Nurses’ compliance with the five moments of hand hygiene and healthcare-associated infections
DOI: https://doi.org/10.33024/minh.v8i11.1692
Five Moments Hand Hygiene Nurses
Abstract
Background: Adherence to the five moments of hand hygiene in hospital settings plays a crucial role in preventing healthcare-associated infections (HAIs). Despite the widespread dissemination and acceptance of these guidelines, nurses’ compliance rates remain suboptimal in many healthcare institutions. Numerous factors have been identified as influencing nurses’ adherence to the five moments of hand hygiene.
Purpose: To identify factors associated with nurses' compliance with the five moments of hand hygiene in reducing healthcare-associated infections.
Method: This study employed a quantitative, non-participatory observational design using a cross-sectional correlational approach. A total of 334 nurses from Prof. Dr. I.G.N.G. Ngoerah General Hospital were recruited as participants. Data were collected through structured questionnaires and analyzed using univariate, bivariate, and multivariate statistical methods.
Results: Overall, the compliance rate of nurses with the five moments of hand hygiene was 62.0%. The main factors significantly associated with compliance included the type of treatment room (p = 0.007; AOR = 2.116; 95% CI: 1.225–3.656), belief (p = 0.001; AOR = 16.596; 95% CI: 4.726–58.279), and glove use (p = 0.001; AOR = 5.957; 95% CI: 3.430–10.340).
Conclusion: The key determinants affecting compliance with the five moments of hand hygiene include nurses’ beliefs, the use of gloves, and the type of treatment room. Beyond the variables examined in this study, additional predictors such as patient conditions, stress levels, workload, and socio-cultural influences may also contribute to variations in nurses’ adherence to the five moments of hand hygiene.
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References
Aryana, I. G. N., Agustini, N. L. P. I. B., Adianta, I. K. A., & Sagitarini, P. N. (2025). Literature Review: Compliance With Five Moments Hand Hygiene in Healthcare Facilities In An Effort To Reduce Healthcare-Associated Infections. Jurnal Riset Kesehatan Nasional, 9(1), 49-58.
Bale, T. L., Ramukumba, T. S., & Mudau, L. S. (2021). Evaluation of compliance to the World Health Organization’s five moments of hand hygiene: Cross-sectional observation of healthcare professionals. Southern African Journal of Infectious Diseases, 36(1), 255.
Blum, H. L., & Knollmueller, R. N. (1975). Planning for health; development and application of social change theory (Vol. 75, No. 8, p. 1388). LWW.
Dillyana, T. A., & Nurmala, I. (2019). Hubungan pengetahuan, sikap dan persepsi ibu dengan status imunisasi dasar di Wonokusumo. Jurnal Promkes, 7(1), 68-78.
Efendy, N. F., & Hutahaean, S. (2022). The Relationship of Workload and Work Stress of Nurses with Hand Hygiene Compliance During The Covid-19 Pandemic. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing), 8(1), 149-160.
Fhirawati, F., & Kurniawan, Y. (2023). Hubungan Sikap dan Keterampilan Dengan Kepatuhan Perawat Dalam Hand Hygiene Five Moment Di Rumah Sakit Bhayangkara Balikpapan. JUKEJ : Jurnal Kesehatan Jompa, 2(1), 154–159.
Fouad, M., & Eltaher, S. (2020). Hand hygiene initiative: Comparative study of pre-and postintervention outcomes. Eastern Mediterranean Health Journal, 26(2), 198–205.
Goh, L. P. W., Marbawi, H., Goh, S. M., bin Abdul Asis, A. K., & Gansau, J. A. (2023). The prevalence of hospital-acquired infections in Southeast Asia (1990-2022). The Journal of Infection in Developing Countries, 17(02), 139-146.
Green, L. W. (1993). Health education planning. A diagnostic approach, Oral Health Promotion, 44-46.
Hoffmann, M., Sendlhofer, G., Gombotz, V., Pregartner, G., Zierler, R., Schwarz, C., Tax, C., & Brunner, G. (2020). Hand hygiene compliance in intensive care units: An observational study. International Journal of Nursing Practice, 26(2), 1–8.
Irwan, I. (2017). Etika dan perilaku kesehatan. Yogyakarta: CV. Absolute Media.
Le, C. D., Lehman, E. B., Nguyen, T. H., & Craig, T. J. (2019). Hand hygiene compliance study at a large central hospital in Vietnam. International Journal of Environmental Research and Public Health, 16(4), 1–10.
Maniriho, F., Rajeswaran, L., Collins, A., & Chironda, G. (2019). Assessment of nurses’ perceptions and adherence to five moments of hand hygiene in selected units at a University Teaching Hospital in Rwanda. Rwanda Journal of Medicine and Health Sciences, 2(2), 160.
Maryana, M., & Anggraini, R. B. (2021). Nurses’ Individual Characteristics Associated with Five Moments Handwashing Compliance. Jurnal Ners, 16(2), 135–141.
Ministry of Health of the Republic of Indonesia. (2017). Peraturan Menteri Kesehatan Nomor 27 Tahun 2017 tentang Pedoman Pencegahan Dan Pengendalian Infeksi Di Fasilitas Pelayanan Kesehatan. Accessed from: https://peraturan.bpk.go.id/Details/112075/permenkes-no-27-tahun-2017.
Notoatmodjo, S. (2003). Pendidikan dan perilaku kesehatan. Rineka Cipta.
Nursalam, K. (2012). Penerapan Metodologi Penelitian Ilmu Keperawatan Pedoman Skripsi (Doctoral dissertation, Tesis dan Instrumen Penelitian Keperawatan. Jakarta: Salemba Medika).
Oyibo, P. G. (2022). Predictors of compliance with the ‘five key moments' for hand hygiene among healthcare providers in public healthcare settings in south-south Nigeria. The Egyptian Journal of Community Medicine, 40(2), 148-155.
Paudi, H. S. K. (2022). Gambaran Praktik Five Moment Cuci Tangan Pada Perawat Di Puskesmas. Journal Syifa Sciences and Clinical Research, 2(2), 91–98.
Prof. Dr. I.G.N.G. Ngoerah General Hospital. (2023). Annual Report of Prof. Dr. I.G.N.G Ngoerah General Hospital 2023.
Rianita, A. D., & Suryani, D. (2019). Factors Influencing Nurses’ Compliance Level in the Application of Hand Hygiene in Inpatient Wards of Muntilan General Hospital. Jurnal Medicoeticolegal Dan Manajemen Rumah Sakit, 8(1), 40–47.
Sanglah General Hospital Denpasar. (2021). Sanglah General Hospital Annual Report 2021.
Sari, V. F., & Sari, D. K. (2023). Gambaran Tingkat Kepatuhan Five Moment Cuci Tangan Pada Perawat Rawat Inap Di RSUD Ir. Soekarno Sukaharjo. Jurnal Ilmiah Penelitian Mandira Cendekia, 1(2), 41–53.
Schmutz, J. B., Grande, B., & Sax, H. (2023). WHO ‘My five moments for hand hygiene’ in anaesthesia induction: a video-based analysis reveals novel system challenges and design opportunities. Journal of Hospital Infection, 135, 163–170.
Sucipto, C. D. (2014). Keselamatan dan kesehatan kerja. Yogyakarta: Gosyen Publishing.
Suetens, C., Latour, K., Kärki, T., Ricchizzi, E., Kinross, P., Moro, M. L., Jans, B., Hopkins, S., Hansen, S., Lyytikäinen, O., Reilly, J., Deptula, A., Zingg, W., Plachouras, D., & Monnet, D. L. (2018). Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: Results from two european point prevalence surveys, 2016 to 2017. Eurosurveillance, 23(46), 1–17.
Swarjana, I. K. (2016). Statistik Kesehatan (AA C. CV). Andi Offset.
Titania, E. L. (2019). Peningkatan program patient safety berdasarkan 7 prinsip menuju keselamatan pasien dirumah sakit. OSFpreprints.
Wandira, B. A., Ashari, M. R., Fitrasyah, S. I., & Yani, A. (2019). Correlation of nurse compliance to the implementation of hand hygiene at undata general hospital, City of Palu, Indonesia. Indian Journal of Public Health Research and Development, 10(8), 2016–2020.
World Health Organization. (2009a). Hand Hygiene Technical Reference Manual: To be used by health-care workers, trainers and observers of hand hygiene practices. Accessed from: https://www.who.int/publications/i/item/9789241598606.
World Health Organization. (2009b). WHO Guidelines on Hand Hygiene in Health Care. Accessed from: https://www.who.int/publications/i/item/9789241597906.
World Health Organization. (2012). Hand hygiene in outpatient and home-based care and long-term care facilities: a guide to the application of the WHO multimodal hand hygiene improvement strategy and the “My Five Moments For Hand Hygiene” approach. Accessed from: https://www.who.int/publications/i/item/9789241503372.
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