needed.