Efektivitas Pelatihan Kebersihan Tangan Terhadap Kepatuhan Five Moments Pada Tenaga Kesehatan di Fasilitas Pelayanan Kesehatan

ABSTRACT Hand hygiene is the single most cost-effective measure to prevent healthcare-associated infections (HAIs), yet compliance with the World Health Organization (WHO) Five Moments remains persistently low, particularly in low and middle-income settings. To assess the effectiveness of a structured, multimodal hand hygiene training program in improving healthcare workers’ compliance with the Five Moments protocol at Siti Hajar Islamic Hospital, Mataram, Indonesia. A quantitative one-group pre–post quasi-experimental design involving 120 healthcare workers (nurses, physicians, midwives, and other clinical staff). Compliance was measured through direct, non-participant observation using the WHO Hand Hygiene Observation Form across 1,908 pre-training and 1,936 post-training opportunities. Data were analyzed using paired-samples t-tests, 95% confidence intervals, and effect-size estimation (Cohen’s d). Overall compliance rose from 66.8% to 87.9%, a mean gain of 21.1 percentage points (t = 18.94; df = 119; p 0.001; 95% CI ≈ 18.9–23.3) with a very large effect size (d = 1.73). All Five Moments improved, with the largest gains in Moment 1 (+24.7) and Moment 5 (+24.4). Post-training compliance surpassed the WHO 85% benchmark in every profession. Structured, multimodal hand hygiene training produced substantial, statistically and clinically significant compliance gains, selectively strengthening the moments most protective for patients. Keywords: Hand Hygiene, Five Moments, Compliance, Healthcare Workers, Infection Prevention and Control,Training Effectiveness. ABSTRAK Kebersihan tangan merupakan intervensi paling efektif terhadap biaya untuk mencegah infeksi terkait pelayanan kesehatan (healthcare-associated infections/HAIs), namun kepatuhan terhadap Five Moments WHO masih rendah di banyak rumah sakit, khususnya di negara berpenghasilan menengah ke bawah. Menilai efektivitas pelatihan kebersihan tangan terstruktur dan multimodal dalam meningkatkan kepatuhan tenaga kesehatan terhadap protokol Five Moments di Rumah Sakit Islam Siti Hajar Mataram. Desain kuasi-eksperimen kuantitatif satu kelompok pra–pasca pada 120 tenaga kesehatan. Kepatuhan diukur melalui observasi langsung nonpartisipatif menggunakan Formulir Observasi Kebersihan Tangan WHO pada 1.908 peluang pra-pelatihan dan 1.936 peluang pasca-pelatihan, dianalisis dengan uji t berpasangan, selang kepercayaan 95%, dan ukuran efek (Cohen’s d). Kepatuhan keseluruhan meningkat dari 66,8% menjadi 87,9% (selisih 21,1 poin; t = 18,94; df = 119; p 0,001; SK 95% ≈ 18,9–23,3) dengan ukuran efek sangat besar (d = 1,73). Seluruh momen meningkat, dengan peningkatan terbesar pada Momen 1 (+24,7) dan Momen 5 (+24,4); seluruh profesi melampaui ambang WHO 85% pascapelatihan. Pelatihan multimodal terstruktur menghasilkan peningkatan kepatuhan yang bermakna secara statistik dan klinis, secara selektif memperkuat momen yang paling protektif bagi pasien. Kata Kunci: Kebersihan Tangan, Five Moments, Kepatuhan, Tenaga Kesehatan, Pencegahan dan Pengendalian Infeksi,Efektivitas Pelatihan.