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Intervention to Improve Hand Hygiene Compliance Based on the Health Action Process Approach (HAPA) Theory in the Education for Novice Nurses and Its Effects

Yoko YAMAMOTO1), Masako MUROTA1), Yukie TAKISHITA1), Yukari NISHIUCHI2), Kiyomi HARADA1) and Yoko IWAWAKI1)
1)School of Nursing, Kyoto Prefectural University of Medicine, 2)Division of Nursing, University Hospital, Kyoto Prefectural University of Medicine


This study aimed to clarify the effects of an intervention to improve hand hygiene compliance based on the Health Action Process Approach (HAPA) theory in the education of novice nurses.
The study was conducted according to a two-year plan wherein nurses in the same hospital were allocated to an intervention group and a comparison group each year. The intervention included action planning on hand hygiene, coping planning to tackle possible problems, and hand hygiene practice and self-evaluation.
Nineteen nurses in the intervention group and 21 nurses in the comparison group were included in the final analyses. On the Hand Hygiene Cognitive Scale for novice nurses based on the HAPA theory, scores for coping planning, action planning, and outcome expectancies two months after the intervention were significantly higher in the intervention group (p =.025,.029, and.001, respectively). The intergroup comparison on the rate of practice at My five moments for hand hygiene showed that the change from baseline to immediately after the intervention was significantly larger in the intervention group (p =.045). The rate of practice satisfying the criteria for both My five moments for hand hygiene and the duration of the entire procedure did not significantly differ between the two groups. Factors hampering the action that were extracted from the group work included [non-personal factors hampering action], which comprised subcategories, such as "I am too busy to spare the time."
These findings suggest that the HAPA-theory-based intervention in this study enhanced the cognitive aspect of hand hygiene and was effective for hand hygiene practices embodied in My five moments for hand hygiene to a certain extent. However, the results failed to show the obvious effect of the practices' rate satisfying the criteria for both My five moments for hand hygiene and the duration of the entire procedure, suggesting an influence of non-personal factors, such as insufficient time allocated to hand hygiene.

Key words:the Health Action Process Approach, hand hygiene, intervention, novice nurses

e-mail: yokoy@koto.kpu-m.ac.jp

Received: October 30, 2020
Accepted: March 17, 2021

36 (4):222─230,2021

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