Knowledge, Perceptions, and Self-reported Performance of Hand Hygiene Among Registered Nurses at Community-based Hospitals in the Republic of Korea: A Cross-sectional Multi-center Study

Objectives: To assess the nurses' hand hygiene (HH) knowledge, perception, attitude, and self-reported performance in small- and medium-sized hospitals after Middle East Respiratory Syndrome outbreak. Methods: The structured questionnaire was adapted from the World Health Organization's survey. Data were collected between June 26 and July 14, 2017. Results: Nurses showed scores on knowledge ($17.6{\pm}2.5$), perception ($69.3{\pm}0.8$), self-reported HH performance of non-self ($86.0{\pm}11.0$), self-reported performance of self ($88.2{\pm}11.0$), and attitude ($50.5{\pm}5.5$). HH performance rate of non-self was $Y_1=36.678+0.555X_1$ (HH performance rate of self) (adjusted $R^2=0.280$, p<0.001). The regression model for performance was $Y_4=18.302+0.247X_{41}(peception)+0.232X_{42}(attitude)+0.875X_{42}(role model)$; coefficients were significant statistically except attitude, and this model significant statistically (adjusted $R^2=0.191$, p<0.001). Conclusions: Advanced HH education program would be developed and operated continuously. Perception, attitude, role model was found to be a significant predictors of HH performance of self. So these findings could be used in future HH promotion strategies for nurses.