Iranian Journal of Public Health 2018. 47(5):648-657.

The Performance of Healthcare-associated Infection Control Guideline among Hospital Nurses: A Structural Equation Model
Jeong Eun MOON, Keum Seong JANG



Background: To improve efficient and systematic management and following of healthcare-associated infection guidelines, the relationship among various factors must be understood. Efforts should be made to strengthen or reduce relevant factors. We developed a structural equation model for following HAI-control guidelines

Methods: Overall, 388 Korean registered nurses participated in this study and data collection was conducted Jul 21-Aug 31, 2014 using a self-reported questionnaire, and 392 of 400 copies were collected (98% recovery rate). Data were analyzed using descriptive statistics, reliability, and Pearson’s coefficient. Model identification evaluation was conducted by goodness-of-fit index and impact analysis.

Results: Results of goodness-of-fit of modified model were as follows: χ2=120.57 (df=16, P<.001), GFI (Goodness of Fit Index)=.95, RMSEA (Root-Mean-Square Error of Approximation)=.10, SRMR (Standardizes Root-Mean-Square residual)=.06, NFI (Normal Fir Index)=.90, CFI (Comparative Fit Index)=.90. Factors with a statistically significant direct impact on behavioral intention are as follows; perceived behavior control (β=.35, P=.008), subjective norm (β=.27, P=.002), and job demands (β=-.08, P=.083). Organizational factors directly influenced following guidelines. Explanatory power of organizational factors on guideline compliance was greatest (C.R. [Critical Ratio] =5.67, P<.001).

Conclusion: Supportive leadership and a positive organizational culture development strategy are essential. The hospital leader group should provide adequate resources to facilitate compliance with guidelines as well as create an atmosphere of on-site support that ensures guidelines will be followed, and engage in continuous monitoring and feedback regarding following of guidelines.




Healthcare-associated infection, Nurse, Theory of planned behavior, Structural model

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