CHAPTER I

THE PROBLEM AND ITS BACKGROUND

Introduction

One of the most basic human needs is safety. “All human being needs to be and

feel safe, both physically and psychologically.” Most of us protect ourselves within the

changing environment by functioning as healthy individuals who make decisions in a

reasonable manner (Arthur Amor Pimpas, 1998). A disease is any deviation from or

interruption of the normal structure or function of any body part, organ, or system that is

manifested by a characteristic set of symptoms and signs and whose etiology, pathology,

and prognosis may be known or unknown (Medical Dictionary).

According to Kozier (2004), once an individual is sick and experiences the signs

and symptoms of a disease, he will then adopt the second stage of illness which is the

assumption of the sick role wherein he excuses himself from normal duties and role

expectations. If this happens, one won’t be able to learn and perform clinical duties,

which he must do as a preparation for being a fully competitive nurse.

“Minute, living organisms, called microorganisms, exist everywhere in the

environment, on the human body and within the human body.” Others, called pathogens,

have the ability to cause diseases. Pathogens are microorganisms that cause diseases,

especially living microorganisms such as a bacterium, virus, or fungus. When the body is

unable to defend itself against these pathogens, they will multiply within the body which

would cause infection and would lead to the formation or start of a disease process.

(Arthur Amor Pimpas, 1998)

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 People who have acquired a disease, especially a life-threatening disease, are

rushed to the hospital for treatment. “They seek help from professional health care

workers (HCWs) to alleviate the pain, signs, and symptoms, and eventually the disease

itself. Health care workers are those clinical and other staff, including those in primary

care, who have regular, clinical contact with patients. This includes staff such as doctors,

dentists and nurses, paramedical professionals such as occupational therapists,

physiotherapists, radiographers, ambulance workers and porters, and students in these

disciplines (The Association of National Health Occupational Physicians or ANHOPS).”

These health care workers are the front liners in giving medical treatment and

care to the patients (A person under health care. The person may be waiting for this

care, may be receiving it, or may have already received it). Because of this, “the health

of the HCWs is compromised or at risk all the time for a vast array of infections that

cause substantial illness and occasional deaths.” Despite this, few studies have

examined the incidence, prevalence, or exposure-associated rates of infection or have

considered infection-specific interventions recommended in maintaining work safety.

(Sepkowitz,1996).

“More than 10 years have elapsed since the last major consideration of

occupationally acquired infections in health care workers. Since then, much has

changed—new infections have been identified, diagnostic tests for previously recognized

diseases have been improved, the use of molecular epidemiologic techniques in

outbreak investigations has increasingly become routine, and outpatient and home care

have become more common.” (Sepkowitz, 1996)

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 “Health workers are exposed to blood and other body fluids in the course of their

work. Consequently, they are at risk of infection with blood-borne viruses including

human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV). The risk

of infection for health workers depends on the prevalence of disease in the patient

population and the nature and frequency of exposures. Occupational exposure to blood

can result from percutaneous injury (needlestick or other sharps injury), mucocutaneous

injury (splash of blood or other body fluids into the eyes, nose or mouth) or blood contact

with non-intact skin. The most common form of occupational exposure to blood and the

most likely to result in infection, is needle-stick injury. The most common causes of

needlestick injury are two-handed recapping and the unsafe collection and disposal of

sharps waste. Health workers in areas such as operating, delivery and emergency

rooms and laboratories have an enhanced risk of exposure. Cleaners, waste collectors

and others whose duties involve handling blood-contaminated items are also at risk.

Among the 35 million health workers worldwide, about 3 million receive

percutaneous exposures to bloodborne pathogens each year; two million of those to

HBV, 0.9 million to HCV and 170 000 to HIV. These injuries may result in 15 000 HCV,

70 000 HBV and 500 HIV infections. More than 90% of these infections occur in

developing countries. Most blood exposures in health settings are preventable.

Strategies to protect health workers include implementation of Universal Precautions,

immunization against hepatitis B, provision of personal, protective equipment and the

management of exposures. Successful implementation of these strategies requires an

effective infection control committee with support from the health setting management

team(World Health Organization).”

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 Safety in the delivery of care in the nursing profession is a growing concern

among health care workers especially staff nurses not only in the country but globally.

Across the US, it was identified by the Occupational Safety and Health Administration

that nursing personnel have the highest percentage of job-related health risk rates of any

occupation (Foley M., 2004). “Nurses give the majority of direct care to patients. Nursing

accounts for about 80% of the direct care, that patient receives and this often involves

personal and intimate care activities where health care-associated diseases are

potentially available outcomes (Jocel A. Frias, 2007).” “HCWs especially nursing staff

have a longer exposure to their clients compared to other members of the health care

team. Because of this, they are susceptible to harbor different microorganisms that are

present in the workplace (Jacobson, 1990).”

“Based on the prospective reports, the rate of injuries to staff nurses was 0.8 per

nurse – year. Factors associated with increased injuries included recapping needles and

temporary work assignments. (Klocinski, USA). In the Philippine settings, the incidence

of harboring a disease is escalating among HCWs. Safety becomes even more a

primary health issue for hospital HCWS in relation to the outbreak of highly and deadly

disease such as HIV/AIDS, Hepa, SARS, Meninggo, Flu and PTB (Pulmonary

Tuberculosis) in Asia in recent years (Gamage, 2003).”

As a nursing student, part of the Bachelor of Science in Nursing Curriculum

includes Related Leaning Experience (RLE) or the student’s hands-on experience in

different medical cases. “RLE’s contributory objectives include: to serve competency in

the promotion of health, prevention of illness, carry out the therapeutic programs of the

patients, give health guidance to patients in the hospital, in the home, and in the

community.” (Donna Lynn Samaniego, et. al., 2005)

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 Majority of Our Lady of Fatima University (OUR LADY OF FATIMA UNIVERSITY)

Lagro Branch affiliations are public hospitals. One does not need to be a keen observer

in assessing the conditions of these hospitals. Most of the time, wards are too crowded

with patients. “Equipments and facilities are inadequate of the patient’s needs. Even the

hospital personnel, nurses, and doctors are not sufficient in number to meet every

patient’s immediate demands.” (Donna Lynn Samaniego, et. al., 2005)

The aim of this research is to identify the most common diseases that Our Lady

of Fatima University nursing students acquired and the preventive strategies they used

during their internship or duty. Through this study, we are able to cite the most common

diseases acquired by the Our Lady of Fatima University Nursing Students and the

effective preventive strategies that can help other HCWs, especially Our Lady of Fatima

University Nursing Students who are doing hospital duties, from acquiring diseases.

This study is significant not only to Our Lady of Fatima University nursing

students, but to other nursing and medical students as well, who will undergo clinical

duties as they go on with their studies as this study attempts to increase their level of

awareness and education about the diseases they may acquire during their internship. It

is also significant to hospital management, doctors, nurses and other medical health

workers, especially those in government hospitals, because they are more at risk of

acquiring life-threatening disease most present in depressed areas. The result of this

study may provide some insights of the realities on the prevalence of health care-

associated diseases so that effective, positive actions may be done to address the

problem.

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 Identification and Prevention of the
Most Common Diseases acquired by
Selected Nursing Students of Our Lady
of Fatima University
during their Hospital Duties

Identification of the Most

Common Diseases Consequences
• Capacity of the
Etiology of the Diseases effectiveness
of performance
during hospital
Respondents rotation
Profile Prevention of the Diseases
• Severity of the
• Name Disease
• Gender acquired
Number of cases with • Effect on self-
Nursing Students
esteem of
Having the disease
students
• Capacity to
carry out duties
Sources of Information in the hospital
about the disease

Preventive Strategies
taken by the Selected
Nursing Students of
Our Lady of Fatima
University from
acquiring the most
common diseases
Strategies used by the
Selected Nursing
Students of Our Lady
of Fatima University to
avoid nosocomial
infection

Figure 1.
Conceptual Framework

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 INPUT

Common diseases acquired by the

Selected Nursing Students of Our
Lady of Fatima University during
their hospital duties
Preventive strategies used by the
Selected Nursing Students of Our
Lady of Fatima University during
their hospital duties

PROCESS

Conducted a survey from selected Nursing Students of Our

Lady of Fatima University using questionnaires.
Used the percentage formula in determining the percentage
of the frequency of the disease and the frequency of the
effectiveness of the preventive strategies used.
Used the weighted mean formula in determining the three
most effective preventive strategies done by the selected
Nursing Students Our Lady of Fatima University.
Used the chi-squared formula in determining the significant
difference between the common diseases acquired by the
male and female Our Lady of Fatima University nursing
students and the significant difference between the
effectiveness of the preventive strategies done by the male
and female Our Lady of Fatima University nursing students.

OUTPUT

Identification and Prevention of

the Most Common Diseases
acquired by the Selected
Nursing Students of Our Lady of
Fatima University

Figure 2.
Research Paradigm

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Statement of the Problem

This study aimed to identify the most common diseases acquired by the selected

Nursing Students of Our Lady of Fatima University during their hospital duties and the

preventive strategies.

Specifically, it sought to answer the following questions:

1. What are the most common diseases acquired by the selected Nursing Students

Our Lady of Fatima University during their hospital duties?

2. What are the three most effective preventive strategies done by the selected

Nursing Students Our Lady of Fatima University?

3. Is there a significant difference between the common diseases acquired by the

male and female Our Lady of Fatima University nursing students?

4. Is there a significant difference between the effectiveness of the preventive

strategies done by the male and female Our Lady of Fatima University nursing

students?

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Hypotheses

Null Hypotheses

Ho1. There is no significant difference between the common diseases acquired

by the male and female Our Lady of Fatima University nursing students.

Ho2. There is no significant difference between the effectiveness of the

preventive strategies done by the male and female Our Lady of Fatima

University nursing students.

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 CHAPTER II

METHODS OF RESEARCH AND PROCEDURES

This chapter presents the research design, population and locale of the study,

data gathering tools and procedures and the statistical treatment of data used.

Research Design

This study aimed to identify the most common diseases acquired by the selected

nursing students of Our Lady of Fatima University during their hospital duties and the

effective preventive strategies they used.

The researchers made use of the descriptive research design which main

purpose is to describe events, phenomena, situations, practices and trends developing

through the use of measurement or quantification of events or variables under the study.

Population and Locale of the Study

The respondents involved included 25 male and 25 female Nursing Students

currently enrolled in Our Lady of Fatima University, Quezon City and were already

exposed to hospital duties, regardless of the frequency of exposure and year level of the

respondents.

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 The locale of the study was at the Our Lady of Fatima University Nursing

Buildings, specifically the San Rafael Building (former New Regalado Building) and the

Fatima Eye Rehab Center, in Regalado, Quezon City.

Data Gathering Tools

The researchers used questionnaire as the main tool for obtaining the data from

the respondents. The questionnaire distributed was composed of 3 parts, namely:

Respondents Profile, Most Common Diseases Acquired and Ways of Prevention.

For part 1, Respondents Profile included the name and gender of the

respondents.

For Part 2, Common Diseases Acquired. Different kinds of illness and diseases

were presented for the respondents to put a check mark on using a multiple response

type questions.

And lastly, for Part 3, Preventive Strategies Used. Upon this part of the

questionnaire was the rating scale type of close ended questions (Kotler and Armstrong,

2001), which was the basis for the rating of the effectiveness of the prevention used.

Tertiary Descriptive Rating

4.51 – 5 Highly Effective

3.51 – 4.5 Effective

2.51 – 3.5 Neutral

1.51 – 2.5 Ineffective

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 0 – 1.5 Highly Ineffective

Data Gathering Procedure

The researchers used the non-probability sampling, specifically the convenience

sampling in determining the respondents involved. The first step done by the researcher

was to select the respondents. The researchers stayed near the vicinity of the Our Lady

of Fatima University school buildings, specifically the San Rafael Building (former New

Regalado Building) and the Fatima Eye Rehab Center, both located at Regalado Avenue

where most nursing students, who experienced hospital duties, gathered up. Each

researcher was assigned to a specific number and gender of respondents. The purpose

of thel study was attached to the questionnaire distributed. Upon making sure that the

respondents understood the purpose of the questionnaires, the researchers made its

way on distributing it to the students and obtaining the needed information.

Statistical Treatment of Data

The data obtained from the respondents were tabulated systematically in order to

obtain accurate information related to each element of the target population.

The statistical treatment of data used to determine the percentage of acquiring

the most common diseases was the percentage formula, as shown below:

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 F x 100 where: P = percentage
P=
F = frequency
N N =number of respondents

The statistical treatment of data used to determine the percentage of acquiring

the most common diseases was the weighted mean formula, as shown below:

where: WM = weighted mean

Σfx f = frequency of score
WM =
x = raw score
N = total number
N of respondents

The statistical treatment of data used in determining the significant difference

between the common diseases acquired by the male and female Our Lady of Fatima

University nursing students and the significant difference between the effectiveness of

the preventive strategies done by the male and female Our Lady of Fatima University

nursing students, using 0.05 as its level of significance, is the chi-squared formula, as

shown below:

where: X² = chi-squared e = expected

o = observed frequency
X² = Σ(o-e)² frequency

Degree of Freedom Degree of Freedom

(Common Diseases Acquired) (Preventive Strategies Used)
df = (c – 1) (r – 1) df = (c – 1) (r – 1)
= (2 – 1) (12-1) = (2 – 1) (11-1)
= (1)(11) = (1)(10)
df = 11 df = 10
α = 0.05 α = 0.05
Critical Value = 19. 675 Critical Value = 18. 307

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 CHAPTER III

RESULTS AND DISCUSSIONS

This chapter deals with the analysis and interpretation of the data gathered from

the questionnaire. It presents the graphical and textual explanations of data to answer

the specific questions based on the statement of the problem.

1. On the Common Diseases Acquired by the Respondents during Hospital

Duties

40
35.48
35
30.11
30

25
Percentage

20
15
10.75
10
5.38 5.38
5 3.23 2.15 2.15 2.15
1.08 1.08 1.08
0

ea
I

r
h

TB

ia
ds

es
ps
x
es

es
UT

ve
ug

Po

on

rh
l

um

sh
Ey

sl
Fe
Co
Co

ar
m

ea
en

Ra
M
re

eu

Di

M
ck
So

Pn
i
Ch

Common Diseases Acquired

Figure 3.

Percentage of the Common Diseases Acquired.

The most common disease acquired by the selected Nursing Students of Our

Lady of Fatima University is cold, which has a frequency of 28 or 30.11%, where 14 or

35.90% is on males and 14 or 25.93% is on females. Second is cough, which has a

frequency of 33 or 35.48%, where 16 or 41.03% is on males and 17 or 31.48% is on

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females. And third is TB (tuberculosis), which has a frequency of 10 or 10.75%, where

3 or 7.69% is on males and 7 or 12.96% is on females.

The frequency of acquiring sore eyes is 5 or 5.38%, where 1 or 2.56% is on

males and 4 or 7.41% is on females. The frequency of acquiring UTI is 5 or 5.38%,

where 2 or 5.13% is on males and 3 or 5.56% is on females. The The frequency of

acquiring chicken pox is 3 or 3.23%, where 1 or 2.56% is on males and 2 or 3.70% is on

females. The frequency of acquiring mumps is 2 or 2.15%, where 0 or 0% is on males

and 2 or 3.70% is on females. The frequency of acquiring fever is 2 or 2.15%, where 1 or

2.56% is on males and 1 or 1.85% is on females. The frequency of acquiring rashes is 2

or 2.15%, where 0 or 0 is on males and 2 or 3.70% is on females. The frequency of

acquiring pneumonia is 1 or 1.08%, where 0 or 0% is on males and 1 or 1.85% is on

females. The frequency of acquiring diarrhea is 1 or 1.08%, where 1 or 2.56% is on

males and 0 or 0% is on females. The frequency of acquiring measles is 1 or 1.08%,

where 0 or 0% is on males and 1 or 1.85% is on females.

2. On the Preventive Strategies Used by the Respondents during Hospital Duties

The most effective preventive strategy used by the selected nursing students is

handwashing. Its effectiveness in the prevention of a disease to males is 4.92, which is

highly effective and 4.52 to females, which is also highly effective. As a whole, it had an

average of 4.72, which is highly effective. Second is vaccination. Its effectiveness to

males is 4.52, which is highly effective and 4.44 to females, which is effective. As a

whole, it had an average of 4.48, which is effective. Third is proper disposal of sharps/

used needles. Its effectiveness to males is 4.56, which is highly effective and 4.16 to

females, which is effective. As a whole, it had an average of 4.36, which is effective.

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 The effectiveness of use of mask to males is 4.36, which is effective and 4.04 to

females, which is effective. As a whole, it had an average of 4.20, which is effective. The

effectiveness of use of gloves to males is 4, which is effective and 4.16 to females, which

is effective. As a whole, it had an average of 4.08, which is effective. The effectiveness

of proper disposal of linens to males is 4, which is effective and 4.14 to females, which is

effective. As a whole, it had an average of 4.06, which is effective. The effectiveness of

taking vitamins/ supplements to males is 4.2, which is effective and 3.88 to females,

which is effective. As a whole, it had an average of 4.04, which is effective. The

effectiveness of use of gowns to males is 4.12, which is effective and 3.92 to females,

which is effective. As a whole, it had an average of 4.02, which is effective. The

effectiveness of enough rest to males is 3.96, which is effective and 3.64 to females,

which is effective. As a whole, it had an average of 3.80, which is effective. The

effectiveness of regular check-up to males is 3.8, which is effective and 3.68 to females,

which is effective. As a whole, it had an average of 3.74, which is effective. The

effectiveness of exercise to males is 3.96, which is effective and 3.28 to females, which

is neutral. As a whole, it had an average of 3.62, which is effective.

3. On the Significant difference between Common Diseases Acquired by Male

Nursing Students and Common Diseases Acquired by Female Nursing

Students

Since the computed value of X² = 45.93, which is greater than the critical value of

X² = 19.675 at α = 0.05 with the df = 11, the null hypothesis is rejected. Therefore, there

is a significant difference between common diseases acquired by Male Nursing Students

and common diseases acquired by Female Nursing Students.

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4. On Significant difference between the effectiveness of the preventive

strategies done by the male and the effectiveness of the preventive strategies

done by the female Our Lady of Fatima University Nursing Students from

acquiring these diseases during their hospital duties

Since the computed value of X² = 1923.15, which is greater than the critical value

of X² = 18.307 at α = 0.05 with the df = 10, the null hypothesis is rejected. Therefore,

there is a significant difference between the effectiveness of the preventive strategies

done by the male and the effectiveness of the preventive strategies done by the female

Our Lady of Fatima University Nursing Students from acquiring these diseases during

their hospital duties.

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 CHAPTER IV

CONCLUSIONS AND RECOMMENDATIONS

This chapter presents the conclusions and recommendations made by the

researchers about this study.

Conclusions

From the data collected in the questionnaire, the researcher had summed up the

following findings:

1. The most common diseases acquired by the Our Lady of Fatima University

Nursing Students is cough which had 33 or 35.48%, where 16 or 41.03% is on

males and 17 or 31.48% is on females. Followed by colds which had 28 or

30.11%, where 14 or 35.90% is on males and 14 or 25.93% is on females. And

third is Tuberculosis (TB) which had 10 or 10.75%, where 3 or 7.69% is on males

and 7 or 12.96% is on females.

2. The most effective prevention used by the Our Lady of Fatima University nursing

students from acquiring such disease is handwashing which is highly effective to

all, regardless of gender.

3. There was a significant difference between the common disease acquired by

male and the common disease acquired by female Our Lady of Fatima University

Nursing Students.

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 4. There was a significant difference between the effectiveness of the preventive

strategies done by the male and the effectiveness of the preventive strategies

done by the female Nursing Students of Our Lady of Fatima University during

their hospital duties.

Recommendations

Considering the results and conclusions made, the researchers offer the

following recommendations:

1. Those nursing students who are and who will undergo hospital duties or

internship must equip themselves with the necessary preventive measures to

prevent from acquiring the most common diseases such as coughs, colds, TB

and others. Since the most common disease acquired in the hospital setting is

about respiratory problem, which is a contagious disease, we recommend that

the nurses must at all times, if possible, keep a 3 feet distance among patients

and should always wear masks in interacting with the patients.

2. Students must always perform handwashing before, during, after or as long as

necessary to prevent from acquiring and transmitting diseases, since

handwashing has been a highly effective prevention for nursing students based

on our study. It is also the oldest, simplest, and cheapest way to control the

spread of infectious organisms.

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3. Based on the study, which showed that the female nursing students are more

susceptible in acquiring diseases than the male nursing students, we

recommended that female nursing students must be more careful in doing

hospital duties.

4. Since the preventive strategies is highly effective on the male respondents than

of the females, females should look for other ways of prevention and or combine

one or more preventive strategies to give them enough prevention so as not to

acquire diseases during their hospital duties and boost their immune system.

They should also see to it that they follow standard precautions and proper ways

of using the preventive measures since it may affect the effectiveness of the

preventive measures done.

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