Original Article

The Performance of Healthcare-associated Infection Control Guideline among Hospital Nurses: A Structural Equation Model

Abstract

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.

 

 

Kim EC (2011). Healthcare-associated infection and infection-control. In Kim TI, editor. Infection-control and prevention in healthcare facilities. (pp. 3-8), 4th ed. Seoul: Hanmi Medical Publishing.

World Health Organization. (2011). Report on the burden of endemic health care-associated infection worldwide [Internet]. Zeneva: WHO Press [cited 2014 Sep 14]. Available from: http://www.who.int/gpsc/country_work/burden_hcai/en/.

Yoo JY, Oh EG, Hur HK, Choi MN (2012). Level of Knowledge on Evidence-based Infection-control and Influencing Factors on Performance among Nurses in Intensive Care Unit. Korean J Adult Nurs,24(3): 232-243.

Park YM, Park KY (2009). Influence of VRE knowledge and awareness with VRE infection-control in compliance with VRE infection-control among nurses in intensive care units. J Korean Biol Nurs Sci,11(1): 42-50.

Choi EJ, Kim SD, Lee JS (2007). The prediction on the behavior of infection-control of operating room nurses in Seoul: an application of the theory of planned behavior. Korean J Nosocomial Infect Control,12(2): 91-102.

Kang JY, Cho JW, Kim YJ et al (2009). Hospital nurses' knowledge and compliance on multidrug-resistant organism infection-control guideline. J Korean Acad Nurs, 39(2): 186-197.

Ko N, Feng M, Chiu D, Wu M, Feng J, Pan SM (2004). Applying Theory of Planned Behavior to Predict Nurses Intention and Volunteering to Care for SARS Patients in Southern Taiwan. Kaohsiung J Med Sci,20(8): 389-398.

Aboumatar H, Ristaino P, Davis RO et al (2012). Infection Prevention Promotion Program Based on the PRECEDE Mod-el: Improving Hand Hygiene Behaviors among Healthcare Personnel. Infect Control Hosp Epidemiol, 33(02): 144-151.

Jeong SY, Kim OS (2012). The Structural Model of Hand Hygiene Behavior for the Prevention of Healthcare-associated In-fection in Hospital Nurses. Korean J Adult Nurs, 24(2): 119-129.

Helms B, Dorval S, Laurent PS, Winter M (2010). Improving hand hygiene compli-ance: A multidisciplinary approach. Am J Infect Control, 38(7): 572-574.

Korniewicz DM, El-Masri M (2010). Ex-ploring the factors associated with hand hygiene compliance of nurses during rou-tine clinical practice. Appl Nurs Res,23(2): 86-90.

Whitby M, Mclaws M, Ross MW (2006). Why Healthcare Workers Don’t Wash Their Hands: A Behavioral Explana-tion. Infect Control Hosp Epidemiol, 27(05): 484-492.

O’Boyle CA, Henly SJ, Larson E (2001). Understanding adherence to hand hy-giene recommendations: The theory of planned behavior. Am J Infect Control, 29(6): 352-360.

Ajzen I (2005). Attitudes, personality and behavior. Maidenhead, Berkshire, Eng: Open Uni-versity Press.

Armitage CJ, Conner M (2001). Efficacy of the Theory of Planned Behaviour: A me-ta-analytic review. Br J Soc Psychol,40(4): 471-499.

Song TM, Kim GS (2012). Structural equation modeling for health & welfare research. 1st ed. Seoul: Hannarae Publishing, 14-49 &278-362.

Francis JJ, Eccles MP, Johnston M et al (2004). Constructing questionnaires based on the theory of planned behaviour: a manual for health services researchers. Newcastle upon Tyne: Centre for Health Services Research, University of Newcastle.

Kim HB (2013 March). Intervention to decrease catheter-related bloodstream infection and urinary tract infection in the ICU. Center for Disease Control & Prevention [Research Project Report]. Report No. 1272. [cited 2016 Feb 20] Available from:http://cdc.go.kr/CDC/info/CdcKrInfo0201.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU1889&fid=28&q_type=&q_value=&pageNum=18

Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R (2004). Guidelines for preventing health-care-associated pneumonia, 2003 recommendations of the CDC and the Healthcare Infection-control Practices Advisory Committee. MMWR Recomm Rep,53(RR03): 1-36.

Chang SJ, Koh SB, Kang DM et al (2005). Developing an Occupational Stress Scale for Korean Employees. Ann Occup Environ Med, 17(4): 297-317.

Park HH (2013). A Structural Model of Nurses' Patient Safety Management Activities (Doctoral dissertation, Eulji University) (pp. 1-100). Daejeon.

World Health Organization (2009). Guide to practice of the WHO multimodal hand hygiene improvement strategy [Internet]. Geneva: WHO Press [cited 2014 Sep 14]. Available from: http://www.who.int/gpsc/5may/tools/evaluation_feedback/en/

Chang HS, Jung DH (2013). Organizational and personal characteristics to determine the intentions and actions of the computer abuse. Informatization Policy, 20(1): 42-60.

Watson PW, Myers LB (2001). Which cogni-tive factors predict clinical glove use amongst nurses? Psychol Health Med, 6(4): 399-409.

Files
IssueVol 47 No 5 (2018) QRcode
SectionOriginal Article(s)
Keywords
Healthcare-associated infection Nurse Theory of planned behavior Structural model

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
MOON JE, JANG KS. The Performance of Healthcare-associated Infection Control Guideline among Hospital Nurses: A Structural Equation Model. Iran J Public Health. 2018;47(5):648-657.