APPENDIX A

University of the East

RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER INC.

College of Nursing

Aurora Blvd., Quezon City

July 8, 2010

Prof. Wilhelmina Z. Atos, PhD, RN

College Secretary

UERMMMCI – College of Nursing

Aurora Blvd., Quezon City

Dear Ma’am:

The Level 4 students of the College of Nursing have just finished the Introduction to Nursing Research

course last semester and are currently planning for the implementation of their respective researches per

group. As instructed by the professors of the said subject and part of the subject Integrating Seminar, the

data implementation can start from summer of April 2010 up to the first semester of 4th year. These will

include the collection of the statistical and scientific informations and data from the participants

involved in the research. This will be helpful in the conduction of research.

In line with the said process, the group of H30 from Section H of the 4th year level would like to ask

your permission to allow the group to conduct our research, “The Relationship Between Washing and
the Number of Microorganisms present in the Sphygmomanometer Cuff used by Nursing Students in the

UERM Hospital” inside the premises of the institution and in Archon Laboratory for our culture and

sensitivity testing of the BP apparatus. The official start of the culture sensitivity test of the

sphygmomanometer will be on July 12, 2010. Furthermore, using the campus of UERMMMCI as the

venue for the survey research will allow the researchers to obtain the necessary data that will be

essential for their study.

We are hoping for your kind consideration.

Respectfully yours,

Ma. Nina Clariz O. Catacutan

Leader of H30

Noted by:

Prof. Wilhelmina Z. Atos, PhD, RN

College Secretary of UERMMMCI – College of Nursing

 APPENDIX B

University of the East

Ramon Magsaysay Memorial Medical Center

College of Nursing

Aurora Blvd., Quezon City

Informed Consent for Nursing Research

“The Relationship Between Washing and the Number of Microorganisms present in the

Sphygmomanometer Cuff used by Nursing Students in the UERM Hospital”

Purpose of Research:

The purpose of this study is to observe the relationship of the competencies of washing and

sterilizing technique the BP cuff in reducing if not totally eradicating microorganisms in the cuff and the

possible nosocomial infections that will arise from the microorganisms found in the cuff.

I understand that I am being asked to participate in a research study at University of the East

Ramon Magsaysay Memorial Medical Center – College of Nursing and at University of the East Ramon

Magsaysay Memorial Hospital. This research will evaluate the relationship of cleaning and sterilizing

technique of cuffs and the possible reduction of microorganisms of the BP cuff used by UERMMMCI

nursing students undergoing clinical duty”. If I agree to participate in the study, I will be given a 10-item

quiz on evaluating knowledge about regularity of washing and sterilizing the BP cuff. The procedures

will take place in the classrooms of the College of Nursing for the quiz. No identifying information will

be included when all of the procedures has been transcribed. No risks are associated with the study.
 I realize that my participation in the study is completely voluntary, and I may withdraw from the

study at any time I wish. If I decide to discontinue my participation in the study, I will continue to be

treated in the usual and customary fashion.

I understand that all study data will be kept confidential but his information may be used in

nursing publications or presentations.

I understand that if I sustain any injuries from my participation in this research project, I will not

be automatically compensated by the University of the East Ramon Magsaysay Memorial Medical

Center – College of Nursing and the University of the East Ramon Magsaysay Memorial Hospital.

If I need to, I can contact Ma. Nina Clariz O. Catacutan, research study leader during any time of

the study.

This study has been explained to me. I have read and understand this consent for, all of my

questions have been answered, and I agree to participate. I understand that I will be given a copy of this

signed consent form.

______________________________________ ___________________

Signature of Participant over Printed Name Date

______________________________________ ___________________

Signature of Investigator over Printed Name Date

 APPENDIX C

Year level: Name (optional):

Last ward assigned for duty:

1. Do you have your own BP cuff? Yes No

2. Do you clean your BP cuff? Yes No

3. If yes how often?

Every after duty Never

Once in 3 months

4. What is your preferred way on maintaining cleanliness of your BP cuff? Please specify.

Aseptic technique Other:

Basic cleaning(washing)

5. Is cleaning your BP cuff part of our vital signs taking lecture? Yes No

*if yes proceed to number 6: If no, proceed to number 7.

6. What is the cleaning technique taught by your clinical instructor? Arrange according to sequence

taught.

Washing & bleaching Direct sunlight exposure Placing in a bag

Cleaning with the use of alcohol Antiseptic sprays

7. How do you maintain cleanliness of your cuff?

Washing & bleaching Direct sunlight exposure Placing in a bag

 Cleaning with the use of alcohol Antiseptic sprays Others:

8. Have you observed any development of irritation of skin to your patient?

Yes No

9. Are the locations of the irritation relative to the placement of cuffs? Yes

No

* Please specify location

Shoulders Thigh

Arms Legs

10. Have you observed any development of diseases on patients?

Yes No

* Please specify if yes

Cough Sore throat Sinusitis

Colds Scabies Chickenpox

Strep throat Impetigo Others:

 Bibliography

Ahmed, S., Ahmad, R., Case, R., and Spencer, R. (2009 March). A study of microbial colonisation of

orthopaedic tourniquets. Annals of The Royal College of Surgeons of England, 91(2): 131–134.

Retrieved September 10, 2010 from http://www.ncbi.nlm.nih.gov/

American Diagnostic Corporation. (2006). How to clean, disinfect, and sterilize the DuraShock

sphygmomanometer. Use, care, and maintenance of the DuraShock integrated

sphygmomanometer. (2nd Ed.) [Brochure]. Retrieved March 14, 2010, from

http://www.adctoday.com

Baruah, J., Kumar, S., Gratrix, A., Dibb, W., and Madeo, M. (2008). Blood pressure cuffs as a potential

fomite for transmission of pathogenic micro- organisms: A prospective study in a university

teaching hospital. Journal of Infection Prevention, 9 (4): 19-21. Retrieved September 10, 2010

from http://bji.sagepub.com/

Base-Smith, V. (1996, April) Nondisposable sphygmomanometer cuffs harbor frequent bacterial

colonization and significant contamination by organic and inorganic matter. JAANA, 64(2): 141-

145.Retrieved March 12, 2010, from www.gehealthcare.com

Beard, M., McIntyre, A., & Roundtree, P. (1969, October 11). Sphygmomanometers as a reservoir

of pathogen bacteria. The Medical Journal of Australia, 2: 758-760. Retrieved March 12, 2010,

from www.gehealthcare.com
Berba, R., et al. (1998). Incidence, risk factors and outcome of hospital-acquired pneumonia in

critically-ill patients at the Philippine General Hospital. Retrieved March 12, 2010, from

http://www.psmid.org.ph

Boston University Medical Center. (May 2009). Multi-drug resistant gram-negative rods found in two

Philippine neonatal intensive care units. Retrieved September 10, 2010 from

http://www.sciencedaily.com/

Bruckner, M. (2008). Gram staining. Website:

http://serc.carleton.edu/microbelife/research_methods/microscopy/gramstain.html

Burton, G., Engelkirk, P. (2007). Burton’s microbiology for the health sciences (8th Ed). Philadelphia:

Lippincott Williams &Wlikins

Boyce, J., Potter-Bynoe, G., Chenevert, C., and King, T. (1997, September). Environmental

contamination due to methicillin-resistant staphylococcus aurues: possible infection control

implications. Infection Control and Hospital Epidemiology, 18(9): 622-627. Retrieved March 12,

2010, from www.gehealthcare.com

Cormican, M., Lowe, D., Flynn, P., and O'Toole, D. (1994). The microbial flora of in-use blood pressure

cuffs. Irish Journal of Medical Sciences, 4:112-3. Retrieved March 12, 2010, from

http://www.welchallyn.com

de Gialluly C, Morange V, de Gialluly E, Loulergue J, van der Mee N, and Quentin R. (2006,

September).
Blood pressure cuff as a potential vector of pathogenic microorganisms: a prospective study in a

teaching hospital. Infection Control and Hospital Epidemiology, 27(9):940-3. Retrieved March

12, 2010, from http://www.journals.uchicago.edu/

Dowling, R. (2010). Hospital acquired infections: a compendium. [Brochure] Retrieved September 10,

2010 from http://www.vital-signs.com/

Ellis,K. (2006, November 7). Fomites and infection transmission. Retrieved March 12, 2010, from

http://www.infectioncontroltoday.com

Hota, B. (2004, October 15). Contamination, disinfection, and cross-colonization: are hospital surfaces

reservoirs for nosocomial infection?. Clinical Infectious Diseases, 39:1182–9. Retrieved March

12, 2010, from http://www.journals.uchicago.edu/

ISO-Line Guardian Series. Impervious blood pressure cuff covers. Retrieved March 7, 2010, from

http://www.creativemedsolutions.com

Kim, K., Oh, Y., Cho, B., Houh, W., Kim, J., and Lee, Y. (1990, January).Norwegian scabies –

dissemination of mites by medical instruments. Annals of Dermatology, 2(1). Retrieved March 7,

2010, from www.gehealthcare.com

Kramer, A., Schwebke, I. and Kampf, G. (2006). How long do nosocomial pathogens persist on

inanimate surfaces? A systematic review. BMC Infectious Diseases, 6:130. Retrieved September

10, 2010 from http://www.biomedcentral.com/

Muench, D., Rajnik, M., (2010). Pneumococcal infections. Medscape. Website:

http://emedicine.medscape.com/article/225811-overview

Myers, M. (1978, January). Longitudinal evaluation of neonatal nosocomial infections: association of

infection with a blood pressure cuff. Pediatrics, 61(1):42-45. Retrieved March 12, 2010, from

http://pediatrics.aappublications.org

Noskin, G. A., Rubin, R. J., Schentag, J. J., Kluytmans, J., Hedblom, E. C., Smulders, M., Lapetina, E.,

and Gemmen, E. (2005). The burden of Staphylococcus aureus to U.S. hospitals: an analysis of

the 2000 and 2001 nationwide inpatient sample database. Arch Intern Med, 165:1756-1761.

Retrieved September 10, 2010 from http://www.ajicjournal.org/

W. A. Baum Co. Inc. Cuff cleaning procedure. Instrument cleaning and maintenance procedures.

Retrieved March 14, 2010, from http://baumanometer.com/docs/english.pdf

Walker, N., Gupta, R., & Cheesbrough, J. (2006). Blood pressure cuffs: friends or foe? Journal of

Hospital Infections, 64(2): 167-169. Retrieved March 12, 2010, from

http://www.springerlink.com/

Rhinehart,E. and Friedman, M. (1999). Infection control in home care. USA: Aspen Publishers Inc.

Siegel, J.D., Rhinehart, E., Jackson, M., and Chiarello L. (June 2007). 2007 Guideline for isolation

precautions: preventing transmission of infectious agents in healthcare settings. Retrieved

September 10, 2010 from http://www.cdc.gov/

Spencer, M., Cohen, S., Gulczynski, D., Cunningham, L., and Kelly, K. (2009). Nondisposable blood

pressure cuffs as a potential source for cross contamination. Society for Healthcare

Epidemiology of America. Retrieved September 10, 2010 from

http://www.workingtowardzero.com/

Todar, K. (2008). Todar's online textbook of bacteriology. Wisconsin: University of Wisconsin,

Department of Bacteriology. Website: http://www.textbookofbacteriology.net/index.html

Engelkirk, P., Burton, G. (2007). Burton’s microbiology for the health sciences (8th Ed.). Philadelphia:

Lippincott Williams &Wlikins

Gurr, E. (2008). Synthetic dyes in biology, medicine and chemistry: Safranin. London: Academic Press.

Website: http://stainsfile.info/StainsFile/dyes/50240.htm

Saviers, D. (2000). Crystal violet. Website: http://www.redwop.com/download/cryviol.pdf

(2010). Agar. Farlex Inc. Website: http://medical-dictionary.thefreedictionary.com/nutrient+agar

(2010). Gram staining. WordIQ. Website: http://www.wordiq.com/definition/Gram_stain

(2009). Denatured alcohol. Yahoo! Inc. website:

http://education.yahoo.com/reference/dictionary/entry/denatured%20alcohol

(2009). The american heritage dictionary of the english language (4th ed.). Houghton Mifflin Company.

Website: http://www.thefreedictionary.com

(2009). Mosby's medical dictionary (8th ed). Elsevier. Website: http://medical-

dictionary.thefreedictionary.com
(2007). The american heritage science dictionary. Houghton Mifflin Company. Website:

http://www.thefreedictionary.com

(2006). Gram stain. Website:

http://www.brooksidepress.org/Products/Military_OBGYN/Lab/GramStain.htm

(2005). Culture testing. U.S.: National Institute of Health. Website: http://www.cancer.gov/dictionary/?

CdrID=556412

(2002). Vacutainer. McGraw-Hill Concise Dictionary of Modern Medicine. The McGraw-Hill

Companies, Inc. Website: http://medical-dictionary.thefreedictionary.com/vacutainer

(2000). Nutrient agar. Mondofacto. Website: http://www.mondofacto.com/facts/dictionary?

nutrient+agar

(2006) How to clean a bp cuff Website: http://www.livestrong.com/article/200344-how-to-clean-a-bp-

cuff/#ixzz0xTb7Ag7K