KNOWLEDGE AND PRACTICES OF HAND HYGIENE AMONG

FIRST YEAR PARAMEDICAL STUDENTS OF SOUTHWESTERN

UNIVERSITY-PHINMA

A Thesis Proposal

Presented to the Faculty of the College of Nursing

Southwestern University PHINMA

Cebu City

In Partial Fulfillment of the Requirements

for Nursing Research

Nisnisan, Dave Jason S. Sagad, Ron Alec S.

Nortiza, Ezra Sagadal, Laire Ann Y.

Orbeta, Frances Maxine O. Tacgos, Katherine P.

Orio, Maan M. Taladro, Debbie Mae G.

Pagal, Gean D. Talam, Sandyliz Joy

Paldo, Chelou Marie V. Teo, Krisly Jade B.

Pe, Jan Katherine G. Varquez, Venessah Gaile

T.
Sabellano, Erica Mhel P.
Zamora, Pearl Marie A.
RESEARCHERS

March 2022
APPROVAL SHEET

This research paper entitled “KNOWLEDGE AND

PRACTICES OF HAND HYGIENE AMONG FIRST YEAR PARAMEDICAL
STUDENTS OF SOUTHWESTERN UNIVERSITY-PHINMA” prepared
 II

and submitted by Dave Jason Nisnisan, Ezra Nortiza, Frances Maxine

Orbeta, Maan Orio, Gean Pagal, Chelou Marie Paldo, Jan Katherine Pe, Erica
Mhel Sabellano, Ron Alec Sagad, Laire Ann Sagadal, Katherine Tacgos,
Debbie Mae Taladro, Sandyliz Joy Talam, Krisly Jade Teo, Venessah Gaile
Varquez, Pearl Marie Zamora in partial fulfillment for the requirements in
NUR 027 NURSING RESEARCH 1 has been examined an recommended for
approval and acceptance.

THESIS COMMITTEE

Adviser

Member Member
Chairman

PANEL OF EXAMINERS

Approved by the Committee on ORAL EXAMINATION with a grade of

PASSED

Chairman

Member Member

Adviser

Accepted and approved in fulfillment of the requirements for

the subject NUR 028 NURSING RESEARCH 2.
Thesis Proposal : Defense :

Michelle B. Yu, DM, MAN, RN

Dean – College of Nursing
 III

ABSTRACT

Title: KNOWLEDGE AND PRACTICES OF HAND HYGIENE

AMONG FIRST YEAR PARAMEDICAL STUDENTS OF
SOUTHWESTERN UNIVERSITY-PHINMA

Authors:
Nisnisan, Dave Jason S.
Nortiza, Ezra
Orbeta, Frances Maxine O.
Orio, Maan M.
Pagal, Gean D.
Paldo, Chelou Marie V.
Pe, Jan Katherine G.
Sabellano, Erica Mhel P.
Sagad, Ron Alec S.
Sagadal, Laire Ann Y.
Tacgos, Katherine P.
Taladro, Debbie Mae G.
Talam, Sandyliz Joy
Teo, Krisly Jade B.
Varquez, Venessah Gaile T.
Zamora, Pearl Marie A.

Subject: NUR 028 NURSING RESEARCH 2

School : Southwestern University-PHINMA

Adviser:

Date :

Pages :
 IV

CONTENT ANALYSIS

Objective and Scope

The study will determine the knowledge and practices of hand

hygiene among first-year paramedical students of Southwestern
University PHINMA. The study will utilize the descriptive correlational
design. The 2,299 first-year paramedical students enrolled in the
second semester will be assigned as the respondents and the subject
of evaluation.

ACKNOWLEDGEMENT
The researchers would like to express their sincere gratitude
and acknowledge the following individuals for assisting them in the
accomplishment of the study:

Before all else, to the Almighty God, who blessed the

researchers with insight, courage, hope, guidance, and compassion
throughout the study.

To the researchers’ families who invested encouragement and

prayers from the beginning of their study until the end.

Mr. Adriel Arman V. Pizarra DHCM, MAN, RN, the researcher’s

adviser, for his advice, wisdom, and sharing of his knowledge to help
the researchers enhance their study.

Mr. Gil Platon Soriano, the researcher’s instructor, for his

undeniable intelligence, substantial propositions, patience, and
perseverance. The researchers were enlightened by the experts'
knowledge.

The panelist during the proposal for guiding and helping the
researchers and went over the research work and made several
adjustments during the proposal stage to make the study more
comprehensive and significant.
 V

Finally, a big thank you to every first-year paramedical student

who took the time to honestly answer the survey, which helped the
researchers achieve their major goal throughout data collecting.
 VI

Table of Contents
TITLE PAGE i
APPROVAL SHEET ii
ABSTRACT iii
ACKNOWLEDGEMENT iv
TABLE OF CONTENTS vi
CHAPTER 1
THE PROBLEM AND ITS SCOPE
INTRODUCTION
Rationale of the Study 1
Theoretical Background 5
THE PROBLEM
Statement of the Problem 31
Hypotheses 32
Significance of the Study 34
RESEARCH METHODOLOGY
Research Design 37
Research Environment 38
Research Respondents 38
Research Instruments 41
Research Procedure 42
Treatment of Data 44
DEFINITION OF TERMS 45
REFERENCES 49
APPENDICES
APPENDIX A Transmittal Letter to 53
 VII

the Registrar
APPENDIX B Informed Consent 57
Appendix C Research Instrument 59
CURRICULUM VITAE 66
LIST OF FIGURES Figure 1

Schematic Diagram of the Study 11

 CHAPTER I

THE PROBLEM AND ITS SCOPE

INTRODUCTION

Rationale of the Study

Hand hygiene is the act of cleaning one’s hands that

significantly reduces potential harmful microorganisms, or

pathogens, on the hands. It also prevents transmission of infection

especially among patients and health care personnel. Therefore,

hand hygiene is a procedure that should be mastered by everyone,

making it mandatory.

Since the start of online classes at Southwestern University

PHINMA, classes are only done in the homes of the students. With

the RAD Learning experience, teachers are unable to monitor each

student’s performance. Thus, having a less supervised learning. The

researchers have decided on finding out the level of knowledge and

practices of the first-year paramedical students in terms of hand

hygiene. The researchers are also trying to find out whether or not

the variables of hand hygiene (level of knowledge and practices)

correlate with each other and with the student’s profile.

1
 As nursing students, the researchers have observed that in

every return demonstration, performing hand hygiene is

compulsory before and after doing the procedures. They were only

given study materials, such as videos that talk about the proper hand

hygiene technique and other methods of hand hygiene, when first

learning how to do proper hand hygiene. This method of learning

may be inefficient for them to actually understand the

correct hand hygiene procedure.

It has been conspicuous that performing hand hygiene is the

most cost-effective and feasible method for reducing

the prevalence of healthcare-associated infection and the spread of

antimicrobial resistance in all settings. The World Health

Organization (WHO) has designed "The 5 Moments for Hand

Hygiene". Before handling a patient, before performing aseptic and

clean operations, after being at danger of exposure to body fluids,

after touching a patient, and after touching patient surroundings are

the five times when hand hygiene is required. This idea has been

successfully applied to improve healthcare professionals'

understanding, training, monitoring, and reporting on hand

hygiene.

2
 A study that assessed the hand hygiene knowledge, practice,

and as well as the facility utilization of the pupils in Batangas City,

Philippines found out that in the student’s profile, only the type of

school they go into has a significance with the knowledge and

practices of hand hygiene. It was stated that public school pupils had

shown higher scores in hand hygiene knowledge, practice, and

facility utilization as well as greater interest in the proposed hand

hygiene activities. These include, among others, the conduct of

health teaching on proper hand hygiene technique with disease

education and preparation of individual hygiene kit for pupils. On the

other hand, grade level and gender has shown no significant

relationship with their knowledge, practice, and facility utilization

(Asilo, Berberabe, & Ramos, 2018).

In a hospital setting, without proper hand hygiene of the

healthcare workers could result in cross-contamination and

transmission of microorganisms. This is called as hospital-acquired

infections. Hospital-acquired infections make up a major source of

morbidity, mortality, and increased cost. Hospital-acquired

infections are prevented through proper hand hygiene thus, making

it the most important procedure (Monistrol, Calbo, Riera, Nicolás,

Font, Freixas, & Garau, 2012).

3
 The value of the study in the nursing profession is that fact

that nurses make more than half of all patient contacts, according to

a research done in a newborn intensive care unit, by Cohen B.,

Saiman L., Cimiotti J., & Larson E. (2003) and are the most likely to

touch patients' skin and bodily fluids. The objective of the study was

to see whether hand hygiene practices alter depending on the level

of interaction with newborns, to characterize different types

of personnel's hand hygiene practices, and to compare hand hygiene

practices in neonatal intensive care units (NICUs) using various

products. The study came out with the results 1472

touches being recorded by research assistants. Each neonate or his

or her immediate surroundings were touched an average of 78 times

every shift. Of the 1472 touches observed in this study, more than

one-half (815 of 1472; 55.4%) were made by nurses (Bevin, et al,

2003). With that being said, this study will be most beneficial to the

nursing field for the reason that the output of the study is to propose

a hand hygiene enhancement plan

As mentioned previously, hand hygiene is a simple yet

effective measure of preventing the spread of pathogens. Cleaning

your hands can even prevent those that are resistant to antibiotics

and are becoming difficult, if not impossible, to treat (CDC, 2019).

4
 Over all, the researchers are competent with

conducting the study. There are several researches that can be used

as references or guides when conducting the study. This can help

the researchers as these can give an insight on what to do and how

to do the study. This makes the job easier for the

researchers.

Theoretical Background

The study is anchored on the Theory of Planned Behavior (TPB)

(Azjen, 1991) Social Cognitive Theory (SCT) (Bandura, 1960), and

Environmental Theory (Nightingale, 1859) which will revolve around

determining the knowledge and practices of firstyear students of

Southwestern University-PHINMA.

To begin, the Theory of Planned Behavior (TPB) was

developed by Icek Ajzen as an attempt to predict human behavior

(Azjen,1991). This is a theory which proposes that behaviors are

immediately determined by behavioral intentions and under certain

circumstances. To be specific, attitudes toward the behavior,

subjective norms and perceived behavioral control are all elements

that influence behavioral intentions (White, Jimmieson,

Obst, ,Graves , Barnett, Cockshaw, Gee, Haneman,Katie, Campbell,

Martin, &Paterson, 2015). Also, Attitude pertains to positive and

5
negative evaluations of the behavior of an individual (e.g.,

performing hand hygiene is good); subjective norms pertains to

perceptions of pressure from other to conduct the behavior (e.g.,

important others would want me to perform hand hygiene); and

perceived behavioral control pertains to perceptions of the ease or

difficulty of performing the behavior of interest (e.g., it would be

easy for me to perform hand hygiene). Therefore, they are theorized

to have a direct impact on the behavior (White et al., 2015).

According to Sheeran, Klein, and Rothman (2017) the Theory

of Planned Behavior (TPB) (Ahjen, 1991) is a classic health behavior

theory which is found by another similar data that TPB is the most

widely cited model to explain hand hygiene behavior among

healthcare workers. Although the study of Godin, Gravel and

Grinshaw (2008), White, Jimmieson, Obst, Graves , Barnett,

Cockshaw, Gee, Haneman, Katie, Campbell, Martin, &Paterson,

(2015), elaborated that the theory of planned behavior's belief

foundation offers a valuable framework for systematically

investigating the underlying beliefs of nurses' hand hygiene

decisions. Individual strategies to combat distraction from other

jobs, peer-based programs to build a feeling of shared

6
responsibility, and management-driven solutions to address staffing

and resource concerns should all be part of a commitment to

enhance nurses' hand hygiene practice. Inspite of this, hand

cleanliness after touching a patient's surroundings is still the most

often neglected opportunity for compliance.

Albert Bandura's Social Learning Theory (SLT) was

developed in the 1960s as the Social Cognitive Theory (SCT)

(Bandura, 1960). Thus, it was renamed the SCT in 1986, and it

proposes that learning takes place in a social context, with a dynamic

and reciprocal interaction between the person, their environment,

and their behavior. However, through the process of observational

learning, this behavior is taught from the

environment. Cherry, Brown, Bethell, Neal and Shaw (2012) stated

that educational interventions, the majority of research taught hand

hygiene technique, with good technique and compliance as the

outcome measures. As a result, the issue is that hand hygiene

intervention studies have not resulted in enhanced or sustained

adherence to hand hygiene recommendations. Furthermore, studies

into educational interventions and the relationship between

knowledge and hand hygiene performance results is still a work in

progress. According to Erasmus, Daha, Brug, Richardus, Behrendt,

7
Vos and van Beeck (2010) while it is common in hand hygiene

instruction to incorporate new knowledge into a knowledge base, it

has not been proved to be successful in modifying long-term

practices. Bandura's social learning theory (1960), attitude, social

influence, and self-efficacy are all legitimate notions for predicting a

person's intention to change their behavior, if not their actual

behavior change (Bandura, 1991). The goal of this study was to find

out what first-year paramedical students at SWU PHINMA knew and

did about the importance of hand hygiene.

According to Mathai, Allegranzi, Seto, Chraïti, Sax, Larson, and

Pittet (2010) in short-term research, educational interventions were

found to be beneficial in promoting hand hygiene compliance. The

majority of the study do not report on the long- term viability

of their findings beyond a year. According to a review of instructional

tactics for hand hygiene, role-modeling is an important part of any

program. Role-modeling is one of the fundamental components of

Social Cognitive Theory (Bandura, 1960), which claims that it is an

aspect of observational learning. The framework of social cognitive

theory can be used to interfere in the development of personal

standards (Bandura, 1991). First-year medical students who get

information and an intervention that boosts confidence and

8
competency are more likely to have higher self-efficacy, which helps

them take action (Bandura, 1991). Intensive training programs in

enriched environments, such as observational learning and

modeling, can provide rich mastery experiences that permanently

enhance students' intellectual level and academic accomplishment,

according to Bandura's social learning theory or the Social Cognitive

Theory (Bandura, 1977). The majority of human behavior is learned

by seeing others and forming ideas about how to conduct new

activities (Bandura, 1997). Since these enriched circumstances

foster a sense of capability, people with high efficacy can persevere

in the face of adversity and stress. As suggested by Bandura's social

learning theory, teaching strategies such as video modeling of the

WHO's 7-step hand hygiene techniques with visual prompts and song

lyrics, and return demonstration of every medical student could help

students increase their concentration, arouse one‘s focus, and

enhance their knowledge by facilitating their motor coordination

(Bandura, 1997) . Otherwise, these social learning components have

been incorporated into the 7-step hand washing technique, return

demonstration, memory of the steps, and encompasses attention,

all of which are leading to improved hand hygiene quality among

students.

9
 Hand hygiene decontamination remains one of the most

essential and effective approaches for minimizing healthcare

associated illnesses and patient cross-infection. Florence Nightingale

recommended that nurses wash their hands regularly throughout the

day in 1860, displaying an early understanding of the importance of

this simple procedure. Nightingale (1820) promoted hand washing

and other cleanliness techniques in British army hospitals during the

Crimean War (1853-1856). This was relatively new advice, first

publicized in the 1840s by Hungarian doctor Ignaz Semmelweis, who

had seen a significant difference in

maternity ward death rates.

Although contemporary understanding of the 'germ theory'

and infection management appears to be common knowledge,

Nightingale's firm hygienic foundations are responsible for most of

this. Today's healthcare personnel are accountable for the health and

safety of their patients, coworkers, and themselves, implying that

fundamental infection control is the responsibility of everyone,

including community members. Hospital-acquired illnesses, or

nosocomial infections, which are still prevalent today, are mostly

transmitted by healthcare personnel, typically due to a lack of basic

hand hygiene. Guidelines have been developed to help healthcare

10
personnel maintain hygienic circumstances and practices that

enhance patient well-being while also adhering to their own health

and safety.

Environmental Theory (Nightingale, 1859) has had a big

influence on modern infection control tactics and nursing practice,

and it's always evolving (Attewell, 2010; Bostridge, 2009; Dossey et

al., 2005; McEnroe, 2020; Zborowsky, 2014). Hand hygiene is one

example of a simple task that can protect patients, visitors, and

healthcare professionals (Nightingale, 1860), especially now,

with the COVID-19 pandemic (WHO, 2020c) considering the

persistence of nosocomial infections in hospitals (Khan, Baig, &

Mehboob, 2017). Similarly, Nightingale's contribution to sanitary

reforms has affected the continuous development of infection control

measures, ranging from aseptic techniques and sterilise methods to

quarantine practices and isolation nursing care procedures, all of

which are still used today (Bostridge, 2009; Dossey et al., 2005;

McEnroe, 2020; Nightingale, 1860, 1863;

Zborowsky, 2014).

11
Figure 1: Schematic Diagram of the study utilizing the Theory
of Planned Behavior by Azjen (1991) and Social Cognitive
Theory by Bandura (1960).

12
 The sex and course profiles of respondent’s match to Azjen

1991's theory of planned behavior since their sexes and courses

predict an individual's intention to engage in a behavior at a given

time and location. While Badura's Social Cognitive Theory from the

1960s corresponds to the respondents' hand hygiene knowledge and

hand hygiene practices since their knowledge and practices of hand

hygiene is learnt from the environment through observational

learning and their hand hygiene practice is influenced by their

perceptions about that person's behavioral and normative views, as

well as the social standards of the society in which they live. The

nursing theory of Florence Nightingale's Environmental Theory

(1859), on the other hand, is linked to the respondents' hand

hygiene practices because she was an advocate and a pioneer of

hand washing and cleanliness for health. Each theory correlates to

the respondents, who are Southwestern University PHINMA first-

year students. The researchers obtained a plan for first-year

paramedical students called Multimodal Hand Hygiene Improvement

Strategy Plan by World Health Organization (WHO) which was

developed in the year 2009. The WHO Multimodal Hand Hygiene

Improvement Strategy consists of a Guide to Implementation and a

range of tools constructed to facilitate implementation of each

13
component. The Guide to Implementation accompanies the WHO

Guidelines on Hand Hygiene in Health Care and outlines a process

for fostering hand hygiene improvement in a health-care facility. It

is important that students in school have correct adherence and can

perform the hand hygiene technique properly. Otherwise, the

frequency of nosocomial infections arises, leading to problems. To

achieve this goal, a strong distribution and implementation

plan is essential to guarantee that students are aware of

the standards and their use (World Health Organization, 2009).

In this study, the theory of planned behavior (Azjen, 1991) is

being utilized in the study particularly in the concept of practices in

a sense that the researchers can forecast and explain a wide range

of health behaviors and intents among first year paramedical

students, particularly in terms of hand hygiene. It aids researchers

in comprehending how student’s behavior can alter as a result of this

theory. The Theory of Planned Behavior (Ahjen, 1991) proposes that

an individual's chance of engaging in a health behavior such as hand

hygiene is proportional to the strength of his or her desire to engage

in the behavior. For example, if the students believe that hand

hygiene is very necessary in order to prevent spreading bacteria,

that it will be simple, and that others will approve, then your

14
intention to practice hand hygiene will be strong, and the students

will predict that he or she should practice hand hygiene on a regular

basis. The Social Cognitive Theory (Bandura, 1960), on the other

hand, is being used in the study particularly in the concept of

knowledge in which students learn about hand hygiene by observing

(e.g. clinical instructors performing hand hygiene), modeling (e.g.

hand hygiene advertisement on TV), and replicating new behaviors

(e.g. return demonstration, doing hand hygiene on a daily basis) that

are reinforced by other individuals, or "models." To conclude, this

study can help to boost effectiveness, newly planned interventions

that should target self-regulatory and social influence mechanisms

(Gaube, Fischer,&Lermer,2014). Lastly, the Environmental Theory

by Florence Nightingale which was developed in the year 1859 is

being used in the study particularly in the concept of practices. Her

legacy of teachings and cornerstones still continue to resonate the

profession today (Hillier, 2020). Florence Nightingale's

environmental theory is based on five points that she believed were

necessary for obtaining a healthy home, such as clean water

and air, basic sanitation, cleanliness, and light, as she believed that

a healthy environment was essential for healing. Furthermore, it is

demonstrated that her theory is critical in filling knowledge gaps

15
related to the holistic dimension in carrying out the nursing process,

with the goal of achieving accurate clinical decision-making by

students and nurses.

Review of Related Literature

An international study by Ahmed, Malik, Memon, Arif, Ali,

Nasim, Ahmad, and Khan (2020) shows the correlational relationship

of knowledge and practice towards hand hygiene. According to them,

when inquired about WHO guidelines regarding hand hygiene and

the use of disinfectant, more than half (62.73%) of the participants

reported being aware of them. Almost half of the participants (97;

45.75%) had never attended or received formal workshops/lectures

regarding the importance of hand hygiene. Significantly, 65.56% of

the participants had adequate awareness regarding ‘nosocomial

infections’ and ‘hospital-acquired infections.’ In addition to that, an

overwhelming 44.81% of the hospital staff (45 nurses, 30 technical

staff, and 20 ward assistants) responded to being unaware of the

complications of nosocomial infections. Nearly two-third (62.26%) of

the participants were aware that the lack of proper hand hygiene

could cause life-threatening complications to the patient as well as

hospital staff (Figure 2). It was observed that 134 (63.20%)

participants were conscious of immune-compromised patients in

16
their wards and 55 (41.04%) said they ensured to take special care

and precaution

while handling them.

According to an international study by Alcan and Dogun

(2018), hand hygiene is an important practice for lowering HCAIs in

healthcare settings. It determines hand hygiene beliefs and practices

among student nurses’ which are vital for improving behaviors

before entering the workforce, usually causes a change in healthcare

staff hand hygiene practices, and provides an opportunity to change

factors leading to poor hand hygiene compliance and, as a result,

improving compliance. During clinical placements, student

nurses carry out a variety of care and

procedures on a large number of patients, which requires frequent

patient interaction. It is crucial that they practice proper hand

hygiene in order to avoid healthcare-associated illnesses (Sundal,

Aune, Storvig, Aasland, Fjeldsaeter, & Torjuul). Alcan and Dogun

(2017) conducted a study that focuses only with the second, third

year and fourth year student nurses’ since the first-year nursing

students focuses only on community health nursing and not on

clinical practice at hospitals. It shows that the women student

17
nurses’ have higher hand hygiene compliance rather than men since

they have received extracurricular hand hygiene education

based on the results, although it does not have much any

difference statistically. In conclusion, student nurses’ have revealed

a high hand hygiene compliance rate and have positive satisfactory

hand hygiene beliefs, and typically practice hand hygiene as

recommended by the guidelines (Alcan and Dogun, 2018).

Knowledge about hand hygiene can differ in terms of age and

sex of a person. When we say knowledge about hand hygiene, this

refers to their awareness or understanding of this particular subject

which they acquired from education or experience from peers.

Talking about identity, there are studies show showing have better

knowledge levels and more favorable behavior. With age group,

there also studies showed that older age group have better hand

hygiene habits that the younger age group. Decrease hand hygiene

literacy may usually lead or cause to poor hand hygiene compliance

so with this, hand hygiene knowledge is very beneficial to avoid

getting sick and spreading germs to others and as well as reduces

potential harmful microorganism or pathogens. Having knowledge

about hand hygiene can be easy to take care yourself to avoid those

harmful

18
pathogens.

In an international study made by Bimerew & Muhawenimana,

(2020) Nurses knowledge, attitudes Nurses’ practices regarding hand

hygiene compliance were investigated in a psychiatric hospital. Data

was collected from 195 nurses who were permanently employed at a

specified psychiatric hospital. There was no significant link between

gender and attitudes about hand hygiene among nurses (P =

0.42). Male nurses had somewhat more knowledge of hand

hygiene than female nurses (mean score 91.41) and female nurses

had a better attitude. Registered nurses had slightly more knowledge

and positive attitudes than the other categories of nurses.

Educational level had an impact on knowledge of hand hygiene, but

less impact on attitudes and practices. Continuous monitoring and

evaluation should be put in place to maintain standards in level of

knowledge and attitudes. Hand hygiene is the single most effective

weapon against hospital infections and a study has found that nurses'

levels of knowledge, attitudes, and hand hygiene practice do, not,

remain consistent throughout their professional lives. Other hand

hygiene predicting factors such as attitudes toward practices and

perceptions of hand hygiene must be investigated in order to address

barriers to optimal hand hygiene procedures holistically.

19
 According to lmoslem, Althumairi, Aljassim, Hassan, and

Berekaa (2021), in the context of their international research study

to determine the level of hand hygiene knowledge, attitudes, and

practices among school students in Eastern Province Schools, Saudi

Arabia lack of proper hand hygiene practice will likely at risk of

communicable diseases, for instance, influenza A, cholera, and

malaria and diarrhea these diseases will be transmitted without

hygiene their hands after picking nose or coughing. Moreover,

students prefer to use hygiene their hands with water and soap

before and after eating since this is the standard procedure. In

addition, Schools provide a unique opportunity to promote health

education in terms of hand hygiene and many other hygiene

practices, and students can learn practical skills and develop positive

behaviors through school-based programs. Thus, the parents may

influence their children to practice hand hygiene. Furthermore, the

finding revealed both gender and all ages gained their knowledge of

hand hygiene practices from their parents. In conclusion student

awareness of hand hygiene is high, especially

among those who learn it at home.

Hand hygiene knowledge differs on age and gender. In terms

on the gender, both genders ranges from poor to moderate;

20
however, majority for both genders have moderate knowledge on

hand hygiene. The study also revealed that the knowledge of both

genders is not different from each other. This means that both

genders have equal knowledge on hand hygiene. With regards to

age, it have shown no significance at all. Therefore, the students

knowledge on hand hygiene would remain the same regardless of

their age and gender due to the fact that their interest don't have

connection on this matter.

Poor compliance of practice hand hygiene nurses will high risk

transmitting microorganism to patient and to the health care.

Furthermore, proper hand hygiene will follow the 5-moment: Before

handling a patient, before performing aseptic and clean operations,

after being in danger of exposure to body fluids, after touching a

patient, and after touching the patient's surroundings also they will

perform after gloves removal. More so, wash their hand before and

after eating. To conclude, Practice of proper technique hand hygiene

can reduce the rate of pathogens and

reduce transmission to the patient.

In the international study of Nair, Hanumantappa, Hiremath,

Siraj, and Raghunath (2014), Nursing and Medical students in India

have received their proper technique of hand hygiene which revealed

21
that their result has a positive attitude in hand hygiene since both

field will be exposed to the patient.

A national literature being reviewed is about the study of the

impact of school-based water, sanitation, and hygiene intervention

on knowledge, practices, and diarrhoea rates in the Philippines. This

review is selected in the study in accordance to its claims regarding

the impacts of interventions in hand hygiene to

knowledge and practices to further support the study.

According to a national study, the school-based water,

sanitation, and hygiene (WASH) intervention in the Philippines from

the results of the evaluation from eight schools (four schools that

received the WASH intervention (intervention school), and

four schools who did not receive the WASH intervention (comparison

school)) showed that students from intervention schools have more

knowledge in critical hand hygiene than those at the comparison

schools. Students from intervention schools have higher rates of

hand hygiene after toilet use, and hand hygiene with soap versus

students from comparison schools. Reported use of school toilets to

defecate was higher among intervention schools versus comparison

schools. Multilevel modelling indicated that students from

22
intervention schools reported a 10-fold reduction in odds of school

absence due to

diarrhea. In addition to school-based findings, self-reported hand

hygiene at critical times was found to be higher among household

members of students from intervention schools. This school-based

WASH program appeared to increase knowledge and hygiene

behaviours of school students, reduce absences due to diarrhoea,

and increase hand hygiene at critical times (Vally, McMichael,

Doherty, Li, Guevarra, & Tobias 2019). The Impact of a SchoolBased

Water, Sanitation and Hygiene Intervention on Knowledge,

Practices, and Diarrhoea Rates in the Philippines. International

Journal of Environmental Research and Public Health).

The evaluation of this study proves that the school-based

WASH intervention with facilities for sanitation, sufficient water

supply, and student hygiene knowledge and practices is effective in

reducing the cases and absence from school due to diarrhea.

Personal knowledge of hand hygiene greatly influence the

perception of its benefits. A students length of experience,

knowledge and attitude towards hand hygiene significantly

manipulate his/her current actions towards sanitation. Students with

wash interventions come as reliable and sophisticated to the idea.

23
To sum up all that has been stated so far, student course play a vital

role on indicating such accumulated idea to the said variables.

Students who are exposed to medical practices adhere their learning

to a broader spectrum of their own understanding. Thus, making

them the ones with the superior knowledge.

Nursing student revealed that there are no significant gender

differences toward knowledge of hand hygiene since the female and

male nursing have moderate knowledge of hand hygiene. This

means that hand hygiene is equally understood by all genders. (Cruz

& Al-Otaibi, 2015).

A local study has been done to assess the hand hygiene

knowledge, practice, and facility utilization of the 1,118 selected

pupils in Batangas City, Philippines during the academic year of

2016-2017. The responses from the self-structured questionnaire

were analyzed through the use of frequency counts, weighted mean,

t-test and Analysis of Variance (ANOVA). The study has shown that

in the pupil’s profiles, only the type of school had a significance with

the pupil’s hand hygiene knowledge, practice, and their facility

utilization. Public school pupils showed higher scores in hand hygiene

knowledge, practice and facilities utilization as well as greater

interest on the proposed hand hygiene activities. These included,

24
among others, conduct of health teaching on proper hand hygiene

technique with disease education and preparation of individual

hygiene kit for pupils. With regards to the pupil’s age, gender, and

grade level, they have shown no significance at all. This is due to the

fact that their interest on hand hygiene would remain the same

regardless of their gender, age, and their grade level. (Asilo,

Berberabe, & Ramos, 2018).

25
Synthesis

This study aims to determine the knowledge level and hand

hygiene practice behaviour of the first year paramedical students in

attempt to identify sex, age and courses differences on this issue.

The findings of this correlational study can substantially contribute

to the understanding on the knowledge and practice of the

students towards hand hygiene, thereby providing information to

gender-specific health promotion activities, school interventions,

and other campaigns for the improvement of hand hygiene

compliance.

Several studies revealed that various factors influence an

individual's level of knowledge and level of practice regarding hand

hygiene. Health teaching in schools or communities about proper

hand hygiene produced better results than those who did not receive

such health teaching. Many studies were collected and reviewed in

order for the researchers to get an overview of the current

knowledge on the subject. Many studies have shown that there are

many variables that have a significance with the level of knowledge

and practices of the respondents. These variables can vary from

research to research. One research have concluded that being

exposed to hand-hygiene-related interventions could impact the

26
student’s knowledge regarding hand hygiene wherein being involved

in such interventions would increase the student’s level of knowledge

on the said variable. Another research mentioned that simply being

in a public school have increased scores in hand hygiene knowledge,

practice, and facility utilization and there were no significance when

it comes to the pupil’s age, gender, and grade level. Another study

claimed that students from interventions schools have more

knowledge in critical hand hygiene than those at the comparison

schools since these schools have higher rates of hand hygiene after

toilet use. A study was conducted and showed that WASH program

helped increased the knowledge of their students according to a

national literature. All interventions re done by schools to guide,

teach and impart the knowledge about the hand hygiene. It is the

school's initiative to educate the students. With this knowledge there

were found less cases of absences of students due to diarrhea that

is most likely the cause death of children. Knowledge about

hand hygiene should be focused especially to the healthcare

staffs since according to one of the study, only half of the population

that were interviewed were aware of it. According to Cruz and Otaibi

(2015), The Nursing student in Saudi Arabia revealed that there is

no significant difference between gender. Since every gender knows

27
the proper hand hygiene since they expose to the patient and fluids.

Furthermore, both gender knows to perform hand hygiene using the

5 moments of hand hygiene: Before handling a patient, before

performing aseptic and clean operations, after being in danger of

exposure to body fluids, after touching a patient, and after touching

the patient's surroundings also they will perform after gloves

removal. This study is relevant to us since we nurses’ will be exposed

to patients and this will decrease the risk of transmitting

the infection to healthcare and patient.

In the final analysis according to the literatures stated above,

age and gender have shown no significance at all since the interest

of the students would remain regardless. On the other hand, women

student nurses have higher hand hygiene compared to men student

nurses and found out that there is no significant link between gender

and attitudes about hand hygiene among nurses. In addition to that,

student nurses' have higher compliance rate and typically practice

hand hygiene. Knowledge and practice should come hand in hand

since hand hygiene efficiency is a combination of washing efficiency

and how it would affect us lessen the spread of the immunodeficiency

virus infection. The findings of this study can provide information on

health promotion activities to achieve

28
sustained improvement in hand hygiene practices.

THE PROBLEM

Statement of the Problem

The purpose of this study is to determine the level of

knowledge and level of practices of hand hygiene among first-year

paramedical students at Southwestern University-PHINMA during

the RAD Learning for the second quarter of 2022.

Furthermore, the study aims to provide answers to the following

questions:

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

1.1 Age;

1.2 Sex; and

1.3 Course?

2. Is there any significant relationship between respondents’ profile

and their level of knowledge in hand hygiene?

3. Is there any significant relationship between respondents’ profile

and their level of practices in hand hygiene?

29
4. Is there a significant relationship between knowledge and

practices of doing hand hygiene among first year paramedical

students in Southwestern University-PHINMA?

5. What is the level of knowledge of the respondents in terms of

hand hygiene?

6. What is the level of practice of the respondents in terms of hand

hygiene?

7. Based on the results, what interventional plan may be proposed?

Hypotheses

Ho1: There is no significant relationship between the

respondents’ profile and their level of knowledge in hand hygiene.

Ho2: There is no significant relationship between the

respondents’ knowledge and their level of skills in hand hygiene.

Ho3: There is no significant relationship between the

respondents’ profile and their level of practices in hand hygiene.

30
SIGNIFICANCEOFTHESTUDY

This study was conducted to provide valuable information

about the level of knowledge and practices of handwashing among
first-year Paramedical students at Southwestern University-PHINMA,
as well as to determine whether there is a significant difference
between the respondents’ self-assessment and supervised learning
in terms of the efficacy of performing proper hand hygiene. The
study will provide benefits to the following:

Paramedical students: The study is beneficial for Paramedical

students as this study explore different aspects of their knowledge
that will be vital in terms of assessing their level of knowledge and
practices towards hand hygiene which tackles about its importance
and the right way to perform it.

College of Nursing: The study provides information on proper

technique of hand hygiene to nurses.

Other Courses: This study will give the researchers the right
information, process and procedure on how to do proper hand
hygiene.

Faculty: This research is beneficial to the faculty as it helps provide

insight on the level of handwashing their students have. This can
provide awareness that some may require additional teachings on
handwashing, and can also provide information as to what may
affect the level of knowledge for handwashing a student has.

School Clinic: This study will benefit school clinics since it will design
an interventional approach to increase students' hand hygiene
knowledge and practices, as well as provide a simple and cost-
effective way of avoiding the spread of infection.

School Administration: The research aims to benefit the school

administration to have a clean environment that is free from
infection or microorganisms and prevent illnesses. Moreover, this
study will help the university to acquire awareness of how competent
the students are concerning the mastery of proper hand washing.

31
The Researcher: Through this research, it will help improve the
ways to halt spread of infection and effective in preventing the
spread of some diseases in researcher's daily living.

Future Researchers: This research can be used as a guidance in

conducting future research. It can serve as a building block when
creating a research study. It can provide information as to how
beneficial handwashing is and how it can determine if there is any
correlation between handwashing to the different medical courses.

RESEARCH METHODOLOGY

Research Design

In this study, the descriptive correlational method of research

will be used. According to Porter and Carter (2000), A correlational

research study not only describes, but also focuses on

what exists between variables, this study systematically investigates

relationships between two or more variables of interest. The

variables that is involved in this study are the respondents' profile

and the respondents' knowledge and practices

in hand hygiene.

A descriptive research design is a type of research design that

aims to obtain information to systematically describe a phenomenon,

situation, or population. However, on the other hand, according to

32
Creswell, researchers use a correlation study design to describe and

measure the degree of relationship between two or more variables or

sets of scores.

Research Environment

The locale of this study is in Southwestern University PHINMA.

The university has two campuses. The main campus is located on

Urgello St. where the study is being conducted, as the study focuses

on the first-year paramedical students at the said university. The

department involves in this study is the Department of Nursing.

The Researcher's environment surrounding will change

significantly in the face of COVID-19 restrictions. The University

restricts students from going to school to signify awareness and

safety. The study is made possible by the university's use of RAD

Learning that is carried out virtually.

Research Respondents

The respondents of the study are the First Year Paramedical

Students of Southwestern University-PHINMA. The total population

who are currently enrolled in first-year second semester S.Y

20212022 are 2,299. The Bachelor of Science in Nursing (BSN) has

33
1,084 students, Bachelor of Science in Medical Technology (BS

MedTech) has 627 students, Bachelor of Science in Pharmacy (BS

Pharm) has 224 students, Bachelor of Science in Physical Therapy

(BSPT) has 84 students, Bachelor of Science in Occupational Therapy

(BSOT) has 12 students, Bachelor of Science in Psychology (BS

Psych) has 210 students, and Bachelor of Science in Biology (BS Bio)

has 58 students. A copy of the list of enrolled students was obtained

and the researchers sent a Letter of

Request to the University Registrar’s Office.

Sampling Design. Complete Enumaration and Probability

Cluster Sampling will be used in this study. According to Thompson

and Gowan (1998), complete enumaration sampling are census of

individuals within a sampling unit. The term census refers to a

quantitative research approach in which all members of the

population are enumerated and this sampling is useful to find out

the ratio male and female and as well as the ratio of literate and

illiterate people about hand hygiene (Surbhi, 2017). On the other

hand, probability cluster sampling is a method of sampling where the

researchers divide the entire population into sections or clusters that

represent a population. Clusters are identified and included in a

34
sample based on demographic parameters like age, sex, location,

etc. This makes it very simple for a survey creator to

derive effective inference from the feedback (Fleetwood, n.d).

Inclusion and Exclusion Criteria. Inclusion criteria are; (1)

registered paramedical courses for the second semester of first

quarter of 2022, (2) enrolled in first-year courses which are the

following: Bachelor of Science in Nursing (BSN), Bachelor of Science

in Medical Technology (BS MedTech), Bachelor of Science in

Pharmacy (BS Pharm), Bachelor of Science in Physical Therapy

(BSPT), Bachelor of Science in Occupational Therapy (BSOT),

Bachelor of Science in Psychology (BS Psych) and Bachelor of

Science in Biology (BS Bio), (3) have consent and signature from

their respective college dean, (4) and those who are willing to

participate and give voluntary consent. The exclusion criteria

involves the students which will refuse to participate, not enrolled at

Southwestern University-PHINMA, or do not have consent and

signature from their respective college dean.

35
Research Instrument

One set of a standardized questionnaire will be administered

to the respondents. The set of questionnaire will be about the profile,

hand washing knowledge, practices and skills of the

respondents.

The questionnaire is based on an existing research instrument

made by Mehta, A. and Tripathi, k., entitled “Knowledge, attitude

and practices of hand hygiene among nurses and nursing students

in a tertiary health care center of Central India: a questionnaire

based study” that aimed to assess levels of knowledge, attitude and

practice in various aspects of hand hygiene in nurses and nursing

students in the study area for identifying gaps for planning necessary

corrective measures. The questionnaire is divided into four parts.

The first part is the profiling where respondents will be directed to

write and put a check mark for their answers on the boxes provided.

The second part is the assessing of the level of knowledge of the

respondents this part of the questionnaire consists of 8 questions all

about hand hygiene knowledge. The third part will be the assessing

of the respondents' practices and will consist of 13 questions.

36
 The respondents will be answering to the hand hygiene

knowledge part of the questionnaire through multiple choice type of

test and a 2 point Likert scale. For the answering of the hand hygiene

practices, it will be a frequency type of Likert scale ranging from

always to never.

Research Procedure

The following preliminary preparations will be done to make

sure that the data to be gathered will be valid: the researchers will

present the questionnaire they have adapted to their research adviser

and the panelists for critiquing. After the approval of the

questionnaire they have adapted, the researchers will prepare a

transmittal letter to be signed by the Dean of the college of nursing.

After the letter will be approved by the department, the researchers

can start gathering the data using the list of first-year

paramedical students from the registrar.

With the presence of the pandemic, the first-year students

have their classes online the researchers are opt to use the online

platform to conduct the survey. The research tool will be sent

through the section mayors of 1st year paramedical students of

Southwestern University-PHINMA via Google form links through

Facebook Messenger and Google Mail accounts.

37
 Prior to accessing the research instrument, the letter of

information consent is provided to the respondents to decide if they

choose to agree with all the terms and conditions set by the

researchers, they will proceed to the research tool proper. On the

other hand, if they choose to disagree, they won't be directed to

the tool, which would exclude them as respondents.

The researchers will retrieve the data from Google forms upon

completion, with regards to the total number of respondents. Data

gathered will be reviewed from time to time only by a designated

number of members of the research team. After which, the complete

data will be imported to a Microsoft Excel file and will be reviewed

by the person in charge. Only members of the research team are

allowed to view the gathered data, for confidentiality. The organized

data will be submitted to the

statisticians for analysis.

Since the collection of data will be done through online

methods, the excel file, that will be used to compile and analyze all

the data to be gathered, will be deleted completely as a means to

dispose the answers from the respondents. This is to avoid any

information about the respondents and their answers from

spreading.

38
Treatment of Data

The statistical treatment will be used to test the null

hypotheses using data that will be gather by the researchers using

the research instrument. To complete the statistical treatment of the

data, the following statistical tool will be used:

Percentage: To determine the demographic profile of the

respondents: Age, Gender, and Course.

Frequency: The frequency distribution will be used to summarize

the frequency of the individual values or ranges of data for each

question that will be collected from the respondents.

Weighted mean: To compute the final average of the responses to

determine the average of the level of knowledge and practices hand

hygiene.

Pearson R- will be used to measure the relationship between

independent and the dependent variables. As shown in each

hypothesis, the researchers are attempting to determine the

significant relationship between the two variable involved which are

the respondents' profile and level knowledge towards hand hygiene,

the respondents' profile and level of practice towards hand hygiene,

and the relationship between level of knowledge and level practices

39
of hand hygiene to first year paramedical students.

Definition of Terms

This section aims to provide the key terms used in the study.

In order to make this study more understandable, the followings

terms are defined based on how they were used in the study.

Level of Knowledge. One of the variables in the study being

conducted, by which it states the learner’s level of knowledge

regarding hand hygiene. Furthermore, it is a level or percentage of

students learning or performance in which the study focuses on the

understanding of first year students about hand hygiene.

Level of Practice. is defined as an act of performing given

procedure(s) according to a set of standard. This is used as one of

the variable that discloses the extent of mastery of first year

students of Southwestern University PHINMA.

Age. It is one of the bases in the students' profile to gather data.

This is used to mean the perceived level of knowledge from people

in any age group regarding the hand hygiene skills.

Sex. Profile of the students used to determine the knowledge from

people in any sex regarding the idea of hand hygiene. This is the the

40
biological attribution of a person that is categorized as male and

female since birth.

Course. These are the all first year paramedical students that are

being used as respondents in knowing their proficiency of hand

hygiene. These are namely: Nursing, Medical Technology, Pharmacy,

Radiolgic Technology, Physical Therapy, Occupational

Therapy, Psychology, and Biology.

Paramedical courses. These are the type of non-major courses

that prepares SWU for medical school. These include: Bachelor of

Science in Nursing (BSN), Bachelor of Science in Medical Technology

(BS MedTech), Bachelor of Science in Pharmacy (BS

Pharm), Bachelor of Science in Radiologic Technology (BS RadTech),

Bachelor of Science in Physical Therapy (BSPT), Bachelor of Science

in Occupational Therapy (BSOT), Bachelor of Science in Psychology

(BS Psych), and Bachelor of Science in Biology (BS Bio).

Hand Hygiene. The variable that is being measured and focused in

the study in which this is defined as a sole measure to reduce

infection. It is the practice that is mainly used as maintaining a clean

environment for the reason that this eliminates the spread of the

microorganisms.

First Year Students. The respondents or the focus of the

41
conducted study that belongs to any paramedical programs is limited

to first year students only. A particular group of people that will be

given a questionnaire to gather data.

Hand hygiene Enhancement Plan. aims to broaden the

knowledge of first-year paramedical students on hand hygiene by

providing some crucial basic yet specific steps to assist you design

and implement strategies aimed at improving hand hygiene.

42
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46
Appendices APPENDIX A A. Letter to the Dean of the College
of Nursing

47
48
B. Letter to the Registrar

49
APPENDIX B Informed Consent

Dear Respondents:

50
Good day! As part of our research journey, we are conducting a study
on “Knowledge and Practices of Hand Hygiene among First Year
Paramedical Students”. We hope that you can share few minutes of
your time to share your experience in relation to the said topic.

Purpose

This study examines their level of knowledge and practices of hand

hygiene among First Year Paramedical student in Southwestern
University PHINMA during the RAD Learning for the quarter of 2022.

Benefits to the Participants

The participants in the study will gain prior knowledge about the
researchers’ study.

Risk and Discomforts

There is no identified risk and discomfort came from the participants

throughout the study. If the participants feel discomfort about the
survey, they may decline to answer any questions.

Voluntary Participation

The participants are not forced to participate in the conducted study.

It is up to the participants whether to take part in the study. The
willingness of the participants is highly appreciated.

Withdrawal from the Study

The participants are free to withdraw any time and without giving
reason even after they signed the informed consent. If the
participant wants to withdraw during or after the survey, please
inform the researchers a head of time for them to be prepared and
to make changes in the study being conducted.

Confidentiality

Rest assured that any information obtains from the participants were
keep between the participants and the researchers. The researchers
agree to never disclose such confidential information to anyone

51
outside of the study. All data associated with the study remain
confidential.

If ever you need to contact us about our research, you may reach as
0915 319 6099 or email us at Dannieclan3@gmail.com.

Conforme:

I fully understand and agree to the term and conditions set by the
researchers. I, therefore, attest that I answered all the questions
with all honesty.

____________________________

Signature over Printed Name/Date

APPENDIX C Research Instrument

Dear Respondents,

Greetings! We are the second year students of Southwestern

University-PHINMA. We are currently conducting a research entitled
“Knowledge and Practices of Hand Hygiene among First Year
Paramedical Students in Southwestern University-PHINMA”.

The purpose of this study is to provide valuable information

about the level of knowledge and practices of hand hygiene among
first year students who are taking up Paramedical courses of
Southwestern University-PHINMA The result will be the basis in
establishing a Multimodal Hand Hygiene Improvement Strategy Plan
by WHO to improve their knowledge and practices. Rest assured that
your responses will be kept in utmost confidentiality and will be used
for the purpose of the study itself.

Part 1 - Respondent’s Profile

Age: 17 and below 18-20 21-23 24-26

Gender:MaleFemale

52
Nationality:

Course:

Bachelor of Science in Nursing (BSN)

Bachelor of Science in Medical Technology (BS MedTech)

Bachelor of Science in Pharmacy (BS Pharm)

Bachelor of Science in Radiologic Technology (BS RadTech)

Bachelor of Science in Physical Therapy (BSPT)

Bachelor of Science in Occupational Therapy (BSOT)

Bachelor of Science in Psychology (BS Psych)

Bachelor of Science in Biology (BS Bio)

Part 2 – Hand Hygiene Knowledge of the Respondents

1. Which of the following is the main route of cross-transmission of

potentially harmful germs between patients in a health-care facility?
Health worker’s hands when not clean

patient’s exposure to colonized surfaces (beds, chairs, tables, floor)

air circulating in the hospital

sharing non-invasive objects between patients

(stethoscope, pressure cuffs, etc

2. What is the most frequent source of germs responsible for health

careassociated infections? the hospital’s water system the hospital air

germs already present on or within the patient

the hospital environment (surfaces)

3. What is the minimum time needed for alcohol based hand

rub to kill most germs on your hand?

53
 20 seconds

3 seconds

1 minute

10 seconds

4. The most appropriate timing for Hand hygiene to prevent

transmission of germs to patients.

a. Before touching a patient yes no

b. Immediately after a risk

of body fluid exposure yes no

c. After exposure to the

immediate surroundings of the

patient yes no

d. Immediately before a

clean/aseptic procedure yes

No

5. The most appropriate timing for Hand hygiene to prevent

transmission of germs to health care workers.

a. After touching a patient yes no

b. Immediately after a risk

of body fluid exposure yes no

c. Immediately before a

clean/aseptic procedure yes

no

54
 d. After exposure to immediate

surroundings of the patient

yes

No

6. Which of the following statements on alcohol based hand rub and

hand washing with soap and water are true?

a. Hand rubbing is more rapid for

hand cleansing than hand
washing

true

false

b. Hand rubbing causes skin dryness

more than hand washing

true

false

c. Hand rubbing is more effective

against germs than hand washing

true false

7. Which type of hand hygiene method is required in the

following situations?

a. Before palpation of the abdomen

rubbing washing

b. Before giving an

injection rubbing washing

c. After emptying a

bedpan rubbing washing

55
 d. After removing examination gloves

rubbing washing

e. After making a patients

bed rubbing washing

f. After visible exposure to

blood rubbing washing

8. Which of the following should be avoided, as

associated with increased likelihood of colonization of hands with harmful
germs?

a. Wearing jewellery yes

No

b. Damaged skin yes

No

c. Artificial fingernails yes

no

d. Regular use of a hand

cream

yes

No

Part 3 - Hand Hygiene Practices of the Respondents

I cleanse my Always Often Sometimes Rarely Never (1)
hands under (5) (4) (3) (2)
following
conditions:

1. Before
physical contact
with a patient

56
2. After physical
contact with a
patient

3. Before caring
for wound

4. After wound
care

5. After touching
potentially
contaminated
objects

6. After contact
with blood/body
fluids/Patient’s
secretions

7. After
inserting an
invasive device

8. Before
entering into

isolation room

9. After exiting
from isolation
room

10. Before
endotracheal
suctioning

11. Before
clean/aseptic
procedure

12. After
removing gloves

57
13. If they look
or feel dirty

58
 APPENDIX D
Curriculum Vitae

DAVE JASON S. NISNISAN

Daanlungsod, Oslob, Cebu

Dase.nisnisan.swu@phimaed.com

0945 257591 | 09989131366

Birthdate: April 7, 1999

Gender: Male Religious Affiliate: Roman Catholic Educational

Background

Senior High School: University of Cebu – Main Campus

Address: Sangcianko Street, Cebu City

Junior High School: Saint Mary’s Academy

Address: Poblacion, Oslob, Cebu

Grade School: Daanlungsod Elementary School

Address: Daanlungsod, Oslob, Cebu

Field of Interests

Hobbies: Listening to music and Playing Billiards.

59
 NORTIZA, EZRA

Tutay, Pinamungajan, Cebu

Ezra.nortiza.swu@phinmaed.com

09560587749 | 09274734335

Birthdate: September 20, 2000

Gender: Male

Religious Affiliate: The church of Jesus Christ of latter day saints

Educational Background

Senior High School: Cebu Institute Technology University

Address: Natalio B. Bacalso Ave. Cebu city

Junior High School: Southwestern University

Address: Urgello, Cebu

Grade School: Pinamungajan Central Elementary School

Address: Poblacion, Pinamungajan, Cebu

Field of Interests

Hobbies: Playing music, reading books, going out in nature, physical

activities

60
 FRANCES MAXINE O. ORBETA

M. Y. Village Ticad Bantayan Cebu

orbetamaxine@gmail.com

0908 145 7761

Birth Date: July 15, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background Senior High School: CIT-University

Address: N. Bacalso Avenue, Cebu City

Junior High School: Saint Paul Academy

Address: Suba Bantayan Cebu

Grade School: Divine Love Study Center

Address: M. Y. Village Ticad Bantayan Cebu

Field of Interest:

Hobbies: Painting and Watching Movies

61
 MAAN M. ORIO

TinagoBagumbyan, Cebu

mami.orio.swu@phimaed.com

(0956) 992 8419

Birthdate: July 10, 2002

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: Southwestern University PHINMA

Address: Urgello Aznar St., Cebu City

Junior High School: Abellana National School

Address: Osmeña Blvd, Cebu City, Cebu

Grade School: Tejero Elementary School

Address: M. J. Cuenco Ave, Cebu City, 6000 Cebu

Field of Interests

Hobbies: Listening to Music, Balisong (Butterfly Knife, Batangas)

Flipping

62
 GEAN D. PAGAL

Purok 1 San Jose 2 Labogon Mandaue City, Cebu 6014

gedi.pagal.swu@phinmaed.com

0961 489 2028

Birth Date: August 17, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: Southwestern University PHINMA

Address: Urgello St., Cebu City

Junior High School: Mandaue City Comprehensive National High

school

Address: Plaridel St. Reclamation Area, Mandaue City, Cebu

Grade School: Basak Elementary School

Address: Basak, Mandaue City, Cebu

Field of Interests

Hobbies: Reading books, and embroidering

63
 CHELOU MARIE V. PALDO

Brookfield Subdivision Basak Sudtunggan Lapulapu City

Chvi.paldo.swu@phinmaed.com

09468478242

Birth of Date: October 26, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: Benthel Asia School of Technology, Inc.

Address: Basak Sudtunggan Lapulapu City

Junior High School: Holy Child Academy of Pitogo Bohol, Inc.

Address: President Carlos P Garcia Bohol

Grade School: Bayog Elementary School

Address: Bayog President Carlos P Garcia Bohol

Field of Interest

Hobbies: Playing Badminton

64
 JAN KATHERINE PE

Township Compound Poog, Toledo City, Cebu

pejankatherine569@gmail.com

09668719348

Birth Date: May 25, 2002

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Address: Don Andres Soriano, Toledo City, Cebu

Senior High School: De La Salle ASMC

Junior High School: Cantabaco National High School

Address: Cantabaco, Toledo City, Cebu

Grade School: De La Salle ASMC;

Address: Don Andres Soriano, Toledo City, Cebu

Field of Interests

Hobbies: Watching movies and reading books

65
 ERICA MHEL P. SABELLANO

Ticad, Bantayan, Cebu

Erpe.sabellano.swu@phimaed.com

09503816336 | 09614893855

Birthdate: April 14, 2002

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: Bantayan Science High School

Address: Ticad, Bantayan, Cebu

Junior High School: Bantayan Science High School

Address: Ticad, Bantayan, Cebu

Grade School: Bantayan Central Elementary School

Address: Ticad, Bantayan, Cebu

Field of Interests

Hobbies: Listening to music, reading books, and watching movies

66
 RON ALEC S. SAGAD

DAS-AYO, Lutapan, Toledo City, Cebu

Dannieclan3@gmail.com

0915 319 6099

Birth Date: May 15, 2001

Gender: Male Religious Affiliate: Roman Catholic Educational

Background

Senior High School: CIT-University;

Address: N. Bacalso Avenue, Cebu City, 6000

Junior High School: De La Salle ASMC;

Address: Don Andres Soriano, Toledo City, Cebu

Grade School: De La Salle ASMC;

Address: Don Andres Soriano, Toledo City, Cebu

Field of Interests

Hobbies: Swimming and Playing Soccer

67
 LAIRE ANN Y. SAGADAL

Honoria and Paz, Guadalupe, Cebu City

layl.sagadal.swu@phinmaed.com

09614893851

Birthdate: June 30, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: University of Cebu-Private Campus

Address: J. Alcantara St., Cebu City

Junior High School: University of Cebu-Main

Address: Sanciangko St., Cebu City

Grade School: Lipata Elementary School

Address: Lipata, Minglanilla, Cebu

Fields of Interests

Hobbies: Listening to KPOP music and watching series and movies

on Netflix

68
 KATHERINE P. TACGOS

Talisay City Cebu

tacgoskath@gmail.com

09073541629

Birth Date: August 06, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: University of Cebu-main

Address: Sanciangko St, Cebu City, 6000 Cebu

Junior High School: San Jose National High School

Address: San Jose Talibon Bohol

Grade School: Carmen Central Elementary School

Address: Carmen Davao del Norte Field

of Interest:

Hobbies: Badminton and Watching K-drama

69
 DEBBIE MAE G. TALADRO

Manlagtang, Tabogon,Cebu

Dego.taladro.swu@phinmaed.com

09702225433

Birthdate: October 23, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: Southwestern University PHINMA

Address: Urgello St.,Cebu City

Junior High School: Abellana National School Address:

Osmeña Blvd., Cebu City

Grade School: Manlagtang Elementary School

Address: Manlagtang ,Tabogon, Cebu

Field of Interests

Hobbies: Listening to music,watching movie and playing volleyball

70
 Sandyliz Joy Talam

3720 Woodland Heights, Banawa, Cebu City

09662910268

Birthdate: March 18, 2001

Sex: Female

Religion: Roman Catholic

Educational Background

Senior High School: Southwestern University PHINMA

Address: Urgello Cebu City

Junior High School: Abellana National School

Address: Osmeña Blvd., Cebu City

Elementary education: Nazarene Christian Learning Center

Address: Good Shepherd Rd., Banawa Cebu City

71
 KRISLY JADE B. TEO

Brgy. 8 Tuburan, Cebu

krba.teo.swu@phinmaed.com

0961 489 3976

Birth Date: October 11, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senior High School: Southwestern University PHINMA

Address: Urgello St., Cebu City

Junior High School: Tuburan National High School

Address: Brgy. 7 Tuburan, Cebu

Grade School: Tuburan Central School

Address: Brgy. 7 Tuburan, Cebu

Field of Interests

Hobbies: Listening to music and watching K-drama and series

72
 VENESSAH GAILE T. VARQUEZ

Belguim St. Suba Cebu City

varquezvenessah@gmail.com

0933481529

Birth Date: January 18. 2002

Gender: Female Religious Affiliate: Roman Catholic Educational

Background

Senoir High School: University of Cebu- Main campus

Address: J. Alcantara St., Cebu City

Junior High School: Cebu City Don Carlos A. Gothong Memorial

National Hight School

Address: C Padilla. Cebu City

Elementary Education: Pasil Elementary School

Address: Pasil, Cebu City

73
 ZAMORA, PEARL MARIE A.

BAOD, BANTAYAN, CEBU

pearlmariezamora@gmail.com

09614890177

Birth Date: December 18, 2001

Gender: Female Religious Affiliate: Roman Catholic Educational

Backgroud

College: Southwestern University PHINMA;

Address: Urgello Cebu City

Senoir High School: Bantayan Science High School

Address: Ticad, Bantayan, Cebu

Junior High School: Bantayan Science High School

Address: Tangke, Ticad, Bantayan, Cebu

Elementary Education: Baod Elementary School

Address: Baod, Bantayan, Cebu

74