A Structural Model of Hand Hygiene Compliance Factors among Hospital Nursesin Jember, Indonesia

Introduction: Healthcare-associated infections (HAIs) are a global epidemic that has yet to be addressed. The occurrence of nosocomial infections is strongly associated with hand hygiene compliance. With an increase in the latter, the occurrence of nosocomial infections decreases. The percentage of people who wash their hands is still low–between 35 % and 55.3 % in Indonesia and 54.7 % worldwide. Objective: To evaluate a structural model of hand hygiene compliance determinants among nurses in Indonesian hospitals. Perceived behavioral control, facility factors, and knowledge factors are some of the determinant factors. Materials and methods: The population in the study was nurses at Jember Regency hospitals in Indonesia. The sampling technique included a total sample of 116 nurses. The inclusion criteria used are nurses who provide direct service to the patient and are willing to respond. In this study, an exclusion clerk refers to a nurse who was on leave or engaged in academic studies at the time of data collection. Data was analyzed descriptively and inferentially using path analysis with the Structural Equation Model (SEM) and the Partial Least Squares (PLS) technique in SmartPLS software. Results: Hospital facilities become an important predictor of hand hygiene compliance (p < 0.05). The respondents agreed that the facilities available at the hospital were adequate, as demonstrated by high-grade response statements (61 %). Nurses’ awareness has a significant influence on hand hygiene compliance (p < 0.05), good knowledge leading to a positive perception of maintaining hand hygiene behaviours. The respondents’ level of knowledge of hand hygiene ranged from high (40 %) to low (34 %). Perceived behavioral control significantly affects hand hygiene behaviour (p < 0.05). Nurses with strong perceptions and beliefs about hand hygiene are more likely to have better hand hygiene performance. Respondent compliance with hand hygiene was high (60 %). The hospital facilities and nurse knowledge have a significant effect on perceived behavioral control with an explanatory factor of 36.4 %. All factors, namely hospital facilities, nurse knowledge, and perceived behavioral control were able to explain hand hygiene compliance by 45.2 %. Conclusions: Factors of knowledge and facilities play a crucial role in shaping perceived behavioral control in hand hygiene. These three influencing criteria have positively influenced hand hygiene compliance among nurses in Indonesian hospitals. The structural model provides insights that can be used to design more effective infection prevention strategies, especially in health care.