The Impact of Authority Factors on Health Workers' Compliance with Hand Hygiene Practices at the Emergency Installation of Adi Husada Hospital, Undaan Wetan, Surabaya
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Filip Yustinus Ongo
Nyoman Anita Damayanti
Abstract
Compliance with hand hygiene is a key National Quality Indicator established for hospitals and serves as a crucial metric for quality across all service units. The national target for hand hygiene compliance is set at over 85%. However, Adi Husada Hospital (AHUW) has set a higher target of 100% to meet the quality indicators for hand hygiene compliance. An analysis of hand hygiene compliance data from March to August 2024 revealed that the emergency department at AHUW achieved a compliance rate of 86%. This rate is lower than that of several other service units, such as the operating rooms (100%) and the intensive care unit (98%). This study aims to explore the relationship between authority factors and adherence to hand hygiene standard operating procedures (SOP) among health workers in the AHUW Emergency Installation. The research employed a quantitative, cross-sectional design and collected primary data via a questionnaire distributed via Google Forms. The study found that compliance among medical personnel at the AHUW Emergency Installation was rated good. The primary factor influencing both compliance and non-compliance was identified as the individual self-factor, followed closely by the organizational authority factor. Notably, only the location status showed a significant impact on handwashing compliance (p = 0.006). This finding suggests that the presence of authority figures in the workplace plays a crucial role in healthcare workers' adherence to hand hygiene practices. In contrast, the variables of responsibility, legitimacy, status, and proximity to authority figures did not exhibit significant effects (p > 0.05), suggesting they do not strongly influence compliance.These findings suggest that the visible presence of authority at the point of care is more impactful than any formal or perceived characteristics of that authority.
Keywords: compliance, hand hygiene, authority, health workers
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Copyright (c) 2026 Filip Yustinus Ongo, Nyoman Anita Damayanti
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References
Andini, F. et al., 2023. Comparison between Milgram’s and Niven’s Obedience Theory on Nurses in Obedience using Personal Protective Equipment. Aisyah Journal: Journal of Health Sciences, 8(1), pp. 1-6. DOI: https://doi.org/10.30604/jika.v8i1.1373
Asch, S., 1951. Effects of group pressure upon the modification and distortion of judgments. Groups, leadership and men, pp. 177-190.
Cialdini, R. B. & Goldstein, N. J., 2004. Social influence: Compliance and conformity. Annual Review of Psychology, Volume 55, p. 591–621. DOI: https://doi.org/10.1146/annurev.psych.55.090902.142015
Erasmus, V. et al., 2010. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infection Control & Hospital Epidemiology, pp. 298-294. DOI: https://doi.org/10.1086/650451
Ernawaty, E. et al., 2022. Applying Milgram’s Theory and Health Belief Model in Understanding Compliance to Health Protocols of Covid-19 Pandemic. Jurnal Aisyah : Jurnal Ilmu Kesehatan, 7(1), p. 223–230. DOI: https://doi.org/10.30604/jika.v7i1.897
Ernawaty, E., Rochmah, T., Pudjirahardjo, W. & Junaidi, M., 2021. The behavior of specialist towards completeness of medical records. International Journal of Healthcare Management, 14(2), p. 462–467. DOI: https://doi.org/10.1080/20479700.2019.1658163
Fattori, F. e. a., 2015. Authority relationship from a societal perspective: Social representations of obedience and disobedience in Austrian young adults. Europe’s Journal of Psychology, 11(2), p. 197–213. DOI: https://doi.org/10.5964/ejop.v11i2.883
Griggs, R., 2017. Milgrams Obedience Study: A Contentious Classic Reinterpreted. Teaching of Psychology, 44(1). DOI: https://doi.org/10.1177/0098628316677644
Gupita, C. A. R., 2016. Factors related to nurses' compliance in implementing standard operational procedures for infusion installation (Study at Haji General Hospital Surabaya). [Online] Available at: http://repository.unair.ac.id/id/eprint/46660
[Accessed 1 December 2024].
Hanafiah, D., 2019. Responsibility for Medical Records. Journal of Medicine and Health, 6(2), pp. 1-8.
Jeli, M. M. & Ulfa, M., 2014. Nurses' Compliance in Implementing Standard Operational Procedures for Infusion Installation at PKU Muhammadiyah Gombong Hospital. Mutiara Medika, 14(1), pp. 51-62.
Mahfudhoh, S. & Rohmah, T. N., 2015. Factors that affect the compliance of prescription writing according to the formulary. Indonesian Journal of Health Administration, 3(1), pp. 21-30. DOI: https://doi.org/10.20473/jaki.v3i1.2015.21-30
McLeod, S., 2007. Obedience to Authority, Simply Psychology. [Online] Available at: https://www.simplypsychology.org/obedience.html
[Accessed 1 December 2024].
Minister of Health, R., 2022. Permenkes No. 30 of 2022 concerning National Indicators of Health Service Quality Places for Independent Practice of Doctors and Dentists, Clinics, Community Health Centers, Hospitals, Health Laboratories, and Blood Transfusion Units. Jakarta: s.n.
Milgram, S., 1963. Behavioral Study of Obedience. Journal of Abnormal and Social Psychology, 67(4), pp. 371-378. DOI: https://doi.org/10.1037/h0040525
Myers, D. & Twenge, J., 2017. Social Psychology. 12th ed. New York: McGraw-Hill.
Niven, N., 2022. Health Psychology: An Introduction to Nurses and Other Health Professionals. 2nd ed. Jakarta: EGC.
Notoatmodjo, P., 2010. Health Behavioral Science. Jakarta: Rineka Cipta.
Putri, A., 2018. Overview of Authority Figures on Nurse Compliance in the Implementation of Standard Operational Procedures for Hand Hygiene. Indonesian Journal of Health Administration, 6(2), p. 164–172.
Rahmatiqa, C., Abdillah, N. & Yuniko, F., 2020. Factors that cause compliance filling medical records in hospitals. International Journal Of Community Medicine And Public Health, 7(10), p. 4180–4184. DOI: https://doi.org/10.18203/2394-6040.ijcmph20204393
Russell, N., 2011. Milgram’s obedience to authority experiments: Origins and early evolution. British Journal of Social Psychology, 50(1), pp. 140-162. DOI: https://doi.org/10.1348/014466610X492205
Sumaningrum, N. D., 2015. Factors related to the compliance of nurses washing handrub hands at the time of infusion installation at Hospital X in East Java. [Online] Available at: http://repository.unair.ac.id/29493/
[Accessed 1 December 2024].
Suriviana, S., Kusumapradja, R. & Widjaya, L., 2023. The Effect of Knowledge, Motivation, Organizational Culture on Medical Record Compliance Compliance in Hospitals. Jurnal Health Sains, 4(5), pp. 91-104. DOI: https://doi.org/10.46799/jhs.v4i5.905
Tandy, D., Witcahyo, E. & Utami, S., 2018. Compliance Analysis of Medical Record Filling at Kalisat Hospital Jember: An Analysis. Jurnal Kesehatan Masyarakat, 9(1), pp. 21-29. DOI: https://doi.org/10.22487/preventif.v9i1.84
Ulum, M. M. & Wulandari, R. D., 2013. Factors Affecting Compliance in Nursing Care Documentation Based on Compliance Theory. Indonesian Journal of Health Administration, 1(3), pp. 252-262.
WHO, 2009. WHO guidelines on hand hygiene in health care: first global patient safety challenge “Clean Care is Safer Care”. S.L.:S.N.