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Purpose: The purpose of this study was to test hand hygiene behavior model of hospital nurses, based on theory of planned behavior. Methods: Data were collected from 253 nurses from four university hospitals for the period of December 2010 to January 2011. Data were analyzed using of SAS (ver.9.1). Fitness of the study model was identified with SAS PROC CALIS. Results: The overall fitness was x 2 =57.81 (df=13, p<.001), GFI=.99, AGFI=.99, CFI=.95, NFI=.93. The variance of actual implementation of hand hygiene by predictor variables was 11.0% and the variance of intention to hand hygiene was 53.5%. Variable that had a direct effect on hand hygiene behavior was intention. Perceived behavior control and attitude affected hand hygiene behavior indirectly. Control belief had a direct effect on perceived behavior control and had an indirect effect on intention and behavior. Behavioral belief had a direct effect on attitude and an indirect effect on intention and behavior. Conclusion: The study provides basic information for understanding nurses’ hand hygiene behavior. Further testing of the model will indicate which variables can contribute to improved hand hygiene.

The Structural Model of Hand Hygiene Behavior for the Prevention of Healthcare-associated Infection in Hospital Nurses