Self-leadership and hand hygiene compliance: Building a hygiene culture from within nurses

Background: Healthcare-associated infections continue to pose a significant threat to patient safety, and hand hygiene practices remain an effective preventive measure. Despite global campaigns, nurse compliance often remains substandard. Previous research has focused on technical and environmental factors; however, the influence of internal psychological aspects, such as self-leadership, has been rarely studied, particularly in Indonesia. Increasing compliance depends not only on external interventions but also on empowering nurses’ motivation and self-regulation. Objective: This study aims to determine the relationship between self-leadership and hand hygiene compliance among inpatient nurses. Materials and Methods: A quantitative correlational design with a total sample of 88 nurses was used. Self-leadership was measured using the Abbreviated Self-Leadership Questionnaire, and compliance was assessed through direct observation based on the World Health Organization “5 Moments for Hand Hygiene” guidelines. Data analysis was conducted descriptively and using the Chi-square test. Results: The results showed that 54.5% of nurses had high self-leadership, but only 29.5% were compliant with hand hygiene procedures. The Chi-square test showed a significant relationship between self-leadership and compliance ( χ 2 = 7.453; P = 0.006). Conclusion: Higher self-leadership correlates with better compliance; however, low overall compliance indicates an intention-behaviour gap. Therefore, integrating self-leadership training with organisational support is necessary to strengthen the patient safety culture.