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Compliance Level among Healthcare Workers of Rural Health Units
on the Standard Infection Prevention and Control
Windy M. Luzon, Rm, Rn, Man., Ara L. Barlizo, Rm, Rn, Man., Ronald C. Abaño, Rn, Man., Marjorie
R. Andalis, Rm, Rn, Man., Joyce N. Olea, Rn, Man., Bernadette F. Martirez, Rn, Man
College of Health Care Education, University of Saint Anthony, Baao, Camarines Sur, Philippines
DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000490
Received: 03 November 2025; Accepted: 10 November 2025; Published: 17 November 2025
INTRODUCTION
In the landscape of community healthcare, the battle against the transmission of infectious diseases is a
concern and underscored by the global impact of healthcare-associated infections (HAIs). These infections,
which afflict millions annually, not only exacerbate patient suffering through extended recovery times and
potential long-term health issues but also impose a heavy financial burden on healthcare systems. The
prevalence of healthcare-associated infections can surpass those in more affluent areas by a significant margin,
highlighting the critical need for robust infection prevention and control strategies. Within community
healthcare settings, where interactions between healthcare providers and patients are frequent, and resources
may be scarce, implementing effective infection prevention and control protocols is a significant challenge and
an essential requirement to protect public health and prevent the spreading of potentially deadly infections.
Moreover, ensuring strict adherence to infection prevention and control measures within community healthcare
environments is important for the safety of both patients and healthcare workers. Recent World Health
Organization (WHO) findings have long emphasized the significance of IPC measures in safeguarding
healthcare quality and patient safety. According to the World Health Organization (2023), good hand hygiene
and other cost-effective IPC measures can prevent up to 70% of HAIs. Despite this, the prevalence of HAIs
remains alarmingly high, with seven patients in high-income countries and 15 in low- and middle-income
countries acquiring at least one HAI for every 100 patients in acute-care hospitals. The impact of HAIs extends
beyond patient morbidity and mortality, contributing to increased healthcare costs and exacerbating the burden
of AMR. The WHO's first-ever global report on infection prevention and control highlights the vast disparities
in infection prevention and control implementation program across regions, with high-income countries being
eight times more likely to have a more advanced infection prevention and control implementation status than
low-income countries.
In the Philippines, the importance of infection prevention and control has been underscored by the COVID-19
pandemic, highlighting the need for preparedness among healthcare facilities to prevent and manage infectious
diseases effectively. A study assessing the compliance of public hospitals and temporary treatment and
monitoring facilities (TTMFs) with infection prevention and control standards revealed varying levels of
preparedness and compliance across different domains of infection prevention and control practices. Public
hospitals reported sufficient infection prevention and control preparedness and compliance compared to
temporary treatment and monitoring facilities, particularly in engineering and administrative controls (De
Claro, 2023).
The Department of Health (DOH) has implemented policies to enhance infection prevention and control (IPC).
The DOH Administrative Order 2022-0051 outlines a revised national policy for IPC in all health facilities,
while DOH Department Circular 2021-0447 disseminates the updated Manual of National Standards in IPC for
Health Facilities. These guidelines provide a comprehensive framework for healthcare institutions to
implement effective IPC measures, emphasizing key areas such as hand hygiene, environmental cleaning, and
proper waste management.
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Possessing an in-depth knowledge of infection prevention and control practices is paramount. This expertise
protects individuals from spreading infectious diseases and protects public health systems against potential
outbreaks. By understanding and implementing rigorous hygiene protocols, proper use of Personal Protected
Equipment (PPE), prevention of needlestick and sharp injuries, and environmental cleaning and disinfection,
healthcare professionals and the public can significantly reduce the incidence of infections. This, in turn,
alleviates the strain on healthcare resources, diminishes economic burdens associated with disease
management, and, most importantly, saves lives. Thus, comprehensive infection prevention and control
knowledge is a cornerstone of a resilient and effective healthcare system.
As an IPC Nurse and frequent client at the Rural Health Unit, the researcher has experienced both sides of
healthcare delivery, witnessing gaps in infection prevention practices while understanding the unique
challenges faced by rural facilities. This dual role has sparked a personal commitment to improving IPC
standards, recognizing that enhanced education and compliance are important for protecting both healthcare
workers and clients in resource-limited settings. The researcher's professional expertise in IPC and firsthand
experience as a service recipient provide a distinctive perspective that emphasizes the urgent need for this
study to strengthen infection control measures in rural healthcare facilities.
Theoretical Framework
This study's theoretical framework comprises a model and a theory: Florence Nightingale's Environmental
Theory and Imogene King's Goal Attainment Theory. These theories play important roles in understanding
the compliance level among healthcare workers of Rural Health Units with standard infection prevention and
control.
Florence Nightingale's Environmental Theory is a fundamental concept in nursing and public health that
emphasizes the role of the environment in the healing process. This theory posits that health and disease are
significantly influenced by environmental factors such as clean air, water, and sanitation. In the context of
Rural Health Units (RHUs), where resources may be limited, applying this theory can be both challenging and
essential for preventing and controlling infections.
The application of Nightingale's Environmental Theory in evaluating RHUs involves assessing how these
facilities manage their environments to support health and recovery. This includes examining factors such as
cleanliness, ventilation, access to natural light, and overall hygiene practices. By using this theoretical
framework, healthcare professionals can critically analyze compliance with national standards, identify gaps in
environmental management, and pinpoint potential infection risks. This approach provides a method for
evaluating infection prevention standards and offers guidance for improving public health outcomes in
resource-constrained settings, potentially serving as a cost-effective strategy for enhancing infection
prevention and control in RHUs.
Imogene King's Goal Attainment Theory emphasizes the collaborative process between nurses and patients
to set and achieve health-related goals. This theory is particularly relevant in understanding compliance in
infection prevention and control as it highlights the importance of communication, mutual goal setting, and
interaction between healthcare workers and their environment. According to
King, effective nursing involves a dynamic process of action, reaction, and interaction in which the nurse and
patient share information and set goals together
This theory suggests that healthcare workers can improve compliance with Infection control standards by
actively involving patients in their care processes. By setting mutual goals related to hygiene practices and
infection prevention, healthcare workers can foster a sense of ownership among patients, which may lead to
better adherence to recommended practices. The theory also underscores the importance of understanding
individual perceptions and roles within the healthcare setting, which can help address specific barriers to
compliance.
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Conceptual Framework
This study utilizes the systems view of research which includes the input, process, and output model, which is
demonstrated in the conceptual paradigm of this study is illustrated in Figure 2.
The Input included the demographic profile of the respondents based on age, sex, civil status, educational
attainment, designation, length of service, and related training attended. Aside from the demographic profiles,
the researcher analyzed compliance level among healthcare workers of Rural Health Units on the standard
infection prevention and control along with hand hygiene practices, use of Personal Protective Equipment
(PPE), prevention of needlestick and sharp injuries, and environmental cleaning and disinfection and
determined challenges encountered by healthcare workers of Rural Health Units affecting the compliance with
the standard in infection prevention and control along with resource constraints, infrastructure and facility
limitations, and human resource challenges.
The Process involved preparation of questionnaire, data gathering through questionnaire, retrieval of
questionnaires, analysis and interpretation of data, testing the significant relationship, and formulation of
proposed strategies to enhance the compliance level among healthcare workers of Rural Health Units on the
standard infection prevention and control.
The Output of the study is a training guide on Standard infection Prevention and Control Procedure and
Policy provide clear, actionable guidelines and standardized practices across all RHUs. It includes detailed
policies and procedures for each IPC component, thus aims to enhance the knowledge and skills of healthcare
workers, ultimately improving patient safety and healthcare quality in rural settings.
Finally, the researcher adopted a feedback loop so that the output of this study provides insights and
information about the proposed strategies to be done.
The feedback shall present a continuing improvement phase on the proposed strategy as it will be implemented
and the study variables’ efforts. This improvement to the proposed strategy has to be made to ensure effective
delivery among healthcare workers of Rural Health Units to enhance adherence to standard infection
prevention and control practices.
Figure 2 Conceptual Paradigm
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Statement of the Problem
The study focuses on determining the compliance level among healthcare workers of Rural Health Units on the
standard infection prevention and control. Specifically, it sought to answer the following:
1. What is the demographic profile of the respondents in terms of:
a. Age
b. Sex
c. Civil Status
d. Educational Attainment
e. Designation
f. Length of Service
g. Related Training Attended
2. What is the compliance level among healthcare workers of Rural Health Units on the standard infection
prevention and control along:
a. Hand Hygiene Practices
b. Use of Personal Protective Equipment (PPE)
c. Prevention of Needlestick and Sharp Injuries
d. Environmental Cleaning and Disinfection
3. Is there a significant relationship between the demographic profile and compliance level among healthcare
workers of Rural Health Units on the standard infection prevention and control?
4. What are the challenges encountered by the healthcare workers of Rural Health Units affecting the
compliance level with the standard in infection prevention and control along:
a. Resources
b. Infrastructure and facility
c. Human resource
5. What strategies maybe proposed to enhance the compliance level among healthcare workers of Rural Health
Units on the standard infection prevention and control?
Assumptions of the study
The following assumptions guided the study:
1. The profile of the respondents varies.
2. The compliance level with standard in infection prevention and control is compliant among healthcare
workers of Rural Health Units.
3. There are challenges encountered by healthcare workers of Rural Health Units that affect the compliance
level with the standard in infection prevention and control.
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4. There are strategies that could be proposed to enhance the compliance level among healthcare workers of
Rural Health Units on the standard infection prevention and control.
Hypothesis of the Study
H
0
: There is no significant relationship between the respondents’ profile and the compliance level among
healthcare workers of Rural Health Units on the standard infection prevention and control.
Significance of the Study
The findings of the study are expected to be of great importance to the following:
Healthcare Workers. The benefit of the study is gaining insights into the areas where compliance with
infection prevention and control standards may be lacking. This understanding can lead to targeted training
programs, provision of necessary resources, and implementation of protocols to improve adherence to
standards, thus enhancing the safety of both patients and healthcare workers.
5
th
District of Camarines Sur Residents. The study's findings directly impact client and residents of the 5th
District of Camarines Sur by ensuring safer medical services, reducing infection risks during facility visits, and
preventing disease transmission, ultimately contributing to improved community health outcomes and
population well-being.
Department of Health Personnel. The findings of this study will benefit as it provides valuable insights into
the overall state of infection prevention and control practices in Rural Health Units. The Department of Health
can utilize this information to formulate policies, allocate resources, and develop training programs to improve
compliance across the healthcare system, thereby enhancing public health outcomes.
Researcher. Through this study, the researcher will gain knowledge and expertise in the field of infection
prevention and control, particularly in rural healthcare settings. The findings contribute to the existing body of
literature on this topic and may guide future research directions. Additionally, the researcher may use the
study's results to advocate for policy changes or interventions to improve infection prevention and control
practices in Rural Health Units.
Future Researchers. The study provides a foundation for future research endeavors related to infection
prevention and control in rural healthcare settings. It offers insights into potential areas for further
investigation, such as the effectiveness of specific interventions or the impact of socioeconomic factors on
compliance with standards. Future researchers can build upon the study's findings to deepen understanding and
address remaining gaps in knowledge.
Scope and Delimitation
The research thoroughly discussed the analysis of compliance level with standard infection prevention and
control among Rural Health Units in the 5
th
District of Camarines Sur, along with hand hygiene practices, use
of Personal Protective Equipment (PPE), prevention of needlestick and sharp injuries, environmental cleaning
and disinfection, and education and training, and also the challenges faced by Rural Health Units in
compliance with the standard in infection prevention and control along with resources, infrastructure and
facility, and human resource challenges.
The respondents were delimited to healthcare providers consisting of a total enumeration of 147 healthcare
workers from different Rural Health Units in the 5
th
District of Camarines Sur. In Rural Health Unit – Baao I
and II, it included 2 Doctors, 13 Nurses, 15 Midwives, 2 Sanitary Inspector, and 1 Medical Technologist. Rural
Health Unit – Balatan had 1 Doctor, 14 Nurses, 4 Midwives, 1 Sanitary Inspector, and 1 Medical Technologist.
At Rural Health Unit – Bato, the staff consisted of 3 Doctors, 17 Nurses, 8 Midwives, 1 Sanitary Inspector, and
1 Medical Technologist. Rural Health Unit – Bula I and II employs 2 Doctors, 20 Nurses, 15 Midwives, 2
Sanitary Inspectors, and 1 Medical Technologist. Lastly, Rural Health Unit – Buhi I and II has 2 Doctors, 11
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Nurses, 7 Midwives, 2 Sanitary Inspectors, and 1 Medical Technologist. One of the RHUs declined to take part
in the research. This study was conducted from August 2024 up to December 2024.
Definition of Terms
To facilitate understanding and comprehension, the terms used have been defined conceptually and
operationally:
Compliance is the act or process of complying with a desire, demand, proposal, and regimen. In the study, it
refers to the extent to which healthcare workers in Rural Health Units consistently adhere to and correctly
execute the prescribed infection prevention and control protocols and guidelines.
Healthcare workers an individual engaged in activities aimed at enhancing health involved in patient care
within the healthcare sector. In the study, these are licensed professionals and support staff employed in Rural
Health Units who are directly or indirectly involved in the delivery of healthcare services, including doctors,
nurses, midwives, medical technologists, sanitary inspectors.
Standard Infection Prevention and Control is a practical, evidence-based approach preventing patients and
health workers from being harmed by avoidable infections. In the study, it is the practices and procedures
implemented by healthcare workers to minimize the risk of spreading infections within the RHU, including
hand hygiene, use of personal protective equipment, prevention of needlestick and sharps injury, and
environmental cleaning.
Rural Health Unit is a government-operated health facility located in rural areas. It provides primary health
care services to the community it serves. This includes outpatient care, maternal and child health care,
immunizations, minor surgical procedures, and health education. In the study, it is a primary healthcare
facility situated in rural communities where healthcare workers are expected to implement and adhere to
standard infection prevention and control protocols while delivering basic medical services to the local
population.
5
th
District of Camarines Sur is a district located in the province of Camarines Sur, in the Bicol Region of the
Philippines. The district comprises several municipalities and city: Baao, Bato, Balatan, Buhi, Bula, Nabua,
and Iriga City.
REVIEW OF RELATED LITERATURE AND STUDIES
This section presents a summary of the relevant literature supporting the study. This review has provided the
researcher with a broader perspective on generating concepts and further understanding of the study.
Compliance level with standard Infection Prevention and Control
The WHO Global Report on Infection Prevention and Control (2024)
highlights the challenge of healthcare-
associated infections (HAIs), which continue to pose significant threats to patient safety and healthcare quality
worldwide. These infections not only cause substantial patient suffering and premature deaths but also serve as
major drivers of antimicrobial resistance (AMR). The report emphasizes that while recent outbreaks like
COVID-19, Ebola, Marburg, and Mpox have dramatically demonstrated infection risks in healthcare settings,
HAIs remain a daily concern in hospitals and clinics globally. Importantly, the report points out that many of
these infections are preventable through proper infection prevention and control (IPC) measures and basic
water, sanitation, and hygiene (WASH) services, offering a high return on investment for healthcare systems.
This comprehensive document provides updated evidence on HAI-related harm. It examines the
implementation of IPC programs across all WHO regions, serving as a resource for improving global
healthcare safety standards.
Moreover, the Centers for Disease Control and Prevention (CDC) has established a set of fundamental
infection prevention and control practices essential for ensuring safe healthcare delivery across various
settings. These core practices, which are applicable to inpatient and outpatient environments, include the
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implementation of standard precautions such as hand hygiene, environmental cleaning, and safe injection
practices. Additionally, CDC has introduced new practices to enhance medication safety by preparing
medications in clean areas away from contamination sources and minimizing potential exposure to infectious
agents through early detection and management of potentially infectious individuals. These practices are
designed to serve as a baseline for healthcare facilities to prevent the transmission of infections and are
expected to be integrated into the routine protocols of healthcare personnel.
According to Elkanafany (2024), Infection Prevention and Control (IPC) is a comprehensive scientific
approach that aims to protect both patients and healthcare workers from harmful infections. Thoroughly
examine how infectious diseases spread and the various methods to control them, from basic community-level
interventions to sophisticated healthcare facility protocols. It emphasizes that effective IPC is fundamental to
patient safety and health system strengthening, with statistics showing that proper implementation can reduce
healthcare-associated infections by at least 30%. The aspects such as the epidemiological triad, standard
precautions in healthcare settings, and the importance of environmental cleaning while also addressing broader
societal factors like education and urban development that influence infection control. A particularly
noteworthy aspect is its global perspective, discussing how IPC measures vary between developed and
developing countries, where up to 7% and 10% of patients, respectively, acquire at least one healthcare-
associated infection during their care.
In addition, Mark Cole (2023) work on emotional intelligence (EI) emphasizes its critical role in infection
prevention and control. He argues that EI, which encompasses the ability to understand, use, and manage
emotions in positive ways to relieve stress, communicate effectively, empathize with others, overcome
challenges, and defuse conflict, is a vital asset for healthcare professionals. Cole suggests that by harnessing
EI, individuals in the healthcare sector can significantly enhance their ability to manage and respond to the
complex emotional and social dynamics encountered in infection control practices. This approach not only
improves the effectiveness of infection prevention strategies but also fosters more supportive and
responsive healthcare environment.
In her work, Heather Loveday (2021) examines the challenges and learning opportunities presented by the
COVID-19 pandemic in infection prevention and control (IPC). She highlights the unprecedented
epidemiological, operational, behavioral, and policy hurdles that IPC services worldwide have encountered to
curb the spread of COVID-19 within healthcare and social care environments. Loveday points out that IPC
teams have been pushed to their limits and emphasizes the necessity of extracting valuable insights to reinforce
the critical role of IPC in future pandemic preparedness. Traditionally, IPC has been focused on enhancing
practices to prevent healthcare-associated infections and tackle antimicrobial resistance, with less attention
given to pandemic planning. Loveday suggests that the experiences from the COVID-19 crisis should inform
and improve IPC strategies for better preparedness in the face of potential pandemics.
In addition, McCauley’s (2021)
reviews delve into the various elements that lead to lapses in care and a lack of
adherence to infection prevention and control protocols among nursing staff. It examines the reasons behind
these shortcomings, aiming to identify the root causes that hinder nurses from fully complying with established
infection control measures. This comprehensive analysis seeks to shed light on the obstacles faced by nurses
that prevent them from executing these critical practices effectively, which is essential for maintaining patient
safety and reducing the spread of infections within healthcare settings.
Moreover, the article by Ramadan (2023)
serves as a guide for community nurses on infection prevention and
control practices. Ramadan emphasizes the importance of hand hygiene, proper use of personal protective
equipment (PPE), and environmental cleaning in preventing healthcare-associated infections (HCAIs). The
guide highlights the need for community nurses to adhere to standard precautions, including hand hygiene
before and after patient contact and the appropriate use of PPE such as gloves, aprons, and face masks.
Additionally, the article stresses the significance of proper waste management and the safe handling of sharps
to minimize the risk of infection transmission in community healthcare settings.
Certainly, antimicrobial resistance (AMR) poses a significant challenge in the Middle East, exacerbated by
ongoing conflicts that disrupt healthcare systems and hinder infection prevention and control (IPC) measures.
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It highlights that the turmoil in the region not only damages healthcare infrastructure but also complicates the
implementation of effective IPC strategies, which are important for managing AMR. The instability caused by
conflict leads to a lack of resources, inadequate sanitation, and difficulties in maintaining hygiene practices, all
of which contribute to the spread of resistant pathogens. Moreover, the displacement of populations increases
the risk of disease transmission and limits access to medical care, further complicating efforts to combat AMR.
Emphasizes the need for IPC programs and international collaboration to address these challenges, particularly
in conflict-affected areas where the healthcare system's resilience is undermined (Collin and Farra, 2021).
Similarly, Domenico Cioffi (2023)
highlights the challenges in achieving optimal infection prevention and
control within healthcare settings, attributing these shortcomings to various factors inherent in the healthcare
culture. Despite developing and implementing evidence-based guidelines and strategies to reduce healthcare-
associated infections (HAIs), such as pneumonia, urinary tract infections, and bloodstream infections,
healthcare facilities often struggle with consistent adherence. This inconsistency can be attributed to a
combination of low compliance with infection prevention practices. This organizational culture may not
prioritize infection control, financial constraints, limited engagement from frontline staff, and insufficient
support from leadership. These issues underscore the need for a comprehensive approach that addresses both
the technical and cultural aspects of infection prevention and control to combat HAIs effectively.
The study conducted by Ochie et al. (2022) focuses on understanding, factors influencing, and adherence to
infection prevention and control measures among healthcare workers in primary care settings within the Enugu
metropolis in southeastern Nigeria. It aims to assess the level of knowledge these workers possess regarding
infection prevention, identify what determines their compliance with established protocols, and evaluate how
consistently they adhere to these measures. Enhancing patient safety and healthcare quality by ensuring that
frontline healthcare professionals are well-informed and committed to preventing the spread of infections
within healthcare facilities.
Furthermore, Kinyenje (2020) examined the state of infection prevention and control (IPC) practices within
primary healthcare facilities across Tanzania, utilizing a star-rating assessment method for evaluation. The
findings revealed a concerning level of inadequacy in IPC measures across these facilities, with many not
meeting the necessary standards for ensuring patient and staff safety from infections. This assessment
highlighted the urgent need for improvements in IPC protocols and training within Tanzanian primary
healthcare settings to elevate the quality of care and minimize the risk of infection transmission.
Based on the systematic review by Alhumaid et al. (2021), healthcare workers (HCWs) generally had moderate
to good knowledge of IPC principles and practices. However, their compliance with recommended IPC
measures was suboptimal. Several factors influenced HCWs' adherence to IPC guidelines, including individual
factors (knowledge, attitudes, beliefs), organizational factors (training, resources, leadership support), and
external factors (policies, guidelines). Adequate knowledge alone did not necessarily translate into better
compliance. The review highlights the need for multifaceted interventions targeting various determinants to
improve IPC compliance among HCWs, such as ongoing education, accessible resources, administrative
support, and clear policies.
Moreover, Hillier (2020) emphasizes the role of effective hand hygiene practices in preventing and controlling
infections in healthcare settings. Proper hand hygiene is one of the most important measures for reducing the
spread of pathogens and healthcare-associated infections. The study stresses the significance of healthcare
professionals adhering to the World Health Organization's "Five Moments for Hand Hygiene" and using
correct handwashing techniques. Additionally, the study underscores the importance of ongoing education,
training, and monitoring to ensure compliance with hand hygiene protocols, ultimately leading to improved
patient safety and reduced infection rates.
Meanwhile, Abraao, L. M. et al. (2021) studied compared three infection prevention and control program
(IPCP) assessment tools: IPCPE, IPCAF, and OGIPCP. The results showed that IPCPE was considered the
most complete, effective, easy to apply, and had easily interpreted indicators. IPCAF was found to be the best
in terms of purpose, easy reporting, and interpretation, although it requires professional experience to use
effectively. OGIPCP was noted for its quick application, ease of understanding, and easily calculated
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indicators, making it suitable for users with less experience. The qualitative data supported these quantitative
findings and indicated that IPCPE and IPCAF were the most accepted tools among the participants. Overall,
while all three tools showed similar potential for supporting IPCP improvements, IPCPE and IPCAF were
deemed more advantageous in terms of effectiveness and fit-for-purpose compared to OGIPCP2.
Similarly, Asgedom A. A. (2024) conducted a narrative review of 13 full-length papers from Africa, Asia, and
Europe to examine the status of infection prevention and control (IPC) in healthcare facilities using the WHO
Infection Prevention and Control Assessment Framework (IPCAF) tool. The findings revealed significant
disparities in IPCAF scores across different regions, ranging from insufficient to advanced levels. Middle-
income and high-income countries generally demonstrated advanced IPCAF levels, while low-income
countries showed lower IPCAF scores. The review highlighted the need for enhanced IPC capacity building
and an improved supply of infection prevention resources, particularly in low-income countries, to prevent
healthcare-associated infections (HAIs). These results underscore the importance of addressing gaps in IPC
practices and resources globally across healthcare settings.
Furthermore, Silva et al. (2021) focused on evaluating the effectiveness of dissemination interventions aimed
at improving healthcare workers' adherence to infection prevention and control (IPC) guidelines. Through a
systematic review and meta-analysis, the research synthesized evidence from various studies to assess the
impact of these interventions. The findings revealed that dissemination interventions, which include strategies
like educational sessions, reminders, and feedback mechanisms, significantly enhance healthcare workers'
compliance with IPC guidelines. This improvement in adherence is crucial for reducing the transmission of
infections within healthcare settings, thereby safeguarding both patient and healthcare worker safety. The study
underscores the importance of implementing targeted interventions to promote best practices in infection
prevention and control among healthcare professionals.
A comprehensive study by Tartari et al. (2021) provides an analysis of how infection prevention and control
(IPC) core components are implemented at the national level across various countries. The significant
variations in IPC practices and policies reveal that while some nations have made substantial progress in
establishing effective frameworks, others still face considerable challenges. The Tartari emphasize the
importance of tailored strategies to strengthen IPC measures, particularly in resource-limited settings, and
advocate for enhanced collaboration among stakeholders to ensure adherence to best practices. This situational
analysis underscores the critical need for ongoing assessment and improvement of IPC systems to safeguard
public health, especially in the context of global health threats like pandemics.
Also, Lotfinejad et al. (2020) found that emojis may be beneficial in bridging the gap between verbal text-
based and nonverbal face-to-face interactions related to hand hygiene and infection prevention and control.
The authors suggest that emojis could potentially be used to improve hand hygiene behavior in accordance
with multimodal promotion strategies. They note that emojis are an integral part of digital communication and
social media platforms, which have been shown to spread health-related messages effectively. The emotional
content conveyed by emojis on social media was described as "contagious", indicating that health interventions
using emojis could leverage this emotional cascade effect to improve efficacy and cost-effectiveness. Overall,
the study concludes that further research is needed to evaluate the impact of emojis on hand hygiene and
infection control behaviors, but that they show promise as a tool for promoting these important public health
measures.
Moreover, the essential elements for an Infection Prevention and Control (IPC) manual framework emphasize
the necessity of a hospital IPC program and alignment with the European Council's 2009 patient safety
recommendations. It underscores the importance of management's commitment to HAI and AMR prevention
through clear budgeting, resource allocation, and activity planning. The framework suggests beginning with an
overview of relevant guidelines and standards, incorporating educational, monitoring, and feedback
components to foster behavioral change among healthcare workers (HCWs). It highlights the need for a
detailed training strategy, the implementation of a HAI surveillance program, and the effectiveness of the
WHO's multimodal strategy in reducing HAIs. Additionally, it addresses staffing needs and the environment's
role in IPC, proposing a standardized framework for hospital IPC manuals to facilitate the implementation of
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best practices and address gaps in application, such as workload and staffing components (Gastaldi et al.,
2024).
The DOH (2022) Guidelines on Tuberculosis Infection Prevention and Control Update provides
comprehensive recommendations aimed at minimizing the risk of Mycobacterium tuberculosis transmission
within healthcare and other high-risk settings. These guidelines emphasize the importance of implementing a
hierarchy of infection control measures, including administrative controls, environmental controls, and
respiratory protection, to effectively prevent TB transmission. The document underscores the necessity of
integrating these TB-specific interventions with the core components of infection prevention and control (IPC)
programs at both national and healthcare facility levels.
The National Standards in Infection Prevention and Control for Health Facilities, 3rd Edition, is a
comprehensive guide that reflects the latest evidence-based practices and international standards in infection
prevention and control (IPC). This updated edition incorporates key elements such as the WHO IPC Minimum
Requirements, revised fundamental concepts, enhanced waste management protocols, and new chapters on
healthcare-associated infection surveillance2. It also addresses antimicrobial stewardship, risk management
strategies, healthcare worker safety, and the importance of IPC education and training. The manual aims to
improve patient safety, enhance the quality of care, and promote efficient resource allocation in healthcare
settings. (Department of Health, 2021).
Furthermore, UNICEF outlines the organization's efforts to combat the spread of COVID-19 in the Philippines
through training and guidelines development. It highlights the challenges of implementing IPC measures due
to restrictions from Enhanced Community Quarantine (ECQ) and the urgent need for community-level
interventions. The report details the development and rollout of IPC guidelines, training methodologies, and
the impact of these initiatives, including the training of thousands of community health workers and the
adaptation of materials for various audiences (UNICEF Philippines, 2020).
Moreover, the Philippine Society for Microbiology and Infectious Disease, (2020)
31
provides interim
guidelines for infection prevention and control (IPC) in healthcare and community settings. It emphasizes the
importance of an organized Infection Control Committee (ICC) in healthcare facilities, the definition of
healthcare workers, and the implementation of administrative and engineering controls. The guidelines cover
triaging, personal protective equipment (PPE), disinfection, waste management, and the safety of healthcare
workers, including the use of PPE and strategies for extended use or reuse of N95 respirators. It also addresses
the management of deceased persons with COVID-19 and IPC in community settings, urging the public to
practice good hygiene and self-quarantine when necessary
Subsequently, the Department of Health's Health Facility Development Bureau's 2021
emphasizes the critical
need for updated standards in infection prevention and control, particularly in the context of the pandemic. It
aims to ensure equitable access to safe and quality health services by complying with care standards in health
facilities. This edition addresses the dissemination of the manual to a wide range of health professionals,
including DOH executives, central and regional directors, and chiefs of health facilities, underscoring the
importance of a unified approach to infection prevention. The document serves as a foundation for developing
quality health service delivery and the necessity of adhering to updated infection control standards to protect
both healthcare providers and patients.
Additionally, The Department of Health's Administrative Order No. 2022-0051 outlines a comprehensive
framework for infection prevention and control across all public and private health facilities in the Philippines.
This revised national policy emphasizes the importance of standardized protocols to mitigate healthcare-
associated infections, ensuring patient safety and enhancing overall healthcare quality. It mandates regular
training for healthcare workers, the implementation of effective surveillance systems, and the adoption of best
practices in hygiene and sanitation. By establishing clear guidelines, the order aims to bolster the resilience of
health facilities against infectious diseases, particularly in light of recent global health challenges (DOH,
2022).
Furthermore, Ma. Teresa Montemayor (2023) emphasizes the importance of hand hygiene as the simplest and
most effective way to prevent infections, particularly in healthcare settings. Dr. Charmaine Louise Lozada, the
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National Infection Prevention and Control (IPC) Program manager, highlighted that hand washing with soap
and clean water is fundamental, and in the absence of these, hand sanitizers or alcohol-based hand rubs can be
used unless hands are visibly dirty. The article outlines five critical moments for hand hygiene for healthcare
workers, including before and after touching a patient, before aseptic procedures, after exposure to body fluids,
and after touching a patient's surroundings. Dr. Lozada also discussed the significance of standard precautions,
proper medical waste management, and the ongoing efforts of the IPC program to develop policies and
strategies to combat Healthcare Associated Infections (HAI) and Antimicrobial Resistance, aiming to achieve
Universal Health Care in the Philippines.
Similarly, UNICEF Philippines (2021), in collaboration with the Department of Education (DepEd) and the
Department of Health (DOH), is committed to fostering a culture of handwashing in schools and communities
as a vital measure against the pandemic. This initiative was part of a broader effort to enhance hygiene
practices and public health safety, recognizing the significant role of handwashing in preventing the spread of
infectious diseases. A collaborative study led by DepEd and UNICEF in Zamboanga del Norte demonstrated
the effectiveness of these efforts, showing a notable increase of 17.3 percentage points in the handwashing
practice among students. This initiative underscores the importance of sustained hygiene practices in
educational settings and communities, aiming to protect public health and ensure the well-being of children
and the broader population during and beyond the pandemic.
Furthermore, CDC (2022)
conducted various activities in the Philippines to address public health concerns and
enhance disease surveillance and control in the country. Findings revealed key areas of focus, including but not
limited to infectious disease management, vaccine distribution, and community health education. The CDC's
efforts contributed to bolstering the Philippines' capacity to respond effectively to health threats, thereby
safeguarding the well-being of its population. Through collaborations with local health authorities and
stakeholders, the CDC worked towards implementing evidence-based strategies to mitigate the spread of
diseases and promote overall health and resilience within communities.
Moreover, Philippine Hospital Infection Control Society (PHICS) released its Infection Control Manual on
May 17, 2020, outlining key findings and recommendations for infection control practices in Philippine
hospitals. The manual provides comprehensive guidelines for healthcare professionals to mitigate the risk of
infections within healthcare settings. It likely includes protocols for hand hygiene, proper use of personal
protective equipment, environmental cleaning, and measures to prevent the spread of infectious diseases
among patients and healthcare workers. These guidelines are essential for ensuring the safety and well-being of
both patients and healthcare providers in Philippine hospitals, particularly in light of the ongoing global health
challenges.
Additionally, Arianna Maever L. Amit (2021) on the early response to the Pandemic in the Philippines
highlights several critical aspects of the country's handling of the pandemic, particularly focusing on the
challenges and strategies implemented during the initial stages. It underscores the Philippines' vulnerability
due to its status as a low- and middle-income country with a weak health system, making it particularly
susceptible to the impacts of the pandemic. The government's early response included imposing travel
restrictions, community interventions, risk communication, and testing from January 30, 2020, when the first
case was reported, until March 21, 2020. Despite these efforts, they point out limitations such as inadequate
pandemic preparedness, slow ramping up of testing capacities, and the resulting uncontrolled disease
transmission. The findings suggest that investing in pandemic preparedness, surveillance, and testing capacity
is crucial for the Philippines and other similar countries to manage current and future public health
emergencies better.
Moreover, the COVID-19 pandemic highlighted the critical need for infection prevention and control (IPC)
preparedness in healthcare facilities, with a study identifying key compliance gaps such as the need for better
resource allocation towards waste bags, personal protective equipment (PPE), signage, informational materials,
and ongoing staff training and policy development. The importance of government oversight in maintaining
high compliance standards was emphasized, alongside the effectiveness of rapid IPC assessments in outbreak
scenarios to prioritize and provide immediate support. Expanding IPC assessments to various facilities and
contexts, urging further exploration into the tool's utility and accuracy compared to comprehensive
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evaluations. Ultimately, it calls for systematic improvements, including thorough planning and sustained
investment in IPC, to fortify health systems against future outbreaks, underscoring IPC’s role in
enhancing healthcare resilience (Vergil de Claro et al., March 2023).
Furthermore, the research conducted by Ellasus (2021), on infectious disease prevention and control practices
among healthcare personnel, a complex interplay of factors influencing infection control in healthcare settings.
It demonstrates a range of knowledge and compliance levels among healthcare workers regarding infection
prevention guidelines, with significant gaps identified in hand hygiene practices, the use of personal protective
equipment (PPE), and adherence to standard precautions. Factors such as the availability of resources,
education and training, organizational support, and the social dynamics within healthcare teams were found to
impact compliance rates. Additionally, the research underscores the importance of continuous education and
monitoring, as well as the need for healthcare facilities to prioritize infection control measures to protect both
healthcare workers and patients from the transmission of infectious diseases.
Similarly, despite clear guidelines on infection prevention and control (IPC), non-adherence remains a
significant issue in healthcare settings globally, risking both patient and provider safety. A study focusing on
Level I hospitals in Rinconada used a descriptive correlational method with questionnaires to assess IPC
practices among healthcare providers, primarily nurses aged 26–35. Findings revealed that while general
adherence to IPC measures like hand hygiene, personal protective equipment use, and needlestick injury
prevention is high, lapses in specific practices persist. Notably, organizational factors more profoundly
influence IPC adherence than individual characteristics, despite the latter's considerable impact (Abanes,
October 2022).
In addition, Campo (2024) found that nurses in a private tertiary hospital in Baguio City possess good
knowledge but demonstrate a suboptimal degree of practice in preventing and controlling healthcare-acquired
infections (HAIs). Interestingly, no significant relationship was found between the nurses' level of knowledge
and their degree of practice in HAI prevention and control. The research identified perceived personal benefits
and organizational encouragement as primary facilitators of nurses' prevention and control practices. On the
other hand, workload due to staff shortage, poor dissemination of guidelines, and personal discomfort
associated with the use of personal protective equipment (PPE) were identified as the main hindrances to
effective HAI prevention and control practices.
On the other hand, it identified 'good' outliers—clusters of cities and provinces demonstrating remarkable
results in managing the pandemic. These included Central Luzon (Region III), CALABARZON (Region IV-
A), the National Capital Region (NCR), and Central Visayas (Region VII), as well as the metropolitan city of
Davao. The key factors contributing to their success were strict border control, early lockdowns, the
establishment of quarantine facilities, effective public communication, and diligent monitoring efforts. The
study concluded that standardizing these policies could enhance any country's preparedness for future health
emergencies (Talabis et al., 2021).
Furthermore, Sta. Ana (2021), investigated the factors influencing compliance with infection prevention and
control measures among physicians in a tertiary government hospital and how this compliance affected their
risk of infection. The research identified three main factors of compliance: hand hygiene and sharps disposal,
medical equipment disinfection and waste disposal, and personal protective equipment utilization. It was found
that the physicians' perception of organizational and environmental factors significantly impacted their
compliance with these measures. However, the study concluded that the risk of infection among the physicians
was not significantly affected by their knowledge, attitudes, perceptions of organizational and environmental
factors, or compliance with infection prevention and control measures.
Similarly, Sangkula (2024) found that nurses at Sulu Sanitarium and General Hospital demonstrated a high
level of compliance with infection control practices. Specifically, the research revealed that 90% of the nurses
consistently adhered to hand hygiene protocols, 85% properly used personal protective equipment, and 80%
followed correct waste disposal procedures. Additionally, the study identified factors influencing compliance,
including adequate training (95% of nurses reported receiving proper education), availability of resources
(88% stated they had access to necessary supplies), and supportive hospital policies (92% felt the institution
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promoted a culture of infection control). These findings suggest that the hospital has implemented effective
measures to ensure nurses' adherence to infection control practices, contributing to a safer healthcare
environment for both patients and staff.
Furthermore, sophisticated modeling techniques provide valuable insights into the dynamics of the pandemic
within the region, enabling a better understanding of its trajectory and facilitating more informed decision-
making by policymakers and public health authorities. By analyzing factors such as transmission rates,
population density, and intervention measures, the study offers predictions and recommendations aimed at
mitigating the spread of the virus and minimizing its impact on the population of Central Visayas (Corcino,
2020)
Moreover, Berdida et al. (2022), revealed that there is a moderate level of knowledge among Filipinos
regarding antibiotic use and resistance, with healthcare workers and males showing a higher percentage of
correct responses. The survey included 3,767 participants, identified age, educational attainment, profession,
antibiotic use in the past year, and household members who took antibiotics as significant predictors of
knowledge about antibiotic resistance. Additionally, the study found significant differences in attitudes toward
antibiotic acquisition, hygienic practices, and the role of health professionals in antibiotic resistance based on
participants' gender, age, and educational status. These findings suggest that government agencies and
policymakers should consider these predictors when formulating policies to ensure safe and effective antibiotic
use.
According to Victoria Haldane (2022) the extension of health system resilience into communities amidst the
pandemic in the Philippines, several key findings emerged. The study focused on community-based actors
providing health services. It revealed that while these actors played a role in bolstering health system
resilience, they faced various challenges, including limited resources, inadequate training, and difficulties in
coordination with formal health systems. Despite these challenges, community-based actors demonstrated
adaptability and innovation in addressing local health needs, emphasizing the importance of strengthening
community-level partnerships and support structures to enhance overall health system resilience during crises.
Synthesis of the State-of-the-Art
The literature and studies reviewed in the study showed different views and perceptions on compliance level
with standard infection prevention and control and their implication to society and every individual. Likewise,
the researcher found similarities and differences between the previous and present studies.
Studies align closely with the research focus on rural healthcare workers' compliance with infection prevention
and control standards. Ochie et al. (2022) study in southeastern Nigeria examined healthcare workers'
understanding and adherence to IPC measures in primary care settings, sharing a similar scope and context.
Kinyenje (2020) research in Tanzania also resonates strongly, as it evaluated IPC practices in primary
healthcare facilities using a star-rating assessment method. Alhumaid et al. (2021) systematic review revealed
that healthcare workers generally possessed moderate to good knowledge but showed suboptimal compliance
with IPC measures, mirroring common findings in rural settings. Campo (2024) study in Baguio City found
that nurses demonstrated good knowledge but suboptimal practice in preventing healthcare-acquired
infections, while Abanes (2022) research in Level I hospitals specifically examined healthcare providers'
adherence patterns, particularly among nurses.
In contrast, several studies took distinctly different approaches or focused on other aspects of IPC compliance.
Tartari et al. (2021) research provided a broader perspective by analyzing IPC implementation at the national
level across various countries rather than focusing on specific rural settings. Silva et al. (2021) study
emphasized the effectiveness of dissemination interventions in improving healthcare workers' adherence to
IPC guidelines, taking a more solution-oriented approach. Lotfinejad et al. (2020) research explored innovative
communication methods using emojis for IPC promotion, demonstrating a unique technological angle. The
WHO Global Report (2024) examined IPC implementation across all WHO regions, offering a more
comprehensive global perspective than localized rural studies. Lastly, Gastaldi et al. (2024) work concentrated
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on developing IPC manual frameworks for hospitals, focusing on structural guidance rather than compliance
assessment.
Research Gap
The analysis of the provided literature and studies reveals several research gaps in the field of infection
prevention and control (IPC), particularly in the Rural Health Units.
While earlier studies like Ochie et al. (2022) and Alhumaid et al. (2021) examined IPC compliance in primary
care and general healthcare settings, and Campo (2024) focused on tertiary hospitals, there is limited research
specifically investigating IPC compliance in Rural Health Units. The current study bridges this gap by
focusing on healthcare workers in rural health units, where resources and infrastructure might be more
constrained than in urban or tertiary facilities. Additionally, while previous studies like Kinyenje (2020) and
Abanes (2022) have identified the knowledge-practice gap in IPC compliance, the present research takes a
more comprehensive approach by examining compliance specifically with the Standard IPC guidelines in
RHUs. This focus is particularly timely and relevant given the Department of Health's emphasis on updated
infection control standards through their 2021 Standards in Infection Prevention and Control for Health
Facilities and the growing recognition of Rural Healthcare Units as frontline defenders against infectious
diseases.
RESEARCH METHODOLOGY
This chapter discusses the research methods and procedures for this study. This includes selecting respondents,
using data gathering tools, and analyzing the statistical treatment of the data.
Research Design
The researcher utilized the descriptive-correlational method using a questionnaire checklist as the data-
gathering instrument. A descriptive research method is concerned with gathering, classifying, presenting,
tabulating, and summarizing the results to describe group characteristics of the data. It focuses on the present
condition to find new truth, valuable in providing facts on which scientific judgments may be based. This
method also plays a large part in developing instruments to measure many things that are employed in all types
of quantitative research (Creswell, 2022).
The descriptive-correlational method was used to determine the respondent's profile, compliance level with
standards in infection prevention and control, challenges encountered by Rural Health Units affecting
compliance with the standard in infection prevention and control, and measures that could be proposed to
enhance compliance with the standard of infection prevention and control. The use of correlation determined
the degree of relationship between the demographic profile and the level of compliance with standards in
infection prevention and control among Rural Health Units.
Respondents of the Study
The researcher employed the purposive sampling technique to select the respondents for this study, specifically
focusing on healthcare workers. This method allowed the researcher to deliberately choose respondents based
on predetermined criteria relevant to the study's objectives. This approach ensured that the selected
respondents possessed the necessary characteristics and experiences to provide valuable insights into the
research topic.
The researcher utilized the total enumeration method for healthcare workers to gather comprehensive data
from the target population. This approach involved including all eligible healthcare workers within the Rural
Health Units. By employing total enumeration, the researcher aimed to capture a complete picture of the
healthcare workforce, minimizing potential bias and ensuring that diverse perspectives and experiences were
represented in the study.
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The respondents of the study were the 147 healthcare workers from different Rural Health Units. In RHU A
(Rural Health Unit - Baao I and II), there are 2 Doctors, 13 Nurses, 15 Midwives, 2 Sanitary Inspector, and 1
Medical Technologist. RHU B (Rural Health Unit - Balatan) has 1 Doctor, 14 Nurses, 4 Midwives, 1 Sanitary
Inspector, and 1 Medical Technologist. At RHU C (Rural Health Unit - Bato), the staff consists of 3
Doctors, 17 Nurses, 8 Midwives, 1 Sanitary Inspector, and 1 Medical Technologist. RHU D (Rural Health Unit
- Bula I and II) employs 2 Doctors, 20 Nurses, 15 Midwives, 2 Sanitary Inspectors, and 1 Medical
Technologist. Lastly, RHU E (Rural Health Unit - Buhi I and II) has 2 Doctors, 11 Nurses, 7 Midwives, 2
Sanitary Inspectors, and 1 Medical Unfortunately, one RHUs failed to participate in the research study.
Table 1 Respondents of the Study
Rural Health Unit
Respondents
RHU A (Rural Health Unit – Baao I and II)
Doctor
Nurse
Midwife
Sanitary Inspector
Medical Technologist
2
13
15
2
1
RHU B (Rural Health Unit – Balatan)
Doctor
Nurse
Midwife
Sanitary Inspector
Medical Technologist
1
14
4
1
1
RHU C (Rural Health Unit – Bato)
Doctor
Nurse
Midwife
Sanitary Inspector
Medical Technologist
3
17
8
1
1
RHU D (Rural Health Unit – Bula I and II)
Doctor
Nurse
Midwife
Sanitary Inspector
Medical Technologist
2
20
15
2
1
RHU E (Rural Health Unit – Buhi I and II)
Doctor
Nurse
Midwife
Sanitary Inspector
Medical Technologist
2
11
7
2
1
TOTAL
147
Setting of the Study
Camarines Sur's 5th congressional district is one of the five congressional districts in the province of
Camarines Sur, Philippines. The district consists of one city, the Iriga City, and six municipalities, namely:
Baao, Balatan, Bato, Buhi, Bula, and Nabua.
Each municipality owned a government health center. Rural Health Unit Baao I and II situated at Del Rosario
(RHU I) and Buluang (RHU II), Baao, Camarines Sur. Rural Health Unit Balatan is located at Duran, Balatan,
Camarines Sur. Rural Health Unit Bato is found at Sta. Cruz (Pob.), Bato, Camarines Sur. Rural Health Unit
Buhi I and II situated at San Buenaventura (Pob.) and San Jose Baybayon, Buhi, Camarines Sur. Rural Health
Unit Bula I and II located at Salvacion (Pob.) and Balaugan, Bula, Camarines Sur.
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Data Gathering Tools
The data collection questionnaire was utilized, consisting of a questionnaire checklist as the primary data
gathering tool.
Questionnaire. A questionnaire was chosen as the data collection instrument to select a tool for gathering
data. Essentially, a questionnaire is a self-report form in print, crafted to draw out information through written
responses from the subjects. The information garnered through a questionnaire shares similarities with that
obtained through an interview, although the questions typically delve less deeply into the subject matter
(Petrat, 2022).
In conducting this study, the researcher employed a questionnaire as the primary tool to collect essential data.
The choice of this data collection method primarily stemmed from the researcher's ability to gather all
completed responses swiftly. It also allowed information to be collected from readily available respondents
who were willing to contribute quickly. To gather data and information from the respondents, questionnaires
were employed to assess various areas.
Preparation of the questionnaire. In the process of gathering data, the researcher developed a questionnaire
by thoroughly reviewing various pertinent studies and literature connected to the present study. The
questionnaire was divided into three parts. Part I aimed to establish the respondents' profile, including details
such as age, sex, civil status, educational attainment, designation, length of service, and related training
attended. Part II focused on analyzing the compliance level with standards in infection prevention and control
among Rural Health Units in 5
th
District of Camarines Sur along with hand hygiene practices, use of Personal
Protective Equipment (PPE), prevention of needlestick and sharp injuries, environmental cleaning and
disinfection, and education and training. Part III assessed the challenges faced by Rural Health Units in
compliance with the standard in infection prevention and control along with resource constraints, infrastructure
and facility limitations, and human resource challenges.
A carefully constructed rating scale was employed to ensure accuracy of the required data. Indicators for the
researcher-identified factors, especially those related to healthcare workers, were thoughtfully prepared to be
pertinent in analyzing the compliance level with standard infection prevention and control standards.
Validation of the questionnaire. The questionnaire created for this study underwent a validation process to
ensure face and content validity. As described by Ranganathan (2023), face validity suggests that a test should,
on the surface, seem to measure what it's intended to assess. On the other hand, content validity emphasizes
that a test should adequately cover the spectrum of behaviors associated with the theoretical concept being
tested.
In the validation phase of this study, the questionnaire and research questions were presented to the
adviser for examination. The expert thoroughly reviewed the research questions and the questionnaire to
evaluate the instrument's appropriateness and adequacy. Based on this review, the adviser suggested
structuring the questionnaire on a five-point Likert scale.
After incorporating the valuable insights and recommendations from the adviser, a pilot test was conducted on
the instrument. This involved distributing the questionnaire to two respondents from each Rural Health Unit in
the actual research location. The purpose of the pilot test was to gauge the respondents' reactions to the
questionnaire, assess the clarity and comprehensibility of the items, identify any need for additional items in
specific areas, uncover items respondents might be hesitant to answer, and evaluate the feasibility of the
proposed data analysis method for the study.
Administration and retrieval of the questionnaire. The questionnaire was distributed and retrieved through
a carefully planned process to ensure accurate data collection. Respondents were approached in a manner that
upheld ethical considerations and promoted their willingness to participate. The method of distribution and
retrieval was done manually using questionnaires. Printed copies of the survey were personally handed out to a
predetermined list of potential respondents. This allowed respondents to complete the questionnaire
conveniently, minimizing disruptions to their work responsibilities. The paper format ensured anonymity and
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confidentiality, encouraging respondents to respond candidly. Retrieving the collected data involved a
methodical process. Completed paper questionnaires were physically collected from the respondents. Each
questionnaire was then carefully reviewed for completeness and legibility. The responses were manually
entered into a secure database, with each entry being double-checked for accuracy to minimize potential errors
during data entry.
Statistical Treatment of Data
The researcher used some tools to treat the data that were gathered. The responses were classified
systematically according to the different variables included in the study. The following statistical tools used
were:
In this research study, the analysis involved the calculation of percentages and rankings. This approach aims
to provide a comprehensive understanding of the demographic profile of the respondents. By employing
percentages, the distribution of characteristics within the sample is quantified, offering insights into the
proportional representation of different demographic factors. Additionally, using rankings will further enhance
the ability to discern the relative significance or prevalence of specific demographic attributes among the
respondents.
The formula for percentage is:
where:
P = Percentage
ΣR = Sum of the responses in the given item
N = Number of responses
Frequency was calculated to analyze the demographic profile of the respondents. Frequency represents the
actual count of respondents in each category, providing a clear picture of the distribution within the sample.
This straightforward measure accurately represents how many individuals fall into each demographic category,
allowing for a precise understanding of the sample composition.
The formula for frequency is:
where:
f = frequency
n = number
The Weighted Mean was employed as a statistical tool to assess and quantify the compliance level with
standard in infection prevention and control among the respondents. Using the Weighted Mean involves
assigning different weights to various factors based on their perceived significance, providing a more nuanced
and comprehensive evaluation of their impact. This approach allows for a more refined understanding of the
relative importance of analyzing the compliance level with standards in infection prevention and control within
the study population. Utilizing the Weighted Mean, the research aims to unveil a detailed and weighted
perspective on compliance level with standards in infection prevention and control among the respondents
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The formula for weighted mean is:
where:
WM = Weighted Mean
w = weight for each data point
x = value of each data point
A five-point Likert scale was employed to analyze the compliance level with standards in infection prevention
and control among the respondents to compute the weighted mean for each indicator. Using the Likert scale
involved assigning numerical values to the responses, ranging from one to five, to gauge the varying degrees
of agreement or disagreement with statements related to the identified indicators. This method allows for a
structured and nuanced measurement of the perceived impact of compliance level with standards in infection
prevention and control within the study population. By applying the Likert scale in this manner, the research
aims to capture the depth and nuances of respondents' perceptions, providing a more detailed understanding of
compliance level with standards in infection prevention and control.
Scale
Range Value
Verbal Interpretation
5
4.20 – 5.00
Very Much Compliant
4
3.40 – 4.19
Much Compliant
3
2.60 – 3.39
Compliant
2
1.80 – 2.59
Slightly Compliant
1
1.00 – 1.79
Not Compliant
In assessing challenges encountered by Rural Health Units affecting compliance with standards in infection
prevention and control, a five-point Likert Scale was adapted to measure the extent to which various factors
contribute to understanding the impact of each identified challenge affect compliance.
Scale
Range Value
Verbal Interpretation
5
4.20 – 5.00
Greatly Affect
4
3.40 – 4.19
Moderately Affect
3
2.60 – 3.39
Affect
2
1.80 – 2.59
Slightly Affect
1
1.00 – 1.79
Not at all Affect
The Chi-square test, a statistical method commonly employed in scientific research, is designed to assess a
concept known as the null hypothesis (Ho). This null hypothesis posits no substantial difference between the
expected outcomes, as predicted by a theoretical model, and the actual observed results in the collected data.
The chi-square test aims to evaluate whether any observed variation in the data is statistically significant or if it
could occur by random chance alone. By comparing expected and observed results, scientists use the chi-
square test to conclude the presence or absence of a meaningful relationship or pattern in the data under
investigation.
This test examined the connection between the demographic profile of the respondents and the level of
compliance with standards in infection prevention and control. In essence, its application aimed to explore
whether there is a discernible relationship or correlation between specific demographic characteristics of the
respondents and the level of compliance with standards in infection prevention and control. By conducting this
analysis, the research sought to unravel potential patterns or associations that could provide valuable insights
into how certain challenges might influence the level of compliance with standards in infection prevention and
control. The formula for chi-square is:
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where:
x
2
= chi square
O
i
= the observed cell frequency
E
i
= the expected or theoretical frequency
N = total number of responses
Compliance Level Among Healthcare Workers Of Rural Health Units On The Standard Infection
Prevention And Control
This chapter includes the presentation, analysis, and interpretation of data relevant to this study. The discussion
consists of the profile of the respondents, compliance level among healthcare workers of Rural Health Units,
and challenges encountered affecting compliance with the standard infection prevention and control. The data
were organized and presented in tabular form, followed by textual interpretation to provide better and more
significant insights into the subject under investigation.
Demographic Profile
The profile of the respondents in terms of age, sex, civil status, educational attainment, designation, length of
service, and related training/seminar.
Age. The data presented in Table 2 provides an age distribution of healthcare workers in Rural Health Units
(RHUs). Out of 147 respondents, the largest age groups are 25-29 and 40-44 years old, with the highest
frequency, representing 32 or 21.77 percent of the total population. Followed by 45 years old and above,
comprising 29 or 19.72 percent of the workforce. The 30-34 age bracket accounts for 25 or 17 percent, while
35-39-year-olds comprise 17 or 11.56 percent. The 20-24 age group makes up only 12 or 8.16 percent. This
distribution shows a blend of experienced professionals and younger workers entering the field, potentially
offering a mix of established expertise and fresh perspectives on healthcare delivery.
Age composition significantly influences healthcare workers' compliance with infection prevention and control
norms. Recent studies have pointed out that age and experience influence compliance with safety protocols.
For instance, Alhumaid et al. (2021) highlighted that older health professionals usually demonstrated better
compliance because of the years of experience and knowledge that they have acquired. On the other hand, Gon
et al. (2020) feel that younger professionals may also quickly adapt to new guidelines and technologies on
infection control. A good variance in age within this population may, therefore, lead to compliance levels that
may not be similar for everyone, and, therefore, different approaches in training and implementation of
infection control may need to be affected.
Table 2 Age Distribution of Respondents
Indicators
Frequency
Percentage
20 -24 y/o
12
8.16
25 -29 y/o
32
21.77
30 -34 y/o
25
17.00
35 -39 y/o
17
11.56
40 – 44 y/o
32
21.77
45 y/o and above
29
19.72
TOTAL
147
100.00
Sex. Based on Table 3, out of 147 respondents, 108 or 73.47 percent were female and 39 or 26.53 percent were
male. This shows a predominantly female workforce among healthcare workers in RHUs.
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This finding is aligned with recent studies on sex distribution in healthcare settings. The World Health
Organization (2024) documented that the healthcare sector remained predominantly female-driven, accounting
for 67 percent globally. Similarly, Boniol et al. (2019)
4
reported that women comprised 70% of the health
workforce globally, particularly in nursing and midwifery.
Table 3 Sex Distribution of Respondents
Indicators
Frequency
Percentage
Male
39
26.53
Female
108
73.47
TOTAL
147
100.00
Civil Status. Table 4 shows the civil status distribution of healthcare workers. Out of 147 healthcare workers,
105 or 71.43 percent of the respondents were married, 42 or 28.57 percent were single. Married healthcare
workers might bring unique perspectives or challenges influenced by familial responsibilities, potentially
affecting their protocol adherence. Conversely, single healthcare workers may have different motivations or
flexibility in their professional commitments.
The high proportion of married healthcare workers was consistent with studies that examined workforce
demographics in healthcare settings. In rural municipalities in Brazil, Nunes et al. (2022)
found that 68% of
healthcare workers were married, mirroring the current data. Similarly, Hoang Cao Sa et al. (2024) research in
Vietnam reported that 72.5% of healthcare workers were married.
Table 4 Civil Status Distribution of Respondents
Indicators
Frequency
Percentage
Single
42
28.57
Married
105
71.43
TOTAL
147
100.00
Educational Attainment. The data presented in Table 5 shows educational attainment among healthcare
workers. Out of 147, the majority, comprising 94 or 63.95 percent were college graduates. 23 or 15.65 percent
had some master's units, 22 or 14.97 percent completed a master's degree, and another eight (8) or 5.44 percent
held a doctorate degree. This suggests a well-educated workforce capable of understanding and implementing
infection prevention and control (IPC) protocols.
Table 5 Educational Attainment Distribution of Respondents
Indicators
Frequency
Percentage
College Graduate
94
63.95
Masters (with units)
23
15.65
Masters Graduate
22
14.97
Doctorate Graduate
8
5.44
TOTAL
147
100.00
The prevalence of college graduates in the healthcare workforce was consistent with the findings of
Labrague et al. (2020, who reported that most health workers in the Philippines held bachelor's degrees. The
presence of healthcare workers with advanced degrees suggested a commitment to continuous professional
development, which Palma et al. (2020) found to be associated with improved healthcare outcomes among
nurses in the Philippines.
Designation. Table 6 shows the distribution of healthcare worker designations. Out of 147 healthcare workers,
nurses constitute the largest group, representing 75 or 51.02 percent of the workforce. Midwives follow as the
second most prevalent designation, comprising 49 or 33.33 percent of the staff. Doctors represented 10 or 6.80
percent of the workforce, while medical technologists and sanitary inspectors constituted five (5) or 3.40
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percent and eight (80 or 5.44 percent, respectively. This staffing pattern reflects the typical distribution of
healthcare workers in RHUs, with nurses forming the backbone of healthcare delivery.
Table 6 Designation Distribution of Respondents
Indicators
Frequency
Percentage
Doctor
10
6.80
Nurse
75
51.02
Midwife
49
33.33
Medical Technologist
5
3.40
Sanitary Inspector
8
5.44
TOTAL
147
100.00
The observed distribution of healthcare workers in rural health units was consistent with findings from recent
studies on healthcare workforce composition. A survey by Wazir et al. (2021) in rural areas of Pakistan found
that nurses and midwives constituted most of the healthcare workforce, emphasizing their important role in
primary healthcare delivery. Similarly, research conducted by Malik et al. (2023)
10
reported that nurses and
midwives formed the backbone of healthcare workers, often compensating for the limited availability of
physicians.
Length of Service. The data presented in Table 7 shows the length of service distribution. Out of 147,
majority of the workforce, 48 or 32.65 percent, have been serving for 4-6 years. This is followed by 41 or
27.89 percent who have been in service for 7-9 years. Newer employees with 0-3 years of service make up 34
or 23.13 percent of the workforce, while those with the most experienced healthcare workers, with 24 or 16.33
percent had served 10 years and above. This indicates a workforce with a balanced mix of experience levels,
with a slight skew towards mid-career professionals.
Table 7 Length of Service Distribution of Respondents
Indicators
Frequency
Percentage
0 – 3 years
34
23.13
4 - 6 years
48
32.65
7 – 9 years
41
27.89
10 years and above
24
16.33
TOTAL
147
100.00
These findings were consistent with recent studies on healthcare workforce demographics in rural settings. A
study by Flinterman et al. (2023) found that health facilities often had a higher proportion of mid-career
professionals, which aligned with the current data showing the majority falling within the 4-9 years of service
range. Additionally, the lower percentage of long-serving staff (10 years and above) corroborated research by
Gregorio, M. V at al. (2023), which highlighted the challenges of retaining experienced healthcare workers in
RHUs in Pantabangan, Nueva Ecija over extended periods.
Related Training / Seminar. The data presented in Table 8 shows healthcare workers' training and seminar
attendance in Rural Health Units. Out of 147 more healthcare workers, 67 or 45.58 percent reported having no
related training or seminars on infection prevention and control. Among those who did receive training, the
most common areas were Basic Emergency Obstetric and Newborn Care (BEmONC) and Newborn Screening,
each accounting for 14 or 9.52 percent of the respondents. Other training areas included Family Planning and
Phlebotomy Training nine (9) or 6.12 percent each; Anti-Rabies Vaccination Training, TB Microscopy, and
Hygiene Promotion by Red Cross seven (7) or 4.76 percent each; Biosafety and Biosecurity and Water
Sanitation and Hygiene five (5) or 3.40 percent each; and Cold Chain Training three (3) or 2.04 percent. The
data needs more comprehensive and widespread training initiatives to enhance the skills and knowledge of
rural healthcare workers, particularly in infection prevention and control.
This lack of comprehensive training among healthcare workers in rural areas was consistent with findings from
recent studies. Ashinyo et al. (2021)
highlighted the importance of continuous professional development and
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training in improving infection prevention and control practices among healthcare workers. Similarly, Desta et
al. (2022) emphasized the need for regular training programs to enhance compliance with infection prevention
standards, particularly in resource-limited settings.
Table 8 Related Training / Seminar Distribution of Respondents
Indicators
Frequency
Percentage
None
67
45.58
Biosafety and Biosecurity
5
3.40
Anti-Rabies Vaccination Training
7
4.76
BEmONC
14
9.52
Family Planning
9
6.12
TB Microscopy
7
4.76
Newborn Screening
14
9.52
Phlebotomy Training
9
6.12
Cold Chain Training
3
2.04
Hygiene Promotion by Red Cross
7
4.76
Water Sanitation and Hygiene
5
3.40
TOTAL
147
100.00
Compliance level among healthcare workers of Rural Health Units on the national standard infection
prevention and control
Hand Hygiene Practices. The data presented in Table 9 shows the level of compliance with hand hygiene
practices among healthcare workers in Rural Health Units. With an average weighted mean (AWM) of 3.71,
the overall interpretation is much compliant. Among the RHUs, RHU C shows the highest overall compliance
with a weighted mean of 3.78 (much compliant), while RHU D adequate supplies for hand hygiene ranked
third (WM, 3.81). However, periodic assessments of hand hygiene-related knowledge among healthcare
workers to identify areas for improvement scored the lowest (WM, 3.39), although still within the compliant
range. Therefore, a need for RHUs to strengthen their monitoring systems, ensure consistent education, and
create a culture of open communication regarding hand hygiene has the lowest at 3.65 (much compliant).
Healthcare workers’ compliance with hand hygiene practices before and after patient contact ranked highest
(WM, 3.94), followed by the presence of clear and visible guidelines for hand hygiene practices displayed
at key locations (WM, 3.84). The consistent provision of
Table 9 Compliance Level among Healthcare Workers along Hand Hygiene Practices
Indicator
RHU
A
RHU
B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1. The Rural Health Unit consistently provides
adequate supplies for hand hygiene (e.g., soap,
water, alcohol-based hand rubs).
3.92
(MC)
3.87
(MC)
3.4
(MC)
3.89
(MC)
3.94
(MC)
3.81
MC
3
2. There is regular and systematic monitoring of
hand hygiene practices within the Rural Health
Unit.
3.89
(MC)
3.47
(MC)
3.74
(MC)
3.43
(MC)
3.66
(MC)
3.64
MC
8
3. Healthcare workers comply with hand hygiene
practices before and after patient contact.
3.84
(MC)
3.99
(MC)
4.00
(MC)
3.99
(MC)
3.88
(MC)
3.94
MC
1
4. The Rural Health Unit has clear and visible
guidelines for hand hygiene practices displayed
at key locations.
3.87
(MC)
3.85
(MC)
3.72
(MC)
3.97
(MC)
3.79
(MC)
3.84
MC
2
5. Training and education on hand hygiene
practices are regularly provided to all healthcare
workers in the Rural Health Unit.
3.9
(MC)
3.89
(MC)
3.86
(MC)
3.66
(MC)
3.38
(C)
3.74
MC
5
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6. The Rural Health Unit has a policy in place for
the use of gloves as a complement to hand
hygiene.
3.8
(MC)
3.74
(MC)
3.84
(MC)
3.32
(C)
3.68
(MC)
3.68
MC
6
7. Regular hand hygiene audits and feedback
help improve hand hygiene compliance.
3.37
(C)
3.67
(MC)
3.92
(MC)
3.97
(MC)
3.91
(MC)
3.77
MC
4
8. Healthcare workers are encouraged to report
any issues or concerns related to hand hygiene
practices.
3.89
(MC)
3.16
(C)
3.64
(MC)
3.89
(MC)
3.47
(MC)
3.61
MC
9
9. The Rural Health Unit conducts periodic
assessments of hand hygiene-related knowledge
among healthcare workers to identify areas for
improvement.
3.38
(C)
3.36
(C)
3.71
(MC)
3.24
(C)
3.28
(C)
3.39
C
10
10. The Rural Health Unit has a designated hand
hygiene champion who promotes and oversees
hand hygiene initiatives.
3.72
(MC)
3.62
(MC)
3.89
(MC)
3.1
(C)
3.94
(MC)
3.65
MC
7
AWM
3.76
(MC)
3.66
(MC)
3.78
(MC)
3.65
(MC)
3.69
(MC)
3.71
MC
This level of compliance was supported by studies that emphasized the role of hand hygiene in healthcare
settings. A study by Ojanperä, H. et al. (2022)
found that consistent availability of hand hygiene supplies and
clear guidelines significantly influenced compliance rates among healthcare workers. Similarly, research
conducted by Weldetinsae, A. et al. (2023) highlighted that regular monitoring and feedback mechanisms were
essential factors in maintaining high compliance levels with hand hygiene protocols. However, they noted that
continuous assessment and training programs were often challenging to implement in rural healthcare settings.
Use of Personal Protective Equipment (PPE). The data from Table 10 shows the compliance level of
healthcare workers in the use of Personal Protective Equipment (PPE) with an average weighted mean of 3.84,
interpreted as much compliant. Among RHUs, RHU A achieved the highest overall compliance with a
weighted mean of 3.89 (much compliant), while RHU C showed the lowest overall compliance with a
weighted mean of 3.77 (much compliant). Healthcare workers had the highest compliance observed in the
incorporation of PPE into emergency preparedness and response plans (WM, 3.97), followed by healthcare
workers feeling protected by the provided PPE (WM, 3.90), and adherence to protocols for used PPE
disposal (WM, 3.90). However, areas that showed relatively lower compliance, though still within the
much compliant range, included the provision of adequate PPE (WM, 3.74) and the review and update of PPE
policies to align with national standards (WM, 3.74). As a result, the Rural Health Units demonstrate an
improvement, particularly in ensuring adequate PPE supply, consistent training, and healthcare worker
involvement in procurement decisions, suggesting the need for targeted interventions and stronger alignment
with standard IPC.
Table 10 Compliance Level among Healthcare Workers along Use of Personal Protective Equipment (PPE)
Indicator
RHU
A
RHU B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1.The Rural Health Unit provides adequate
personal protective equipment (PPE) for all
healthcare workers.
3.94
(MC)
3.98
(MC)
3.99
(MC)
3.53
(MC)
3.25
(C)
3.74
MC
9.5
2. Healthcare workers receive training on the
proper use of PPE.
3.92
(MC)
3.8
(MC)
3.43
(MC)
3.89
(MC)
3.94
(MC)
3.81
MC
6.5
3. PPE is readily accessible in areas where
patient care is delivered.
4.00
(MC)
3.76
(MC)
3.79
(MC)
3.89
(MC)
3.92
(MC)
3.87
MC
4.5
Legend:
3.40 – 4.19 Much Compliant (MC)
2.60 – 3.39 Compliant (C)
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4. Guidelines for PPE use are clearly
communicated to all staff members.
3.9
(MC)
3.93
(MC)
3.77
(MC)
3.9
(MC)
3.83
(MC)
3.87
MC
4.5
5. There is a protocol for the disposal of used
PPE that all staff members follow.
3.69
(MC)
3.93
(MC)
3.93
(MC)
3.99
(MC)
3.95
(MC)
3.90
MC
2.5
6. Training on PPE use is regularly updated to
reflect current best practices.
3.96
(MC)
3.58
(MC)
3.93
(MC)
3.42
(MC)
3.97
(MC)
3.77
MC
8
7. Healthcare workers feel protected by the
PPE provided to them.
3.91
(MC)
3.97
(MC)
3.9
(MC)
3.91
(MC)
3.79
(MC)
3.90
MC
2.5
8. Healthcare workers are involved in the
selection and procurement of PPE to ensure it
meets their needs.
3.91
(MC)
3.68
(MC)
3.88
(MC)
3.84
(MC)
3.73
(MC)
3.81
MC
6.5
9. The use of PPE is incorporated into the
Rural Health Unit's emergency preparedness
and response plans.
3.96
(MC)
3.98
(MC)
3.96
(MC)
3.98
(MC)
3.95
(MC)
3.97
MC
1
10. The Rural Health Unit reviews and
updates its PPE policies to align with national
standards and best practices.
3.69
(MC)
3.97
(MC)
3.11
(C)
3.94
(MC)
3.99
(MC)
3.74
MC
9.5
AWM
3.89
(MC)
3.87
(MC)
3.77
(MC)
3.83
(MC)
3.83
(MC)
3.89
MC
According to Cordeiro, L. et al. (2022)
proper PPE implementations in healthcare facilities significantly
reduced healthcare-associated infections and improved worker safety, emphasizing the importance of
emergency preparedness integration. Additionally, Brooks, S. K. et al. (2021) found that healthcare workers'
involvement in PPE selection and clear communication of guidelines were important factors in achieving
sustained compliance with infection prevention protocols. Both studies underscored the necessity of regular
training updates and adequate PPE supply management in maintaining high compliance levels.
Prevention of needlestick and sharp injuries. Based on the data presented in Table 11, healthcare workers in
Rural Health Units demonstrated high compliance with measures for preventing needlestick and sharp injuries,
with an average weighted mean of 3.63 and interpreted as much compliant. Among the Rural Health Units,
RHU A showed the highest overall compliance (WM, 3.74), while RHU D demonstrated the lowest overall
compliance (WM, 3.55). The highest-ranked indicator was the sufficient supply of safety-engineered sharp
devices (WM, 3.94), followed by healthcare workers' confidence in the following protocols (WM, 3.87) and
clear guidelines on proper disposal of needles and sharp instruments (WM, 3.84). The lowest-ranked indicators
were the regular conduct of training sessions (WM, 3.35), interpreted as compliant and the provision of
counseling and support to healthcare workers who experienced needlestick and sharp injuries (WM, 3.42),
interpreted as much compliant. Therefore, the healthcare workers’ infection prevention measures for
needlestick and sharp injuries remain areas for improvement, particularly in policy updates, counseling
support, and the visibility of safety measures. Strengthening these aspects may elevate compliance levels and
promote safer workplace environments.
A similar pattern of compliance was documented in a study by Saadeh R. et al. (2020), which demonstrated
that healthcare facilities with adequate sharp safety devices and clear disposal protocols showed higher
compliance rates in preventing needlestick injuries. Additionally, research by Alfulayw, K.H. et al. (2021)
emphasized that healthcare institutions maintained good compliance with sharp safety protocols, areas such as
regular training and post-incident support required enhancement.
Table 11 Compliance Level among Healthcare Workers along Prevention of Needlestick and Sharp Injuries
Indicator
RHU
A
RHU
B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1. The Rural Health Unit regularly conducts
training sessions on the prevention of
needlestick and sharp injuries.
3.87
(MC)
2.67
(C)
3.51
(MC)
3.52
(MC)
3.2
(C)
3.35
C
10
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2. There are clear and accessible guidelines
on the proper disposal of needles and other
sharp instruments in the health unit.
3.95
(MC)
3.89
(MC)
3.95
(MC)
3.88
(MC)
3.53
(MC)
3.84
MC
3
3. Healthcare workers feel confident in their
ability to follow protocols for preventing
needlestick and sharp injuries.
3.92
(MC)
3.96
(MC)
3.86
(MC)
3.99
(MC)
3.64
(MC)
3.87
MC
2
4. The health unit has a sufficient supply of
safety-engineered sharp devices.
3.99
(MC)
3.98
(MC)
3.92
(MC)
3.99
(MC)
3.83
(MC)
3.94
MC
1
5. The reporting system for needlestick and
sharp injuries is efficient and encourages
healthcare workers to report incidents.
3.65
(MC)
3.36
(MC)
3.01
(C)
3.93
(MC)
3.79
(MC)
3.55
MC
6.5
6. Healthcare workers regularly receive
feedback and updates on needlestick and
sharp injury prevention measures.
3.87
(MC)
3.70
(MC)
3.42
(MC)
3.94
(MC)
3.48
(MC)
3.68
MC
4
7. Safety measures for preventing needlestick
and sharp injuries are visibly posted in areas
where they are most needed.
3.19
(C)
3.86
(MC)
3.19
(C)
3.54
(MC)
3.45
(MC)
3.45
MC
8
8. The Rural Health Unit has a plan in place
to address any gaps or deficiencies in
needlestick and sharp injury prevention
measures.
3.89
(MC)
3.42
(MC)
3.67
(MC)
3.34
(MC)
3.41
(MC)
3.55
MC
6.5
9. The Rural Health Unit provides counseling
and support to healthcare workers who
experience needlestick and sharp injuries.
3.67
(MC)
3.46
(MC)
3.26
(C)
3.28
(C)
3.43
(MC)
3.42
MC
9
10. The Rural Health Unit reviews and
updates its needlestick and sharp injury
prevention policies to align with national
standards and best practices.
3.43
(MC)
3.79
(MC)
3.79
(MC)
3.31
(C)
3.73
(MC)
3.61
MC
5
AWM
3.74
(MC)
3.61
(MC)
3.56
(MC)
3.67
(MC)
3.55
(MC)
3.63
MC
Environmental cleaning and disinfection. Based on the data presented in Table 12, the healthcare workers in
Rural Health Units of the 5th District of Camarines Sur demonstrated high compliance with environmental
cleaning and disinfection standards. The overall average weighted mean of 3.91 indicated that the healthcare
workers were much compliant with the standard Infection Prevention and Control measures. Among the five
RHUs, RHU B and RHU E tied for the highest compliance with a weighted mean of 3.93 (much compliant),
while RHU A showed the lowest compliance with a weighted mean of 3.89 (much compliant). The highest
compliance was observed in the involvement of healthcare workers in developing and implementing
environmental cleaning and disinfection protocols (WM, 4.39), followed by providing necessary resources
(WM, 3.97) and incorporating activities into quality improvement initiatives (WM, 3.97). The lowest
compliance was noted in implementing a color-coding system for cleaning equipment (WM, 3.58), which still
fell under the much-compliant interpretation. Moreover, the RHUs maintains acceptable standards in
environmental cleaning and disinfection. There are areas for enhancement, particularly in standardizing color-
coding systems and strengthening audit processes. The generally high compliance levels across all indicators
reflect effective implementation of infection prevention and control measures, though achieving full
compliance would require targeted improvements in specific areas.
Table 12 Compliance Level among Healthcare Workers along Environmental Cleaning and Disinfection
Indicator
RHU
A
RHU
B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1. Cleaning and disinfection protocols are
clearly communicated to all staff within the
Rural Health Unit
3.85
(MC)
3.90
(MC)
3.88
(MC)
3.86
(MC)
3.87
(MC)
3.87
MC
6.5
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2. A regular schedule for cleaning and
disinfection that is strictly followed.
3.8
(MC)
3.82
(MC)
3.81
(MC)
3.80n
(MC)
3.82
(MC)
3.81
MC
9
3. Staff are provided with the necessary
resources to perform environmental cleaning
and disinfection effectively.
3.95
(MC)
3.98
(MC)
3.97
(MC)
3.98
(MC)
3.97
(MC)
3.97
MC
2.5
4. Staff receive regular training on the latest
infection prevention and control practices
related to environmental cleaning.
3.85
(MC)
3.88
(MC)
3.87
(MC)
3.88
(MC)
3.87
(MC)
3.87
MC
6.5
5. The Rural Health Unit conducts regular
audits to assess the effectiveness of
environmental cleaning and disinfection
practices.
3.82
(MC)
3.85
(MC)
3.84
(MC)
3.85
(MC)
3.84
(MC)
3.84
MC
8
6. The Rural Health Unit uses cleaning
products that are approved and effective
against a broad spectrum of pathogens.
3.92
(MC)
3.95
(MC)
3.94
(MC)
3.95
(MC)
3.94
(MC)
3.94
MC
4
7. Healthcare workers are involved in the
development and implementation of
environmental cleaning and disinfection
protocols.
4.32
(MC)
4.42
(MC)
4.36
(MC)
4.37
(MC)
4.48
(MC)
4.39
MC
1
8. Environmental cleaning and disinfection
activities are incorporated into the Rural
Health Unit's quality improvement initiatives.
3.95
(MC)
3.98
(MC)
3.97
(MC)
3.98
(MC)
3.97
(MC)
3.97
MC
2.5
9. The Rural Health Unit has implemented a
color-coding system for cleaning equipment to
prevent cross-contamination between different
areas.
3.56
(MC)
3.58
(MC)
3.59
(MC)
3.58
(MC)
3.59
(MC)
3.58
MC
10
10. The Rural Health Unit regularly reviews
and updates its environmental cleaning and
disinfection policies to align with standards.
3.88
(MC)
3.90
(MC)
3.91
(MC)
3.90
(MC)
3.91
(MC)
3.90
MC
5
AWM
3.89
(MC)
3.93
(MC)
3.91
(MC)
3.92
(MC)
3.93
(MC)
3.91
MC
These findings were consistent with recent studies on infection prevention and control compliance. A study by
Daba, C. et al. (2023) highlighted that healthcare worker participation in protocol development significantly
improved compliance with infection prevention measures. Similarly, research conducted by Parry, M. F. et al.
(2022)
demonstrated that resource availability and the integration of cleaning protocols into quality
improvement programs were important factors in maintaining high compliance levels with environmental
cleaning standards.
Challenges affecting compliance level with standard Infection Prevention and Control
Resources. Based on the data presented in Table 13, resource constraints significantly affect the compliance
level of healthcare workers in Rural Health Units regarding the standard Infection Prevention and Control.
Among RHUs, RHU D appears to be most affected by these challenges with the weighted mean of 3.61
(moderately affect), while RHU B shows the lowest impact with weighted mean of 3.36 (affect).The most
significant challenges identified were the lack of ongoing IPC training programs for healthcare workers
(WM, 3.77, moderately affect), limited access to updated IPC guidelines and protocols (WM, 3.68,
moderately affect), and financial constraints in implementing recommended IPC practices (WM, 3.61,
moderately affect). Conversely, the study identified areas of lesser concern, though still affecting operations,
which included the lack of proper waste disposal systems (WM, 3.35, affect), inadequate supply of cleaning
materials (WM, 3.32, affect), and insufficient technological resources for monitoring infection rates (WM,
3.19, affect). Overall, with an average weighted mean of 3.47, these resource constraints are interpreted as
moderately affect compliance levels among healthcare workers in the Rural Health Units. The data indicates
that RHUs faces a complex array of resource-related challenges in maintaining IPC compliance. The most
significant issues revolve around training, budget allocation, and access to necessary equipment and
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information. Addressing these challenges, particularly through improved training programs and increased
budget allocation, could significantly enhance compliance with standard infection prevention and control
measures.
Table 13 Challenges Affecting Compliance Level along Resources
Indicator
RHU
A
RHU
B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1. There is a lack of ongoing infection
prevention and control (IPC) training
programs for healthcare workers in Rural
Health Units.
3.71
(MA)
3.65
(MA)
3.68
(MA)
3.95
(MA)
3.85
(MA)
3.77
MA
1
2. Healthcare workers experience shortages of
personal protective equipment (PPE)
necessary for effective infection control.
3.40
(MA)
3.96
(MA)
3.51
(MA)
3.98
(MA)
2.76
(A)
3.52
MA
4
3. Financial constraints limit the ability to
implement recommended IPC practices.
3.98
(MA)
3.53
(MA)
3.46
(MA)
3.55
(MA)
3.53
(MA)
3.61
MA
3
4. The facility lacks proper waste disposal
systems to manage infectious materials.
3.90
(MA)
2.91
(A)
3.28
(A)
3.07
(A)
3.61
(MA)
3.35
A
7.5
5. There are insufficient technological
resources for monitoring and reporting
infection rates.
2.05
(SA)
3.94
(MA)
2.39
(A)
3.86
(MA)
3.73
(MA)
3.19
A
10
6. Support services for thorough cleaning and
disinfection of the facility are deficient.
3.38
(MA)
3.12
(A)
3.34
(A)
3.46
(MA)
3.45
(MA)
3.35
A
7.5
7. There are struggles with the timely
replacement of outdated or non-functioning
equipment
3.95
(MA)
2.27
(SA)
3.50
(MA)
3.46
(MA)
3.92
(MA)
3.42
A
6
8. Access to updated guidelines, protocols,
and research on infection prevention and
control is limited.
3.68
(MA)
3.69
(MA)
3.65
(MA)
3.68
(MA)
3.69
(MA)
3.68
MA
2
9. There is an inadequate supply of cleaning
materials and disinfectants to maintain a
hygienic environment.
2.62
(A)
3.36
(MA)
3.53
(MA)
3.55
(MA)
3.52
(MA)
3.32
A
9
10. Insufficient budget allocation for IPC
activities makes it difficult to prioritize and
implement effective infection control
measures.
3.64
(MA)
3.19
(A)
3.49
(MA)
3.52
(MA)
3.41
(MA)
3.45
MA
5
AWM
3.43
(MA)
3.36
(A)
3.38
(A)
3.61
(MA)
3.55
(MA)
3.47
MA
Recent research has emphasized the role of continuous IPC training and resource availability in healthcare
settings. A study conducted in Myanmar public hospitals demonstrated that approximately 80% of hospitals
maintained functional IPC status and provided training on infection prevention, yet resource constraints
remained a significant challenge, particularly in primary healthcare facilities (Than, T. M. et al., 2024).
Similarly, a comprehensive review of healthcare workers' behaviors towards IPC practices highlighted that
knowledge-oriented, person-oriented, and environment-oriented factors significantly influenced compliance
with IPC protocols, emphasizing the importance of adequate resources and continuous professional
development (Mutsonziwa, G. A. et al., 2024).
Infrastructure and facility. The data from Table 14 highlights the infrastructure and facility limitations
impacting IPC compliance among healthcare workers in RHUs. The RHUs most and least affected by these
challenges, RHU A, showed the highest overall impact (WM=3.46), while RHU D experienced the lowest
overall impact (WM=3.38) from these infrastructure and facility limitations. The lack of separate areas for
sterile and non-sterile supplies emerged as the most concern with a weighted mean of 3.68, indicating a
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moderate affect on infection control practices. This was followed by inadequate WASH facilities and
insufficient waiting areas, both scoring 3.52, indicating a moderate affect. Conversely, the layout of the health
unit, with a weighted mean of 3.26; lack of emergency power sources, with a weighted mean of 3.29; and
inadequate physical infrastructure, with a weighted mean of 3.32, were identified as less impactful barriers,
though still affects infection prevention protocols. Overall, the AWM is 3.43; these infrastructure limitations
collectively moderate affect the ability to adhere to national standard IPC protocols. These results emphasize
the need for targeted interventions, such as improving infrastructure (e.g., isolation rooms, ventilation systems,
and lighting) and ensuring the availability of fundamental IPC resources, including water and sanitation
facilities. Addressing these challenges would likely enhance compliance with IPC standards and improve
overall healthcare delivery in RHUs.
Table 14 Challenges Affecting Compliance Level along Infrastructure and facility
Indicator
RHU
A
RHU
B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1. The layout of the health unit makes it
difficult to follow infection prevention
protocols.
3.02
(A)
3.13
(A)
3.98
(MA)
3.01
(A)
3.14
(A)
3.26
A
10
2. The ventilation system is inadequate for
preventing the spread of infections.
3.11
(A)
3.47
(MA)
3.30
(A)
3.57
(MA)
3.95
(MA)
3.48
A
4
3. The physical infrastructure does not
adequately support IPC practices (e.g.,
isolation rooms and proper ventilation).
3.22
(A)
3.35
(A)
3.54
(MA)
3.27
(A)
3.23
(A)
3.32
MA
8
4. Inadequate availability of water, sanitation,
and hygiene (WASH) facilities for IPC.
3.80
(MA)
3.97
(MA)
3.33
(A)
3.25
(MA)
3.24
(A)
3.52
MA
2.5
5. The water supply is insufficient for hygiene
and sanitation needs.
3.46
(MA)
3.36
(A)
3.59
(MA)
3.31
(A)
3.40
(MA)
3.42
MA
5.5
6. Lack of emergency power sources to
support infection control during outages.
3.23
(A)
3.65
(MA)
3.02
(A)
3.25
(A)
3.32
(A)
3.29
A
9
7. Absence of necessary signage to guide
patients and staff on infection control
practices.
3.65
(MA)
3.43
(MA)
3.09
(A)
3.25
(A)
3.33
(A)
3.35
A
7
8. Inadequate waiting areas for patients,
leading to overcrowding and increased risk of
infection transmission.
3.64
(MA)
3.38
(A)
3.43
(MA)
3.55
(MA)
3.61
(MA)
3.52
MA
2.5
9. Lack of separate areas for sterile and non-
sterile supplies, increasing the risk of
contamination.
3.64
(MA)
3.68
(MA)
3.62
(MA)
3.69
(MA)
3.77
(MA)
3.68
MA
1
10. Insufficient lighting in patient care areas
makes it difficult to maintain proper hygiene
and infection control practices.
3.78
(MA)
3.12
(A)
3.39
(A)
3.67
(MA)
3.16
(A)
3.42
MA
5.5
AWM
3.46
(MA)
3.45
(MA)
3.43
(MA)
3.38
(A)
3.42
(MA)
3.43
MA
Recent studies have highlighted similar infrastructure-related challenges in healthcare facilities. In a
comprehensive analysis of 7,948 health facilities across multiple countries, only 19.71% had all basic infection
control materials, with particularly significant gaps in rural healthcare settings (Hakim, S. et al, 2024).
Additionally, a study in Ethiopia found that consistent water supply at hand washing stations increased
Legend:
3.40 – 4.19 Moderately Affect (MA)
2.60 – 3.39 Affect (A)
1.80 – 2.59 Slightly Affect (SA)
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adherence to infection prevention practices by nearly three-fold (AOR, 2.90; 95% CI, 1.62-5.20), while proper
training improved compliance by 1.7 times (AOR, 1.68; 95% CI, 1.04-2.72) (Babore, G. O. et al, 2020).
Human Resources. Table 15 highlights human resources affecting compliance with standards infection
prevention and control among healthcare workers. Among RHUs, RHU B shows a moderate effect (WM,
3.60), while RHU A demonstrates an affect (WM, 3.21). Insufficient training on IPC standards emerged as the
most significant concern with a weighted mean of 3.65, followed by limited availability of IPC mentors and
coaches (WM, 3.58), and insufficient motivation among healthcare workers to adhere to IPC guidelines (WM,
3.55). On the other end of the spectrum, high turnover rates, unfunded resources for additional staffing, and
inadequate leadership emphasis on IPC were identified as the least impacting factors, all scoring a weighted
mean of 3.35. Overall, the AWM of 3.48, these challenges collectively have a moderate affect on IPC
compliance. Correspondingly, the compliance level of healthcare workers in RHUs is primarily hindered by
insufficient training, limited mentorship, and lack of recognition systems, suggesting the need for
comprehensive human resource development strategies to enhance adherence to infection prevention and
control standards.
Table 15 Challenges Affecting Compliance Level along Human Resources
Indicator
RHU
A
RHU
B
RHU
C
RHU
D
RHU
E
Total
WM
I
R
Weighted Mean
1. Insufficient training on IPC standards for
healthcare workers.
3.02
(A)
3.88
(MA)
3.74
(MA)
4.00
(MA)
3.63
(MA)
3.65
MA
1
2. The high turnover rate of healthcare
workers affects the continuity of IPC
practices.
3.15
(A)
3.14
(A)
3.99
(MA)
3.26
(A)
3.19
(A)
3.35
A
9
3. Unclear directives in implementing IPC
guidelines arise from higher authorities' lack
of clear communication.
3.09
(A)
3.95
(MA)
3.61
(MA)
3.07
(A)
3.88
(MA)
3.52
A
4.5
4. Inadequate staffing ratios, leading to
increased workload and decreased attention to
infection control practices.
3.37
(A)
3.09
(A)
3.12
(A)
3.98
(MA)
3.56
(MA)
3.42
MA
7
5. Healthcare Workers are not sufficiently
motivated to adhere to infection prevention
and control guidelines.
3.19
(A)
3.93
(MA)
3.53
(MA)
3.86
(MA)
3.25
(A)
3.55
MA
3
6. There are unfunded resources to hire
additional staff necessary for effective
infection prevention and control.
3.05
(A)
3.87
(MA)
3.01
(A)
3.66
(MA)
3.15
(A)
3.3
A
9
7. Inadequate leadership emphasis on
infection prevention and control negatively
impacts staff adherence to protocols.
3.19
(A)
3.25
(A)
3.40
(MA)
3.15
(A)
3.77
(MA)
3.35
A
9
8. Limited opportunities for professional
development and continuing education on
infection prevention and control exist for
healthcare workers
3.38
(A)
3.73
(MA)
3.48
(MA)
3.17
(A)
3.65
(MA)
3.48
MA
6
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9. There is a limited availability of IPC
mentors and coaches to support new staff
members.
3.55
(MA)
3.52
(MA)
3.82
(MA)
3.52
(MA)
3.48
(MA)
3.58
MA
2
10. Lack of recognition or incentives for
healthcare workers who demonstrate excellent
infection prevention and control practices,
leading to low motivation and adherence to
protocols.
3.08
(A)
3.67
(MA)
3.67
(MA)
3.39
(A)
3.77
(MA)
3.52
MA
4.5
AWM
3.21
(A)
3.60
(MA)
3.54
(MA)
3.51
(MA)
3.53
(MA)
3.48
MA
Recent studies supported these findings, where compliance with IPC guidance was significantly influenced by
training and mentorship. A study in Ethiopia showed that healthcare workers who received IPC training were
1.68 times more likely to adhere to infection prevention practices, with only 60.2% demonstrating good
adherence overall (Babore, G. O. et al, 2020). Similarly, research in Addis Ababa public hospitals indicated a
mere 36.49% compliance rate with standard precautions, emphasizing that receiving IPC training (AOR, 1.81,
95% CI 1.06, 3.09) and knowledge of standard precautions significantly improved compliance levels.
Relationship between the demographic profile and compliance level among healthcare workers of Rural
Health Units on the standard infection prevention and control
Table 16 shows significant relationships between all demographic factors and compliance levels among
healthcare workers. All computed values exceed their respective tabular values, leading to the rejection of the
null hypothesis for each factor. Age (47.2), sex (19.01), civil status (23.06), educational attainment (37.32),
designation (23.06), and length of service (39.82) all demonstrate statistically significant associations with
compliance to standard infection prevention and control measures. In conclusion, these findings highlight the
complex interplay between personal and professional characteristics and compliance with infection prevention
and control standards. Healthcare administrators and policymakers should consider these demographic factors
when designing training programs, implementing compliance measures, or developing targeted interventions
to improve overall adherence to infection control protocols in RHUs.
Table 16 Relationship between the demographic profile and Compliance Level among Healthcare Workers of
Rural Health Units on the Standard Infection Prevention and Control
Demographic Profile
Computed Value
Tabular Value
Decision on Ho
Interpretation
Age
47.2
31.41
Rejected
Significant
Sex
19.01
9.49
Rejected
Significant
Civil Status
23.06
15.51
Rejected
Significant
Educational Attainment
37.32
21.03
Rejected
Significant
Designation
36.11
26.30
Rejected
Significant
Length of Service
39.82
21.03
Rejected
Significant
Training Guide on Infection Prevention and Control Procedure and Policy
The Training Guide on Infection Prevention and Control Policy and Procedure was developed in response to a
critical finding that 45.58% (67 out of 147) healthcare workers in Rural Health Units had no training in
infection prevention and control. This significant knowledge gap poses substantial risks to both healthcare
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providers and patients, emphasizing the fundamental importance of proper infection control measures in
healthcare delivery. The study identified inadequate training as a major challenge affecting compliance, with a
weighted mean of 3.77, demonstrating an urgent need for structured educational interventions.
Resource limitations, particularly in ongoing IPC training programs and access to current guidelines, were
found to significantly impact healthcare workers' ability to maintain proper infection control standards. It
highlighted insufficient IPC training as the primary human resource concern, with limited availability of IPC
mentors and coaches following closely. These findings emphasize the need for a comprehensive, standardized
training resource that can effectively bridge knowledge gaps and ensure consistent guidance across all RHUs.
The study also revealed significant correlations between demographic factors and compliance levels,
necessitating a training guide capable of addressing diverse learning needs while maintaining standardized
practices. The guide responds to these challenges by incorporating practical, cost-effective, and sustainable
strategies specifically tailored to rural healthcare settings with limited resources. Through clear, actionable
guidelines and standardized procedures, this training guide serves as a vital tool for enhancing infection
prevention and control compliance and ultimately improving healthcare quality in Rural Health Units.
SUMMARY, FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
This chapter presents the summary of the study, the findings, and conclusions based on the findings of the
study as well as the recommendations.
Summary
The study focused on assessing the compliance level among healthcare workers of Rural Health Units on the
standard of infection prevention and control. Specifically, it sought to answer the following: 1. What is the
demographic profile of the respondents in terms of age, sex, civil status, educational attainment, designation,
length of service, and related training attended? 2. What is the compliance level among healthcare workers of
Rural Health Units on the standard infection prevention and control along with hand hygiene practices, use of
Personal Protective Equipment (PPE), prevention of needlestick and sharp injuries, and environmental
cleaning and disinfection? 3. Is there a significant relationship between the demographic profile and
compliance level among healthcare workers of Rural Health Units on the standard infection prevention and
control? 4. What are the challenges encountered by healthcare workers of Rural Health Units affecting the
compliance level with the standard in infection prevention and control along with resources, infrastructure and
facility, and human resources. 5. What strategies may be proposed to enhance the compliance level among
healthcare workers of Rural Health Units on the standard of infection prevention and control?
The study used a descriptive-correlation method with the use of a survey questionnaire as the primary
instrument for conducting the study. The respondents of the study consisted of 147 healthcare workers of Rural
Health Units
Findings
The following are the findings derived from the result of the research study:
1. The demographic profile of healthcare workers in Rural Health Units (RHUs reveals a diverse workforce.
Most of the respondents are between 25-29 and 40-44 years old (32 or 21.77 percent each), females (108 or
73.47 percent), and married (105 or 71.43 percent). The majority were college graduates (94 or 63.95 percent),
with nurses comprising the largest group (75 or 51.02 percent). Most have 4-6 years of service (48 or 32.65
percent). Notably, 67 or 45.58 percent reported no related infection prevention and control training or
seminars.
2. The compliance level among healthcare workers of Rural Health Units on the standard infection prevention
and control were Hand Hygiene Practices (3.71), use of Personal Protective Equipment (3.84), Prevention of
needlestick and sharp injuries (3.63), and Environmental cleaning and disinfection (3.91), all interpreted as
much compliant.
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3. The significant correlations between demographic profile and compliance level among healthcare workers
demonstrated statistically significant relationships, as their computed values consistently exceeded their
respective tabular values, leading to the rejection of the null hypothesis.
4. Implementing the standard of infection prevention and control among healthcare workers faces significant
challenges. Resources (3.47, interpreted as affect), infrastructure and facility (3.43, interpreted as affect), and
human resources (3.6, interpreted as moderately affect).
5. Strategic interventions to enhance compliance levels among healthcare workers in Rural Health Units
regarding standard infection prevention and control can be proposed. There's a need to strengthen the training
and education component. Additionally, improving facility infrastructure would support better compliance
with infection control protocols. Developing a comprehensive documentation and reporting system would
enhance accountability and tracking of compliance levels. This should include standardized incident reporting
protocols, regular infection prevention practices assessments, and clear procedure guidelines. Lastly, fostering
a culture of safety and continuous improvement is essential. This involves encouraging open communication
about infection control concerns, recognizing and rewarding good practices, and ensuring leadership support
for infection prevention initiatives.
Conclusions
In the light of the findings, the following conclusions were drawn:
1. Most of the respondents were females, married, college graduates, nurses and lacked related training and
seminars.
2. Healthcare workers in the RHUs demonstrated a generally high level
of compliance with standard infection prevention and control measures, such as hand hygiene, use of personal
protective equipment, prevention of needlestick and sharp injuries, and environmental cleaning and
disinfection, which are all rated as much compliant. This suggests a positive foundation for infection control
practices but also indicates room for improvement to reach full compliance.
3. There is statistically significant relationship between demographic profiles and compliance levels among
healthcare workers. It suggests that factors such as age, education level, professional role, and years of service
may influence adherence to infection control standards. Understanding these relationships can help in tailoring
interventions and training programs to specific demographic groups for maximum effectiveness.
4. Significant challenges exist in implementing standard infection prevention and control measures such
as resource constraints, infrastructure limitations, and human resource issues are identified as key factors
affecting compliance. These challenges underscore the need for targeted interventions and resource allocation
to improve RHUs' overall infection control environment.
5. A multi-faceted approach is necessary to enhance compliance levels with standard infection prevention and
control measures. This approach should include strengthening training and education programs, improving
resource allocation and infrastructure, developing comprehensive documentation and reporting systems, and
fostering a culture of safety and continuous improvement. Such strategic interventions are important for
addressing the identified gaps and challenges, ultimately leading to better infection prevention and control
practices in the RHUs of the 5th District of Camarines Sur.
Recommendations
In the light of the findings and conclusions, the following recommendations were formulated.
1. A multifaceted approach to improving IPC compliance begins with establishing comprehensive education
and training programs. Healthcare workers should receive regular updates on IPC practices, including hand
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hygiene practices, use of Personal Protective Equipment (PPE), prevention of needlestick and sharp injuries,
and environmental cleaning and disinfection.
2. Infrastructure and resource allocation must be addressed to support IPC compliance. This includes ensuring
adequate supplies of PPE, hand hygiene facilities, and proper cleaning materials.
3. The development and implementation of a comprehensive IPC Manual of Policy and Procedure serves as a
cornerstone for standardizing practices. This manual is evidence-based, regularly updated, and easily
accessible to all healthcare workers. It should include detailed protocols for all aspects of infection prevention
and control, clear guidelines for implementation, and specific procedures tailored to rural health unit settings.
4. LGU and RHU foster a culture of safety, and continuous improvement is essential. This involves
encouraging open communication about infection control concerns, recognizing and rewarding good practices,
and ensuring leadership support for infection prevention initiatives.
END NOTES
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