Determinant Analysis of Hand Hygiene Compliance and Its Relation to HAIs in Hospitals: Systematic Literature Review
https://doi.org/10.33860/jik.v17i4.2621
Keywords:
Hand Hygiene, HAIs, Nosocomial, ComplianceAbstract
Hand hygiene is one of the practical steps that healthcare providers can take to reduce the incidence of HAIs or nosocomial infections. The percentage of hand hygiene compliance is still low, between 35-55.3%. Several previous studies showed that many factors cause hand hygiene adherence. However, the results are still varied, so this study aimed to determine the factors of hand hygiene, determine the factors that most influence hand hygiene adherence, and the link between hand hygiene and the incidence of HAIs in hospitals. This systematic literature review follows the PRISMA protocol guidelines in three electronic databases (PubMed, Science Direct, and Google Scholar). Article quality was assessed using the JBI assessment tool and analyzed using meta-synthesis. The inclusion criteria are articles discussing hand hygiene compliance among hospital nurses and articles published in 2021-2023, so 15 selected papers. The determinants of hand hygiene compliance include knowledge, attitude, motivation, supervision from superiors or related parties, facilities, age, gender, years of service, and feedback. An electronic monitoring system also has significantly affected hand hygiene compliance. Several articles stated that the multimodal approach initiated by WHO positively impacted hand hygiene compliance. The most dominant factor is the knowledge variable. Hand hygiene compliance is closely related to the incidence of HAIs, when hand hygiene compliance is high, it can reduce the incidence of HAIs in health services.
References
Windyastuti, Widyastuti NKA, Kustriyani M. Hubungan kepatuhan cuci tangan enam langkah lima momen dengan kejadian infeksi nosokomial di ruang dosen program studi ners widya husada Semarang Dosen Program Studi Ners Widya Husada Semarang Emai. Proceeding Widya Husada Nurs Conf [Internet]. 2019;118–28. Available from: http://journal.uwhs.ac.id/index.php/whnc/article/view/291/296
Tumiwa FF. Hubungan pengetahuan dan sikap tentang pencegahan infeksi nosokomial dengan kepatuhan perawat dalam mencuci tangan di IGD RSUP. Prof. Dr. R.D. Kandou Manado. Gastron ecuatoriana y Tur local. 2019;2(2):5–24.
World Health Organisation. Global report on infection prevention and control [Internet]. 2022. 1–182 p. Available from: http://apps.who.int/bookorders.
Kementerian Kesehatan Republik Indonesia. Panduan cuci tangan pakai sabun [Internet]. 1st ed. Kesehatan Lingkungan. Jakarta; 2020. p. 1–34. Available from: https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Panduan_CTPS2020_1636.pdf
Ferdinah R. Gambaran Perilaku Hand Hygiene Dan Determinannya Pada Perawat Di Ruang Rawat Inap Gedung X Rumah Sakit Y Jakarta Tahun 2017. UIN Syarif Hidayatullah Jakarta; 2017.
Caesarino RI, Wahjono H, Lestari ES. Tingkat kepatuhan perawat rumah sakit x di Semarang Terhadap Pelaksanaan Cuci Tangan. Diponegoro Med J (Jurnal Kedokt Diponegoro) [Internet]. 2019;8(2):852–9. Available from: https://ejournal3.undip.ac.id/index.php/medico/article/view/23834
Henderson J, Willis E, Roderick A, Bail K, Brideson G. Why do nurses miss infection control activities? A qualitative study. Collegian [Internet]. 2020 Feb;27(1):11–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1322769619300885
English KM, Langley JM, McGeer A, Hupert N, Tellier R, Henry B, et al. Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control. BMC Infect Dis [Internet]. 2018 Dec 17;18(1):184. Available from: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3093-x
Abd Rahim MH, Ibrahim MI, Md Noor SS, Fadzil NM. Predictors of self-reported hand hygiene performance among nurses at tertiary care hospitals in east coast Malaysia. Int J Environ Res Public Health. 2021;18(2):1–10.
Dewi F, Hayati M, Yusrawati Y. Determinan peran kepemimpinan kepala ruang terhadap kepatuhan perawat dalam melaksanakan hand hygiene di RSUD Cut Meutia Aceh Utara. 2022;1(6):945–53.
Umar H, Geremew A, Worku Kassie T, Dirirsa G, Bayu K, Mengistu DA, et al. Hand hygiene compliance and associated factor among nurses working in public hospitals of Hararghe zones, Oromia region, eastern Ethiopia. Front Public Heal. 2022;10.
Ayu, SD, Dewi TK, Juhana C. Hubungan pengetahuaan dan motivasi perawat terhadap kepatuhan melakukan five moment hand hygiene di RSUD Sayang Kab. Cianjur. Malahayati Nurs J. 2020;4(3):537–55.
Knudsen AR, Kolle S, Hansen MB, Møller JK. Effectiveness of an electronic hand hygiene monitoring system in increasing compliance and reducing healthcare-associated infections. J Hosp Infect [Internet]. 2021;115:71–4. Available from: https://doi.org/10.1016/j.jhin.2021.05.011
Ataiyero Y, Dyson J, Graham M. The barriers and facilitators to hand hygiene practices in Nigeria: A qualitative study: “There are so many barriers the barriers are limitless.” Am J Infect Control [Internet]. 2023;51(3):295–303. Available from: https://doi.org/10.1016/j.ajic.2022.10.013
Blomgren PO, Lytsy B, Hjelm K, Swenne CL. Healthcare workers’ perceptions and acceptance of an electronic reminder system for hand hygiene. J Hosp Infect [Internet]. 2021;108:197–204. Available from: https://doi.org/10.1016/j.jhin.2020.12.005
Ojanperä H, Ohtonen P, Kanste O, Syrjälä H. Impact of direct hand hygiene observations and feedback on hand hygiene compliance among nurses and doctors in medical and surgical wards: an eight-year observational study. J Hosp Infect. 2022;127:83–90.
Rozi AN. Hubungan antara karakteristik dengan kepatuhan perawat dalam melaksanakan hand hygiene di rumah sakit islam sultan agung Semarang. Vol. 14, Universitas Sultan Agung Semarang. Universitas Sultan Agung Semarang; 2021.
Handayani NLP, Suarjana IK, Listyowati R. Hubungan Karakteristik, Pengetahuan dan motivasi perawat dengan kepatuhan cuci tangan di ruang rawat inap RSU Surya Husadha Denpasar. Arch Community Heal. 2019;6(1):9.
Iriandoko OW, Chalidyanto D. The relationship between characteristics of health workers on handwashing behavior. J Medicoeticolegal dan Manaj Rumah Sakit. 2020;9(2).
Octaviani E, Fauzi R. Analisis faktor yang berhubungan dengan kepatuhan mencuci tangan pada tenaga kesehatan di RS Hermina Galaxy Bekasi. J Kedokt dan Kesehat. 2020;16(1):12–9.
Jalinus N, Verawardina U, Krismadinata. Buku Model Flipped Blended LearninG [Internet]. 1st ed. Jawa Tengah: VC. Sarnu Untung; 2020. Available from: https://www.google.co.id/books/edition/PERBEDAAN_PEMBERIAN_ASI_EKSLUSIF_DAN_NON/w_uZEAAAQBAJ?hl=id&gbpv=1&dq=teori+tentang+usia+berpengaruh+pada+kematangan+berfikir&pg=PA63&printsec=frontcover
Mohaithef M AL. Assessing hand hygiene practices among nurses in the Kingdom of Saudi Arabia. Open Public Health J [Internet]. 2020 May 23;13(1):220–6. Available from: https://openpublichealthjournal.com/VOLUME/13/PAGE/220/
Indiyani, Saparwati M, Susilo E. Persepsi perawat terhadap fungsi pengarahan kepala ruang tentang kepatuhan dalam menjalankan hand hygiene di ruang rawat inap. Indones J Nurs Res. 2020;3.
Kurnia S, Hastuti W, Fadilla AI, Apriansyah S, Kurniawidihastutiikmuadacid CP. Faktor-faktor yang berhubungan dengan kepatuhan perawat dalam pelaksanaan hand hygiene di ruang rawat inap salah satu rumah sakit swasta di Yogyakarta perkenalan kewaspadaan universal merupakan upaya pencegahan infeksi nosokomial ( inos ) yang wajib dilak. 2021;10(2):177–88.
Anugrahwati R, Hakim N. Faktor-faktor yang mempengaruhi kepatuhan perawat dalam melakukan hand hygiene five moments di Rs. Hermina Jatinegara. J Ilm Keperawatan Altruistik. 2019;2(1):41–8.
Kurniasari E, Ilham MIA. Hubungan pengetahuan dan pengalaman kerja tenaga kesehatan terhadap kepatuhan 5 moments hand hygiene di ruang maternitas Rsud I Lagaligo Wotu Tahun 2021 Relationship of Knowledge and Work Experience of Health Workers to Compliance with 5 Moments of Hand H. 2023;6(1):20–31.
Chairani, Riza S, Putra Y. Hubungan pengetahuan dan sikap pencegahan infeksi nosokomial dengan kepatuhan perawat dalam mencuci tangan di ruang rawat inap terpadu rumah sakit umum daerah Aceh Besar tahun 2022 Knowledge and Attitudes about Prevention of Nosocomial Infections with Nur. J Healthc Technol Med [Internet]. 2022;8(2):1293–302. Available from: https://jurnal.uui.ac.id/index.php/JHTM/article/download/2397/1239
Sembiring R, Rahayu P, Todingbua CLT. Hubungan pengetahuan perawat dengan kepatuhan mencuci tangan berdasarkan standar operasional prosedur di ruang ICU dan ruang HCU saraf rumah sakit umum Jayapura. Sentani Nurs J. 2021;3(2):36–43.
Nia A., Mahfud, Admanto P. Hubungan lama kerja dengan kepatuhan perawat dalam melaksanakan sop hand hygiene di ruang dahlia dan anggrek RSUD Panembahan Senopati. Universitas Alma Ata Yogyakarta; 2020.
Hastuti SKW, Fadilla AI, Apriansyah S. Factors related to nurse compliance in the implementation of universal precaution in the inpatient room one of private hospital in Yogyakarta. JMMR (Jurnal Medicoeticolegal dan Manaj Rumah Sakit). 2021;10(2):177–88.
Rohman R. PMIK Berani Bertransformasi [Internet]. Nasrudin M, editor. Jawa Tengah: Penerbit NEM; 2023. Available from: https://www.google.co.id/books/edition/PMIK_Berani_Bertransformasi/XoW9EAAAQBAJ?hl=id&gbpv=1
Muhdar. Manajemen SDM: Teori dan aplikasi pada bank umum syariah - rajawali pers [Internet]. 1st ed. Hidayati, editor. Depok: PT. RajaGrafindo Persada; 2020. Available from: https://www.google.co.id/books/edition/Manajemen_SDM_Teori_dan_Aplikasi_Pada_Ba/ykwaEAAAQBAJ?hl=id&gbpv=0
Bambang Sumardi, Omega Dr Tahun, Angel Berta Fau. Hubungan Pengetahuan Dan Sikap Dengan Kepatuhan perawat dalam melakukan penerapan standar cuci tangan. J Antara Keperawatan. 2020;3(2):42–9.
Iskandar R. Correlation between behavior and nurse’s compliance in hand hygiene five movement at inpatient ward in Sleman general hospital. J Kesehat Bakti Tunas Husada J Ilmu-ilmu Keperawatan, Anal Kesehat dan Farm. 2019;19(1):124–32.
Harlinisari R. Hubungan faktor individu dan organisasi terhadap kepatuhan bidan menerapkan standar prosedur operasional cuci tangan. J Adm Kesehat Indones [Internet]. 2018 Dec 7;6(2):103. Available from: https://e-journal.unair.ac.id/JAKI/article/view/7439
Dwi RA, Suryani D. Factors influencing nurses’ compliance level in the application of hand hygiene in inpatient wards of muntilan general hospital. J Medicoeticolegal dan Manaj Rumah Sakit. 2019;8(1):40–7.
Laila SA, Zainaro MA. The Correlations of Motivation and Attitude To Obedience of Nurse. MALAHAYATI Nurs J. 2020;2(1):68–82.
Surya DP. Hubungan motivasi dengan tingkat kepatuhan tenaga kesehatan dalam melakukan five moments hand hygiene pada era pandemi di klinik rawat inap dr. M. Suherman Universitas Muhammadiyah Jember. J Pengabdi Kpd Masy [Internet]. 2021;4(1):1–8. Available from: http://ejournal.bsi.ac.id/ejurnal/index.php/abdimas
Mariani P. Faktor - faktor yang berhubungan dengan kepatuhan perawat dalam melakukan hand hygiene di RSUD Lahat tahun 2021. Sekol Tinggi Ilmu Kesehat Bina Husada. 2021;
Gurning M, PH WM, Rahayu NLPD. Hubungan pengetahuan dan pengawasan dengan perilaku hand hygiene untuk pencegahan infeksi nosokomial pada perawat di ruang rawat inap. 2022;15(September):74–7.
Komala Dewi RR. Faktor determinan kepatuhan perawat dalam melakukan praktik cuci tangan Di RSUD Ade Muhammad Djoen Sintang. J Kesmas (Kesehatan Masyarakat) Khatulistiwa. 2019;4(4):232.
Budianto A, Setyaningrum I, Prastiani DB. Hubungan Supervisi oleh Kepala Ruang dengan Kebiasaan Cuci Tangan Perawat Pelaksana di Rumah Sakit Mitra Keluarga Tegal. JITK Bhamada. 2021;12(1):60–5.
Astuti W, Pujiyanto TI, Nurhayati S. The supervision and transformational leadership styles on nurses’ compliance in prevention and control of infection risks at a hospital in Kotamobagu, Indonesia. GHMJ (Global Heal Manag Journal) [Internet]. 2023 Feb 8;6(1):11–7. Available from: https://publications.inschool.id/index.php/ghmj/article/view/928
Gunawan, Yendra, Sudirman A, Naninsih N, Suyatno A, Muhammad S, et al. dasar-dasar manajemen (konsep, prinsip, dan teori) [Internet]. Hartini, editor. Jawa Barat: Media Sains Indonesia; 2023. Available from: https://www.google.co.id/books/edition/Dasar_Dasar_Manajemen_Konsep_Prinsip_dan/qcilEAAAQBAJ?hl=id&gbpv=0
Aidi S, Ni Made Utami D, Desak P. Y K. Evaluasi program dan hambatan pelaksanaan hand hygiene di RS “X” BALI. J Penelit dan Kaji Ilm Kesehat [Internet]. 2020;6(1):31–41. Available from: www.lppm-mfh.com
Sulisno M, Nurmalia D, Warsito BE, Jannah AM, Ulliya S, Santoso A, et al. Hubungan peran tim pencegahan dan pengendalian infeksi (tim ppi) dan fasilitas cuci tangan dengan kepatuhan cuci tangan perawat. Holist Nurs Heal Sci. 2022;5(1):23–33.
Shen L, Wang X, An J, An J, Zhou N, Sun L, et al. Implementation of who multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a traditional chinese medicine hospital in Xi’an, China. Antimicrob Resist Infect Control [Internet]. 2017 Dec 20;6(1):98. Available from: http://aricjournal.biomedcentral.com/articles/10.1186/s13756-017-0254-4
Iversen AM, Stangerup M, From-Hansen M, Hansen R, Sode LP, Kostadinov K, et al. Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors. Am J Infect Control. 2021;49(6):733–9.
Sakihama T, Kayauchi N, Kamiya T, Saint S, Fowler KE, Ratz D, et al. Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals. Am J Infect Control. 2020;48(1):77–81.
Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 27 Tahun 2017 [Internet]. 27 Indonesia; 2017 p. 2–20. Available from: http://hukor.kemkes.go.id/uploads/produk_hukum/PMK_No._27_ttg_Pedoman_Pencegahan_dan_Pengendalian_Infeksi_di_FASYANKES_.pdf
Sugiyono. Metode penelitian kuantitatif kualitatif dan R&D. kedua. Sutopo, editor. Bandung: Penerbit Alfabeta; 2019. 144–147
Marfu’ah S, Sofiana L. Analisis tingkat kepatuhan hand hygiene perawat dalam pencegahan infeksi nosokomial. Kes Mas J Fak Kesehat Masy [Internet]. 2018;12(1):29–37. Available from: https://core.ac.uk/download/pdf/295186766.pdf
Nzanga M, Panulo M, Morse T. Kepatuhan terhadap kebersihan tangan di antara perawat dan dokter di rumah sakit Distrik Chiradzulu , Malawi Selatan. 2022.
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