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

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: χ=120.57 (df=16, <.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, =.008), subjective norm (β=.27, =.002), and job demands (β=-.08, =.083). Organizational factors directly influenced following guidelines. Explanatory power of organizational factors on guideline compliance was greatest (C.R. [Critical Ratio] =5.67, <.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.