{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:15:43Z","timestamp":1788156943634,"version":"build-2803163510"},"reference-count":30,"publisher":"Korean Gerontological Nursing Society","issue":"3","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","award":["RS-2020-NR049581"],"award-info":[{"award-number":["RS-2020-NR049581"]}],"id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["jkgn.org"],"crossmark-restriction":true},"short-container-title":["J Korean Gerontol Nurs"],"abstract":"<jats:p>Purpose: Despite the critical importance of hand hygiene (HH) in long-term care facilities, research on adherence and its determinants in these settings remains scarce. This study examined HH adherence and its associated factors among nursing staff in long-term care facilities. Methods: This cross-sectional study surveyed 128 nursing staff members (registered nurses, n=78; nurse assistants, n=50). Data were collected from 35 long-term care facilities across South Korea. HH adherence was calculated from self-reported HH performances and opportunities based on the WHO Five Moments, and HH perception and infrastructure were assessed using adapted WHO-based instruments. Results: The mean clinical experience of participants was 14.58\u00b110.12 years. The HH adherence rate was 70.85%. The mean scores of HH perception and infrastructure were 73.41\u00b111.65 out of 84 points and 32.42\u00b15.18 out of 40 points, respectively. HH adherence was significantly associated with infrastructure (\u03b2=0.22, p=.042) and working in a specialized unit (\u03b2=0.22, p=.013). Conclusion: This study identified HH infrastructure quality and working in specialized units as significant factors associated with HH adherence among nursing staff in long-term care facilities. These findings suggest that strengthening HH infrastructure and considering unit-level working conditions may contribute to improved adherence. Facility-wide multimodal strategies that combine infrastructure improvement with ongoing education are recommended to sustain HH practices in long-term care settings. Future research should examine system-level and organizational factors using multilevel designs to further elucidate determinants of HH adherence in these settings.<\/jats:p>","DOI":"10.17079\/jkgn.2025.00409","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:40:17Z","timestamp":1788154817000},"page":"276-286","update-policy":"https:\/\/doi.org\/10.17079\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hand hygiene adherence and associated factors among nursing staff in long-term care facilities: A cross-sectional study"],"prefix":"10.17079","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8867-0804","authenticated-orcid":true,"given":"Eunkyo","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7871-6848","authenticated-orcid":true,"given":"Eunhee","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9823-6107","authenticated-orcid":true,"given":"Gwang Suk","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2964-8356","authenticated-orcid":true,"given":"Kyung Hee","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6725","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref1","volume-title":"Surveillance of health care-associated infections at national and facility levels: practical handbook [Internet]","year":"2024"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfpn.2022.11.004"},{"key":"ref3","volume-title":"WHO guidelines on hand hygiene in health care [Internet]","year":"2009"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1086\/650451"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003868"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-022-01088-w"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07143-6"},{"key":"ref8","volume-title":"Perception survey for health-care workers [Internet]","year":"2009"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.17.188"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.02.013"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.14192\/kjicp.2022.27.2.153"},{"key":"ref12","volume-title":"Enforcement rule of the Elderly Welfare Act, article 22, appendix 4: facility standards and staffing requirements for elderly medical welfare facilities [Internet]","year":"2020"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-023-01318-9"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.4235\/agmr.20.0036"},{"key":"ref15","volume-title":"Enforcement rule of the Medical Service Act, article 34, appendix 4: facility specifications for medical institutions [Internet]","year":"2024"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2024.5175"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/15271544211056051"},{"key":"ref18","volume-title":"Status of welfare facilities for older adults: statistical indicators [Internet]","year":"2023"},{"key":"ref19","volume-title":"Status of welfare facilities for older adults: list of facilities [Internet]","year":"2019"},{"key":"ref20","volume-title":"Measuring hand hygiene adherence: overcoming the challenges. Chapter 3: observing adherence to hand hygiene guidelines (p. 29) [Internet]","year":"2009"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-023-01296-y"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.7586\/jkbns.2012.14.3.156"},{"key":"ref23","first-page":"53","volume-title":"The effects of hand hygiene education on knowledge, perception, and bacterial colony count on the hands of care workers [master\u2019s thesis]","author":"Yoo","year":"2016"},{"key":"ref24","volume-title":"Guideline for hand hygiene in healthcare facilities [Internet]","year":"2014"},{"key":"ref25","volume-title":"Hand hygiene self-assessment framework 2010 [Internet]","year":"2010"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2022.07.008"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1111\/ijn.12120"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S91433"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1086\/666740"},{"key":"ref30","volume-title":"Call for participating institutions in the 2026 pilot program for specialized care units in long-term care facilities [Internet]","year":"2026"}],"container-title":["Journal of Korean Gerontological Nursing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/jkgn.org\/upload\/pdf\/jkgn-2025-00409.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkgn.org\/journal\/view.php?doi=10.17079\/jkgn.2025.00409","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/jkgn.org\/upload\/pdf\/jkgn-2025-00409.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:40:26Z","timestamp":1788154826000},"score":1,"resource":{"primary":{"URL":"http:\/\/jkgn.org\/journal\/view.php?doi=10.17079\/jkgn.2025.00409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,8]]}},"URL":"https:\/\/doi.org\/10.17079\/jkgn.2025.00409","relation":{},"ISSN":["2384-1877","2383-8086"],"issn-type":[{"value":"2384-1877","type":"print"},{"value":"2383-8086","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"2025-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}