COMPLIANCE WITH THE STANDARD PRECAUTION PRACTICES AMONG

STAFF NURSES IN SELECTED HEALTH INSTITUTIONS

IN BATANGAS CITY

An Undergraduate Thesis
Presented to the Faculty of the
College of Nursing and Midwifery
University of Batangas
Batangas City, Batangas, Philippines

In Partial Fulfilment
of the Requirements for the Degree
Bachelor of Science in Nursing
Nursing Research

By:
Aloria, Mikhail Andre A.
Candava, Xyrene Joy R.
Danduan Jessamine M.
Orkeghen, Ruth Mbakaan
Tupaz, Shazney Kathleen A.
Vasquez, Emilyn S.

Thesis classification: B

June 2021

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

1 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 DECLARATION OF AUTHORSHIP

The researchers hereby declare that this submission is their own work

and, to the best of their knowledge, it contains no materials previously published

nor written by another person. This work does not also contain materials which,

to a substantial extent, has been accepted for an award of any other degree or

diploma, except where due acknowledgement is made in the manuscript. Any

contribution made to the research by other, with whom we have worked at the

University of Batangas or elsewhere, is explicitly acknowledged in the

manuscript.

They also declare that the intellectual content of this manuscript is the

product of our their work, except the assistance that we received in the project's

design, concept and style, presentation and linguistic expression which we also

acknowledge.

Signed:

Date Signed:

Signed:

Date Signed:

Signed:

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

2 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
Date Signed:

Signed:

Date Signed:

Signed:

Date Signed:

Signed:

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

3 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 ACKNOWLEDGEMENT

This undergraduate thesis becomes a reality with the kind of support and

help of many individuals; the researchers would like to extend their deepest

gratitude and sincere appreciation to all of them.

First and foremost, praises and appreciation to the God, the Almighty, for

the showering blessings all through the way and to complete this research

successfully.

They are highly indebted to the University of Batangas College of Nursing

and Midwifery for their guidance and constant supervision as well as providing

necessary information regarding this research and completing this endeavor.

To Mrs. Sofia Catibog RN, MAN., the Dean of the College of Nursing and

Midwifery, for her effort in checking and giving enough time in the process of

making this study.

They would also like to express their deep and sincere gratitude to their

research adviser, Mrs. Maria Joycelyn Zaraspe RN, MAN., for her unending

support and imparting her knowledge as well as expertise in this study.

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

4 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 A profound gratitude to the distinguished members of the panelists, Dr.

Mardes M. Asilo RN. MAN. MBA, Dr. Mark John Thomas D. Buquiz RN. MAN

and Mrs. Aquilina L. De Ramons RN. MAN, for their meaningful advices that

guide the researchers for the better results of the study and exemplary

recognition.

To the statistician, Dr. Romell Ramos, who gave suggestions as well as

help in analysis and interpretation of data of the study

To the researchers' loving parents and friends for their moral

encouragement and spiritual support in every path the researchers took and

lastly;

To all relatives, friends and others who in one way or another shared their

support, either morally, financially and physically, thank you for all unwavering

assistance.

The Researchers 

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

5 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 DEDICATION

This study is wholeheartedly dedicated to the researchers’ beloved loved

ones, who have been their source of inspiration and gave them strength when

they thought of giving up, who continually provide their moral, spiritual, emotional

and financial support.

To Almighty God, that provides strength, guidance, power of mind,

protection, wisdom and for giving the researchers’ a healthy life.

To their parents, friends, mentors and advisers who shared their words of

advice, knowledge and encouragement to make this study possible.

They finally dedicate this to all individuals whose untiring support and

assistance have made possible to the fruition of their efforts. All of these, they

offer to all of you.

The Researchers 

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

6 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 Table of Contents
Page
TITLE PAGE I
DECLARATION OF AUTHORSHIP Ii
ACKNOWLEDGMENT iii
DEDICATION V
TABLE OF CONTENTS Vi
LIST OF TABLES Viii
LIST OF FIGURE ix
Chapter 1 The Research Problem
Introduction 1
Theoretical/ Conceptual Framework 6
Statement of the Problem 9
Hypothesis of the Study 10
Scope, Delimitation and Limitation of the Study 11
Significance of the Study 12
Definition of Terms 13
Chapter 2 Review of Related Literature and Studies
Related Literature 16
Related Studies 30
Synthesis 33
Chapter 3 Research Methodology
Research Design 36
Respondents/ Subjects of the Study 37
Ethical Consideration 38
Data Gathering Instruments 39
Data Gathering Procedures 40
Statistical Analysis of Data 41

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

7 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
Chapter 4 Presentation, Analysis and Interpretation of Data 47
Action Plan 69
Chapter 5 Summary, Findings, Conclusions and 69
Recommendations
Summary 70
Findings 72
Conclusions 76
Recommendations 77
BIBLIOGRAPHY 79
APPENDICES
I. Letter to Conduct the Study 83
II. Application for Research Ethics Review 85
III. Research Ethics Review Results 91
IV. Survey Questionnaire 93
V. Waiver 98
VI. Informed Consent 100
VII. Milestone or Time Table 102
VIII. Budget Proposal 104
CURRICULUM VITAE 105

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

8 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 LIST OF TABLES
Table Page
Number

1 Table of Samples 37

2 Frequency and Percentage Distribution as to Age of 47

Respondents
3 Frequency and Percentage Distribution as to Gender of 48
Respondents
4 Frequency and Percentage Distribution as to Highest 49
Educational Attainment of Respondents
5 Frequency and Percentage Distribution as to Length of 50
Work Experience of the Respondents
6 Frequency and Percentage Distribution as to Area of 51
Assignment of the Respondents
7 Frequency and Percentage Distribution as to Working 53
Position of the Respondents
8 Frequency and Percentage Distribution as to Shifting 54
Schedule of the Respondents
9 Frequency and Percentage Distribution based on the 55
Standard Precaution-Related Trainings/Seminars Attended
by Staff Nurses
10 Mean Response of Staff Nurses’ Compliance to Standard 57
Precautions on Proper Hand Washing
11 Mean Response of Staff Nurses’ Compliance to Standard 59
Precautions on Use of Personal Protective Equipment and
Proper Disposal
62
12 Mean Response of Staff Nurses’ Compliance to Standard
Precautions on Safe Injection Practices and Handling
13 Relationship between the Profiles of the Respondents and 64
Compliance with the Standard Precaution Practices among
Staff Nurses

Address: Hilltop Road, Brgy. Kumintang Ibaba, Batangas City 4200,

9 Philippines
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 LIST OF FIGURE
Figure Page
Number

1 Relational Pattern of Compliance with the Standard Precaution 7

Practices among Staff Nurses in Selected Health Institutions in
Batangas City
 CHAPTER 1
The Research Problem

Introduction

In most developing countries, including the Philippines, infection in

healthcare facilities was a major public health problem. The total incidences of

health-care-associated infection had risen recently, and the burden of these

infections is immense. Regardless of a patient's infection status, standard

precautions were widely recognized recommendations for infection prevention

practices in health care settings. These numerous recommendations not only

help to prevent health care staff from being infected when caring for patients, but

they also help to minimize infection spread among patients. The priority,

however, was to keep health-care workers (HCWs) safe from blood-borne

pathogens.

Standard Precautions are work procedures that must be followed in order

to maintain the highest degree of infection prevention for all customers,

regardless of diagnosis. It encompasses all policies, practices, and activities

aimed at preventing or reducing the risk of infectious disease transmission in

health-care settings. Standard precautions are recommended for all patients,

regardless of whether they are infected or not. Hand hygiene, personal protective

equipment to avoid needle sticks or sharp injuries, waste control, instrument

processing, processing linen, housekeeping, and clinical laboratory facilities are

all standard precautions. Occupational exposure to blood and bodily fluids is a

serious problem for health-care staff, and it poses a significant risk of infection

transmission.

1
 The Centers for Disease Control and Prevention (CDC)(2017) coined the

term "standard precautions" to describe this modified version of universal

precautions, as the preventive recommendations were updated to include not

only blood but also body fluids. Since a patient's infectious status cannot always

be determined, it is recommended that standard precautions be taken when

dealing with all types of patients, regardless of their infectious status. Even if the

patient didn’t have a reported presence of an infectious agent, standard

precautions presume that blood and other body fluids, including secretions and

excretions, have the ability to spread pathogens (Zeb, 2019).

Every nurse should be aware of compliance to standard precaution

or infection control because noncompliance with this is linked to the spread of

infection. Nosocomial infection is one of the leading causes of morbidity in the

medical field. Healthcare-associated diseases are serious issues in the

healthcare industry that put patients' safety at risk. Nurses should be

knowledgeable about infection prevention and follow standard precautions when

providing treatment to patients. This provides a first line of defense against

infection.

Nurses in various parts of the world have inadequate knowledge of

common measures and infection prevention procedures, according to studies

published in the American Journal of Biomedical Science and Research

(Zeb.,2019). Nurses were practitioners who supported people. They may have

become more vulnerable to infections as a result of their lack of knowledge about

these forms of precautions and diseases. Nurses from various parts of the world

2
conformed to common precautions in varying degrees. The main method for

avoiding hospital acquired diseases in both healthcare personnel and patients

was to strictly follow standard precautions. Standard precautions were the most

detailed and up-to-date recommendations for preventing infectious risk. They

focused on the premise that all blood, body fluids, secretions, and excretions,

with the exception of sweat, non-intact skin, and mucous membranes, which

contain infectious agents that can be transmitted. (Donati, Biagioli, 2019)

Standard Precautions includes eye protection, avoidance of needle

recapping, glove use when required, personal protective equipment use when

needed, hand washing before and after patient contact, use of face masks, and

avoidance of a used syringe. Healthcare professionals' compliance with standard

precautions was reported to be inadequate. (Abdo., 2017) According to standard

precautionary guidelines, a number of items were required for successful

infection control. Hand hygiene, the use of gloves and other personal protective

equipment (PPE), proper cleaning and disinfection of patient care equipment and

environment surfaces, proper waste disposal, proper management of used

needles and other sharp objects, and proper cough etiquette were all important

because they prevent the spread of microorganisms from one patient to another

through healthcare workers (Tartaglini, 2019).

Healthcare-Associated Infections (HAIs) cannot be prevented, particularly

if proper procedures were not followed, so they continued to be the most

common adverse event in any healthcare delivery system, affecting millions of

people each year and causing substantial morbidity and mortality.

3
Microorganisms were frequently exposed to health care workers, especially

nurses, and many of them can cause severe or even fatal infections. When the

Centers for Disease Control and Prevention (CDC) issued the Standard

Precautions, they established guidelines to avoid exposure, but despite their

simplicity and accuracy, nurse compliance was low (Haile., 2017). Regardless of

the infectious agents identified or expected at the time, standard protocols are

highly enforced and practiced at any healthcare activity for all patients at all times

to avoid unwanted diseases.

Despite organizations' widespread acceptance of Standard Precautions,

weaknesses in their implementation by healthcare workers had been found

(Powers 2016), and percutaneous injuries from needle sticks and sharps

continue to be a concern (Kevitt 2017). Inadequate infrastructure, such as a lack

of hand washing facilities; a lack of knowledge about transmission; inadequate

personal protective equipment (PPE); worker risk behaviors; and unsafe working

conditions are among the obstacles identified by healthcare staff (Porto 2017).

This resulted to strategies being devised to encourage the use of Standard

Precautions as the foundation for infection prevention and control. According to

BioMed Central Research Notes (2017), implementing standard precautions (SP)

had been a significant challenge for health care staff, particularly in developing

countries, putting their safety at risk and their exposure to blood-borne

pathogens. Health workers' adherence to safety precautions and workplace

injuries were often unreported.

4
 Higher authorities were able to use the findings to help them take further

measures to correct possible inefficiencies in enforcing and complying with

standard precautions. A total of 35 registered nurses had been recruited through

ease and simple random sampling from two separate hospitals: United Doctors

of St. Camillus de Lellis Hospital with 20 participants, and Batangas Health Care

Hospital – Jesus of Nazareth with 15 participants. At each hospital, volunteers

were chosen at random from different departments and recruited to participate in

the study. To gather additional data and observations, the researchers used self-

administered survey questionnaires. The researchers included their findings on

respondents' readiness and precision in conducting the survey.

The primary aim of the research was to identify and assess how well

different staff nurses adhered to standard precautions. More specifically, it

reflected and demonstrated the importance of infection prevention and control

activities implemented in various health institutions of Batangas Province in an

effort to raise staff nurse awareness of how to prevent the spread of various

hospital infections as a result of noncompliance. As a result, nurses were able to

participate in infection control programs as first-line staff, such as following

standard precautions. Furthermore, after eventually completing this study, the

researchers' trust and self-achievement increased significantly.

Theoretical Framework

The research study is integrated with some health theories that further

support the practice of health promotion, disease prevention and improvement of

health behavior. Health Belief Model (HBM) as cited in the Behavioral Change

5
Models by Lamorte W. (2019), a psychological model aimed at understanding

and predicting health-related behaviors. It recommends that a person's belief in

an individual threat of a disease or illness along with a person's belief within the

effectiveness of the prescribed health behavior or activity predicted the likelihood

the individual adopt the behavior. Rosenstock I. et al, social psychologists at the

US Public Health Service, created this theory.

The HBM derived from mental and behavioral hypothesis with the

foundation that the two components of health-related behavior are the desire to

avoid illness, and the belief that a particular wellbeing action will prevent, or cure,

ailment. (LaMorte, 2019). Key components of the health belief model center on

person beliefs about health conditions, which predict individual health-related

behaviors. It characterizes the key components that impact health behaviors as

an individual's perceived danger to disease or infection (perceived susceptibility),

belief of consequence (perceived severity), potential positive results of action

(perceived benefits), perceived boundaries to action, exposure to variables that

prompt action (cues to action), and certainty in ability to succeed (self-efficacy).

The theory of Health Belief Model Rosenstock et al is relevant to the

researcher's study as it caters the adaptation of health behavior based on the

perceived health threat. It referred to the delivery and protection of patient care

and safety, as well as raising awareness and proper adherence to standard

precautions. It also considered the relationship between a patient's health needs

and the nurse's role in promoting those needs. In addition, it supported protection

by preventing collisions, injuries, and trauma, as well as the spread of infection.

6
At its core, it is utilized to clarify and predict individual changes in health

behaviors as to compliance to standard precautions.

Biological theory, according to Newman S. ( 2020), was committed to

theoretical improvements within the areas of evolution and cognition, with a

center on the intellectual integration managed by developmental and evolutionary

approaches to an individual. It referred to a person's ability to grow and evolve

over time. As a result of the biology and physiology, it was believed to be a

biological and therefore physical examination of emotions, feelings, and

behaviors.

Newman's theory was also related on the study since it was a branch of

biology that studied the mechanisms by which multicellular organisms grow and

develop. As a result, it enabled a person to recognize and be mindful of the

various effects of his or her actions as a result of his or her decisions. The

biological viewpoint was a way of looking at human issues and behavior from a

biological standpoint.

Conceptual Framework

7
 Figure 1.1 Relational pattern of Compliance with the standard precaution
practices among staff nurses in selected health institutions in Batangas City
The first figure, which is the input column, indicates the demographic

profile of the respondents, the trainings and seminars related to compliance of

standard precautions attended by the staff nurses, and the respondents'

compliance as to proper hand washing, use of personal protective equipment

and proper disposal and safe injection practices and handling. It is followed by an

arrow leading to the second column the process, which presents the hypothesis

of the study. A second arrow leading to the third figure, indicates the output of the

research which is a recommended plan of action to enhance compliance to

standard precautions among staff nurses.

8
Statement of the problem

This study aimed to determine and evaluate the nurses’ compliance with

Standard Precaution Practices in selected health care institutions in Batangas

City Province. More specifically it sought to find the answers to the following:

1. What is the profile of respondents in terms of:

1.1 Age,

1.2 Gender,

1.3 Type of institution,

1.4 Highest Educational Attainment,

1.5 Length of work experience ,

1.6 Areas of assignment ,

1.7 Working position ,and

1.8 Shifting schedule ?

2. What are the trainings and seminars attended by the respondents related to

the compliance of standard precautions?

3. To what extent do nurses comply to standard precautions as to:

3.1 Compliance on proper hand washing

3.2 Compliance on use of personal protective equipment and proper

disposal and lastly;

3.3 Compliance on safe injection practices and handling

4. Is there a significant difference between nurses’ profile and compliance to

standard precaution practices?

9
5. What plan of action can be proposed to enhance compliance to standard

precautions?

Hypothesis

The researchers tested the null hypothesis that there is no significant

difference between the profiles of respondents and compliance with the standard

precaution practices among staff nurses in selected health institutions in

Batangas City.

Scope and Delimitation of the Study  

The focus of the study was to assess the compliance of staff nurses on the

standard precautions. More so, conducting a study can provide a greater

understanding and evaluation on the different measures that can be done to

enhance compliance to standard precautions. The study only involved 35

respondents from two different healthcare institutions namely, United Doctors of

St. Camillus de Lellis Hospital and Batangas Health Care Hospital – Jesus of

Nazareth.

The data and interpretation that had been gathered by the researchers were

limited only to the answers based on the questionnaires. Due to the safety risks

brought by the public health emergency and strict compliance of different other

health institutions situated at Batangas City, only two (2) hospitals permitted the

researchers to conduct this study. The researchers come up to a plan or

schedule of delivering a letter and questionnaire to each healthcare institution. In

assurance of their safety, researchers find contact personnel in each institution

10
that can assist in addressing concerns. In regards to that, researchers

encountered difficulties in informing thoroughly the medical directors, chief

nurses, and staff nurses regarding the objectives and importance of the study.

Accordingly, twenty (20) respondents were from the United Doctors of St.

Camillus de Lellis Hospital and fifteen (15) and Batangas Health

Care Hospital – Jesus of Nazareth. These hospitals were selected based on

specific criteria such as private healthcare institutions and tertiary healthcare

institutions.

Generally, this study limits its coverage on the three (3) out of ten (10) set of

standard precaution practices — compliance on hand washing, compliance on

use of personal protective equipment and proper sharp disposal and compliance

on safe injection practices and handling. This specifically tackles on the

compliance of staff nurses alone and the results of this study cannot be

generalized all the registered nurses working in the province. Thus, compliance

of other hospital personnel and patients were not be covered.

Finally, the researchers guaranteed to the respondents the privacy and

confidentiality of the data gathered from them. This was to ensure anonymity and

safety of the respondents. In addition, this study had been conducted with limited

amount of financial resources and time framework. More so, the researchers had

delimited their study on the degree of willingness, honesty, sincerity and integrity

of the respondents exhibited on the course of the study.

Significance of the Study

11
 The objective of this study is to gain knowledge and put information to the

readers about the topic of this research. The researchers believe that the findings

of this study would be valuable to the nurses, educators, student nurses, and

future researchers.

Administrators of Health Institutions. The study gives

various institutions ideas about what they can change or develop. This will help

aid in the creation of better guidelines and protocols for healthcare workers'

compliance.

Staff Nurses. The nurses will be able to comply better when it came to

the said subject and they can focus on their work on how to solve the problems

with compliance with standard precautions. It also demonstrates the

consequences of their decisions in the hospital setting, allowing them to

comprehend more about the subject and make a difference in their

comprehension and success for better adaptation and understanding.

Patients. It can educate people, especially patients in a hospital

environment, on the importance of following standard precautions, which helps to

prevent hospital-acquired infections and improve patient safety.

Student Nurses. Similarly, student nurses are able to understand the

significance, benefits, and drawbacks of making an application of learning by

traditional precaution procedures and related factors.

Future Researchers. Furthermore, the results of this study will provide

necessary reference material for future researchers who would perform similar

12
studies. It will make it easier for future researchers to collect some of the similar

information found in this study.

Researchers. The researchers will benefit from the study because they

can learn more about the subject and develop a better understanding of it. This

paper made a two-fold contribution to the literature. To begin with, this study aids

in the improvement of nurse awareness and comprehension, as well as that of

the researchers. The second contribution was to show how these variables

influenced nurse output in the hospital environment.

Definition of Terms

The following terms were defined in different journal articles or references

hence the definitions are defined operationally and conceptually.

Compliance. This refers to act or process of complying to a desire, demand,

proposal or regimen or to coercion (Meriam Dictionary, 2020). In the

study, it pertains to the obedience of staff nurses on the standard

precautions being implemented by an institution.

Contaminations. This refers to the act of process of making something dirty or

poisonous, or the state of containing unwanted or dangerous

substances (Cambridge Dictionary, 2020)

Health Institutions. This refers to the organizations that provides health care

and related services to the provision of inpatient and outpatient care (IGI

Global Dictionary, 2020). In the study, it pertains to the facility that

provides short term or long term care to the patients.

13
Microorganisms. This refers to an organism such as bacterium of protozoan or

microscopic or ultramicroscopic in size (Meriam Dictionary, 2020). It is

used in the study as it pertains to bacteria, fungi and virus.

Morbidity. This refers to a diseased state or symptom (Meriam Dictionary,

2020). It is used in the study as state of being ill and cases of people who

has diseases.

Mortality. This refers to death (Meriam Dictionary, 2020). As viewed in the

study, it pertains to decease or demise of people.

Pathogens. This refers to a specific causative agent (such as a bacterium or

virus) of disease. (Meriam Dictionary, 2020). It pertains to an organism

that causes diseases or illnesses.

Personal protective equipment (PPE). This refers to equipment such as

gloves, masks, and gowns worn by people who are at risk of injury or

infection (Collins Dictionary, 2021). It is used in the study as refers to the

protective clothing that minimize exposure to hazards that cause serious

workplace injuries and diseases among staff nurses.

Precaution. This refers to a measure taken beforehand to prevent harm or

secure good (Cambridge Dictionary, 2020). As viewed in the study, it

pertains to an action of an individual to prevent any harm in the health

condition of a person.

Safe injection handling. This refers to designating a place where intravenous

drug users may inject drugs under supervision of medical staff (Oxford

14
 English and Spanish Dictionary, 2021). As it viewed in the study, it

pertains to safe handling and disposal of needles and other sharps.

Standard Precautions. This refers to the minimum infection prevention practices

that apply to all patient care in any health care setting to prevent

spreading of infections among patients (Centers for Disease Control and

Prevention, 2018) As it viewed in the study, it pertains to practices on

hand hygiene, use of personal protective equipment, sharps safety, safe

injection practices, sterile instruments and disinfected environmental

surfaces.

Transmissible infectious agents. This refers to infectious agents that are

generally used to describe and encompass any material that can cause an

infection and disease. (California State Polytechnic University, 2020)

Chapter 2

Related Literature and Studies

This chapter presents a review of related studies as well as literature

related to the present study. The related literature provided information about on

compliance on standard precautions, knowledge and competencies, nursing

responsibilities and potential risks.

Demographic Profile

15
 Standard measures, according to the Centers for Disease Control and

Prevention (CDC) (2018), are the minimum infection prevention procedures that

extend to all patient care, regardless of the patient's suspected or confirmed

infection status, in every environment where health care is given. According to

the literature, major detailed factors that affect compliance with standard

precautions include, but are not limited to, a lack of understanding and expertise

among healthcare workers on standard precaution, a lack of time to enforce the

safety measures (work overload), limited assets, a lack of adequate training,

uncomfortable equipment, skin irritation, distraction, and distance from the critical

facilities, and inadequately support from administration in making an encouraging

work environment.

In addition, certain socio-demographic factors such as age, sex, job group,

marital status, working position within the hospital, and work experience were

also found to be linked to adherence to standard safety measures. Interventions

tried in other countries to improve healthcare workers' compliance with SPs

include, but are not limited to, in-service instructions on SPs above the normal

stage, pre-service training by including SPs in educational programs, and

individual protective equipment accessibility. Haile et al. (2017).

According to Uthaman, et al (2016), the widespread lack of nurses was

exacerbated by the aging population, which explains why there are more nurses

in hospitals in the middle of their 30s. Reductions in aerobic capacity, strength

and stamina of the muscles, reaction speed, sensory acuity, sleep disorder and

an increased risk of chronic disease all had to do with age. While elderly nurses

16
are vulnerable in the middle of older nurses, they have many advantages.

Patients are considered the most competent and successful in their later years.

They have more experience in life, better communication skills, are more

committed and loyal, take less sick days, and have less opportunities to work in

other countries.

According to D’Antonio (2020), Well-educated women could greatly

improve the treatment of disease patients through scientific concepts and

informed lifestyle education as nightingale believed. In addition, she thought

nursing was an ideal autonomous calling full of intellectual and social

independence, offering women with few other career opportunities at the time.

Nursing was a good job for women, according to Florence Nightingale, as it

expanded her domestic function. Nightingale was generally agreed to depict the

nurse as a subordinate, loving, domestic, humble and unskilled person.

Traditionally, becoming a nurse has become a caring, hard-working woman.

In line with the study of Chenjuan Ma, PhD (2017), sspecifically by the

number of nurses with at least the bachelor’s degree, a professional nursing staff

is necessary and one strategy to prepare the workforce is to promote the training

of nurses. They need training to develop the core skills required for their patients

and their profession to be leaders and, most critically, public advocates. More

research has shown that the quality of treatment and patient outcomes are

associated with more schooling. A higher proportion of nurses have been linked

to the BSN (Bachelor's Degree in Nursing), several studies have helped nurses

improve the critical thinking skills they would need to contribute to the transition.

17
 According to Fukada (2018), many evaluation studies on nursing skills is

based on nurses with 1-5 years of expertise, and the advancement of mid-level

nursing skills is little understood. New nurses concentrated more on the activities

involved, thereby improving basic nursing skills such as ethics and tasks. It is

difficult for them, on the contrary, to provide individualized nursing services that

respect the lifestyle of patients and take part in professional growth.

According to Monti (2021), medical careers continue to grow at an

unprecedented pace. A the number of specialized care positions for registered

nurses (RRNs) and registered advanced practice nurses have increased the

demand for healthcare services (APRNs). One of the most enticing features of

nursing is the ability to function in many settings and tasks. With the emergence

of many specializations, nurses can now focus on a specific area of practice or

patient population through the acquisition of work experience and the fulfillment

of particular qualifications.

According to Lee (2020), all health services are concerned with the

safeguarding of human health but, in particular, greater consideration is needed

for high risk children. In the fast-growing health care sector, neonatal health care

is one of the most challenging and rewarding careers. In the first days or weeks

after birth, this specialization focuses on the treatment of premature babies with

health problems. NICU nurses also supported parents by facilitating contact

between newborns and their parents in adapting to their new positions as

parents. They needed to acquire experience on a variety of diverse approaches

covering various areas in order to address the rapidly evolving health needs of

18
newborns and had outstanding clinical decision making skills to provide adequate

and timely treatment on the basis of newborns conditions. The clinical decision-

making skills of the NICU infants are one of the nursing competences that

improve nursing success and have a positive impact on newborn care results.

According to, Kellye (2018) around 7 am and 11 a.m., hands-on activities

happened more often and longer. The majority of nurses prefer this time, as the

day shift generally becomes busier and the hospital is fully equipped, so more

hands are available to help. In addition, most scheduled, non-emergent

procedures have taken place during the day, giving enough room for more skills

development.

Trainings and Seminars

According to the study of Asiri et al (2020), healthcare-associated

diseases (HAIs) are apparently a serious public wellbeing concern universally. It is

capable of the increase in morbidity and mortality of patients that included high

costs, expanded require for progressed therapeutic care, and the utilization of

medications to treat HAIs. Nurses served as front liners which they ended up

vulnerable in procuring HAIs.

Consequently, their commitment requires serious consideration of the

execution of infection control procedures. In a nutshell, a well-planned disease

anticipation programs and training are exceedingly significant in foreseeing

spread of HAIs.

19
 According to the article of Weber R. (2019), nursing education help nurses

with their skills to effectively do their jobs. Different health institutions provide

tailored education for nurse to continuously train them. A great deal of these

training programs gives them with the information on what’s needed of them to be

effective in numerous parts in nursing.

Furthermore, excellent training programs for nurses outlined the

development curve of nurses. Accordingly, one of its objectives is to impart

nursing staff all the fundamentals on patient healthcare and maintain the

responsibilities as nurses.

Compliance on hand washing

According to a report conducted by the Centers for Disease Control and

Prevention (CDC) (2018), standard precautions are a series of infection

prevention procedures that apply to all patient care in every healthcare

environment, regardless of health status. Hand hygiene, the use of personal

protective equipment (e.g., gloves, masks, and eyewear), respiratory hygiene/

cough etiquette, and sharps safety practices are all part of it.

Following that, it was claimed that hand hygiene is the most efficient form

of preventing pathogen transmission associated with health care, and that the

use of personal protective equipment should be driven by risk evaluation and the

degree of expected interaction with blood and body fluids, or pathogens. As a

consequence, it has the ability to protect health-care staff and patients from

infection. Blood-borne infections acquired during clinical and laboratory services

20
have remained a major public health concern around the world, especially in low-

income countries where such infections are associated with high morbidity and

mortality (Malawi Med J. 2017)

Accordingly, hand washing is one of the first successful ways to minimize

the spread of bacterial and viral sicknesses. To appropriately wash the hands

and be compelling, utilize soap and rub each surface of the fingers and hands for

at least 20 seconds. Consequently, standard hand washing can compel the

transfer of organisms by following the in-depth direct or step-to-step direct a few

times during the day Leonard J. (2020).

Compliance on use of personal protective equipment and proper disposal

According to Banaser (2020), nursing staff must consider a variety of

factors, including instruction on how to prevent and manage infections, as well as

how to protect themselves by wearing protective clothing. There are also

procedures for preventing infections by learning how different forms of infections

occur so that nurses can make the best decisions. Regardless of whether there

is a risk of infection or not, despite the availability of custom provisions, it is

widely recommended that nurses take precautions.

Exposure to infectious materials can be reduced by following standard

precautions, which are intended to mitigate the risk of contracting an

occupational infection in the healthcare setting from both known and unknown

sources. Standard precaution, according to Magar (2019), is a community of

infection-prevention procedures that extend to all patients, regardless of

21
suspected or confirmed diagnosis or presumed infection status. They are the

most common infection prevention measures that can be used when providing

treatment to all patients, regardless of whether they are infected or not. In the

event of potential infection or a chance of contact with blood, body fluids,

secretions, or excretions other than sweat, the equipment should be deemed

contaminated, regardless of the presence or absence of clear blood and skin with

continuity solution and mucous tissues. This aided in the prevention and

elimination of HAI, as well as the protection of nurses from a variety of injuries.

Compliance with routine precautions by healthcare professionals has been

identified as an efficient and reliable method of preventing and controlling health-

care-associated infections in patients and health-care workers.

In accordance with the study of McCarthy et al (2020) expressed that

donning and doffing of PPE plays a significant role in minimizing contamination of

healthcare providers caring for patients with transmissible infectious ailments. In

this way, it is vital to mitigate spread and keeping up the healthcare workforce.

Inadequately instruction and training relating to appropriate utilization of PPE can

unfavorably impact compliance with recommendations for PPE utilization.

Besides, they emphasized that PPE secures healthcare providers from harmful

pathogens by maintaining a strategic distance from exposure to bodily fluids and

respiratory droplets. In that sense, reasonable utilization of PPE is one of the first

essential procedures for guaranteeing both patients and healthcare specialists

from distinctive pathogens.

22
 According to the study of Blahd Jr. W. (2019), hypothesized that blood and

body fluid safety measures include the utilization of protective barriers such as

gloves, gowns, covers, and eye security. These diminish the chance of exposing

the skin or mucous membranes to conceivably infectious fluids.

Health care workers need to ceaselessly utilize protective barriers to

guarantee themselves from exposure to another person's blood or body. In

expansion, gloves secure healthcare providers from being injured, burned, or

scratched. The utilization of gloves besides reduces the danger of contamination

transmission in case they are pricked with a needle.

Compliance on safe injection practices and handling

Poor preparation is entirely the fault of the medical group (s). This may be

due to a lack of commitment on the part of the group to be updated on the risks

related to hazardous pollution management practices. Safe injection procedures,

according to Anwar (2019), are intended to prevent the transfer of infectious

diseases from one patient to another, or from a patient to a healthcare worker,

when arranging and organizing parenteral (e.g., intravenous or intramuscular

infusion) solutions. Safe injection practices are a series of procedures that should

be followed in order to administer injections in the safest possible manner for the

safety of patients.

Health-care-associated infections (HCAIs) are infections that develop after

48 hours of receiving medical treatment and are contracted in a hospital or other

health-care setting. A number of studies have found that adverse drug reactions,

23
HCAIs, and surgical complications are the most common types of adverse events

affecting hospitalized patients. According to the US Centers for Disease Control

and Prevention, about 1.7 million hospitalized patients get HCAIs per year when

being treated for other health problems, and more than 98,000 patients (one in

17) die as a result of these infections Haque et al (20f18).

Increased morbidity and mortality, extended hospitalization, increased

healthcare costs, and soaring antimicrobial resistance are all possible outcomes

of these infections. Blood borne pathogens have been identified as one of the

most significant occupational risks for nurses. Nurses are often exposed to blood

and bodily fluids, which may result in unintended injuries (e.g., needle-stick

injuries), mucosa exposure to blood or bodily fluid splashes (e.g., into the mouth,

eyes, or nose), or blood contact with lacerated skin. Despite the benefits, nurses

in health care settings (HCSs) around the world continue to have poor

compliance with SPs interventions and prescribed guidelines.

In accordance to the study of Stoker R. (2018), demonstrate that

healthcare workers around the world are concerned about needle sticks and

other sharps wounds that result in life-threatening contaminations. This

incorporates home healthcare experts and waste organization staff. They use

needles, syringes, lancets, auto injectors, and infusion sets. Safe sharps holder

transfer is vital whether at domestic, work, school, traveling, or in other open

places such as lodgings, parks, and eateries. It is critical to never put free

needles and other sharps inside the family or open trash cans or reusing bins.

Utilized sharps have to be put in an approved sharps disposal holder. These

24
holders are made of puncture-resistant plastic with leak-resistant sides and foot.

Besides, they must have a tight fitting, puncture-resistant cover.

Standard Precautions Practices

Standard precautions are designed to reduce the risk of blood borne and

other pathogens spreading from both known and unknown sources. Standard

precautions are a series of infection prevention procedures used to prevent

disease transmission, according to the World Health Organization (WHO),(2019).

They are the basic level of infection control precautions that should be used, at a

minimum, in the treatment of all patients.

In accordance to the study of Atlanta (2017) Standard Precautions (SPs)

are a recommendation that is still underutilized by healthcare providers as a key

method for preventing healthcare-associated infections. Hand grooming, the use

of gloves and other personal protective equipment (PPE), proper washing and

disinfection of patient care equipment and environment surfaces, proper waste

disposal, proper handling of used needles and other sharp items, and proper

cough etiquette are all part of standard precautions. Compliance with standard

precautions is to avoid a higher perception of infection risk. Access to personal

protective equipment, infection prevention training, and management support

were all found to be substantially associated factors with standard precautions

compliance.

While it is common knowledge that the safety of the patient comes first,

research has shown that certain medical teams participate in sub-standard safety

25
procedures, such as hand hygiene Cabrera (2019). Usually a factor that forms

the basis of Standard Safeguards (SP) in therapeutic classes, destitute

preparation of groups or students is concerned with the degree of strength and

progression as it pertains to preparing the student concerning SP, when the

training is bad (inappropriate learning conditions, inappropriate learning

equipment, inaccessibility of guides, etc.) the student appears to be deficient in

the significance of SP in this manner influencing patient wellbeing eventually.

According to Haile T (2017), major reported factors that affect compliance

with standard precautions include a lack of understanding and knowledge among

healthcare workers about Standard Precautions, a lack of time to implement the

precaution, limited resources, a lack of proper training, uncomfortable equipment,

skin irritation, forgetfulness, and insufficient management support. Age, sex,

employment type, marital status, working site in the hospital, and work

experience are factors correlated with implementation and standard precaution

based on socio demographic variables

Nurses are the front liners in any health institutions. They sometimes put

their personal safety on the back because of their commitment to serve. Different

infections, such as bacteria, fungus, and viruses, pose a threat to them. These

harmful foreign bodies can be contracted through food or water from infected

people, contaminated equipment, and airborne viruses. Because of the essence

of nurses' function, they are exposed to patient's body fluids on a regular basis

(including blood, urine, and amniotic fluid) De Vera (2020). .

26
 Despite the fact that there have been several research on healthcare

workers' compliance with Standard Precautions (SPs), there were still numerous

causes and factors that contribute to nurses' non-compliance with SPs. Various

studies have revealed some related factors that have a substantial effect on their

decision to fail to comply. According to a report by Zeb S (2019), lack of funding,

workload, and infection management policies were all contributing factors to

noncompliance.

In accordance to the study of Haile et al. (2017), while there were larger

percentages of healthcare workers who always followed SPs, there were also

higher proportions of healthcare workers who did not always follow SPs. The lack

of current instruction on the principles of SPs, as well as the lack of some

personal protective equipment and inconsistent management support, was

discovered

Knowledge and Competencies

Nurses, as one of the frontline providers, play a vital role in ensuring that

standard safety measures, such as infection prevention techniques, are followed.

The presence of an infection control personnel, infection control rules, and hand

washing before contacting patients is all linked to the knowledge level of

healthcare staff, including specialists and nurses. Furthermore, the importance of

profession, preparation, and disease control rules were stressed. Standard

measures include the use of gloves, aprons, masks, proper handling of

contaminated instruments (such as needles and sharps), adequate cleaning

policies, and strict adherence.

27
 Occupational exposure has become prevalent, according to research by

Beza et al. (2019), resulting in a serious problem among healthcare workers. As

stated by the World Health Organization (WHO), there were 35 million health-

care staff worldwide, and three million of them are exposed to blood-borne

pathogens each year. Similarly, two million health professionals were infected

with Hepatitis B, 0.9 million with Hepatitis C, and 170,000 with Human

Immunodeficiency Virus.

Nursing Responsibilities in Standard Precaution Practices

The Centers for Disease Control and Prevention (CDC) were the first to

develop standard precautions (CDC). It emphasized the importance of preventing

and spreading communicable diseases in hospitals and other healthcare

facilities, which had become one of the most important disease prevention

procedures. Nurses and other healthcare professionals play a vital role in

ensuring that patients' needs are met, regardless of their condition or anticipated

disease status. Basic safety procedures must be observed at all times. Nursing

care includes proper hand hygiene, the use of personal protective equipment,

and environmental care and cleaning Cauthen L. (2017).

According to Carrico et al. (2018), nurses are required to provide and

deliver nursing care consistently and efficiently as part of the healthcare

community. Disease prevention and control is one of their capable regions that

must demonstrate continuity by complying with various standard precautions, as

they stand and follow their performance to the best sharpens.

28
Potential Risks

Occupational hazards linked to the organization and work environment,

individual worker characteristics, and the quality and quantity of work material

available are all factors that affect the occurrence of occupational illnesses and

injuries caused by nursing work.

Biological, physical, chemical, industrial, ergonomic, and psychosocial

hazards are all present in a hospital setting Porto J and Palucci (2016). As a

result of their ability to create toxic and unsanitary conditions in the workplace,

biological hazards have been identified and studied more regularly. Handling

items has been polluted with pathogens that cause severe diseases such as

hepatitis C and B, as well as the Acquired Immunodeficiency Syndrome, due to

health professionals' constant and direct interaction with patients.

Standard Precautions (SP) are internationally accepted interventions

developed by the Center for Disease Control and Prevention to regulate

exposure to occupational hazards in health services, particularly in relation to the

transmission of infectious diseases and the isolation of bodily substances,

according to the Center for Disease Control and Prevention (CDC) (2016). More

so, when health-care staff neglects to follow these precautions, the risk of

contracting multiple dangerous diseases increases.

Related Studies

In accordance to the study of Ather H et al (2020) “Knowledge and

Compliance Toward Standard Precaution Among Health Care Workers at Bahria

29
International Hospital Pakistan”, it was stated that there is a significant positive

relationship between awareness and regulatory activities of the staff nurses. It

was also emphasized that staff nurses' knowledge and understanding improves

the profession of a hazard-free hospital. The study also discovered that in order

to avoid nosocomial infections among healthcare employees, standard

precautions must be followed. This research is close to the current research in

that it assesses compliance with standard precautions. When it comes to the

focus, it differs from the current study in that it aims to measure the level of

expertise and compliance of all healthcare staff with standard precautions.

According to of Thapa S. et al (2019) with the study entitled, “Knowledge

and Compliance with Standard Precaution among Critical Care Nurses”, it

determined the level of compliance and standard precaution to avoid health

degradation and achieve high quality nursing care. They came to the conclusion

that strict adherence to infection control standard precautions is required. This

research was similar to the current study in that it focused on testing compliance

with standard precautions.

As stipulated on the study entitled, “Compliance With The Standard

Precautions: An Infection Control Measure Of Nurses In Ilocos Sur”, researchers

calculated the level of compliance with standard precautions among nurses in

government hospitals in Ilocos Sur Nero's (2020). It also looked at the connection

between respondents' level of adherence to standard precautions and socio-

demographic and hospital-related profile variables. The overall level of conformity

of the respondents to the standard precautions is "Very High," according to the

30
study's findings. In addition, the respondents' socio-demographic variables and

hospital-related profile are not substantially associated with their level of

compliance with standard precaution. The study is similar to the current study in

that they both concentrate on nurse compliance when it comes to standard

precautions, but the current study varies in that it only assessed nurse

compliance rather than the socio-demographic and hospital-related profile.

According to Srinivasan’s (2019) study of “Review of Health Hazards and

Prevention Measures for Response”, they had accentuated that health care

workers are at risk of various occupational hazards such as blood borne and

other pathogens infections in the hospital while performing their duties. The

research aimed to determine the factors that influence health-care workers'

adherence to standard precautions (SP) in Nigeria's primary, secondary, and

tertiary hospitals. It is similar to the current study in that it discusses factors

impacting enforcement, but the difference is that the current study focused on the

nurses' compliance rather than the factors.

Standard precautions (SPs) are considered fundamental preventive

measures to control health care-associated infections and to minimize

occupational health hazards Wang (2017). The similarities are evident in the

current research, but they vary in scope because they aimed to evaluate the

efficacy of a mixed media education intervention, while the current study focused

on how nurses adhere to the standard precautions in their hospitals.

Cruz (2017) with the study entitled, “Compliance with standard

precautions among baccalaureate nursing students in a Saudi University”, noted

31
that the research was conducted to determine self-reported compliance with

standard precautions among baccalaureate nursing students in a Saudi

university. Nursing students' compliance should be assessed on a regular basis

to ensure that procedures are followed. Since becoming a student nurse is the

first step, it's important to understand the standard precautions in a hospital to

prevent avoidable mishaps. It is similar to the current study in that it

demonstrates the guidelines and enforcement that a nurse should adhere to;

however, the difference is that this study focused mostly on nursing students,

while the current one is only for nurses.

In accordance to the study of Abukhelair A et al (2019) entitled "Personal

Protective Equipment Knowledge and Practices among Nurses Working at Al-

Baha King Fahad Hospital, Saudi Arabia", stipulated that there is

a strong prove of a positive relationship between awareness of the respondents

with PPE with most of the nurse's demographic characteristics. More so, it was

also emphasized that female nurses had the next recognition of being

at risk by virtue of working within the clinic compared to male nurses. 

According to the study of Hiller J et al (2017) entitled “Gender influence on

health and risk behavior in primary prevention: a systematic review”, appeared

that females tend to become more health conscious than males. In this way, they

engaged more in preventive health behaviors related to essential prevention.

Synthesis of the Related Literature and Studies

32
 Nursing is both an art and a science, requiring both a heart and a mind. A

fundamental respect for human dignity and an intuition for a patient's needs are

at its heart. There is no such thing as a standard response in a profession as

diverse as nursing. With the rising demand for nurses around the world, there

seems to be a rise in the demand for training.

Standard precautions are a series of infection prevention procedures used

to prevent disease transmission, according to the World Health Organization

(WHO), (2019). They are the basic level of infection control precautions that

should be used, at a minimum, in the treatment of all patients. Standard

precautions, according to the Centers for Disease Control and Prevention (2018),

are the minimum infection prevention measures that extend to all patient care in

any environment where health care is provided, regardless of the patient's

suspected or confirmed infection status.

Most nurses are exposed to patients' bodily fluids on a regular basis

(including blood, urine, and amniotic fluid) because of the essence of their job.

Exposure can also occur as a result of precautionary injuries from infected

needles and sharp instruments that abound in any area/suite to which they are

allocated. De Vera (2020)

Nursing staff must consider a variety of factors, including instruction on

how to prevent and manage infections, as well as how to protect themselves by

wearing protective clothing. Banaser (2019). These precautions, according to

Magar (2019), are the most basic level of infection prevention precautions that

33
should be used when providing treatment to all patients, regardless of their

assumed infection status.

Major reported factors that affect compliance with standard precautions

include a lack of understanding and knowledge among healthcare workers about

standard precautions, a lack of time to implement the precaution, limited

resources, a lack of proper training, uncomfortable equipment, skin irritation,

forgetfulness, and insufficient management support. As concluded by Zeb A

(2019), lack of funding, workload, and infection management policies were all

contributing factors to noncompliance. Nurses, as one of the frontline services,

played a critical role in ensuring that common protocols, such as infection

prevention procedures, are followed.

Nurses are required to provide and deliver nursing care consistently and

efficiently as members of the healthcare team. Infection prevention and control is

one of their specialist fields that must demonstrate consistency by enforcement

as they abide and adhere to best practices.

The researchers in Nero's (2020) study calculated the level of compliance

with standard precautions among nurses in Ilocos Sur government hospitals. The

overall level of conformity of the respondents to the standard precautions is very

high according to the study's findings. Standard precautions (SPs), are

considered fundamental preventive steps for managing health-care-associated

diseases and reducing occupational health hazards. The aim of the study was to

see how successful a mixed-media education experiment could be at improving

nursing students' awareness, attitude, and compliance with SPs. Wang (2017)

34
 Chapter 3

Research Methodology

This chapter shows the procedures and methods that the researchers had

utilized in conducting the study. It centers the type of research design, the

respondents of the study, the research instrument applied, the data gathering

procedures and the statistical treatment of data.

Research design

Research design refers to an appropriate framework suitable for the study

Sileyew K. (2019). The design permits researchers to sharpen in on research

methods that are reasonable for the subject matter. The researchers used the

non-experimental research specifically descriptive design that objects to

comprehensively describe a population, situation or phenomenon. In order to

35
ascertain the compliance of staff nurses on the standard precautions being

implemented, the researchers used questionnaires to obtain relevant data that

used to validate the result of this study. Accordingly, a descriptive research aims

to answer what, where, when and how questions concerning the present study

McComber S (2020).

Subjects of the study

In this non-experimental study, there were 35 staff nurses as respondents

who participated in the study; 20 respondents were selected in United Doctors of

St. Camillus de Lellis Hospital while 15 respondents participated in Batangas

Health Care Hospital – Jesus of Nazareth. Probability sampling design especially

the convenience and simple random sampling were utilized in this study. It is a

technique in which each possible respondent within the population has an indeed

chance of being chosen in the sample. Hence, it proposes an unbiased

representation of the population. Besides, convenience sampling is a particular

type of non-probability strategy where the respondents are being conveniently

accessible and simple to contact or reach. The researchers chose selected

private health care institutions in Batangas Province. The names of the hospitals

were being changed to Hospital A, and Hospital B for the reason of privacy. The

subjects of the study were limited only to staff nurses who were willingly

participated the study.

Table 1

Table of Samples

36
 Private Hospital Total number of Sample of

Population Respondents
Hospital A 68 20
Hospital B 87 15
TOTAL 155 35
TOTAL 35

RESPONDENTS

Ethical Considerations

The College Research Ethics Committee (CREC) reviewed and approved

the research study. The researchers provided a copy of informed consent from

College Research Ethics Committee (CREC) for respondents from selected

institutions in Batangas City, and potential participants were informed that they

had the option to withdraw from the study at any time if they so desired.

Administrative approval was also obtained from each participating health

institutions. A well explained informed consent was presented to the participants

before data collection to ensure their safety. Anyone who was not willing to

participate in the study had their full right not to participate. The confidentiality of

the respondents was protected throughout the study period to maintain their

privacy, anonymity and safety as adherence to the Data Privacy Act (RA 10173).

The participants conducted a survey among selected institutions in

Batangas City after the study was approved by the institutional research ethics

committee. Before data collection and analysis, each participating health

37
institution’s human resource and research committees were consulted for ethical

approval.

Data Gathering Instruments

A standardized, structured self-administered questionnaire was developed

after a thorough literature search. The researchers used Likert scale and

demographic questions as their type of questionnaire. It consists of prepared list

of items that best describe the respondents answer. Thereupon, the

questionnaires that were administered were based on a comprehensive

understanding of relevant literatures and studies as well as the statement of the

problem of the study.

The questionnaire was divided into three (3) parts. The first part consisted

of the demographic questions including their age, gender, type of working health

institution, highest educational attainment, length of work experience, areas of

assignment, working position and shifting schedule. The second part composed

of the trainings and seminars attended by the respondents as related to the

compliance to standard precautions. On the third part of the questionnaire, this

was composed of questions and scenarios regarding their compliance to

standard precautions and was answerable by selecting appropriate scale

indicated. Wherefore, Likert scale was used in the second part of the

questionnaire.

To determine the compliance and measures done by the nurses on

standard precautions, a scale of four, three, two, one and verbal interpretation of

38
always, sometimes, seldom, and never were used. On the other hand, in

determining the mean responses of staff nurses’ to compliance to standard

precautions, a verbal interpretation of Never (Not Fully Compliant), Rarely (Not

Compliant), Sometimes (Compliant), and Always (Fully Compliant) were used.

The research instruments were subjected to professional and statistical validation

by a statistician. More so, it had undergone a comprehensive and proper

validation and successful pilot study before distribution of the questionnaires to

the respondents.

PART III. Compliance on Standard Precaution Practices on Staff Nurses

Four- point Likert Scale
Score Verbal Interpretation
4 Always
3 Sometimes
2 Rarely
1 Never
The validation of the questionnaire had undergone a few revisions before

being electronically encoded on Google Forms. Each item is being checked upon

approval by the research adviser. The survey questionnaire was also consulted

and validated by the statistician. A formal approach of data gathering, a waiver

inquiring consent to the college dean and research adviser for the dissemination

of online surveys is prepared along with a letter of permission for the participants

of the study. Besides, a pilot study was conducted which included seven staff

nurses from two different health institutions. After the pilot study, the survey was

re-assessed before the mass distribution.

39
Data Gathering Procedures

The researchers determined accessible and researchable problems

through different references from literatures and studies concerning compliance

on standard precautions in selected health institutions in Batangas Province.

Different sources of related information from E-libraries and online educational

websites were being optimally utilized to gather sufficient data.

As part of the study, the researchers made a letter asking for permission

to the Medical Directors of each institution before the dissemination of the

questionnaires. To make the study feasible, the researchers obtained approval to

their thesis adviser to further gathered related literatures and studies that

supported their present study. Consequently, an approval letter from the dean of

the department and instructors of the school requesting permission to conduct a

study was given to the selected health institutions who also given their approval

to the researchers for the study to be conducted. After the approval of the thesis

adviser, discussions about the topic and focus of the problem, proposed titles,

target respondents and samples of the study were being done. Further, the

researchers started to find different references, literatures and studies that make

their study feasible and justifiable.

After that, the questionnaires were distributed through online to the

respondents who were available to participate on the study. The objectives of the

study were comprehensively explained by the researchers to the respondents.

After the collection of the questionnaires from the different selected health

40
institutions, the data gathered were be properly tally, analyze, and treated

statistically with the help of statistician.

Statistical Treatment of the Data

The following statistical techniques and procedures were used by the

researchers to analyze and interpret the data that were gathered from the

respondents. The researchers utilized the following statistical techniques and

procedures.

Frequency Distribution. This statistical procedure was used to show data

clearly. It accurately presented a tabulated form with its corresponding rows and

columns for each class and category.

Simple Percentage. This statistical method was used to analyze the proportion

of the respondents and their responses, expressed as a percentage ranging from

zero to one hundred.

The formula for computing Simple Percentage is as follows:

P=F/N (100)

Where: P= Percentage

F=Frequency

N= Total number of respondents belonging to a class 100 is

a constant multiplier.

Weighted Mean. This method was applied to interpret data that was gathered

from the respondents’ assessment of questionnaire items on the major topics

41
and concerns of the study, more specifically on the compliance on standard

precaution practices of staff nurses in selected health care institutions in

Batangas Province.

The formula that was applied for this statistical method was as follows:

Wm= ∑Fw/N

Where: Wm= weighted mean

∑= summation symbol

F= Frequency of each option

w= assigned weight

N= Total number of responses for each item.

ANOVA Procedure. Refers to a test that provides a global assessment of a

statistical difference in more than two independent means. It applies when there

are exactly two independent comparison groups. The ANOVA procedure is used

to compare the means of the comparison groups, according to Sullivan L. (2017).

42
This method was applied to interpret data that were gathered from the

respondents’ assessment of questionnaire items on the major topics and

concerns of the study, more specifically on the compliance on standard

precaution practices among staff nurses in selected health care institutions in

Batangas Province. The formula was applied for this statistics is as follows:

 X = individual observation

  = sample mean of the jth treatment (or group),

  = overall sample mean,

 k = the number of treatments or independent comparison groups, and

 N = total number of observations or total sample size.

The ANOVA table above is organized as follows.

 The first column is entitled "Source of Variation" and delineates the

between treatment and error or residual variation. The total variation is the

sum of the between treatment and error variation.

 The second column is entitled "Sums of Squares (SS)". The between

treatment sums of squares is

  

and is computed by summing the squared differences between each

treatment (or group) mean and the overall mean. The squared

43
 differences are weighted by the sample sizes per group (n j). The error

sum of squares is:

  

and is computed by summing the squared differences between each observation

and its group mean (i.e., the squared differences between each observation in

group 1 and the group 1 mean, the squared differences between each

observation in group 2 and the group 2 mean, and so on). The double summation

( SS ) indicates summation of the squared differences within each treatment and

then summation of these totals across treatments to produce a single value. The

total sum of squares is:

and is computed by summing the squared differences between each observation

and the overall sample mean. In an ANOVA, data are organized by comparison

or treatment groups. If all of the data were pooled into a single sample, SST

would reflect the numerator of the sample variance computed on the pooled or

total sample. SST does not figure into the F statistic directly. However, SST =

SSB + SSE, thus if two sums of squares are known, the third can be computed

from the other two.

 The third column contains degrees of freedom. The between treatment

degrees of freedom is df1 = k-1. The error degrees of freedom is df2 = N -

44
 k. The total degrees of freedom is N-1 (and it is also true that (k-1) + (N-k)

= N-1).

 The fourth column contains "Mean Squares (MS)" which are computed

by dividing sums of squares (SS) by degrees of freedom (df), row by row.

Specifically, MSB=SSB/(k-1) and MSE=SSE/(N-k). Dividing SST/(N-1)

produces the variance of the total sample. The F statistic is in the

rightmost column of the ANOVA table and is computed by taking the ratio

of MSB/MSE.  

45
 CHAPTER 4
PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA
This chapter presents the analysis and interpretation of the results based

on the data gathered of the respondents by the use of questionnaires. The data

are classified and presented in tabular forms.

Profile of respondents

Age. Table 2 shows the age of the respondents as part of their

demographic profile.
Table 2.
Frequency and Percentage Distribution as to Age of Respondents
(n=35)
Age of the Respondents Frequency Percentage
31-35 years old 16 45.70
26-30 years old 8 22.90
46-50 years old 4 11.40
36-40 years old 4 11.40
41-45 years old 2 5.70
21-25 years old 1 2.90
Total 35 100.00

Table 1 shows the frequency and percentage distribution as to age of the

respondents. It revealed that the majority of them are between the ages of 31

and 35, with a frequency of 16 and a percentage of 45.7 percent. The age group

of 26-30 year old nurses is next, with a frequency of 8 and a percentage of 22.9

percent. Following that, both the 36-40 and 46-50 year old age groups had the

same frequency of 4 and percentage of 11.40 percent .With a frequency of 1 and

a percentage of 2.90 percent, the lowest age group is 21-25 years old.

46
 According to Uthaman, et al (2016), an aging population has worsened the

widespread shortage of nurses and that is why more nurses in the hospital at this

rate are in their mid-30s. Reductions in aerobic ability, muscle strength and

endurance, reaction speed, acuity of the senses, sleep disturbances, and an

increased risk of chronic disease had all been linked to aging. While mid to old

older nurses are more vulnerable, there are many benefits to keeping them on

the job. Nurses in their later years are considered to be the most professional

and active. They had more life experience, better communication skills, are more

dedicated and loyal, take less sick days, and are less likely to consider working

abroad.

Gender. Table 3 shows the gender of the respondents as part of their

demographic profile.
Table 3.
Frequency and Percentage Distribution as to Gender of Respondents
(n=35)
Gender of the Respondents Frequency Percentage
Female 30 85.70
Male 4 11.40
LGBTQA+ 1 2.90
Total 35 100.00

Table 3 shows the frequency and percentage distribution as to gender of

the respondents. It revealed that the majority of them are female with the

frequency of 30 and percentage of 85.70 percent. The male gender is next with

the frequency of 4 and percentage of 11.40 percent. Lastly is the LGBTQA+ with

the frequency of 1 and percentage of 2.90 percent.

47
 According to D’Antonio (2020), Nightingale believed that well-educated

women could dramatically improve the care of sick patients by applying scientific

principles and providing informed education about healthy lifestyles.

Furthermore, she believed that nursing offered women, who had few other career

options at the time, an ideal independent calling full of intellectual and social

freedom. Nursing, according to Florence Nightingale, was a good work for

women because it was an extension of their domestic roles. Nightingale's

portrayal of the nurse as a subordinate, caring, domestic, modest, self-sacrificing,

and not overly trained became widely accepted. Traditionally, becoming a nurse

has been associated with becoming a loving, hardworking woman.

Highest educational attainment. Table 4 shows the highest educational

attainment of the respondents as part of their demographic profile.
Table 4.
Frequency and Percentage Distribution as to Highest Educational Attainment of
Respondents
(n=35)
Highest Educational Attainment
Frequency Percentage
of the Respondents
Bachelor’s Degree 23 65.70
Master’s Degree (with units) 7 20.00
Master’s Degree Holder 5 14.30
Total 35 100.00

Table 4 shows the frequency and percentage distribution of respondents'

highest educational attainment. It revealed that the majority of them are

Bachelor’s Degree holder with the frequency of 23 and percentage of 65.70

percent. The Master’s Degree (with units) holder is next with the frequency of 7

48
and percentage of 20.00 percent. Lastly was be the Master’s Degree Holder with

the frequency of 5 and percentage of 14.30 percent.

In line with the study of Chenjuan Ma, PhD (2017), a skilled nursing

workforce is important, and one strategy for preparing the workforce is to

advance nurse education, especially by increasing the number of nurses with at

least a bachelor's degree. Nurses need education in order to build the core

competencies necessary to be leaders and, most importantly, public advocates

for their patients and profession. More evidence has emerged that more nurse

education is related to better care quality and patient outcomes. Many studies

have linked a higher proportion of hospital nurses with a bachelor's degree in

nursing (BSN) to lower patient mortality rates, and it can help nurses develop the

critical thinking skills they'll need to lead the charge of change.

Length of Work Experience of the Respondents. Table 5 shows the

length of work experience of the respondents as part of their demographic profile.
Table 5.
Frequency and Percentage Distribution as to Length of Work Experience of the
Respondents
(n=35)
Length of Work Experience of
Frequency Percentage
the Respondents
1-5 years 12 34.30
6-10 years 11 31.40
11-15 years 9 25.70
Less than 1 year 3 8.60
Total 35 100.00

Table 5 shows the frequency and percentage distribution as to length of

work experience of the respondents. It revealed that the majority of them are

49
working for 1-5 years with the frequency of 12 and percentage of 34.30 percent.

Nurses working for 6-10 years are next with the frequency of 11 and percentage

of 31.40 percent. Following that is the 11-15 years of working with the frequency

of 9 and percentage of 25.70 percent. Lastly were the nurses that worked less

than 1 year with the frequency of 3 and percentage of 8.60 percent.

According to Fukada (2018), in terms of nursing competency many

evaluation studies had focused on nurses with 1–5 years of experience, and little

is known about mid-level nurse competency development. New nurses became

more focused on the tasks at hand, which improved basic nursing skills like

ethics and responsibilities. Delivering individualized nursing care that honors

patients' lifestyles and participating in professional development while offering

care, on the other hand, is difficult for them.

Area of Assignment of the Respondents. Table 6 shows the area of

assignment of the respondents as part of their demographic profile.
Table 6.
Frequency and Percentage Distribution as to Area of Assignment of the
Respondents
(n=35)
Area of Assignment of the
Frequency Percentage
Respondents
Others 9 25.70
NICU 7 20.00
Ward 7 20.00
ER 6 17.20
ICU 5 14.30
OR 1 2.90
Total 35 100.00

50
 Table 6 shows the frequency and percentage distribution as to area of the

assignment of the respondents. It revealed that the majority of them are working

in other areas which were not mentioned, with a frequency of 9 and a percentage

equivalent to of 25.70 percent. Following that, both the Neonatal Intensive Care

Unit and Ward had the same frequency of 7 and percentage of 20.00 percent.

The Emergency room was next, with a frequency of 6 and a percentage of 17.20.

After that is the Intensive Care Unit with a frequency of 5 and a percentage of

14.30 percent. With a frequency of 1 and a percentage of 2.90, the lowest area is

the Operating room.

According to Monti (2021), Careers in healthcare continue to expand at an

unparalleled rate. The increased demand for healthcare services has resulted in

an increase in the number of specialty nursing jobs available to registered nurses

(RNs) and advanced practice registered nurses (APRNs). The ability to work in a

number of environments and roles is one of the most attractive aspects of

nursing as a profession. Nurses may now concentrate on a specific field of

practice or patient population by acquiring job experience and fulfilling certain

training and qualification criteria thanks to the emergence of several

specializations. Nurses who earn these in-demand advanced certifications have

more job prospects with more responsibility and autonomy, better pay, and

promotion opportunities.

Working Position .Table 7 shows the working position of the respondents

as part of their demographic profile.

Table 7.

51
 Frequency and Percentage Distribution as to Working Position of the
Respondents
(n=35)
Working Position of the
Frequency Percentage
Respondents
Neonatal Nurse 7 20.00
ER Nurse 6 17.10
Ward Nurse 6 17.10
ICU Nurse 5 14.30
Cardiac Nurse 5 14.30
Others 5 14.30
OR Nurse 1 2.90
Total 35 100.00

Table 7 shows the percentage distribution of respondents' working

position. It revealed that the majority of them are working as a Neonatal nurse

with a frequency of 7 and a percentage equivalent to 20.00 percent. After that,

both ER Nurse and Ward Nurse had the same results with a frequency of 6 and a

percentage of 17.10 percent. Following that, three positions weighed the same

which are the ICU Nurse, Cardiac Nurse and other positions with the frequency

of 5 and percentage of 14.30 percent. With a frequency of 1 and a percentage of

2.90, the lowest position is the OR Nurse.

According to Lee (2020), all healthcare providers aim to protect human

health, but high-risk children, in particular, need more attention. Neonatal nursing

is one of the most demanding—and rewarding—jobs in the rapidly growing

healthcare industry. This nursing specialty focuses on the care of premature

babies with health issues in the first days or weeks after birth.

52
 Nurses in the NICU also assisted parents in adjusting to their new roles as

parents by encouraging communication between the newborns and their parents.

To respond to newborns' rapidly changing health needs, they needed to gain

expertise in a range of dynamic practices spanning multiple domains, and they

needed to have excellent clinical decision-making skills to provide timely,

appropriate nursing care based on the newborns' conditions. One of the nursing

competencies that increases nursing performance and has a positive effect on

newborn care outcomes is clinical decision-making skills among NICU nurses.

Shifting Schedule of the Respondents. Table 8 shows the shifting schedule of

the respondents as part of their demographic profile.

Table 8.
Frequency and Percentage Distribution as to Shifting Schedule of the
Respondents
(n=35)
Shifting Schedule of the
Frequency Percentage
Respondents
7am to 3pm 28 80.00
11pm to 7am 5 14.30
3pm to 11pm 2 5.70
Total 35 100.00

Table 8 shows the frequency and percentage distribution as to the shifting

schedule of the respondents. It revealed that the majority of them are working

during 7am to 3pm with the frequency of 28 and percentage equivalent to 80.00

percent. 11pm to 7am shift was next with the frequency of 5 and percentage of

14.30 percent. Lastly would be the 3pm to 11pm shift with the frequency of 2 and

percentage of 5.70 percent.

53
 According to, Kellye (2018) hands-on tasks occurred more often and

longer between 7 a.m. and 11 a.m. Most nurses prefer this time because the day

shift is usually more hectic, and the hospital is fully staffed, which means there

are more hands available to assist when needed. Furthermore, the majority of

non-emergent, planned procedures took place during the day, offering ample

space for additional skill growth.

Standard Precaution-Related. Trainings/Seminars Table 9 shows the Standard-

Precaution-Related Trainings/Seminars Attended by Staff Nurses.
Table 9.
Frequency and Percentage Distribution based on the Standard Precaution-
Related Trainings/Seminars Attended by Staff Nurses
(n=35)
Seminars/Trainings of the Frequency Percentage
Respondents
Infection and Prevention Control 31 88.60
COVID-19 Infection Prevention
Standard Precautions: Hand Hygiene 23 65.70
Standard Precautions: Waste
Management 23 65.70
Standard Precautions: Injection
Safety and Needle-Stick Injury 20 57.10
Management 18 54.30
Standard Precautions:
Environmental Cleaning and 17 48.60
Disinfection
Decontamination and Sterilization of
Medical Devices or Equipment 11 31.40
Occupational Health and Safety
Practices 9 25.70
Others
6 17.10

Note: Multiple responses allowed

Table 9 shows the trainings and seminars attended by the staff nurses

related to the Standard Precaution Practices. The results had shown that the

infection and prevention control seminar/training has the highest frequency of 33

54
and percentage equivalent to 88.60 percent. It is followed by COVID-19 infection

prevention and standard precautions: hand hygiene with a frequency of 23 and

percentage of 65.70 percent. Standard precautions: waste management is the

next with a frequency of 20 and percentage equivalent to 57.10 percent.

Meanwhile, standard precautions: injection safety and needle-stick injury

management have a frequency of 18 and percentage of 54.30 percent. Following

that, with a frequency of 17 and percentage of 48.60 percent, is the

seminar/training regarding standard precautions in environmental cleaning and

disinfection. However, decontamination and sterilization of medical devices or

equipment seminar/training has a frequency of 11 and a percentage equivalent to

31.40 percent. Lastly, with a frequency of 6 and percentage of 17.10 percent,

respondents indicated other seminars and trainings related to standard

precautions that were not indicated on the questionnaire.

As stated Asiri et al (2020), healthcare-associated infections (HAIs) are

evidently a serious public health concern globally. It is capable of the increase in

morbidity and mortality of patients that included high expenses, increased need

for advanced restorative care and the utilization of medications to treat HAIs.

Nurses served as front liners which they become vulnerable in acquiring HAIs.

Subsequently, their obligation requires serious consideration of the execution of

infection control techniques. In a nutshell, a well-planned infection prevention

programs and trainings are exceedingly significant in anticipating spread of HAIs.

Proper Handwashing .Table 10 shows the Compliance to Standard Precautions

on Proper Hand Washing among the Staff Nurses.

55
 Table 10.
Mean Response of Staff Nurses’ Compliance to Standard Precautions on Proper
Hand Washing
(n=35)
Compliance on Hand Mean Standard Deviation Verbal
Washing Interpretation
Rub hands palm to palm 4.00 0.00 Always
Palm to palm with fingers 0.17 Always
interlaced 3.97
Back of fingers to opposing 3.97 0.17 Always
palms with fingers interlocked
Right palm over dorsum with 3.94 0.24 Always
interlaced fingers and vice
versa
Rotational rubbing of left 3.91 0.28 Always
thumb clasped in right palm
and vice versa
I wash my hands after 3.91 0.37 Always
touching patient surroundings
I wash my hands immediately 3.91 0.28 Always
after contacting with any
blood, body fluid, secretion,
excretion and dirty
substances
I wash my hands before 3.89 0.32 Always
clean/aseptic procedures
I wash and decontaminate my 3.89 0.40 Always
hands after taking off the
gloves
I wash my hands between 3.86 0.43 Always
patient contacts
Rotational rubbing, 3.83 0.38 Always
backwards and forwards with
clasped fingers of right hand
in left palm and vice versa

Overall Mean 3.92 0.15 Fully

Compliant
Legend: SD means Standard Deviation, VI means Verbal interpretation; 1.00-1.49 Never
(Not Fully Compliant), 1.50-2.49 Rarely (Not Compliant), 2.50-3.49 Sometimes (Compliant),
3.50-4.00 Always (Fully Compliant)
Table 10 shows the mean response of staff nurses’ compliance to

Standard Precautions on Proper Hand Washing with an overall mean of 3.92 and

verbal interpretation of fully compliant. The results had shown that the first motion

of hand washing which is rub hands palm to palm has the highest mean of 4.00

56
and verbal interpretation of always. It was followed by, two motions of hand

washing which is palm to palm with fingers interlaced and back of fingers to

opposing palms with fingers interlocked weighed the same with a mean of 3.97

and verbal interpretation of always. Next is right palm over dorsum with

interlaced fingers and vice versa motion with a mean of 3.94 and verbal

interpretation of always. It is followed by rotational rubbing of left thumb clasped

in right palm and vice versa, washing of hands after touching patient

surroundings, and washing of hands immediately after contacting with any blood,

body fluid, secretion, excretion and dirty substances with a mean of 3.91 and

verbal interpretation of always. Then, it is followed by washing of hands before

clean/aseptic procedures and washing and decontaminating hands after taking

off the gloves with a mean of 3.89 with verbal interpretation of always. However,

washing of hands between patient contacts garnered a mean of 3.86 and verbal

interpretation of always. Lastly, rotational rubbing, backwards and forwards with

clasped fingers of right hand in left palm and vice versa has the lowest mean of

3.83 and verbal interpretation of always. In terms of overall mean, the

respondents’ compliance on hand washing has a mean of 3.92 and verbal

interpretation of fully compliant.

In accordance to the study of Leonard J. (2020), hand washing is one of

the foremost effective ways to minimize the spread of bacterial and viral ailments.

To appropriately wash the hands and be compelling, utilize soap and rub each

surface of the fingers and hands for at least 20 seconds. Hence, standard hand

57
washing can constrain the transfer of organisms by following the in-depth guide

or step-to-step guide several times during the day.

Use of Personal Protective Equipment and Proper Disposal Table 11 shows

the Compliance to Standard Precautions on Use of Personal Protective

Equipment and Proper Disposal among Staff Nurses.

Table 11.
Mean Response of Staff Nurses’ Compliance to Standard Precautions on Use of Personal Protective
Equipment and Proper Disposal

(n=35)
Compliance on Use of Personal Protective
Equipment and Proper Disposal Mean Standard Deviation Verbal Interpretation

Donning PPE 3.91 0.28 Always

Doffing PPE 3.91 0.28 Always

I wear gloves when I am exposed to body 3.91 0.28 Always

fluids, blood products, and any excretion of
patients

I change gloves between patient contacts 3.91 0.28 Always

3.91 0.28 Always

I wear gloves to decontaminate used
equipment with visible soils

I will not reuse a surgical mask or disposable 3.86 0.36 Always

Personal Protective Equipment (PPE)

I clean up spillage of blood or other body 3.86 0.36 Always

fluids immediately with disinfectants

My mouth and nose are covered when I wear 3.83 0.45 Always
a mask

I decontaminate surfaces and equipment after 3.83 0.38 Always

use

I remove Personal Protective Equipment 3.80 0.58 Always

(PPE) in a designated area

I wear gown or apron when exposed to blood, 3.80 0.41 Always

body fluids or any patient excretions
3.77 0.43 Always
I take shower in case of extensive splashing
even after I have to put on Personal Protective
Equipment (PPE)

I wear surgical mask alone or in combination 3.77 0.43 Always

with goggles, face shield and apron whenever
there is a possibility of a splash or splatter

Waste contaminated with blood, body fluid, 3.71 0.67 Always

secretion and excretion is placed in red plastic
bags irrespective of the patient’s infection
status

Overall Mean
3.84 0.30 Fully Compliant

58
 Table 11 shows the mean response of staff nurses’ compliance to

Standard Precautions on Use of Personal Protective Equipment (PPE) and

proper disposal with an overall mean of 3.84 and verbal interpretation of fully

compliant. The results shown that Donning and Doffing of PPE, wearing of

gloves when exposed to body fluids, blood products, and any excretion of

patients and wearing of gloves to decontaminate used equipment with visible

soils has the highest mean of 3.91 and verbal interpretation of always. More so,

not reusing of surgical mask or disposable Personal Protective Equipment (PPE)

and cleaning up spillage of blood or other body fluids immediately after

disinfectants has a mean of 3.91 and verbal interpretation of always.

It is followed by, covering of mouth and nose when wearing a mask and

decontaminating of surfaces and equipment after use has a mean of 3.83 and

verbal interpretation of always. Meanwhile, removing of Personal Protective

Equipment in a designated area and wearing of gown and apron when exposed

to any excretions of patient tied up with a mean of 3.80 and verbal interpretation

of always. Followed by, taking shower in case of extensive splashing even after

putting of Personal Protective Equipment (PPE) with a mean of 3.77 and verbal

interpretation of always. Next is the wearing of surgical mask alone or in

combination with goggles, face shield and apron whenever there is possibility of

a splash and splatter with a mean of 3.77 and verbal interpretation of always.

Lastly, placing of waste contaminated with blood, body fluid, secretion and

excretion in red plastic bags irrespective of the patient's infection status has a

mean of 3.71 and verbal interpretation of always. In terms of overall mean,

59
respondents’ compliance on use of personal protective equipment (PPE) and

proper disposal has a mean of 3.84 and verbal interpretation of fully compliant.

The study of McCarthy et al (2020) stated that appropriate donning and

doffing of PPE plays an imperative part in minimizing contamination of healthcare

providers caring for patients with transmissible infectious illnesses. In this way, it

is vital to mitigate spread and keeping up the healthcare workforce. Inadequately

and insufficient education and training relating to appropriate utilization of PPE

can unfavorably influence compliance with suggestions for PPE utilization.

Besides, they emphasized that PPE secures healthcare providers from harmful

pathogens by avoiding exposure to bodily fluids and respiratory droplets. In that

sense, suitable utilization of PPE is one of the foremost fundamental strategies

for ensuring both patients and healthcare workers from different pathogens.

As claimed by Blahd Jr. W. (2019), postulated that blood and body fluid

safety measures include the utilization of protective barriers such as gloves,

gowns, covers, and eye protection. These decrease the chance of exposing the

skin or mucous membranes to possibly infectious fluids.

Health care workers ought to continuously utilize protective barriers to

ensure themselves from exposure to another person's blood or body. In addition,

gloves secure healthcare providers from being wounded, burned, or scratched.

The utilization of gloves moreover diminishes the hazard of infection transmission

in case they are pricked with a needle.

60
Safe Injection Practices and Handling . Table 12 shows the Compliance to

Standard Precautions on Safe Injection Practices and Handling among Staff

Nurses

Table 12.
Mean Response of Staff Nurses’ Compliance to Standard Precautions on Safe
Injection Practices and Handling
(n=35)
Compliance on Safe
Injection Practices and Standard Verbal
Mean
Handling Deviation Interpretation

I put needles and blade in 3.80 0.58 Always

a sharp disposal box or
receptacle after using
If the skin is injured by 3.74 0.51 Always
polluted sharps, it Is
squeezed for the blood
flowing and then
thoroughly cleaned,
disinfected and taped up
The second hand syringe 3.51 0.89 Always
is not reused or
reprocessed
The sharp box is disposed 3.50 0.51 Always
only when it is ¾ full
I will recap used needles
2.29 1.38 Rarely
after giving an injection

Overall Mean Fully

3.59 1.50
Compliant

Table 12 shows the mean response of staff nurses’ compliance to

Standard Precautions on Safe Injection Practices and Handling with an overall

mean of 3.54 and verbal interpretation of fully compliant. Based on the results,

putting of needles and blade in a sharp disposal box or receptacle after using has

61
the highest mean of 3.80 and verbal interpretation of always. It is followed by

squeezing of skin for blood flowing if injured by polluted sharps and thoroughly

cleaned, disinfected and tape it up with a mean of 3.74 and verbal interpretation

of always. Next is the practice of not reusing or reprocessing of second hand

syringe with a mean of 3.51 and verbal interpretation of always. However,

practice of disposing a sharp boxy only when its ¾ full has a mean of 3.50 and

verbal interpretation of always. Lastly, recapping of used needles after giving an

injection has the lowest mean of 2.29 and verbal interpretation of rarely.

According to the study of Stoker R. (2018), indicate that healthcare

workers around the world are concerned about needle sticks and other sharps

injuries that result in life-threatening contaminations. This incorporates home

healthcare professionals and waste administration staff. They uses needles,

syringes, lancets, auto injectors and infusion sets. Safe sharps container disposal

is vital whether at home, work, school, traveling, or in other open places such as

lodgings, parks, and restaurants.

It is important to never put free needles and other sharps within the

household or open trash cans or recycling bins. Utilized sharps ought to be put in

an approved sharps disposal container. These containers are made of puncture-

resistant plastic with leak-resistant sides and bottom. Furthermore, they must

have a tight fitting, puncture-resistant cover.

62
 Table 13 shows the relationship between the profiles of the respondents

and compliance with the standard precaution practices among staff nurses.

Table 13.

Relationship between the Profiles of the Respondents and Compliance with the Standard
Precaution Practices among Staff Nurses

(n=35)
Independent Test Statistic p-value Significance
Dependent Variable
Variable (df)
F(5, 29) = 0.62 0.69 Not Significant
Proper Hand Washing F(5, 29) = 1.01 0.43 Not Significant
Use of PPE & Disposal
Age
Safe Injection Practices and F(5, 29) = 0.21 0.96 Not Significant
Handling

t (33) = -1.03 0.31 Not Significant

Proper Hand Washing t (33) = -2.68 0.01 Significant
Use of PPE & Disposal
Gender t (33) =-0.49 0.63 Not Significant
Safe Injection Practices and
Handling

F(2, 32) = 2.20 0.13 Not Significant

Proper Hand Washing
Highest
Use of PPE & Disposal F(2,32) = 0.58 0.57 Not Significant
Educational
Safe Injection Practices and
Attainment F(2, 32) = 0.47 0.63 Not Significant
Handling
F(3, 31) = 0.38 0.77 Not Significant
Proper Hand Washing F(3, 31) = 2.29 0.10 Not Significant
Length of Work Use of PPE & Disposal
Experience Safe Injection Practices and F(3, 31) = 0.40 0.75 Not Significant
Handling

F(5, 29) = 0.77 0.58 Not Significant

Proper Hand Washing F(5, 29) = 1.57 0.20 Not Significant
Area of Use of PPE & Disposal
Assignment Safe Injection Practices and F(5, 29) = 0.12 0.99 Not Significant
Handling

F(2, 32) = 1.37 0.27 Not Significant

Proper Hand Washing
Shifting Use of PPE & Disposal F(2, 32) = 2.55 0.09 Not Significant
Schedule Safe Injection Practices and
Handling F(2, 32) = 0.12 0.89 Not Significant
Note: Test statistic is significant at 5%.

63
 The quantitative data rejected the null hypothesis of the study. Based

on the results, there is a significant difference between the profiles of the

respondents and compliance with the standard precaution practices among staff

nurses to 5%.

Table shows relationship between the profiles of the respondents and

compliance with the standard precaution practices among staff nurses. Based on

the results, relationship between gender and use of PPE and disposal has a p-

value of 0.01 and an interpretation of significant. It is followed by the relationship

of shifting schedule and use of PPE and disposal with a p-value of 0.09 and

interpretation of not significant. Next is the relationship between length of work

experience and safe injection practices and handling with a p-value of 0.10 and

interpretation of not significant.

More so, relationship between highest educational attainment and proper

hand washing has a p-value of 0.13 and interpretation of not significant. After

that, the relationship between area of assignment and use of PPE and disposal

has a p-value of 0.20 and interpretation of not significant. With a p-value of 0.27,

relationship between shifting schedule and proper hand washing has the

interpretation of not significant. Meanwhile, the relationship between gender and

proper hand washing has a p-value of 0.31 and interpretation of not significant.

Following that is the relationship between age and use of PPE and disposal with

a p-value of 0.43 and interpretation of not significant.

However, the relationship between area of assignment and proper hand

washing has a p-value of 0.58 and interpretation of not significant. It is followed

64
by the relationship between age and proper hand washing with a p-value of 0.69

and interpretation of not significant. Likewise, the relationship between highest

educational attainment and use of PPE and disposal has a p-value of 0.58 and

interpretation of not significant. Next is the relationship between gender and safe

injection practices and handling with a p-value of 0.63 and interpretation of not

significant. With a p-value of 0.63, the relationship between highest educational

attainment and safe injection practices and handling has an interpretation of not

significant. Following that is the relationship between length of work experience

and safe injection practices and handling with a p-value of 0.75 and interpretation

of not significant. Further, with a p-value of 0.77 the relationship between length

of work experience and proper hand washing has an interpretation of not

significant.

In addition, relationship between age and safe injection practices and

handling has a p-value of 0.96 and interpretation of not significant. Lastly, the

relationship between area of assignment and safe injection practices and

handling as well as the relationship between shifting schedule and safe injection

practices and handling weighed the same with a p-value of 0.99 and

interpretation of not significant.

According to the study of Abukhelair A et al (2019) entitled "Personal

Protective Equipment Knowledge and Practices among Nurses Working at Al-

Baha King Fahad Hospital, Saudi Arabia", stated that there is a strong evidence

of positive relationship between awareness of the respondents with PPE with

most of the nurse's demographic characteristics. More so, it was also

65
emphasized that female nurses had a higher perception of being at risk by virtue

of working in the hospital compared to male counterparts.

In accordance to the study of Hiller J et al (2017) entitled "Gender

influence on health and risk behavior in primary prevention: a systematic review",

showed that females tends to become more health conscious than males. Thus,

they engaged more in preventive health behaviors associated with primary

prevention.

5. Action Plan

The general objectives of the action plan are to help nurses viably utilize

the personal protective equipment and persistent adherence to proper disposal.

However, the specific objective is to address the fundamental needs of nurses as

to their utilization of personal protective equipment (PPE) and complying with

proper disposal. In addition, this is often regularly to improve their clinical

experience, abilities development as well as their compliance. The researchers

took part in the dissemination of online brochures in which they were able to

spread awareness and abidance to the respondents.

Further, recommendations on particular approaches and where they can

best utilize the PPE are further discussed. The results were utilized to decide and

assess the circumstance. Given the results about, strategies were made and the

researchers aiming to form an online brochure where nurses of different genders

can be recipients regarding PPE and appropriate disposal compliance. Thus, an

action plan is being made by the researchers to assist nurses effectively utilize

66
the use of PPE and adherence to appropriate disposal as to attain an ideal skills

improvement on their individual and professional development.

67
 ACTION PLAN
GENERAL OBJECTIVES: To enhance staff nurses knowledge on use of personal protective equipment (PPE) and
proper disposal to achieve optimal skills development and continuously adherence to compliance of standard precautions
during hospital duties.

Specific Recommendation Strategies Time Persons Resources Expected

Objective Frame Responsible Available Outcome
Deliver the basic A brochure with The researchers intend to
needs of nurses as explanation and launch a variety of online
Within 2 The Internet The nurses
to their utilization discussion of brochures wherein nurses
weeks. Researchers. Connection will continually
of reasons why it is of various genders can
use the
personal protective needed to be browse from different Money
personal
equipment (PPE) followed will be given multimedia platforms and
Research protective
and proper for better share their experiences
Study equipment
disposal to understanding of the with PPE enforcement and
and meet all
enhance their topic and to spread proper disposal.
of the
compliance to the awareness and
The researchers will then program's
standard abidance to the
ask for recommendations objectives,
precautions. respondents.
and suggestions that could including
help them comply better professional
regardless of their gender growth and
that can be beneficiary for enforcement
each one of them. of compliance
to SP.

68
 Chapter 5

SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

This chapter presents the summary of findings obtained through data and

analysis, interpretations as well as conclusions and recommendations drawn

from the thesis results.

Summary:

This study aimed to determine and evaluate the nurses’ compliance with

Standard Precaution Practices in selected health care institutions in Batangas

City Province.

Specifically, this study sought to answer the following questions:

1. What is the profile of respondents in terms of:

1.1 Age ,

1.2 Gender,

1.3 Type of institution,

1.4 Highest Educational Attainment,

1.5 Length of work experience,

1.6 Areas of assignment,

1.7 Working position , and

1.8 Shifting schedule

2. What are the trainings and seminars attended by the respondents related

to the compliance of standard precautions?

69
 3. To what extent do nurses comply to standard precautions as to:

a. Compliance on proper hand washing,

b. Compliance on use of personal protective equipment and proper

disposal and lastly; and

c. Compliance on safe injection practices and handling?

4. Is there a significant difference between nurses’ profile and compliance to

standard precaution practices?

5. What plan of action can be proposed to enhance compliance to standard

precautions?

The study tested the null hypothesis that there is no significant relationship

between the profile of the respondents and compliance to standard precautions

among staff nurses in selected health institutions in Batangas City.

The researchers sought to conduct this study because they believe that

this topic has a great implication to nursing profession. This also provides a basis

for the administrators and medical directors in enhancing the implementation of

compliance and health protocols in different health institutions. This study

involved a total of thirty five (35) respondents who came from different healthcare

institutions in Batangas Province; twenty (20) respondents came from Hospital A

in Diverson Road, Batangas City and fifteen (15) from Hospital B at Gulod Itaas,

Batangas City.

This study gives awareness and information about the compliance of staff

nurses. Moreover, this study provides a ground for development and

70
enhancement of better compliance as to proper hand washing, use of personal

protective equipment and proper disposal, and safe injection practices and

handling. The study used a survey questionnaire as the mode of data gathering

and had applied the non-experimental design specifically descriptive method in

which it is used to describe and elaborate the nature and causes of an existing

phenomenon at the time of study. The statistical treatment that was used in the

study were: frequency, percentage, mean, standard deviation and ANOVA

procedure.

Findings of the Study

The following were the findings of the study:

1. The demographic profile of the respondents:

The top range of the nurses respondents belongs to the age group

of 31-35 with a frequency of 16 with 45.70 percent. As to the gender of the

respondents, it revealed that the majority of them are female with a

frequency of 30 and percentage equivalent to 86.70 percent. Based on the

findings of the study, it only involved 35 respondents from two different

healthcare institutions, 20 respondents from United Doctors of St.

Camillus de Lellis Hospital and 15 respondents from Batangas Health

Care Hospital – Jesus of Nazareth. The highest educational attainment

revealed that most of respondents are Bachelor's Degree holder with a

frequency of 23 and percentage equivalent to 96.70.

Based on the length of work experience of the respondents has an

average of 1-5 years with 34.50 percent of the respondents. Work

71
 assignment of the respondents’ revealed that the majority of them are

working in other areas that are not mentioned, with a frequency of 9 and

percentage equivalent to 25.70 percent. Work position of the respondents

showed that 7 respondents with an equivalent of 20.00 percent were

working as a Neonatal nurse. The shifting schedule of the majority of the

respondents was 7am-3pm with a frequency of 28 and 80.00 percent.

2. What are the trainings and seminars attended by the respondents related

to the compliance of standard precautions?

The training and seminars attended by the respondents showed

that 33 respondents equivalent to 88.60 percent had previously attended

Infection and Prevention Control Seminar/Training, while 17.10 percent

equivalent to 6 respondents indicated other seminars and trainings related

to Standard Precautions.

3. To what extent do nurses comply to standard precautions as to:

3.1 proper hand washing

Based on the research findings, the motions of palm to palm with fingers

interlaced are being practiced with a mean of 4.00 and verbal interpretation of

always compliant by the staff nurses. Among the enumerated practices and

motion of hand washing, rotational rubbing, backwards and forwards with

clasped fingers of right hand in left palm and vice versa had the lowest mean of

3.83 with a verbal interpretation of always compliant. The findings suggests that

the staff nurses were being practiced as fully compliant in terms of following

standard precaution practices as to hand washing.

72
 3.2 use of personal protective equipment and proper disposal and

lastly;

In terms of donning and doffing of PPE, wearing of gloves when being

exposed to body fluids, blood products, and any excretion of patients, changing

of gloves between patient contacts, and wearing of gloves to decontaminate

used equipment with visible soils were being practiced by the staff nurses with a

mean of 3.91 and verbal interpretation of always compliant. On the other hand,

placing of waste contaminated with blood, body fluid, secretion and excretion in

red plastic bags irrespective of the patient’s infection status has the lowest mean

of 3.71 and verbal interpretation of always compliance. Based on the tabulation

result, the overall compliance on use of personal protective equipment (PPE) and

proper disposal by the staff nurses were fully compliant.

3.3 safe injection practices and handling

Based on the research findings, putting of needles and blades in a sharp

disposal box or receptacle after using, staff nurses are being practiced with a

mean of 3.80 and verbal interpretation of always compliant. Lastly, recapping of

used needles after giving an injection is being practiced as rarely by the

respondents with a mean of 2.29. The findings suggest that the staff nurses are

being practiced as fully compliance in terms of following standard precaution

practices as to safe injection practices and handling.

4. Is there a significant difference between nurses’ profile and compliance to

standard precaution practices?

73
 Based on the result of the tabulation, the result rejects the null

hypothesis of the study. As illustrated on the table thirteen (13), pertaining

on the relationship between the profiles of the respondents and

compliance with the standard precaution practices among staff nurses

showed that there is a significant relationship between the gender and the

use of personal protective equipment (PPE) and proper disposal with a p-

value of 0.01.

5. What plan of action can be proposed to enhance compliance to standard

precautions?

The general objectives of the said action plan are to help nurses

effectively utilize the use of personal protective equipment and continuous

adherence to proper disposal. The specific objective is to address the basic

needs of nurses as to their utilization of personal protective equipment (PPE)

and complying on proper disposal. In addition, this is to enhance their clinical

experience, skills growth as well as their compliance. The researchers took

part in dissemination of online brochures in which they were able to spread

awareness and abidance to the respondents. Given the results, strategies

were made and the researchers intended to make an online brochure where

nurses of various genders can be beneficiaries regarding PPE and proper

disposal compliance. Thus, an action plan is being made by the researchers

to help nurses effectively utilize the use of PPE and adherence to proper

disposal as to achieve an optimal skills development on their personal and

professional growth.

74
 Conclusions:

1. The majority of the respondents were female, between the ages of 31 and 35,

with a Bachelor's of Science in Nursing and 1 to 5 years of experience, employed

in a Cardiovascular Unit, usually on an am shift (7am-3pm) and working in a

private institution.

2. The majority of the respondents had attended trainings and seminars on

standard precautions practices.

3. Most of the respondents confirmed that they were completely compliant in

terms of hand washing, the use of personal protective equipment (PPE) and

proper disposal, as well as safe practices and handling.

4. There is a significant difference between respondents’ gender and use of

personal protective equipment and proper disposal.

5. An action plan aimed at assisting and informing the staff nurse about the

appropriate use of personal protective equipment and adherence to proper

disposal.

Recommendations:

The researchers in this study suggest that staff nurses in selected health

institutions in Batangas Province have a detailed discussion about their

adherence to common precautionary practices. The following suggestions are

hereby proposed for the purpose of future studies to be undertaken by future

researchers with the objectives and benefits of College of Nursing and Midwifery

who want to reproduce based on the results of our study entitled Compliance

75
with Standard Precaution Practices Among Staff Nurses in Selected Health

Institutions in Batangas City.

1. Healthcare organizations and management must provide and maintain

education and training for nurses on hand washing, the use of personal

protective equipment (PPE), proper disposal, and safe injection procedures and

handling. They must also emphasize and raise consciousness about the proper

use of personal protective equipment and disposal.

2. The researchers suggest that personal protective equipment be readily

available, as well as consistent and good management support.

3. For school institutions, a more rigorous curricula and detailed education on

student nurses is needed in order for them to have a greater understanding of

the value and significance of standard precautions enforcement, as well as the

implications of non-compliance. This will also serve as a form of preparation and

training for their future career.

4. For future researchers, continue to study and define compliance with common

precautionary practices; this will provide additional knowledge, education, and

understanding for nursing practice and career.

5. The researchers also recommend an action plan that will support nurses in all

gender to effectively utilize the use of personal protective equipment (PPE) and

proper disposal and continuously adherence to compliance of standard

precautions during hospital duties.

76
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80
 APPENDIX I
RESEARCH PROPOSAL
Letter of Request to Conduct the Study

February 2021

Dear Respondents:
Warm Greetings!

We, third year nursing student of University of Batangas are presently

working on the research study entitled: “Compliance with Standard Precaution
Practices among Staff Nurses in Selected Health Institutions in Batangas City” as
partial requirement for the course, Nursing Research. This study aims to seek the
compliance of staff nurses in the standard precaution practices that best reflects
their clinical practice.
In connection with this, may we request permission from you to allow us to
gather data through survey questionnaire. Attached here with us a questionnaire
for our research study. Kindly accomplish the questionnaire honestly and answer
the items completely.
Rest assured that the result of this data will be used purposively for this
research study and will be held in strict confidentiality.

Thank you so much for sharing your time with us!

Respectfully yours,

Mikhail Andre A. Aloria

Xyrene Joy R. Candava
Jessamine M. Danduan
Ruth Mbakaan Orkeghen

81
 Shazney Kathleen A. Tupaz
Emilyn S. Vasquez
Noted by:

Mrs. Sofia G. Catibog R.N.,M.A.N

Dean, College of Nursing and Midwifery

Mrs. Maria Joycelyn Zaraspe R.N.,M.A.N

Research Adviser

82
 APPENDIX II
RESEARCH PROPOSAL

APPLICATION FOR RESEARCH ETHICS REVIEW

COLLEGE OF NURSING AND MIDWIFERY
COLLEGE/ DEPARTMENT
Date: December 04, 2020
Research Title : COMPLIANCE WITH STANDARD PRECUTIONS
PRATICES AMONG STAFF NURSES IN SELECTED HEALTH INSTITUTIONS
IN BATANGAS CITY
Author’s Name/ Contact No./ E-Mail:
ALORIA, MIKHAIL ANDRE A. / 09451786083 / 1501275@ub.edu.ph
CANDAVA, XYRENE JOY R. / 09672575070 / 1801790@ub.edu.ph
DANDUAN JESSAMINE M. / 09454586484 / 1802312@ub.edu.ph
ORKEGHEN, RUTH MBAKAAN / 09453417616 / 1892324@ub.edu.ph
TUPAZ, SHAZNEY KATHLEEN A. / 09565810771 / 1801188@ub.edu.ph
VASQUEZ, EMILYN S. / 09654176840 / 1803888@ub.edu.ph

Cooperating Agency: PRIVATE HEALTH INSTITUTIONS IN BATANGAS CITY:

ST. CAMILLUS DE LELLIS HOSPITAL AND JESUS OF NAZARETH HOSPITAL
SUMMARY OF THE PROPOSED RESEARCH (Research Problem and
Objectives)

Infection in healthcare facilities is a major public health problem in most developing countries
including Philippines. Currently the overall incidences of health care associated infection have been
increased and the burden of these infections is staggering. Standard precautions are universally accepted
guidelines for infection control practices in health care settings regardless of the infection status of a patient.
These different guidelines do not just help in preventing health care workers from getting infection while
caring for a patient but also reduce the spread of infection among patients. The strict implementation of
standard precautions is the primary strategy for the prevention of hospital acquired diseases in both
healthcare professionals and patients. This includes appropriate hand hygiene, use of gloves and other
personal protective equipment (PPE), appropriate cleaning and disinfection of patient care equipment and
environment surfaces, right waste disposal, correct management of used needles and other sharp objects
and appropriate cough etiquette.

83
This study aims to assess the compliance with standard precaution practices among nurses in selected
health institutions in Batangas City. Specifically, the study seeks to answer the following questions:

 determine the personal profile of the respondent in terms of age, gender, type of institution, highest
educational attainment, length of work experience, areas of assignment, working position, shifting
schedule
 determine the trainings and seminars related to the compliance of standard precautions of the
respondents
 assess the compliance of staff nurses as to compliance on proper hand washing, use of personal
protective equipment and proper disposal and lastly, compliance on safe injection practices and
handling
 identify if there is a significant relationship between nurses' profile and compliance to standard
precautions
 identify the plan of action can be proposed to enhance compliance to standard precautions

BRIEF DESCRIPTION OF THE RESEARCH METHODOLOGY

Research Design

The study utilized non-experimental research specifically descriptive design that

objects to comprehensively describe a population, situation or phenomenon. In order to
ascertain the compliance of staff nurses on the standard precautions on selected health
institutions in Batangas City. The researchers used simple random and convenience
sampling for data gathering.

Subjects of the Study

The target population were limited only to the staff nurses currently employed on
selected health institutions in Batangas City. This involved a total of population of thirty five
(35) nurses. The researchers considered male and female nurses regardless of age,
gender, civil status, and their respective areas of designation.

Research Instrument

The researchers used a self-administered questionnaire as a survey method to

collect data from the respondents. This instrument was used because it is considered to be
no interviewer bias, second one it can be considered cost effective.

84
 Research techniques

In order to analyze and answer the specific problems and to test the hypothesis of
the study, the researchers utilized the simple statistical analysis of data. Frequency
distribution and percentage were used by the researchers to determine the total number of
staff nurses in terms of their compliance with standard precaution practices.

Recruitment Procedure

Upon the approval of the institutional research ethics committee to the study, the
participants conducted survey among selected private health institutions. Ethical approval
was sought from each participating health institutions human resource and research
committee prior to data collection and commencing. The researchers disseminated a
waiver and a letter per health institution asking the permission to allow the researchers in
gathering information through online survey questionnaire. The researchers explained the
purpose of conducting the survey.
MAIN CHARACTERISTICS OF THE PARTICIPANTS
Age: 22 years old and above
Gender: Any Gender
Institutional Affiliation: Health Institutions in Batangas City

REVIEW CHECKLIST
Please tick the appropriate space. For YES answers, provide explanation/reason
of its necessity.
1. Will the study involve the participation of vulnerable groups such as minors,
ethnic group, people with disability (learning, physical, cognitive)?
No __/__
Yes _____
______________________________________________

______________________________________________

85
2. Will participation in the research result to anxiety, stress, discomfort, or pose a
risk of harm to participants?
No __/__
Yes _____
______________________________________________

______________________________________________
3. Will there be psychological or social risks to participants (loss of status, privacy
and/or reputation)?
No __/__
Yes _____
______________________________________________

______________________________________________
4. Will the results have an adverse impact on the environment or food /health
safety?
No __/__
______________________________________________
Yes _____
______________________________________________
5. Does the procedure include physical contact with the participants?
No __/__
Yes _____
______________________________________________

______________________________________________
6. Does the procedure involve administration of substance/chemical agents
(including vitamins and food supplements), vaccine, or blood extraction?
No __/__
Yes _____
______________________________________________

86
 ______________________________________________

7. Will the research procedure pose risk to the personal safety of the
researchers?
No __/__
Yes _____
______________________________________________

______________________________________________

8. Does the research involve the use of subjects other than human? (e.g.
animals)
No __/__
Yes _____
______________________________________________

______________________________________________
9. Are the participants required to sign a consent form?
Yes _____
No __/__
______________________________________________

______________________________________________

In submitting this form, I/we certify that the information provided accurately
describes how the research will be conducted.

Researchers (print name and affix signature) Date

ALORIA, MIKHAIL ANDRE A. December 4, 2020
CANDAVA, XYRENE JOY R. December 4, 2020

87
DANDUAN JESSAMINE M. December 4, 2020
ORKEGHEN, RUTH MBAKAAN December 4, 2020
TUPAZ, SHAZNEY KATHLEEN A. December 4, 2020
VASQUEZ, EMILYN S. December 4, 2020

Note: Please attach the following documents to your application form.

Informed Consent Form

Questionnaire/ Interview Guide/ FGD Guide/ Observation Checklist

Research Proposal

88
 APPENDIX III
RESEARCH ETHICS REVIEW RESULTS

COLLEGE OF NURSING AND MIDWIFERY

COLLEGE/ DEPARTMENT

Procedure No. __________

Research Title: COMPLIANCE WITH THE STANDARD PRECAUTION

PRACTICES AMONG STAFF NURSES IN SELECTED
HEALTH INSTITUTIONS IN BATANGAS CITY.

Authors: ALORIA, MIKHAIL ANDRE A.

CANDAVA, XYRENE JOY R.
DANDUAN JESSAMINE M.
ORKEGHEN, RUTH MBAKAAN
TUPAZ, SHAZNEY KATHLEEN A.
VASQUEZ, EMILYN S.

Action Taken:

Approved

Pending Approval (Subject to conditions)

_______________________________________________________

89
 _______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________

Disapproved
_______________________________________________________
_______________________________________________________
________________________________________________

Mrs. Sofia G. Catibog. RN, MAN December 4, 2020

Chair- Research Ethics Committee Date
(Signature over printed name)

90
 APPENDIX IV
QUESTIONNAIRE

Name (optional): Gender: Institution:

Part 1: Respondent Profile

DIRECTION: Check out the space that hits your answer.

1.1 Age

__21-25 yrs old ___51-55 yrs old

__26-30 yrs old ___56-60 years old

__31-35 yrs old ___60 and above

__36-40 yrs old

__41-45 yrs old

__46-50 yrd old

1.2 Gender

__Male __Female __ LGBTQA+

1.4 Educational Attainment

__ BSN Graduate __ MAN Graduate

__ Man Units __ PhD

__ PhD Units __________others: (Please

specify)

I.5 Length of Work Experience

___Less than a year

91
 ___ 1-5 years
___ 6-10 years
___11-15 years _____________others (Please specify)

I.6 Area of Assignment

__ Emergency Room __ Operating Room

__ NICU __ Ward

___ICU

__ Delivery Room ______others (Please specify)

I.7 Working Position

___ ER nurse ___ Neonatal nurse

___OR nurse ___ Oncology nurse

___ Ward nurse ___ Urology Nurse

___ ICU nurse ___ Psychiatric nurse

___ Cardiac nurse _______ others (Please specify)

I.8 Shifting Schedule

____ 7 am-3 pm ____ 11 pm- 7 am

____ 3 pm-11 pm

Part 2: Trainings and seminars related to the compliance of standard

precautions
 Infection Control and Prevention

92
  COVID-19 Infection Prevention

 Occupational Health and Safety Practices

 Standard Precautions: Hand Hygiene

 Standard Precautions: Waste Management

 Standard precautions: Injection safety and needle-stick injury

management

 Standard precautions: Environmental cleaning and disinfection

 Decontamination and sterilization of medical devices or equipment

Others please specify: __________________________________________

Part 3: Compliance on Standard Precaution Practices of Staff Nurses

Please rate the following standard precaution practices done by the staff nurses
according to their compliance by putting a (/) check mark on the space provided
that best described your answers.
4- Always 3- Sometimes 2- Rarely 1-Never
Compliance on hand washing:
Motion for hand washing
 Rub hands palm to palm
 Right pal over dorsum with interlaced fingers and vice versa
 Palm to palm with fingers interlaced
 Back of fingers to opposing palms with fingers interlocked
 Rotational rubbing of left thumb clasped in right palm and
vice versa
 Rotational rubbing, backwards and forwards with clasped
fingers of right hand in left palm and vice versa

As a nurse, I: 4 3 2 1
I wash my hands between patient contacts
I wash and decontaminate my hands after taking off the gloves

93
I wash my hands immediately after contacting with any blood, body
fluid, secretion, excretion and dirty substances
I wash my hands before clean/ aseptic procedure
I wash my hands after touching patient surroundings
Compliance on use of personal protective equipment and
proper disposal:
a. Donning PPE
b. Doffing
I wear gloves when I am exposed to body fluids, blood products,
and any excretion of patients
I change gloves between patient contacts
I remove Personal Protective Equipment (PPE) in a designated
area
I take shower in case of extensive splashing even after I have to
put on Personal Protective Equipment (PPE)

I wear surgical mask alone or in combination with goggles, face

shield and apron whenever there is a possibility of a splash or
splatter
My mouth and nose are covered when I wear a mask
I will not reuse a surgical mask or disposable Personal Protective
Equipment (PPE)
I wear gown or apron when exposed to blood, body fluids or any
patient excretions
I decontaminate surfaces and equipment after use
I wear gloves to decontaminate used equipment with visible soils
Waste contaminated with blood, body fluids, secretion and
excretion is placed in red plastic bags irrespective of the patient's
infection status
I clean up spillage of blood or other body fluids immediately with
disinfectants
Compliance on safe injection practices and handling:
I will recap used needles after giving an injection

94
I put needles and blades in a sharp disposal box or receptacle
after using
The second hand syringe is not reused or reprocessed
The sharp box is disposed only when it is ¾ full
If the skin is injured by polluted sharps, it is squeezed for the blood
flowing and then thoroughly cleaned, disinfected and taped up

APPENDIX V

95
 WAIVER
Dear Respondents:

Warm Greetings!

We, the third-year nursing students of University of Batangas are

presently working on the Research Study entitled: “Compliance with Standard
Precaution Practices among Staff Nurses in Selected Health Institutions in
Batangas City” as a partial requirement for the course, Nursing Research 1.

The study aims to provide information about the compliance of staff

nurses to standard precaution practices. The result will serve as a tool and basis
for further understanding and assessment of compliance of staff nurses with
standard precautions.

In line with this, may we request permission from you to allow us to gather
data through survey questionnaire. Attached herewith is a questionnaire for our
research study. Kindly accomplish the questionnaire honestly and answer the
items completely.

Rest assured that the result of this data will be used purposely for this
research study and will be held in strict confidentiality.

Thank you so much for sharing your time with us!

Respectfully yours,

ALORIA, MIKHAIL ANDRE A.

CANDAVA, XYRENE JOY R.

DANDUAN JESSAMINE M.

96
 ORKEGHEN, RUTH MBAKAAN
TUPAZ, SHAZNEY KATHLEEN A.
VASQUEZ, EMILYN

Noted by:
Mrs. Sofia G. Catibog R.N.,M.A.N
Dean, College of Nursing and Midwifery

Mrs. Maria Joycelyn Zaraspe R.N.,M.A.N

Research Adviser

APPENDIX VI

97
 INFORMED CONSENT
I, _____________________________________ (Name of Participant), voluntarily agree
to participate in the research study titled Dimension of Burnout Syndrome and its
Impact on Coping Mechanisms among Staff Nurses in selected Healthcare
Institutions in Batangas City.

Further:
1. I hereby confirm that I have met the age requirement and am capable of acting on
behalf of myself. Otherwise, I have the permission of my parents/ legal guardians.

2. I agree to follow the set procedures and to provide all necessary information to the
study as needed.

3. I have read and understood all the terms and conditions of my participation in the
research and all questions relating to the research have been answered to my
satisfaction.

4. I understand that even if I agree to participate now, I may, at any time, decide to
withdraw from this study without giving reasons and /or refuse to answer any question
without consequences of any kind.

5. I understand that all information I shall provide for this study will be treated with
confidentiality and that in any report on the results of this research, my identity will
remain anonymous.

6. I have the right to refuse permission for further use of the data provided beyond the
need of this research. Moreover, materials arising from my participation will be deleted.

7. I understand that I will not be paid nor benefit directly from participating in this
research.

8. I have the right to contact any of the people involved in the research for further
clarification and/or information.

9. I have been given a copy of this consent form

98
 I fully understand the terms and conditions of this consent form and hereby sign
this form.

Name of Participant
_______________________________________________
Signature
_______________________________________________
Date
_______________________________________________

 To be filled by parents/guardians for participants under the age of 18 years

old.

Name of Parent/ Legal Guardian

_______________________________________________
Relationship to the Participant
_______________________________________________
Signature
_______________________________________________

APPENDIX VII

99
 Time Table

100
 Task Completed Due date
Identification of the problem September 05, 2020
Gathering of information and resources September 05, 2020
Submission of Proposed Title September 07, 2020
Disseminated of task September 07, 2020
Gathering of Data and Related Literature September, 2020

Composition of conceptual framework, September 19, 2020

statement of the problem

Composition of the significance of the September 30, 2020

study, scope and limitation, Definition of
Terms
Composition of literature and studies October, 08 2020

Title Defense
Start of Chapter 1 and 2 October, 2020

Revision of chapter 1 and 2 October 2020

Interpretation of Research Design and November 2020

research instrument
Data gathering Procedure and Statistical November 2020
Treatment of Data
Construction of Acknowledge, Dedication, November 2020
Table of Contents, List of Figures and
Tables
Construction of Bibliography, Appendices November 2020
and Curriculum Vitae
Final Editing
Preparation for Proposal Defense December 2020
Proposal Defense December 2020
Submission of Documentation December 2020
Submission of Other Requirements December 2020
Revision of Chapter 1-3 January 2021
Duplication of Questionaires and January 2021
distribution to different institutions
Collecting Answered Questionnaires from February 2021
Different Institutions
Tallying of Results March 2021
Start of Chapter 4101and 5 March 2021
Updating Chapter 1,2 and 3 April 2021
Completion of Chapter 1 to 5 April 2021
 APPENDIX VIII
BUDGET PROPOSAL

LIST OF EXPENSES PRICE OF EXPENSES

LOAD Php 1,000.00

PRINTING Php 500.00

SUPPLIES AND MATERIALS Php 400.00

OTHER EXPENSES Php 500.00

TOTAL Php 2,400.00

102
 CURRICULUM VITAE

Mikhail Andre A. Aloria

EDUCATIONAL ATTAINMENT
Primary Saint Bridget College 2006-2012
M.H Del Pilar Street, Batangas City

Secondary University of Batangas 2012-2018

Hilltop, Batangas City

Tertiary University of Batangas 2018-Present

Security Management Department
National Road, Hilltop Kumintang Ibaba,
Batangas City

103
ORGANIZATIONAL AFFILIATION

1. Sigma Theta Tau-University of Batangas Chapter- Member (AY 2019-

2020)

CURRICULUM VITAE

Xyrene Joy R. Candava

EDUCATIONAL ATTAINMENT
Primary Holy Child Montessori School 2006-2009
Sto. Nino Puerto Galera Or. Mindoro

Puerto Galera Central School 2009-2012

Poblacion, Puerto Galera Or. Mindoro

Secondary Puerto Galera Academy 2012-2018

Poblacion, Puerto Galera Or. Mindoro

Tertiary University of Batangas 2018-Present

104
 Security Management Department
National Road, Hilltop Kumintang Ibaba,
Batangas City
ORGANIZATIONAL AFFILIATION

1. Sigma Theta Tau-University of Batangas Chapter- Member (AY 2018-

2019)
2. Sigma Theta Tau-University of Batangas Chapter – 2nd Year
Representative
(AY 2019-2020)
3. Sigma Theta Tau-University of Batangas Chapter- Member (AY 2020-
2021)

CURRICULUM VITAE

Jessamine M. Danduan

EDUCATIONAL ATTAINMENT
Primary San Juan East Central School 2006-2012
San Juan Batangas

Secondary Batangas Eastern Colleges 2012-2018

San Juan Batangas

Tertiary University of Batangas 2018-Present

Security Management Department
National Road, Hilltop Kumintang Ibaba,
Batangas City

105
ORGANIZATIONAL AFFILIATION

1. Sigma Theta Tau-University of Batangas Chapter- Member (AY 2019-

2020)

CURRICULUM VITAE

Ruth Mbakaan Orkeghen

EDUCATIONAL ATTAINMENT
Primary Tiny Tots Nursery and Primary School 2004-2008
Makurdi, Nigeria

Secondary Our Lady of Mount Carmel College Makurdi 2008-2013

Makurdi, Nigeria

Tertiary University of Batangas 2018-Present

Security Management Department
National Road, Hilltop Kumintang Ibaba,
Batangas City

106
ORGANIZATIONAL AFFILIATION
None

CURRICULUM VITAE

Shazney Kathleen A. Tupaz

EDUCATIONAL ATTAINMENT
Primary North Daanghari Elementary School 2006-2012
Brgy. North Daanghari, Taguig City
Secondary Saint Francis of Assisi College 2012-2016
Holy Family Village, Bagumbayan, Taguig City
Centro Escolar University 2016-2018
Gil Puyat, Makati City
Tertiary University of Batangas 2018-Present
Security Management Department
National Road, Hilltop Kumintang Ibaba,

107
 Batangas City
ORGANIZATIONAL AFFILIATION

1. Sigma Theta Tau-University of Batangas Chapter – Assistant Treasurer

(AY 2018-2019)
2. Sigma Theta Tau-University of Batangas Chapter- Member (AY 2020-
2021)

CURRICULUM VITAE

Emilyn S. Vasquez

EDUCATIONAL ATTAINMENT
Primary Sitio Sto. Tomas Elementary School 2006-2011
Brgy. Sta Maria Abra de Ilog Occidental Mindoro

Secondary Abra de Ilog National High School 2014-2015

Abra de Ilog Occidental Mindoro

Tertiary University of Batangas 2018-Present

Security Management Department
National Road, Hilltop Kumintang Ibaba,
Batangas City
ORGANIZATIONAL AFFILIATION

108
1. Sigma Theta Tau-University of Batangas Chapter- Member (AY 2019-
2020)

109