The 5R culture (Sort, Set in Order, Shine, Standardize, and Sustain) supports workplace sanitation and housekeeping, which are important for controlling rats in hospital environments. This study aimed to analyze the relationship between the implementation of the 5R culture and the presence of rats at Hospital “X” in Surabaya City. An observational analytic study with a cross-sectional design was conducted in 51 rooms selected through total sampling. Data were collected through observation and analyzed using univariate and bivariate analyses with an exact test. The results showed that 41.2% of rooms had good 5R implementation, 47.1% moderate, and 11.8% poor. Signs of rat presence were identified in 11.8% of rooms. Statistical analysis showed a significant relationship between 5R implementation and rat presence (p<0.001). These findings indicate that consistent 5R implementation is associated with better environmental control in hospitals.
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