Hand washing remains a fundamental element of the nursing practice and a key determinant of patient safety in all health care settings. Although its relevance was proven as far back as the mid-19th century through the works of Ignaz Semmelweis, the evidence today continues to prove that it is vital in healthcare-associated infections prevention. The development of a nursing theory on hand washing offers an opportunity to integrate history, behavioural constructs and the environment in a unified framework to explain and guide hand hygiene practices. This paper examines the development of hand washing in nursing, considers existing theories that relate to hygiene and infection control, and considers the conceptual elements that are required for theorizing hand washing as a nursing-specific behaviour. Drawing on behavioural models, institutional perspectives and empirical research findings on compliance, the suggested theory emphasizes the interaction between knowledge, self-efficacy and motivation or environmental support and institutional culture in adopting effective hand hygiene behaviour. It further highlights technique quality as an intermediary variable between hand washing frequency and infection control outcome. The significance of this theoretical development is that it can be applied to nursing education, policy formulation, and clinical intervention design.

Keywords: Development, Nursing Theory, Hand Washing, Hand Hygiene,