Appendices1 - Letters, Etc

Appendix A-1
Cover Letter
University of the Philippines Manila

The Health Sciences Center
College of Nursing
Pedro Gil St. Ermita, Manila
Date__________________
Dear Respondents,
I am a graduate student of the University of the Philippines, College of Nursing

currently working on my thesis paper entitled, Prevalence and Associated Factors of
Needlestick and Sharp Injuries among Health Care Workers in Military Hospitals.
The study aims to determine the prevalence and factors associated with needle stick
injuries and sharp objects among health care workers in selected military hospitals in
Metro Manila and Cavite.
Enclosed is the Needle Stick and Sharp Injuries Questionnaire. A pen is provided for
your use. This will take 8-10 minutes to complete the questionnaires. Feel free to ask any
questions you have in mind. You can contact me by mobile phone no.
09177111906/093289064002 or to my email- michellemibuna@yahoo.com.ph.
Your honest response is valuable for the study. Rest assured that all data gathered
shall be treated with strict confidentiality and will be utilized only for research purposes.
Once you have completed the survey, you can inform me thru mobile phone text
message or return the answer sheet to the designated research assistant.
Your full cooperation and whole- hearted support will be highly appreciated. Thank
you very much!
Very truly yours,
Michelle M. Ibuna, RN
MAN Candidate
Appendix A-2
Cover Letter
Unibersidad ng Pilipinas Manila
Sentro ng Siyensyang Pangkalusugan
Kolehiyo ng Pagnanarsing
Petsa__________________
Giliw kong mga tagasagot,
Ako ay gradwadong mag-aaral ng Unibersidad ng Pilipinas Manila, Kolehiyo ng

Pagnanarsing ay kasalukuyang gumagawa ng pananaliksik na pinamagatang,
Prevalence and Associated Factors of Needle Stick and Sharp Injuries. Nilalayon ng
pag-aaral na ito na matukoy gaano kadalas nangyayari ang pagkatusok nito sa mga
manggagawa na nangangalaga ng kalusugan sa apat na ospital ng kasunduluhan sa Metro
Manila and Cavite.
Nakapaloob sa sulat na ito ang Needle stick and Sharp Injuries Questionnaires. May
panulat ding kasama para inyong magamit. Tinatayang aabot sa 8-10 minuto para
matapos ang pagsagot sa mga katanungan na nakapaloob sa instrumentong ito. Huwag po
kayong mag alinlangan na magtanong sa mananaliksik hinggil sa pag-aaral na ito. Maari
niyo pong akong iteks o tawagan sa numerong 09177111906/09328906402 o di kaya sa
aking e-mail- michellemibuna@yahoo.com.ph.)
Ang inyong matapat na sagot ay malaking tulong para sa pag-aaral na ito. Anumang
malilikom na sagot sa inyo ay mananatiling konpidensyal at gagamitin lamang para sa
pananaliksik na ito.
Sa sandaling natapos po ninyo ang sarbey ay ipagbigay alam sa akin pamamagitan ng

pagteks o di kayay pagsauli nito sa itinatalagang tagalikom ng nga datos ng
mananaliksik.
Ang inyong suporta sa pamamagitan ng paglahok na ito ay malugod kong

pinasasalamatan.
Lubos na nagpapasalamat,
Michelle M. Ibuna, RN
MAN Candidate
Appendix B-1
Informed Consent Form
(Informed Consent Form for Health Workers)
Project Title: Prevalence and associated factors of needle stick and sharp injuries
among health care workers in military hospitals
You are being invited to take part in this research project. Before you decide whether or
not to take part, it is important for you to understand why the research is being done and
what it will involve. Please take time to read the following information carefully.
_______________________________________________________________________
PART I: Information Sheet
Introduction
I, Michelle M. Ibuna, RN, currently taking Master of Arts in Nursing major in
Nursing Administration at the University of the Philippines, College of Nursing. I am
doing a research study on Prevalence and associated factors of needle stick and sharp
injuries among health care workers in military hospitals. I am going to give you
information and invite you to be part of this research. You do not have to decide today
whether or not you participate in the research. Before you decide you can talk to anyone
you feel comfortable with about the research.
There may be some words that you do not understand. Please write it down in the
survey questionnaires and I will take time to explain. This study will last for 6 weeks.
A. Purpose of the Research

The study aims to determine the prevalence and factors associated with needle
stick and sharps injuries among health care workers in four (4) military hospitals in
Metro Manila and Cavite.
B. Procedures and Protocols

This research will involve the following: (1) record review and (2) administration
of survey questionnaires.
Records Review: Upon approval to conduct the study in the 4 military hospitals
by their respective Commanding Officers, the researcher will proceed with records
review at Hospital Infection Control Committee.
Administration of Self-report questionnaires: You will be asked to answer sets of
questions on history of needle stick and sharps injuries and the circumstance surrounding
it, work practices, and hospitals program related to prevention and control of needle
stick and sharps injuries that you are aware of. As a respondent, you are free to answer or
refuse to answer any questions in the survey questionnaire. You are also free to write
down questions and the researcher will deal with it appropriately.
C. Risk and Benefits
No foreseeable risks are being anticipated as result of your participation in this
study nor will you directly benefit from it. However, the findings from this study may
help devise strategies to control needle stick and sharps injuries and promote safety in the
workplace.
D. Reimbursement of Expenses
The data collection will be done in the clinical area. Survey questionnaire can be
answered in an average of 8 minutes and can be done during break time. Should you
decide to participate, you will not be given any money or gifts to take part in this
research.
E. Voluntary Participation
Your participation in this study is completely voluntary. There is no penalty for
not participating or for refusal to answer one or more questions. You may also withdraw
your participation from the study if you feel uncomfortable about answering the
questions.
F. Confidentiality
All of you responses will be kept anonymous. The information that we collect
from this research project will be confidential. Information about you that will be
collected during the research will be kept only by the researcher. Any information about
you will have a number on it instead of your name. It will not be shared with or given to
anyone except for the researchers involved in the study and those responsible oversight
such as the UPMREB Ethics Review Panel will have the access to the information you
provide. Upon completion of the study, all answered survey forms will be kept in cabinet
and will be in storage for one (1) year, after which it will be destroyed and will not be
used for any further analysis and purpose not included in the objectives of this research.
G. Sharing the Results

After the study has been completed you will be notified regarding the collective
result of the study. Pertinent findings will be posted in your respective Hospital Infection
Control Committee. If you wish to see your record, you are free to contact the researcher.
The result of this research endeavor may be published for a larger audience. However,
please note that confidential information will not be shared and findings will first be
presented to you first before it will be made available to the public.
H. Right to Refuse or Withdraw

You do not have to take part in this research if you do not wish to. Refusing to
participate will not affect your employment status or training activities (medical interns).
Should you decide to withdraw, your data will be destroyed and will not be used in the
study.
I. Who to Contact
If you have any questions or concerns regarding this study or about the way it
will be conducted, you may contact the researcher Michelle M Ibuna, RN at
michellemibuna@yahoo.com.ph or at cp# 09177111906.
This proposal has been reviewed and approved by the UP Manila Research Ethics Board
(UPM-REB) which is a committee whose task is to make sure that research participants
are protected from harm.
Further, if you want to find out more about the UPMREB Review Panel, contact:
Name:
Address: 2/f Paz Mendoza
547 Pedro Gil St
Ermita 1000 Manila
Email:upmreb@post.upm.edu.ph
Tel: +63 2 5222684
Mobile: +639273264910 or +639153080212
Note: this informed consent form was adopted from the WHO ERC ICF template for
clinical studies.
PART II: Certificate of Consent
I have read the foregoing information, or it has been read to me. I have had the
opportunity to ask questions about it and any questions that I have asked were answered
to my satisfaction. I consent voluntarily to participate as a participant in this research.
Print Name of Participant _________________________________
Signature of Participant___________________________________
Date ___________________________________________
Day/month/year
Statement by the researcher/person taking consent
I have accurately read out the information sheet to the potential participant, and to the
best of my ability and that I also explained that the following procedures will be done to
support the research:
1. Administration of self-report questionnaires
2. Records Review
I confirm that the participant was given an opportunity to ask questions about the
study, and all the questions asked by the participants have been answered correctly and to
the best of my ability. I confirm that the individual has not been coerced into giving
consent and the consent has been given freely and voluntarily.
A copy of this ICF has been provided to the participant.
Print name of researcher/person taking the consent___________________
Signature of researcher/person taking the consent_____________________
Date _____________________________
Day/month/year
Note: this informed consent form was adopted from the WHO ERC ICF template for
clinical studies.
Appendix B-2
INFORMED CONSENT
(Filipino version)
Pamagat ng Pagsasaliksik: Prevalence and associated factors of needle stick and

sharp injuries among health care workers in military hospitals.
Ikaw ay malugod na inaanyayahan na makibahagi sa pag aaral na ito.Bago kamagpasya

kungnais mo na makibahagi o hindi, mahalaga para sa iyo na maunawaankung bakitang
pag aaral na ito ayisinasagawa at kung ano ang nasasakupan nito.Mangyaring maglaanng
orasupangbasahin ng maingat ang mga sumusunod na impormasyon
_______________________________________________________________________
PART I: Impormasyon ng kalahok
Panimula
Ako ay si MichelleM.Ibuna, RN, kasalukuyang nag-aaral ng Master of Arts in Nursing
major sa Nursing Administration sa Unibersidad ng Pilipinas, Kolehiyo ng Narsing. Ako
ay gumagawang pananaliksikna pinamagatang Prevalence and associated factors of
needle stick and sharp injuries among health care workers in military hospitals.
Inaanyayahan kita na maging bahagi ng aking pananaliksik. Hindi mo kinakailangang
magpasya agad kung ikaw ay lalahok o hindi. Bago ka magpasya, maaari kang makipag-
usap sa kahit sino sa tingin mong komportable kausapin tungkol sapag aaral na ito.
Maaaring may ilang mga salita na hindi mo maintindihan. Mangyaring itong isulat sa
questionnaire survey at maglalaan ako ng oras upang ito ay ipaliwanag. Ang pag-aaral na
ito ay tatagal ng anim (6) na linggo.
A. Layunin ng Pananaliksik
Nilalayon ng pag-aaral na ito matukoy gaano kadalas nangyayari ang pagkatusok ng
karayom at matatalim na bagayat mga nauugnay na kadahilananng pagkatusok nito sa
mga manggagawa na nangangalaga ng kalusugan sa apat(4) naospital ng military sa
Metro Manila at Cavite.
B. Mga Pamamaraan at mga Protokol

Ang pananaliksik na ito ay kinapapalooban ng mga sumusunod:(1)pagsusuri ng
mgarekord o talaan at (2)pangangasiwa ng questionnairesurvey.
Pagususuri ng mga Talaan. Pagkatapos aprubahan ang pananaliksik na ito ng

mga Commanding Officers ng 4 na mga ospital mg militar, ang tagapagpanaliksik ay
magpatuloy sa pagsusuri ng mga talaan o rekord sa kani kanilang Infection Control Units.
Pamamahagi ng self-report na palatanungan. Aking hinihiling na iyong sagutan
ang mga katanungan sa kasaysayanng pinsalang dulot ng pagkatusok ng karayom at
matatalim na bagay, ang mga pangyayari nakapalibot dito, at ang mga kasanayan sa
trabaho. Ikaw ay may layang sumagot o tumangging sagutin ang anumang mga
katanungan sa survey questionnaire. Kung mayroon kang hindi maintindihan,
mangyaring isulat ito at ipaalam sa mananaliksik. Nakahandang magbigay ng paliwanag
ang mananaliksik sa iyong mga katanungan.
K. PanganibatMga Benepisyo
Walang nakikinitang anumang panganib bilang resulta ng iyong paglahok sa pag-aaral
na ito o ikaw ay direktang makikinabang mula dito. Gayunpaman,ang mga natuklasan
mula sa pananaliksikna ito ay maaaring makatulong na makabuo ng mga istratehiya
upang makontrol ang pinsalang dulot ng pagkatusok ng karayom at matatalim na bagay
at maisulong ang kaligtasan sa lugar ng trabaho.
D. Ang Pagbabayad ng mga Gastos

Ang koleksyon ng mga datos ay gagawin sa hospital. Ang palatanungan ay masasagot sa
tinatayang 8 minuto at maaaring gawin sa oras ng break. Hindi bibigyan ng anumang
pera o regalo ang mga makikibahagi sa pananaliksik na ito.
E. Kusang-loob na Paglahok
Ang iyong paglahok sa pag-aaral na ito ay kusang-loob. Walang multa para sa hindi
lalahok o sa mga tumanggi magsagot ng isa o higit pang mga tanong. Maaari mo ring
bawiin ang iyong paglahok mula sa pag-aaral kung sa tingin mo ay hindi ka komportable
sa pagsasagot sa mga tanong.
G. Pagka-kumpidensyal
Lahat ng impormasyon na makakalap sa pag aaral na ito ay mananatiling konpidensyal at

maari lamang ilathala matapos makuha ang iyong pahintulot. Lahat ng mga tugon mo o
inpormasyong nakolekta namin ay mapapanatiling lihim. Sa anumang impormasyon
tungkol sa iyo ay may nakaatas na numero sa halip na iyong pangalan. Hindi ito
ibabahagi o ibibigay sa kahit sino maliban lamang sa mga mananaliksik na kasangkot sa
pag-aaral na ito at iba pang nangangasiwa ng pananaliksik tulad ng UPMREB Review
Panel Ethics na magkakaroon ng access sa impormasyon na iyong ibinigay. Sa oras na
makumpleto ng ang pag-aaral, ay sisirain ang lahat ng datos at hindi gagamitin para sa
anumang karagdagang pag-aaral.
H. Pagbabahagi ng Resulta
Pagkatapos na nakumpleto ang pag-aaral, aabisuhan ka tungkol sa kolektibong resulta ng

pag-aaral. Ipo-post ang mahalagang natuklasan sa iyong kaukulang Infection Control
Committee. Kung nais mong makita ang iyong mga tala, ikaw ay malayang makipag-
ugnayan sa tagapagpananaliksik. Ang resulta ng pananaliksik ay maaring ilathala para sa
isang mas malaking madla. Gayunpaman, pakitandaan na ang kumpidensyal na
impormasyon ay hindi ibabahagi at ang napag-alaman ay unang ipapakita sa iyo muna
bago ito ay dapat masa publiko.
I. Karapatang Tanggihan o Bawiin

Hindi sapilitan ang pagsali sa pananaliksik na ito. Hindi mo kailangang sumali sa
pananaliksik kung itoy hindi mo nais. Ang pagtangging lumahok ay hindi makakaapekto
sa iyong katayuan sa pagtatrabaho o mga gawaing pagsasanay (medical interns). Kung
iyong napagpasyahan bawiin ang mga impormasyong iyong binigay, ito ay sisirain at
hindi na gagamitin sa pag-aaral.
L. Kanino Maaring Makipa-Ugnay

Kung mayroon kang anumang mga katanungan o alalahanin patungkol sa pag-aaral na ito
o tungkol sa paraan naito ay isinasagawa, maaari kang makipag-ugnay sa
tagapagpanaliksik na si Michelle M Ibuna, RN sa michellemibuna@yahoo.com.ph o
saCP#09177111906.
Ang panukalang ito ay nasuri at naaprubahan ng UP ManilaResearch & Ethics Board

(UPM-REB) na isang komite na ang gawain ay upang matiyak ang kapakanan ng mga
kalahok sa pananaliksik na ito.
Para sa karagdagang impormasyong, makipag ugnayan kay:
Name:
Address: 2/f Paz Mendoza
547 Pedro Gil St
Ermita 1000 Manila
Email:upmreb@post.upm.edu.ph
Tel: +63 2 5222684
Mobile: +639273264910 or +639153080212
Tandaan: Ang informed consent na ito ay hango sa template ng WHO ERC ICF para sa
klinikal na pag-aaral.
PART II: Certificate of Consent
Nabasa koang nabanggit na impormasyon o ito ay binasa sa akin. Ako ay nagkaroon ng

pagkakataon upang magtanong tungkol ditto at anumang mga katanungan ay nasagot ng
naaayon. Sumasang-ayon ako at kusang-loob na lumalahok sa pananaliksik na ito.
Pangalan ng Kalahok _________________________________

Lagda ng Kalahok___________________________________
Petsa ___________________________________________
araw/buwan/taon
Pahayag ng tagapagpananaliksik/humihingi ng pahintulot

Tumpak kong binasa ang information sheet ayon sa potensyal na mga kalahok,at sa abot
ng aking makakakaya at naipaliwanag din na ang mga sumusunod na pamamaraan ay
gagawin upang suportahan ang aking pananaliksik.
1. Pamamahagi ng self-report na mga palatanungan
2. Pagsusuri ng mga Talaan
Kinukumpirma ko na ang kalahok ay binigyan ng pagkakataon upang magtanong tungkol
sa pag-aaral, at lahat ng mga katanungan ng mga kalahok ay nasagot ng tama at sa abot
ng aking makakakaya. Kinukumpirma ko na ang mga indibidwal nakalahok ay hindi
pinilit sa pagbibigay ng pahintulot at ang pahintulot ay malaya at kusang-loob na
ibinigay.
Ang isang kopya ng informed consent ay ibinigay sa mga kalahok.
Pangalanngtagapagpananaliksik/taong kumukuha ng pahintulot

___________________________________________________________
Lagda ng tagapagpananaliksik/taong kumukuha ng pahintulot

___________________________________________________________
Petsa_____________________________
Araw / buwan/ taon
Tandaan: Ang informed consent na ito ay hango sa template ng WHO ERC ICF para sa
klinikal napag-aaral.
Appendix C-1
NEEDLE STICK AND SHARPS INJURY QUESTIONNAIRE (NSSIQ)

Directions: Kindly answer appropriately the following questions. Please put check ( ) or
(x) on the boxes as it applies.
PART 1- SOCIODEMOGRAPHIC PROFILE

__________________________________________________________________
Name (Optional)
OCCUPATIONAL GROUP
Physician Nurse
Medical Technologists 1
Ancillary Staff
Age : ______________
from the last birthday
Gender a) Male
b) Female
Area of Assignment 1) Medical-surgical wards 6) Emergency Room

(for the last 12
2) Pediatrics 7) Operating Room/RR
months)
3) Orthopedic ward 8) Intensive care unit
4) OB/Gyne 9) Clinical Laboratory
5) Nursery/NICU
Length of Service (please specify):_____ years

Hours at work per shift 1) 8 hours
2) 12 hours
3) >12 hours
4) others, please specify: ___________________
Shift time
1) 7AM-3PM
2) 3PM-11PM
3) 11PM-6AM
4) others, please specify:__________
PART II. KNOWLEDGE ON UNIVERSAL PRECAUTIONS & WORK
PRACTICES
Directions: Please answer appropriately the following items:
Yes No
1. Do you know about the universal precautions guidelines?
2. Do you know about the needleless safety device?
3. Can hepatitis B be transmitted by needle stick and sharps

injuries?
4. Can Hepatitis C be transmitted by needle stick and sharps
injuries?
5. Can HIV/AIDS be transmitted by needle stick and sharp
injuries?
6. Do you need gloves during phlebotomy? (for physicians,
nurses, med tech)
7. Do you use gloves during phlebotomy? (for physicians, nurses,
med tech)
8. Do you wear gloves when withdrawing a needle from a patient?
(for physicians, nurses, med tech)
9. Should needles be recapped/bent after use?
10. Do you recap needles after use?
11. Do you disassemble used needle or sharps with your hands?
12. Do you wear gloves when disposing of contaminated needles

or sharps?
13. Do you separate the needle from the syringe prior to disposal?
14. Do you throw used needles or sharps into the sharp bin
immediately
15. Do you wear gloves when manipulating the sharp bin?
16. Do needle stick and sharps injuries need to be reported?
Adopted with permission from Rampal, et al (2010). Needle stick injuries and factors associated
among health care workers in Malaysian Hospital. European Journal of Social Sciences, 13
(3): 354-362
PARTIII. NEEDLE STICK AND SHARPS INJURIES HISTORY
Directions: Tick the box as it applies. There can be multiple responses in each item.
How many times in the past have you had needle stick and sharp object injury:
Last 12 months: ____ needle & sharp object (ampules, scalpel, etc)
>12 months: ____ needle & sharp object (ampules, scalpel, etc)
____ none at all
Activities at the time of needle stick & 1) recapping needle

sharps injuries 2) disassembling needle or sharp device
3) before use of item (item broke or slipped, assembling
device, etc)
4) during use of item (item slipped, patient jarred item, etc
5) after use, before disposal (disassembling device,
sorting, in transit to trash, device left on inappropriate
places, etc
6) disposal of needles and sharps
7) others, pls specify____________
What type of device caused 1) pre-filled syringe needle

the injury 2) hypodermic needles attached to a syringe
3) surgical instruments/sharps
4) glass (ampules, vacuum tube, etc.
5) intravenous catheter stylet
6) winged butterfly needle
7) lancet for skin prick
8) others, please specify:________________
If the injury was the hands, did the 1) single pair gloves
sharp item pentrates the: 2) double pair gloves
3) wasnt wearing any gloves at all
What did you do when you had the 1) nothing

injury? 2) washed with soap & water/water alone
3) cleaned with betadine/disinfectant
4) underwent the post-prophylaxis exposure protocol
5) others, please specify: ____________
Was the incident reported? 1) Yes
2) No
If yes, to whom: 1)colleague

2) immediate supervisor: identify____________
3) Infection Control Committee member
4) no one
PART IV.
Direction: Select all that applies.
What are the reasons for not 1) item was unused

reporting the 2) being too busy
Incident 3) not significant/did not know it is worth reporting
4) did not know whom to report to
5) fear of punitive response
6) belief that Hepatitis B vaccination is sufficient
7) others, please specify: ________________
Appendix C-2
NEEDLE STICK AND SHARPS INJURY QUESTIONNAIRE (NSSIQ)

(Filipino version)
Direksyon: Pakisagutan ang mga sumusunod ng naayon sa pamamagitan ng paglagay ng

tsek (/) or ekis (x) sa mga kahon.
UNANG BAHAGI- DEMOGRAPIKONG SOSYAL
___________________________________________________________________
Pangalan (Opsyonal)
TRABAHONG KINABIBILANGAN
Doktor Nars
Medical Technologist 1 Ancillary Staff
Edad : ______________
base sa huling kapanganakan
Kasarian a) Lalaki
b) Babae
Lugar kong saan 1) Medical-surgical wards 6) Emergency Room

Nakatalaga 2) Pediatrics 7) Operating Room/RR
(Sa nakalipas na 12 3) Orthopedic ward 8) Intensive care unit
buwan) 4) OB/Gyne 9) Clinical Laboratory
5) Nursery/NICU
Tagal ng serbisyo :_____ taon

Haba ng oras kada 1) 8 hours
shift
2) 12 hours
3) >12 hours
4) iba pa; tukuyin: _________________
Oras ng Pagtratrabaho 1) 7AM-3PM

2) 3PM-11PM
3) 11PM-6AM
5) iba pa; tukuyin: ____________
PANGALAWANG BAHAGI: KAALAMAN SA UNIVERSAL PRECAUTIONS
AT MGA KASANAYAN SA TRABAHO
Panuto: Sagutan ang mga sumusunod ng naaangkop. Lagyan ng tsek (/) ang OO kung ito
ay sa tingin mo ay tama at kung ito ay mali, lagyang ng tsek (/) ang HINDI.
OO HINDI
1. Alam mo ba ang mga alituntunin tungkol sa universal
precautions?
2. Alam mo ba ang tungkol sa paggamit ng needleless safety
device?
3. Maaari bang maipasa ang Hepatitis B sa pamamagitan ng
karayom at pinsalang dulot ng matatalim na bagay?
4. Maaari bang maipasa ang Hepatitis C sa pamamagitan ng
1. Maaari bang maipasa ang HIV o AIDS sa pamamagitan ng
6-9 Ang mga tanong ay para sa mga doktor, nars at medical
technologists
10.Binabalik mo bang muli ang takip ng karayom pag ito ay nakita
mong nakahiwalay sa heringgilya o syringe ?
11.Tinatanggal mo ba ang mga gamit na karayom o
mga matatalim sa pamamagitan ng walang proteksyon na
kamay?
12.Gumagamit ka ba ng guwantes tuwing magtatapon ng kontami-
nadong karayom o matatalim na bagay?
13.Pinaghihiwalay mo ba ang karayom at heringgilya (syringe)
bago mo itapon?
14.Itinatapon mo ba agad ang gamit na karayom at matatalim sa
tamang basurahan o sharps bin?
15.Gumagamit ka ba ng guwantes kapag hinahawakan ang
basurahan para sa mga karayom at matatalim na bagay?
16.Kinakailangan bang i-report ang anumang pinsala o sugat dulot
ng pagkatusok ng karayom at matatalim na bagay?
Hango sa pag aaral na isinagawa nila Rampal, et al (2010). Needle stick injuries and factors
associated among health care workers in Malaysian Hospital. European Journal of Social
Sciences, 13 (3): 354-362
PANGATLONG BAHAGI: NEEDLE STICK AND SHARPS INJURIES HISTORY
Panuto: Lagyan ng tsek ang kahon. Maaaring magkaroon ng mahigit sa isang sagot
sa bawat tanong.
Ilang beses sa mga nakaraang buwan ka nagkaroon ng pinsala sanhi ng karayom at

matatalim na bagay?
Nakalipas na 12 buwan ______ karayom at matatalim na bagay
Mahigit sa 12 buwan_________karayom at matatalim na bagay
____ hindi kahit kelan
Mga gawain nung nangyari ang 1) pagbalik ng takip ng karayom

pinsala dulot ng pagkatusok ng 2) paghihiwalay ng parte ng karayom at matatalim na
karayom at matatalimna bagay bagay
3) bago gamitin ang bagay (itoy nabasag, nahulog o
habang ito ay inaayos, atbp)
4) habang ito ay ginagamit ( nadulas ang gamit,
nagalaw o natabig ng pasyente, atbp)
5) pagkatapos gamitin (paghihiwalay ng partes, pag
aayos ng mga gamit,bago ito ay itapon, ang karayom o
sharps ay naiwan sa maling lugar, atbp)
6) pagtatapon ng mga karayom at matatalim na bagay
7) ang iba, tukuyin: ___________________
Anong klaseng aparato ang nagiging 1) karayom ng heringggilya (syringe)

sanhi ng pinsala? 2) nakakabit na karayom sa isang heringgilya
3) mga instrumentong matatalim na karamihan na gamit
pang opera
4) mga babasaging bagay (ampules,vacuum tube, atbp)
5) intravenous catheter stylet
5) winged butterfly needle
6) lancet gamit panusok sa balat
8) ang iba, tukuyin:___________________
Kung ang naapektuhan ay ang mga 1) isang pares na guwantes

kamay, pumasok ba sa: 2) dalawang pares na guwantes
3) walang suot na guwantes
Ano ang ginawa mo ng 1) walang ginawa
nangyari 2) hinugasan ng sabon at tubig
ang pinsala? 3) nilinis ng betadine o disinfectant
4) sumailalim sa post-prophylaxis exposure protocol
5) ang iba, tukuyin: _______________
Pinagbigay alam mo ba ang 1) oo

insidente? 2) hindi
Kung Oo, kanino? 1) kasamahan sa trabaho
2) superbisor: : tukuyin:_________________
3) miyembro ng Infection Control Committee
4) wala kahit isa
PANG- APAT NA BAHAGI:

Direksiyon: Piliin ang lahat na naangkop.
Mga rason bakit hindi 1) hindi pa nagamit ang aytem

naipagbigay 2) masyadong abala
alam ang insidente 3) hindi naman makabuluhan kung ipaalam
4) hindi alam kung kanino ipagbigay alam
5) takot sa anumang parusa dahil sa pagkakamali
6) paniniwala na ang bakuna sa hepatitis B
ay sapat na
7) ang iba, tukuyin: ______________
Appendix D- Records Review
SUMMARY OF THE REVIEW OF RECORDS OF PHYSICIANS, NURSES, MED

TECHNOLOGISTS & ANCILLARY STAFF (2011-2015)
Physicians Nurses Med Tech Ancillary TOTAL

Staff
n % n % n % n % N %
Prevalence 5 2.7 115 61.2 51 27.1 17 9.0 188 100
Location where the injury happened
ER 2 40 1 0.9 2 3.8 5 29.4 10 5.4
OR/RR 12 10.4 1 5.9 13 7.0
ICU 1 20 15 13.0 8 47.0 24 12.8
Medical surgical wards 2 40 79 68.7 13 25.5 1 5.9 95 50.6
OB/Gyne 5 4.3 1 2.0 1 5.9 7 3.8
Nursery/NICU 3 2.7 3 1.6
Laboratory 34 66.7 1 5.9 35 18.7
others 1 2.0 1 0.01
Type of device that caused the
injury
Prefilled syringe needle 4 80 3 2.6 48 94 13 76.5 3 1.5
Hypodermic needle attached to a 81 70.4 146 77.7
syringe 8 7.0 2 4 3 17.6 8 4.3
Surgical instruments/sharps 2 1.7 7 3.7
Glass-ampules, etc 7 6.1 1 5.9 7 3.7
Intravenous catheter stylet 1 0.9 2 1.1
Winged butterfly needle 1 20 4 3.5 1 2 4 2.1
Lancet for skin prick 9 7.8 11 5.9
Others, specify
Activities at the time of injury
(available data-2013 & 2014 only)
Before use of item 2 4.9 2 2.7
Recapping needles 9 22.0 7 38.9 1 7.7 17 22.7
During use of item 3 100 14 34.1 2 11.0 19 25.3
After use of item, before disposal 12 29.2 7 38.9 1 7.7 20 26.7
Disposal of needles and sharps 10 76.9 10 13.3
Disassembling needles or sharps 2 4.9 1 5.6 3 4.0
Others; specify 2 4.9 1 5.6 1 7.7 4 5.3
Appendix E-1
Letter to Commanding Officers/Chief Nurses

College of Nursing
COL EDWIN LEO T TORRELAVEGA MC (GSC)

Commanding Officer
V. Luna General Hospital
AFP Medical Center, Quezon City
Dear COL TORRELAVEGA,
The undersigned is currently taking her Master of Arts in Nursing major in

Nursing Administration at the University of the Philippines, Manila and is working on a
research study entitled, Prevalence and Associated Factors of Needlestick and Sharp
Injuries among Health Care Workers in Military Hospitals. The study aims to determine
the prevalence and factors associated with needle stick injuries and sharp objects among
health care workers in selected military hospitals in Metro Manila and Cavite.
In this connection, may I request permission to carry out the research study in
your hospital? Please be assured that informed consent will be obtained from all the
participants in the study. The participation of the subjects will be entirely voluntary and
they will not be required to spend more time on the study than is necessary. All data
gathered will be treated with utmost confidentiality and will be utilized for research
purposes only. The capsule proposal, informed consent and self-report questionnaires are
attached for your perusal.
I sincerely hoped for your favorable consideration. Your support would surely
bring depth and substance to this research endeavor.
Sincerely yours,
MAJ MICHELLE M IBUNA NC

MAN Student
Appendix E-2

College of Nursing
COL MA VICTORIA P JUAN NC (GSC)

Chief Nurse, VLGH
V. Luna Avenue, Quezon City
Pasay City
Dear COL JUAN,

Sincerely yours,

MAN Student
Appendix E-3

College of Nursing
COL VILLAMIN F PATRICIO MC (GSC)

Commanding Officer
Army General Hospital, Taguig City
Dear COL PATRICIO,

Sincerely yours,

MAN Student
Appendix E-4

College of Nursing
COL RUBY P EVANGELIO NC (GSC

Chief Nurse
Army General Hospital, Fort Bonifacio
Taguig City
Dear COL EVANGELIO,

Sincerely yours,

MAN Student
Appendix E-5

College of Nursing
LTC JONATHAN H MANUEL MC (GSC)

Commanding Officer
Air Force General Hospital, Villamor Air Base
Pasay City
Dear LTC MANUEL,

Sincerely yours,

MAN Student
Appendix E-6

College of Nursing
COL RUDITH VIVIENNE C VILLANUEVA NC (GSC)

Chief, Nursing Service
Air Force General Hospital, Villamor Air Base
Pasay City
Dear COL VILLANUEVA,

Sincerely yours,

MAN Student
Appendix E-7

College of Nursing
COL RAMON H TAN MC (GSC)

Commanding Officer
Cavite Naval Hospital, Fort San Felipe
Cavite City
Dear COL TAN,

Sincerely yours,

MAN Student
Appendix E-8

College of Nursing
COL GRACE A INFANTE NC (GSC)

Chief Nurse, Cavite Naval Hospital
Fort San Felipe, Cavite City
Dear COL INFANTE,

Sincerely yours,

MAN Student
Appendix E-9
Letter to Commanding Officers/Chief Nurse

College of Nursing
11 December 2014
PSUPT MARIA CHONA SEVILLANO WAMILDA

Chief Nurse, PNP General Hospital
Camp Crame, Quezon City
Dear Madame,

In this connection, may I request permission to carry out the pilot study of the
Filipino version of the Informed Consent Form and the Needle Stick and Sharp Injuries
Questionnaire among nursing attendants, midwives, institutional workers and corpsmen
in your hospital? The purpose of this pilot study is to determine the comprehensibility
and appropriateness of the tool which will be used for the actual research study in
selected military hospitals. The participation of the subjects will be entirely voluntary and
purposes only.
Sincerely yours,

MAN candidate
Appendix F
Letter correspondence with the authors for the use of the Knowledge on Universal
Precautions and Work Practices Questionnaire
To: rampal@medic.upm.edu.my rosidah_zakaria@yahoo.com

Mar 31, 2014
Sir/Madame:
I am Michelle M Ibuna, a registered nurse and currently enrolled in the
University of the Philippines, College of Nursing for my Master of Arts in
Nursing Major in Nursing Administration. I am now writing my thesis paper
entitled Prevalence and Associated Factors on Needlestick and Sharps Injuries in
the four (4) military hospitals in the country. The assessment findings are
important in policy making especially on needle stick and sharps safety programs.
In the review of literature, I came across on your study on Needle stick and Sharp
Injury and Factors Associated Among Health Care Workers in a Malaysian
Hospital. With our country as a hyper endemic in Hepa B virus and the increasing
cases of HIV and HCV, it's high time that our health care workers will be aware
of these problems and develop measures/ strategies to prevent them.
In this regard, may I ask for permission to use the questionnaire you used
in your data collection? I agree to any terms and condition for the approval of the
use of the questionnaires. Rest assured, you will also be properly acknowledge in
my paper. Thank you and more power.
MAJ MICHELLE MISLANG IBUNA NC

C, Nursing Service Management Branch
Office of the Chief Nurse Air Force
Col Jesus Villamor Air Base, Pasay City
Tel no. 09177111906, 09328906402
02-8534947
LEKHRAJ RAMPAL A/L GYANCHAND RAMPAL

To : me
Apr 3, 2014
Dear Major Michelle,
You are most welcome.
Prof. Dr. Lekhraj Rampal

MBBS, MPH, DrPH, FAMM ,FAMS, FPHMM
LEKHRAJ RAMPAL A/L GYANCHAND RAMPAL

lekhraj@upm.edu.my
michelle ibuna <michellemibuna@yahoo.com.ph>
rampal@medic.upm.edu.my <rampal@medic.upm.edu.my> , rosidah_zakaria@yahoo.com

<rosidah_zakaria@yahoo.com>
Appendix G- UPMREB Approval
Appendix H- AFPMC Ethics Review Board Approval;
Appendix I- Infection Control Manual (AFPMC)
SECTION 3
SHARPS AND NEEDLE STICK INJURIES
3.1 SAFE HANDLING, USE AND DISPOSAL OF SHARPS
Sharp items used for nursing procedures; including needles, lancets, scalpel and
similar items, are handled with extreme caution. These items may provide a route of
transmission for bloodborne pathogens or may be used by a patient to harm him/herself
or others. Doctors and/or nurses using sharps are responsible for the safe use and disposal
of these items immediately after use.
Policies:
1. Whenever a sharp item or instrument is used during a procedure, nursing
staff is responsible for monitoring its appropriate use and disposal.
2. A designated nurse monitors the number of sharps used in a procedure
assures that all are safely removed and returned to the appropriate area, or
are disposed of properly.
3. After use, NO sharp is recapped or re-covered. All sharps used in
patient procedures at the hospital are single use items.
4. Sharps are disposed of in appropriately identified, impenetrable sharps
containers.
5. Sharps containers are replaced, sealed and disposed of according to
infectious waste management guidelines when they are full.
6. Assistance is appropriate when completing procedures with a sharp item
or instrument, for protection of both patient and staff.
7. Any exposure to a used or contaminated sharp is reported. The employee
follows the guidelines in the policy of needle stick injury.
3.2 NEEDLESTICK INJURIES OR EXPOSURES TO BLOOD AND/OR BODY

FLUID
Health care workers exposed to blood or body fluids with direct needle stick
injury are considered potentially at risk for Human Immunodeficiency Syndrome (HIV),
Hepatitis B virus infection (HBV) and Hepatitis C virus infection (HCV). Rapid
assessment of hospital exposed by needlestick injuries is essential to ensure timely work
up and prophylaxis as needed. Likewise, such incidents should be fully documented for
relevant medicolegal purposes and probable workers compensation as may be
appropriate.
3.2.1 IMMEDIATE CARE OF THE EXPOSED
After exposure to blood or other body substance the healthcare workers should do
the following as soon as possible:
Wash the exposure site with soap and water;

If eyes are contaminated, rinse them, then while they are open, gently but
thoroughly run clean water;
If blood or other body substances get in the mouth, spit them out and then rinse
the mouth with water several times;
If clothing is contaminated, remove clothing and shower if necessary;
Refer said exposed healthcare worker to the Infectious Ward for further
evaluation and management by the Infectious Disease consultant/resident-on-
duty;
Where water is not available use of no-water cleanser or antiseptic should replace
the use of soap and water for washing cuts or punctures of the skin.
3.2.2. RISK ASSESSMENT
Personal suffering from needlestick injury shall fill up a hospital form stating
the details of the incident including:
a. Name and position
b. Date and time
c. Ward or area
d. Nature of item that caused (used or unused, gauge of needle or sharps,
direct contact with blood, etc)
e. Extent of injury
f. Nature of the body substance where the healthcare is potentially exposed
(positive or negative for HBV, HIV or HCV)
Exposed health care workers should have baseline HIV, HBV and HCV
testing if significant amount of exposure is noted. Pre and post counseling
must be given and informed consent given as per DOH protocol for HIV
testing.
Blood collected from the health care worker may be stored for future testing if
required.
Health care worker potentially at risk for HIV, HBV or HCV by needle stick
injury shall be advised on the following for the next 6 months or until cleared
by serologic studies:
a. Not to donate plasma, blood, body tissue, breast milk or sperm
b. To protect sexual partners by safe sexual practices (use of condoms)
c. Seek medical advice on pregnancy and lactation
d. Seek immediate medical consultation for any signs or symptoms of illness

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Appendix A-1

University of the Philippines Manila

I am a graduate student of the University of the Philippines, College of Nursing

Very truly yours,

Giliw kong mga tagasagot,

Ako ay gradwadong mag-aaral ng Unibersidad ng Pilipinas Manila, Kolehiyo ng

Sa sandaling natapos po ninyo ang sarbey ay ipagbigay alam sa akin pamamagitan ng

Ang inyong suporta sa pamamagitan ng paglahok na ito ay malugod kong

A. Purpose of the Research

B. Procedures and Protocols

G. Sharing the Results

H. Right to Refuse or Withdraw

Print Name of Participant _________________________________

Statement by the researcher/person taking consent

Pamagat ng Pagsasaliksik: Prevalence and associated factors of needle stick and

Ikaw ay malugod na inaanyayahan na makibahagi sa pag aaral na ito.Bago kamagpasya

B. Mga Pamamaraan at mga Protokol

Pagususuri ng mga Talaan. Pagkatapos aprubahan ang pananaliksik na ito ng

D. Ang Pagbabayad ng mga Gastos

Lahat ng impormasyon na makakalap sa pag aaral na ito ay mananatiling konpidensyal at

Pagkatapos na nakumpleto ang pag-aaral, aabisuhan ka tungkol sa kolektibong resulta ng

I. Karapatang Tanggihan o Bawiin

L. Kanino Maaring Makipa-Ugnay

Ang panukalang ito ay nasuri at naaprubahan ng UP ManilaResearch & Ethics Board

Para sa karagdagang impormasyong, makipag ugnayan kay:

PART II: Certificate of Consent

Nabasa koang nabanggit na impormasyon o ito ay binasa sa akin. Ako ay nagkaroon ng

Pangalan ng Kalahok _________________________________

Pahayag ng tagapagpananaliksik/humihingi ng pahintulot

Ang isang kopya ng informed consent ay ibinigay sa mga kalahok.

Pangalanngtagapagpananaliksik/taong kumukuha ng pahintulot

Lagda ng tagapagpananaliksik/taong kumukuha ng pahintulot

NEEDLE STICK AND SHARPS INJURY QUESTIONNAIRE (NSSIQ)

PART 1- SOCIODEMOGRAPHIC PROFILE

Area of Assignment 1) Medical-surgical wards 6) Emergency Room

Length of Service (please specify):_____ years

1. Do you know about the universal precautions guidelines?

2. Do you know about the needleless safety device?

3. Can hepatitis B be transmitted by needle stick and sharps

10. Do you recap needles after use?

11. Do you disassemble used needle or sharps with your hands?

12. Do you wear gloves when disposing of contaminated needles

15. Do you wear gloves when manipulating the sharp bin?

16. Do needle stick and sharps injuries need to be reported?

Activities at the time of needle stick & 1) recapping needle

What type of device caused 1) pre-filled syringe needle

What did you do when you had the 1) nothing

If yes, to whom: 1)colleague

What are the reasons for not 1) item was unused

NEEDLE STICK AND SHARPS INJURY QUESTIONNAIRE (NSSIQ)

Direksyon: Pakisagutan ang mga sumusunod ng naayon sa pamamagitan ng paglagay ng

UNANG BAHAGI- DEMOGRAPIKONG SOSYAL

Lugar kong saan 1) Medical-surgical wards 6) Emergency Room

Tagal ng serbisyo :_____ taon

Oras ng Pagtratrabaho 1) 7AM-3PM

Ilang beses sa mga nakaraang buwan ka nagkaroon ng pinsala sanhi ng karayom at

Mahigit sa 12 buwan_________karayom at matatalim na bagay

____ hindi kahit kelan

Mga gawain nung nangyari ang 1) pagbalik ng takip ng karayom

Anong klaseng aparato ang nagiging 1) karayom ng heringggilya (syringe)

Kung ang naapektuhan ay ang mga 1) isang pares na guwantes

Pinagbigay alam mo ba ang 1) oo

PANG- APAT NA BAHAGI: