CHAPTER I

The Problem and Its Background

INTRODUCTION

Nursing is a profession of art and science that involves interaction with the client

equipped with a touch of care. Unlike the other jobs, it opts to give care to those who are

sick with a sense of desire to promote wellness and provide treatment. As promoters of

health, nurses teach, give care, and treat patients who are physically, emotionally, mentally

and socially sick and ill. It is a profession that offers the individual the chance to touch

other people’s lives and be sensitive to them.

Nurses are the heart and hands of the team and they are sensitive to the needs of

the client that enables them to have a good nurse-client relationship by being more

emphatic as well as rendering services in a hands-on manner. This would mean constant

contact and exposure with the various nosocomial infections present in the hospital setting.

It is the duty and responsibility of the nurse to strictly comply and adhere to the hospital’s

preventive measures against nosocomial infections and other infectious diseases.

Furthermore, nurses as health care workers should be aware of the ways to slow or

prevent the transmission of infectious diseases and be knowledgeable of its potential risk

to the client and hospital staffs.

 2

As future nurses, the study aims to identify the ways of preventing nosocomial

infections in Far Eastern University – Dr. Nicanor Reyes Medical Center as well as the

different kinds of preventive measures that are implemented and foreseen as an effective

way in breaking down the chain of infection.

This study would serve as a baseline guide for further development and growth of

nursing care and enhance the preventive strategies used to minimize nosocomial infection

from the patient or client, hospital setting, and care giver itself.

STATEMENT OF THE PROBLEM

The study aims to determine the prevention of nosocomial infection as perceived by

staff nurses of Far Eastern University –Dr. Nicanor Reyes Medical Center. Specifically, it

attempts to answer the following questions:

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

1.1 Age

1.2 Gender

1.3 Educational Attainment

1.4 Length of service

2. What is the nature of nosocomial infection in terms of:

2.1 Mode of transmission

 3

2.2 Prognosis

2.3 Prevention and treatment

3. How effective are the preventive measures implemented by FEU-NRMF Medical

Center in terms of:

3.1 Hand washing

3.2 Use of protective gears

3.3 Proper sanitation

3.4 Controlling spread of infection

3.5 Sterilization

3.6 Surveillance

3.7 Isolation

3.8 Personal hygiene

3.9 Safe injection practices

3.10 Cleaning of the hospital environment

3.11 Disinfection of patient’s equipments

4. What are the implications of results and findings of the study to the improvement of

nursing profession and service of the institution?

 4

OBJECTIVE

The purpose of this study is to determine the most effective preventive measures

applied and implemented in Far Eastern University-Dr. Nicanor Reyes Medical Center in

slowing down or preventing the spread of nosocomial infections. Moreover, it also aims to

seek an effective way to prevent and avoid the acquisition of nosocomial infections without

affecting the quality of health care rendered by the nurse.

CONCEPTUAL FRAMEWORK

In this area of study, the researchers present concepts tackled in the course of

study. These concepts are essential in guiding and directing the researchers toward data

analysis and interpretation.

One significant conceptual framework of this study was depicted from an integration

of Leavell and Clark’s Ecologic Model: Agent-Host-Environment. This is effective for

assessing and examining the causes of disease in an individual. The agent, host and

environment interact in a manner that creates risk factors, and understanding these is

important for the maintenance and promotion of health. An agent is a stressor or an

environmental factor that must be absent or present for a disease to occur. A host is a

living organism capable of being infected by an agent. Leavell and Clark emphasize health

concepts and disease acquisition as:

 5

1. The model is used primarily in preventing illness rather than promoting wellness,

although identification of risk factors that result from interaction of agent-host-

environment is helpful in promoting and maintaining health.

2. The model consist of dynamic interaction of three elements:

2.1. Agent. Any environmental factor or stressor (biologic, chemical, mechanical,

physical or psychosocial) that by its presence or absence can lead to illness

or disease.

2.2. Host. Person(s) who may or may not be at risk of acquiring a disease.

2.3. Environment. All factors external to the host that may predispose the person

to develop disease.

3. Defines health as ever-changing state; when variable are balanced, health is

maintained, when variables are not in balanced, disease occurs.

Another significant conceptual framework of this study is one of Leavell and Clark’s

Three Levels of Prevention primarily the Primary Prevention which states that:

1. Primary prevention is the action taken prior to the onset of the disease that

removes the possibility that the disease will occur.

2. Primary prevention can be accomplished by measures of specific

protection and health promotion.

3. It signifies intervention in the pre-pathogenesis phase of a disease.

 6

4. Primary prevention can be accomplished by measures or procedures

designed to promote well-being, general health and quality of life of people

or by certain protective measures.

5. Primary prevention includes the concept of positive health, a concept that

promotes maintenance and achievement of an acceptable level and degree

of health that will allow every individual to lead a normal and productive life.

6. The strategy for prevention starts from the identification of the populations

at high disease risk, assessing their exposure, conducting research on

mechanisms, applying population-based intervention programs, evaluating

the intervention programs and ending by modifying the existing intervention

programs.

7. Primary prevention is a holistic approach.

8. Primary prevention keeps the disease process from becoming established

by increasing resistance to the disease or eliminating causes of disease.

9. Primary prevention refers to health promotion, which promotes wellness

and thus reduces the likelihood of premature death, disease and disability

in a nonspecific way, as well as particular protection against the inception

of disease.

10. Primary prevention precedes dysfunction or disease and is applied to

generally healthy individuals or groups.

 7

Input Throughput
1. Demographic profile of Evaluation of the
the respondents preventive measures
1.1 Age implemented in Far
1.2 Gender Eastern University-Dr.
1.3 Educational Nicanor Reyes Medical
Attainment Center in slowing down
1.4 Length of Service or preventing the spread
2. Nature of the of nosocomial infections.
nosocomial infection
2.1 Mode of 1. nosocomial infection
transmission encountered and
2.2 Prognosis acquired
2.3 Prevention and
treatment 2. Preventive measures
3. Preventable Measures
to avoid and minimize
nosocomial infection and
the transmission of other
diseases. Output
3.1 Hand washing Implication to Effective
3.2 Use of protective Preventive Measures
gears and Modes of Control.
3.3 Proper sanitation
3.4 Controlling spread
of infection
3.5 Sterilization
3.6 Surveillance
3.7 Isolation
3.8 Personal hygiene
3.9 Safe injection
practices
3.10 Cleaning of the
hospital environment
3.11 Disinfection of
patient’s equipments
4. Implications to the
improvement of nursing
profession and services
of the institution.

Fig. 1 Conceptual Paradigm

 8

ASSUMPTION

Based on the related problems:

1. Primary causes of nosocomial infection originate from the client having contagious

disease, hospital environment, and hospital personnel or health care provider.

2. Preventive measures play a vital role in breaking down the chain of infection.

SIGNIFICANCE OF THE STUDY

The researcher believed that the study could further help and contribute to the following:

To the nurse. This study is significant in the sense that it could improve the nurses’ health

awareness and early prevention skills and method thus, suppressing the possibility of the

spread and transmission of nosocomial infections. It could also further contribute to the

growth of the nursing profession thus allowing them to grow professionally.

To the hospital administrators. This study may determine the most effective preventive

measures in slowing down or preventing the spread of nosocomial infections. Thus, can

serve as bases of promoting and implementing standard precautionary measures for the

clients, care givers and hospital administrators welfare.

To the future researchers. The findings in this research can help other studies that are

related to prevention of nosocomial infection.

 9

SCOPE AND DELIMITATIONS OF THE STUDY

This study is focused on the prevention of nosocomial infections as perceived by

staff nurses of Far Eastern University-Dr. Nicanor Reyes Medical Center with a particular

description of the preventive measures implemented and foreseen as effective in

preventing the spread of nosocomial infections.

It is limited to the hospital settings in terms of the preventive measures and modes

of control that are implemented, practiced and seen as effective in slowing down and

preventing the transmission of nosocomial infections among the clients, hospital setting,

and care giver itself.

DEFINITION OF TERMS

Aerosolized- in the form of ultramicroscopic liquid or solid particles suspended in air.

Agent- an environmental factor that must be absent or present for a disease to occur.

Airborne transmission- occurs by dissemination of either small particles or airborne

droplet nuclei containing the infectious agent.

Aseptic- using methods to keep free of pathological microorganisms.

Compliance- acting in accordance to certain accepted standards, procedures, rules and

preventive measures.

Direct contact- involves skin-to-skin contact and physical transfer of microorganisms to a

susceptible host from an infected person.

Disease- a condition of abnormal functioning or an impairment of health.

 10

Droplet transmission- contact of the mucous membranes of the mouth or nose or the

conjunctivae of a susceptible person with large- particle droplets containing infectious

microorganisms generated from a person who is a carrier of the microorganism or has a

clinical disease.

Ecologic- interdependence of living organisms in an environment.

Effectiveness- capability of producing desired results.

Environment- all factors external to the host that may predispose the person to develop

disease.

Epidemiology- branch of science that deals with the transmission and control of diseases.

Fomite- any inanimate object or substance capable of carrying infectious organisms and

thus transferring them from one individual to another.

Hand washing- universal precaution in the prevention of the spread of disease.

Host- a living organism capable of being affected or infected by an agent.

Implemented- ensure observance of rules, procedures and preventive measures or laws

that are enforced and followed.

Inanimate- non-living things; object

Inception- an event that is a beginning; origin

Indirect- contact- involves contact of a susceptible host with a contaminated intermediate

or inanimate object in the patient’s environment.

Infirm- lacking muscular or body strength.

Isolation- separation between infectious and non-infectious groups or persons.

Measure- steps or standards in preventing the acquisition of nosocomial diseases.

Morbidity- relative incidence of a particular disease.

 11

Mortality- ratio of deaths in an area to the population of that area; expressed per 1000 per

year.

Nosocomial Infections- hospital-acquired infection or infections that develop as a result of

stay in the hospital or are produced by viruses and infectious agents acquired during

hospitalization.

Preventive- slows or hinders the course of a disease or illness.

Process- particular course of action intended to achieve a result.

Rapport- a relationship of mutual trust and understanding between people.

Sanitation- making the environment free from germs or state of being clean, neat and

conducive to health.

Surveillance- close observation of a person or group.

Vector- any agent that carries and transmits a disease.

Wellness- a healthy state of well-being free from disease and infirmity.

Acronyms:

AHA- American Hospital Association

CDC- Centers for Disease Control and Prevention

DOH- Department of Health

FEU-NRMF- Far Eastern University- Dr. Nicanor Reyes Medical Foundation

ICC- Infection Control Committee

JCAHO- Joint Commission on Accreditation of Health Care Organizations

SHEA- Society for Hospital Epidemiology of America

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CHAPTER 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the literature, reading, and studies that are related to the

present study which is prevention of nosocomial infections as perceived by staff nurses of

Far Eastern University-Dr. Nicanor Reyes Medical Center.

FOREIGN LITERATURE

Katrena Wells (2009) in her article “Best Ways to Prevent Nosocomial Infections”

suggests five ways to help prevent the spread of infections in hospital. These are hand

hygiene, avoiding infecting others if you are sick, using a tissue when you cough or

sneeze, ensuring that you are up-to-date on any necessary vaccines, and supplies should

be sanitized before they touch your skin.

Other methods of preventing nosocomial infections include observance of aseptic

technique, frequent hand washing especially between patients, careful handling, cleaning,

and disinfection of fomites, air filtration within the hospital, and use of single-use

disposable items (Abedon, Stephen 2009).

Hospitals may bring diseases and infections to nurses while attending to all the

patients' needs because they are the primary caregivers of patients and are more in

contact with the patients. Preventive measures are being implemented for the patients and

to the nurses as well in order to prevent nosocomial infections. Some precautionary

measures must be implemented in the event of any social conflict within the area like using
 13

of gloves as a protective gear to prevent transmission of diseases from patients onto the

nurses and proper hand washing. The head nurse must be informed immediately as soon

as the nurse starts to manifest any signs and symptoms of a possible communicable

disease (Smith, John 2009).

According to John Bosso (2004), Hand washing by health care workers is crucial in

preventing and controlling the spread of nosocomial infection. Only through staff education

and awareness, ongoing surveillance, and appropriate intervention can this common

problem be alleviated.

Maggie Edgar (1996) in her article “Preventing the Spread of Disease: Tips for

Providers, stated that care providers can stay healthier by following these guidelines: wash

hands properly and frequently, maintain current immunizations, especially tetanus, take

scheduled breaks and vacations, observe good nutrition, exercise regularly, rest sufficiently

each day, and engage in hobbies or other activities that do not involve caring for someone

else. Care providers who are ill should take care of themselves because they cannot

provide the usual quality of care and they can spread germs to others. A healthy care

provider is the key to a healthy, happy client care experience for clients and their families.

FOREIGN STUDY

JC Bridger (1997) conducted a study entitled a study of nurses’ views about the

nosocomial urinary tract infections which was conducted at school of nursing, Middlesex

university, Royal Free Hospital at London, UK. This study sought to discover the
 14

contribution of nursing practice to the prevention of hospital-acquired or nosocomial urinary

tract infections (NUTIs), the most commonly occurring nosocomial infection. This

qualitative study utilized unstructured interviews to explore the views of 12 registered

nurses about three key issues: first, what care do nurses give with the aim of preventing

catheter-associated NUTIs; secondly, what improvements in practice would further prevent

catheter-associated NUTIs; thirdly, what do nurses see as constraints to the prevention of

catheter-associated NUTIs? The nurses identified many of the measures that were cited in

the literature as effective for preventing NUTIs; however in reality, they stated that their

practice differed because of a lack of time to give care and to update themselves. Those

interviewed identified feelings of powerlessness in effecting preventative measures, and

identified not only the role of medical staff in influencing NUTIs but also their inconsistent

approach to care.

Improving Nurses’ Hand Washing Compliance (Journal of Hospital Infection, 2002)

is a study that explored the effectiveness of teaching strategies and the availability of

additional hand-carried alcohol dispensers on nurses' compliance with hand disinfection.

(2) Registered nurses and nurse assistants (n = 480) received standardized instruction on

alcohol hand disinfection. To determine the amount of disinfectant used, the volume of the

solution was measured before and after each study period. The clinical implications are

that hand disinfection is a critical step in minimizing nosocomial infections. This study

supports the premise that nurses and nursing assistants improve compliance with hand
 15

washing when teaching is provided. It also supports the importance of having hand-

washing supplies in adequate supply and readily available at the point of care.

A study was also conducted by Suzanne Beyea (2003) entitled Nosocomial

Infections; Hand-washing Compliance; Comparing hand hygiene protocols; Sensor-

operator faucets - Evidence For Practice. This prospective, controlled study was conducted

in eight medium-sized hospitals and examined the effect of appropriate quality

management activities on nosocomial infection rates during a 26-month period. The study

focused on surgical departments. Intensive care units (ICUs) were included to capture data

for patients requiring this type of treatment after surgery. The intervention group comprised

four hospitals, and the control group comprised four hospitals. The result was Clinicians

should be aware of opportunities to use quality improvement and surveillance activities as

strategies to reduce the risks of infection. In this study, clinicians from the units involved

were instrumental in evaluating infection control measures and relating and implementing

strategies to reduce the risk of infection.

Another study was conducted by Sau-Pin Won et. al (2004) which is the hand

washing program for the prevention of nosocomial infections in neonatal intensive care unit

that was held at a level-III NICU in a teaching hospital. The participants are Nurses,

physicians, and other healthcare workers in the NICU and the objective of this study is

to To evaluate the effects of a hand hygiene program on compliance with hand

 16

hygiene and the rate of nosocomial infections in a neonatal intensive care unit

(NICU). The result was improved compliance with hand washing was associated with a

significance decrease in overall rates of nosocomial infection and respiratory infections in

particular and that washing hands is a simple, economical and effective method for

preventing nosocomial infections.

Another study was conducted by Torregrossa M.V., Valentino L., Cucchiara P.,

Masellis M., Sucameli M. (2000) entitled Prevention of Hospital-Acquired Infections in the

Palermo Center. This study reports on an extensive epidemiological survey of the

microbiological monitoring of the environment, staff, and patients in the Intensive Care Unit

of the Palermo Bums Centre (Italy). The aim of the survey was to evaluate the presence

and distribution of environmental sources of pathogens and opportunistic bacterial agents

of nosocomial infection in immunocompromised hosts. Strains collected from air, tap water,

and medical and nursing staff were compared with strains isolated from burn patients in

order to study the potential transmission route of bacteria. The results showed

environmental strains presenting a profile identical to that of the clinical strains, suggesting

a link between the environment, staff, and the patients. A programme of routine

microbiological monitoring proved to be effective as a surveillance programme for the

reduction of nosocomial infection.

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LOCAL LITERATURE

Nosocomial infections according to Rep. Narciso D. Santiago III (Party-list, ARC), is

a result of treatment in a hospital or a health care service unit, but secondary to the

patient’s original condition. It is a hospital- acquired infection or more generally known as

healthcare-associated infections that is responsible for the large number of deaths in the

world. Hand washing and improving hygiene practices in the hospital is the most effective

way for reducing the spread of these infectious agents.

The House Bill 5905 suggests that all hospitals should maintain and gather records

of data on the hospital-acquired infection cases for a particular surgical procedure and

surveillance in the intensive care units. Under the house bill, the Secretary of Health shall

determine the different types of infections present in the hospital. (Camero, Jazmin, 2009)

House Bill 5905 also known as the "Hospital-Acquired Infections Disclosure Act of

2009" requires all hospitals to submit a yearly report of all the collected data regarding

hospital- acquired infection cases to the Department of Health then, the DOH will submit a

report to the congress summarizing all the data submitted by the hospitals. (Camero,

Jazmin, 2009)

The Department of health shall also appoint members of the advisory committee

which includes the physicians, representation of infection control department of both

private and public hospitals, academic researchers, epidemiologists, health maintenance

 18

organization and health insurers who will help the department formulate and establish

standards, rules and regulations needed to execute this bill. (Camero, Jazmin, 2009)

According to Tessa Tan-Torres, M.D., “surveillance is the close and continuing

observation of an individual or group. Its goal, in the hospital is the collection of accurate,

reliable and timely data on infections and notifiable diseases acquired within the hospital.

Surveillance data also includes information on risk factors, etiologic agents and

antimicrobial susceptibility.”

The specific aims of surveillance are the following:

1. detect the areas of concern in terms of infection control;

2. identify potential epidemics;

3. assess and consider the effectiveness of infection control measures;

4. remind the personnel about the infection control practices.

5. give and provide a basis for comparison with other services.

Surveillance of nosocomial infections is not a control measure by itself and the

presence of ICC personnel can possibly lead to a stricter adherence on infection control

practices among the hospital staff.

In the Philippine journal of microbiology and infectious diseases, it was stated that

“nosocomial infections continue to be of major clinical and epidemiological importance” and

this might be because of the continuous incidence of transmission of nosocomial

 19

infections; which is greatly associated with improper delivery of health. This kind of

infection develops during a client’s confinement at the clinical facility, but not also that this

can be manifested even after the client is discharge. Moreover, nosocomial infections are

not limited to patients but also the health care workers can also acquire this situation which

usually gives a significant effect on the health workers lifestyle.

LOCAL STUDY

A study about the incidence of nosocomial infections within a tertiary hospital was

formulated by “Bienvido Alora, M.D., Enrique Carandang, M.D. and Ludovico Jurao, Jr

M.D.” they stated that “the problem of hospital-acquired or nosocomial infections have

baffled physicians for a long time. The awareness of the extent and significance of this

problem became apparent in the past two or three decades as more studies have been

published.” With this the researchers can say that due to the increase of the studies made

for this topic the incidence of nosocomial infection within a hospital is still on hand.

Moreover, according to Rebecca Littaua, M.D. and Thelma Tupasi, M.D, they stated,

“despite major advances in antimicrobial therapy, nosocomial infections continue to be of

major clinical and epidemiologic importance. Because nosocomial infections constitute a

major source of morbidity, mortality and expense for the hospitalized patient, a prospective

study was undertaken to determine the incidence and identify the major determinants of

morbidity and mortality to serve as basis for recommending preventive measures against

nosocomial infection.”

Another important contribution is Katz SS. M.D. who made an unpublished study

about treatments and guidelines for nosocomial infections. According to her, “Health care
 20

workers should be equipped with requisite knowledge, skills and attitudes for good

infection control practices. The infection control team should: assess training needs of the

staff and provide required training through awareness programs, in-service education and

on-the-job training; organize regular training programs for the staff for essential infection

control practices that are appropriate to their job description; provide periodic re-training or

orientation of staff; and review the impact of training.” Hence the researchers further belief

that the study should not only focus on the frequency of the nosocomial infections but also

the preventive strategies that can be used to lessen the incidence rate of the problem.

RELEVANCE OF THE REVIEWED LITERATURE AND STUDIES TO THE PRESENT

STUDY

The researcher’s present study relates to the previously gathered and reviewed

literatures which show the relevance on the study about the prevention of nosocomial

infections as perceived by staff nurses of FEU-NRMF.

The present study conducted by the researchers used a descriptive method such

like other studies and made use of questionnaires that be given to the respondents and to

be answered while interviewing the respondents.

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CHAPTER III

Research Methodology

RESEARCH DESIGN

This study used the descriptive research. It is used to determine if there is certain

relationship between variables. Descriptive research was defined as “research studies in

which phenomena are described on the relationship between variables is examined; no

attempt is made to determine the cause-and-effect relationships”.

SUBJECT

This study about the prevention of nosocomial infections as perceived by the staff

nurses involved a target total of 33 nurses positioned within the service wards of selected

station of Far Eastern University – Dr. Nicanor Reyes Medical Center as our respondents.

RESEARCH INSTRUMENTS

The researchers used the questionnaire for gathering and researching the

information needed in the study. It is aimed towards determining the prevention of

nosocomial infections as perceived by staff nurses of Far Eastern University – Dr. Nicanor
 22

Reyes Medical Center. The questionnaire was formulated with the use of the researcher’s

basic knowledge acquired from literary sources and class discussions.

The questionnaire contains three parts. The first part was used to gather data about

the personal profile of the respondents, including the name, age, civil status, educational

attainment, nurse’s action and the length of service. The second part contains gathered

data about the most common nosocomial infections present and encountered in the

hospital as perceived by the staff nurses of FEU-NRMF. The third part contains gathered

data about the respondent’s practiced precautionary measures.

DATA GATHERING PROCEDURE

The descriptive method was used by the researchers of this study. After the retrieval

of the questionnaires, the obtained data are carefully and manually tabulated and tallied by

the researchers. The items with the most frequency were identified in order to arrive at an

accurate interpretation of the results. The percentage of each item is also reflected on the

tabulation to help the researchers have a clearer analysis of the survey’s result.

STATISTICAL TREATMENT

The following are statistical tools we used to treat research data for in depth solution

of problems:
 23

1. Slovin’s Formula- is the scientific way of determining a representative or acceptable

sample size from any given population.

Formula: n = N

(1+Ne^2)

Where:

n= sample size

N= population size

e= margin of error (usually 0.05, since the preferred confidence level in sampling is

95%).

2. Frequency Distribution - is the tabulation of data by category or class intervals with

corresponding frequency with each class.

3. Relative Frequency – is used to convert distribution to percentage distribution.

Formula: % = f / n x 100

Where: % = is the relative frequency

f = frequency

n = number of respondents

4. Percentage- is computed to determine the proportional part to a whole such as given

numbers of respondents in relation to the entire population.

Formula: P = f / n x 100

Where: P = percentage

f = frequency

n = total umber of respondents

 24

5. Ranking is used to determine the order of decreasing or increasing magnitude of

variables. The largest frequency is ranked 1 and the second is 2 and so and so on

down to the last rank.

6. Weighted Mean – is the sum of item values times the weight divided by the number

of items; is used in determining the perceptions of the respondents on effects of

physical environment in reducing nursing care.

7. Likert Scale – summated rating scale; is the most widely used scale; the sum of all

responses are calculated to arrive at degree at which an individual possesses the

attribute measured.

BIBLIOGRAPHY

Fundamentals of Nursing; Seventh Edition, Kozier and Erb, 2004

Nosocomial Infection in a Tertiary Hospital: a Two Year surveillance at Sto. Tomas Hospital. ,

B. Alora, MD. Et al.

Nosocomial Infection at Makati Medical Center: A Prospective Study and Analysis of Risk

Factors, R. Littaua, MD.

Nurses on Duty, by John Smith;2009

Preventing the Spread of Disease: tips for Providers, by Margie Edgar; 1996

Treatment and guidelines for Nosocomial Infection, by Katz Ss.

Supplemental lecture, by Stephen abedon; 2009

Prevention and Control of Nosocomial Infections, by John A. Bosso; 2004

Handwashing program for the prevention of nosocomial infections in neonatal intensive care

unit. By sau-pin won et. al 2004

 25

Surveillance of Nosocomial Infections, by Tan-Torres, Tessa M.D.; 1997

Fourteenth Congress of the Republic of the Philippines, Second Regular Session, by

Senator Miriam Santiago; 2009

Solon moves to prevent the spread of hospital- acquired infection, by Jazmin Camero;

2009

Nosocomial Spread of Viral Disease, by Celia Aitken et. al., 2001

Best Ways to Prevent Nosocomial Infections by Katrena Wells, 2009

Bridger JC. A Study of Nurses’ Views about the Nosocomial Urinary Tract Infections 1997

Suzanne Beyea. Nosocomial Infections; Hand-washing Compliance; Comparing hand

hygiene protocols; Sensor-operator faucets - Evidence For Practice 2003

Improving Nurses’ Hand Washing Compliance by Journal of Hospital Infection, 2002

Torregrossa M.V. et. al. Prevention of Hospital-Acquired Infections in the Palermo Center

2000
 26

Dear respondents,

We are third year nursing students of Far Eastern University-Dr. Nicanor Reyes

Medical Foundation and we would like to ask you to honestly answer our questionnaire for

our thesis regarding the prevention of nosocomial infection as perceived by staff nurses of

Far Eastern University-Dr. Nicanor Reyes Medical Center.

We promise to keep your answers confidential. Thank You!

The researchers

Fill in the following needed information:

Name:
Age:
Civil Status:
Educational Attainment:
Length of service in the hospital:

Legend:
5- Always
4- Often
 27

3- Sometimes
2- Seldom
1- Never

Mark the item that corresponds to your answer:

1. How often do you encounter the following nosocomial infections in the hospital?
5 4 3 2 1
Chicken pox
Cholera
Dengue
Hemorrhagic
Fever (DHF)
Diarrhea
Diphtheria
Hepatitis A
Hepatitis B
Hepatitis C
Influenza
Measles
Mumps
Pertussis
Pneumonia
Tuberculosis

2. In your own opinion, how often do you perceive each modes of transmission as being
the common cause of incidence of nosocomial infection in the hospital setting?
5 4 3 2 1
Direct
contact
Indirect
contact
Droplet
transmission
Airborne
transmission
 28

Common
vehicle
transmission
Vector borne
transmission

3. In your own opinion, how frequent does the following symptoms of nosocomial infection
being exemplified, shown or referred to by the clients?
5 4 3 2 1
Breathing
difficulties
Fever
Inflammation
Infection
Night sweats
Pain
Swelling

4. How often do you practice the following precautionary measures in the hospital?
5 4 3 2 1
Hand
washing
Use of
protective
gears (e.g.
cap, mask,
gloves)
Proper
Sanitation
Controlling
spread of
infection
Sterilization
Surveillance
 29

Isolation
Personal
hygiene
Safe
injection
practices
Cleaning of
the hospital
environment
Disinfection
of patients
equipments

5. How often do you practice the following nursing responsibilities?

5 4 3 2 1
■ promoting
the
improvement
of
nursing
techniques
and review of
aseptic
nursing
policies
■ monitoring
of nursing
adherence to
rules and
policies
■ maintaining
hygiene,
consistent
with hospital
policies
■ instructing
collection of
culture
specimens
from patients
 30

showing any
signs of
having a
communicable
disease, when
the physician
is not
immediately
available and
initiating
patient
isolation
■ participating
in the
outbreak
investigation
■ Informing
quickly the
attending
physician for
any signs or
evidence of
infection in
patients under
the nurse’s
care
■ limiting
client’s
exposure to
infections
from hospital
staff,
visitor, other
patients, or
equipments
used for
treatment and
diagnosis.
■ maintaining
an adequate
and safe
supply of
drugs or
medications,
 31

ward
equipments,
and patient
care supplies.
■ monitoring
aseptic
techniques,
including use
of isolation
and hand
washing
■ Excellent
nursing
practice on
the ward