<![CDATA[Background: Healthcare-Associated Infections (HAIs) are an important indicator of healthcare quality and patient safety. Inhalation therapy devices, including micromist nebulizer components, require appropriate cleaning and handling to minimize contamination and cross-infection risks. A preliminary audit in the 5C Inpatient Ward of Hospital X, Jakarta, showed that nurses’ compliance with micromist cleaning after inhalation therapy was 57.1%, while 42.9% of observed procedures were not compliant with the applicable SOP. Objective: To describe nurses’ baseline compliance and the development of SIM-CLEAN (System for Monitoring Micromist Cleaning After Inhalation) as a nursing management innovation to strengthen compliance with micromist cleaning after inhalation therapy. Methods: A descriptive case report was conducted using direct observation of 56 inhalation procedures over one week, SOP-based compliance auditing, interviews with 10 staff nurses, identification of contributing factors, and development of SIM-CLEAN using the Plan-Do-Check-Act (PDCA) approach. Results: Of 56 observed inhalation procedures, 32 (57.1%) were followed by micromist cleaning according to the SOP, whereas 24 (42.9%) were not. Interview findings identified the absence of a monitoring checklist (90%), visual reminders (80%), cleaning documentation (80%), inadequate supervision (70%), and forgetting to clean the device (60%). Three-month contextual safety data included 3 respiratory infection cases related to care, 2 respiratory-device colonization cases, 1 reported cross-infection event, and 5 near-miss events involving uncleaned inhalation devices. SIM-CLEAN was designed to integrate a monitoring checklist, visual reminders, cleaning documentation, head-nurse supervision, and periodic evaluation. Conclusion: A compliance gap was identified and requires system-level reinforcement. SIM-CLEAN has potential as a nursing management intervention to strengthen monitoring, documentation, supervision, and safety culture. Quantitative effectiveness requires complete post-intervention audit data.]]>
