1

Waste Management Practices of Camarines Norte Provincial

Hospital in Daet, Camarines Norte: An Evaluation

By

EDGAR BRYAN B. NICART

This is only a proposal, if you need to see the full length of the study you
can ask the author via email: [email protected] or contact me:
+639218139483
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Chapter I

The Problem

Introduction

One of the problems of hospital management is waste

segregation and management because of the concern brought by

hospitals towards the waste disposal techniques they need to

implement. This is to avoid possible danger not only on the

community by which hospitals are involved but also on a

national concern of waste segregation especially those that

are toxic and contains materials which may endanger the

health of the community.

Recycling and waste reduction efforts have become

increasingly important as a critical strategy for meeting

the changing needs of hospital waste management. Cost, new

regulations, public health, community relations, and an

emerging environmental consciousness are all combining to

pressure hospitals to take a proactive stance in changing

their waste management practices. Waste disposal is

becoming an independent cost factor at many institutions,

and many hospitals have found that the easiest money to find

to implement new programs is money that they do not have to

spend for disposal under old management practices, (R. Mann,

2004).
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Even in America, waste management is an issue and is

still one of the biggest challenges in a dominating country.

The American hospitals are responsible for approximately one

percent of all the municipal solid waste (MSW) generated in

the United States. This means that in the course of

providing health care, hospitals alone are sending 12

million pounds of waste per day to landfills and

incinerators (almost 2 million tons a year!). Of this, U.S.

hospitals currently classify approximately 15 percent of

this waste as infectious, which must be treated differently

from MSW. One thousand tons of the waste coming out of

hospitals each day is treated as special waste. This is the

waste that most often gets the attention of hospital

administrators and managers—and in many cases even the

media, (E. Humes, 2004).

In the Philippines, stringent regulations governing the

handling and disposal of infectious waste have gained

attention especially that more subtle forces are starting to

pressure hospitals to pay attention to the rest of the waste

they generate. The issue of hospital waste has been a

growing concern for some time. As what Secretary Angelo

Reyes of the Department of Environment and Natural Resources

maintained, that it is their legal duty to regulate the

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waste management of hospitals by issuing notices of

violation. Hence, he organized an inspection team composed

of representatives from the DENR, the Department of Health

(DOH), the National Anti-Environment Crime Task Force

(NAECTAF) and the Philippine Hospital Association, Inc.

(PHA) to monitor the compliance of Metro manila hospitals to

waste management regulations, (C. Davis, 2007).

In a report given by Dr Antonio Chang of PHAP, he said

that the practices of hospitals in the rural areas should

also be more closely looked into. He said that the

inadequacies of waste management by Philippine hospitals are

a reflection of the general society's inattention to waste

issues and basic hygiene. Carrying this view, it would be

fundamental to note further that the disposal options

(landfills, incinerators, etc.) are becoming increasingly

narrow. The pipeline of "products in, wastes out" has now

become a funnel with an ever-narrowing outlet for waste.

Waste disposal practices have changed dramatically in the

past 30 years from open burning, "dumps," and ocean dumping,

to engineered "sanitary" landfills and highly regulated

incinerators. Years of environmental abuse adversely

affecting both water and air quality have caused thousands

of landfills to close, with few new "safe" ones opening to

 5

replace them. Hospitals which in the past legally operated

incinerators without environmental safety controls, are

finding that they must shut them down due to new regulations

and poor public relations, (T. Brooks, 2007).

As a governing body, the Environmental Health Service

of the Department of Health implements Hospital Waste

Management Program as one of the thrusts to achieve health

for all. However, Presidential Decree No. 825 clearly

provides penalty for improper disposal of garbage and other

forms of uncleanliness and for other purposes. Along with

Republic Act No. 6969 which is an act to control toxic

substances and hazardous and nuclear waste, provides

penalties for violations thereof. This was further supported

by Commonwealth Act No. 383 which is an act to punish the

dumping into any river of refuse waste water or substances

of any kind whatsoever that may bring about the rise or

filling in of river beds or cause artificial alluvial

formations. Hence, with these radical laws, it would be fit

for hospitals to maintain proper standards of waste disposal

and management to avoid issues and problems related to

health and environmental pollution, (R. Santiago, M.D.,

1994).
 6

As one of the many hospitals in the country that adhere

to the requirements of the Department of Health in waste and

sanitation management, the Camarines Norte Provincial

Hospital share the same problem of waste disposal and

control in the claim that proper health care waste

management is difficult, expensive and impractical in terms

of management and practice.

It is in the light of these insights that this study

inspired the researchers to determine the waste management

practices of Camarines Norte Provincial Hospital in Daet. As

a nursing student, this will provide better insights on the

problems related to the existing waste management program

and be of help by doing our part to improve the waste

management and practice and gain deeper understanding to the

problems.

Statement of the Problem

This study will evaluate the waste management practices

of Camarines Norte Provincial Hospital in Daet, Camarines

Norte.

Specifically, it will seek answers to the following

questions:
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1) What is the profile of the respondents in Camarines

Norte Provincial Hospital in terms of:

a. Age

b. Sex

c. Length of service, and

d. Position

2) How does the Waste Management Program in Camarines

Norte Provincial Hospital operate in terms of the following:

a. segregation

b. disposal

c. collection, and

d. recycling

3) What program can be proposed to improve the existing

waste management practices of Camarines Norte Provincial

Hospital?

Scope and Limitation of the Study

This study will attempt to investigate the waste

management practices of the Camarines Norte Provincial

Hospital. These practices will involve and will be limited

to the Camarines Norte Provincial Hospital delivery of their

waste products along the five (4) major components namely:

a) segregation, b) disposal, c) collection, and d)

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recycling. The period and scope covered by the study is from

December 2008 to March 2009 and the locale will be Daet,

Camarines Norte.

This study will involve only the nurses and janitors of

the Camarines Norte Provincial Hospital as respondents of

the study who are working directly on the planning,

implementation and reduction of waste management in

Camarines Norte Provincial Hospital.

Significance of the Study

The findings of this study focused on the waste

management practices of Camarines Norte Provincial Hospital

will serve as a guide and source of information for the

improvement of the delivery of waste program and services in

the provincial hospital of Camarines Norte.

Similarly, in deciding to conduct this study, the

researcher believes that the results may benefit the sector

and persons involved in the health care field as follows:

Camarines Norte Provincial Hospital. As the prime

benefactor of this study, the findings will help the

Camarines Norte Provincial Hospital in the planning and

implementation of a better program for waste disposal and

reduction. Likewise, the result will serve as guidelines to

 9

reference rehabilitation of Camarines Norte Provincial

Hospital for a better waste management system.

Public and Private Hospitals. Data gathered will reveal

pertinent insights in the conduct of proper waste management

practice. This in turn will serve as a guideline for

existing hospitals of the country to better improve the

existing program on waste disposal and may become an

implementing pattern for some hospitals in dealing with

their waste and waste products.

Nurses, Doctors and Other Health Personnel. Information

gathered will complement the medical and paramedical sectors

in the improvement of sanitation and in contributing proper

waste management system.

Department of Health. The findings of this study can be

further analyze to provide inputs for the provision of new

policies, rules and regulations to enhance and alleviate

problems in the waste disposal and sanitation of hospitals

in the public and private sector.

Nursing Students. The exposure of the students in the

clinical area will make them more aware about the program

and help contribute to a better waste disposal strategy.

People of Daet, Camarines Norte. From the results of

the study, the researchers envisioned the needs for a proper

 10

waste management practice to secure the health and safety of

the people against danger of not following proper waste

disposal. Bearing this in mind, the result of the study will

benefit the people of Daet, Camarines Norte and the

neighboring municipalities. The study will also serve to

protect and illuminate the people of Daet, Camarines Norte

on the safety of the waste management practices of CNPH.

Future Researchers. Findings of this study will benefit

other researchers who may wish to embark on studies related

to the waste management practices of hospitals.

Definition of Terms

Several terms used in this study were operationally

defined for the sole purpose of the research while other

terms retained their conceptual definition.

Administration. This refers to the doctors’ in-charge,

heads, nurses, and even janitors of the Camarines Norte

Provincial Hospitals.

Camarines Norte Provincial Hospital (CNPH). A tertiary

level hospital that caters the hospital and medical needs of

the province located at Daet, Camarines Norte. This is the

locale of the study.

 11

Chemical wastes. This comprises discarded, solid,

liquid, and gaseous chemicals, for example from diagnostic

and experimental work, and cleaning, housekeeping and

disinfecting procedures Chemical waste may be hazardous or

non- hazardous, (surgicenteronline.com).

Collection. This refers to the gathering of waste and

classifying them according to their given classification. In

this study, this is the gathering of collected waste such as

pathological, infectious, sharps, pharmaceutical,

radioactive and chemical wastes products thrown by hospital

staffs, doctors, nurses, and patients.

Disposal. This refers to throwing away or dumping

garbage to a sanitation field or garbage site. In this

study, this is the actual disposal of hospital waste

products classified and controlled in incinerators.

Hospital Waste. This refers to all the waste generated

from a facility (including cafeteria, office, and

construction wastes),(Ibid).

Medical Waste. This is also a subset of hospital waste

that was generated as a result of patient diagnosis,

treatment, or immunization of human beings or animals,

(Environmental Health and Services, 1994).

 12

Pathological wastes. These consist of tissues, organs,

body parts, human fetuses and animal carcasses; and most

blood and body fluids.

Pharmaceutical wastes. This refers to pharmaceutical

products, drugs, and chemical that have been returned from

wards, have been spilled, are outdated or contaminated, or

are to be discarded because they are no longer required,

(Ibid).

Potentially Infectious Waste. This is also a subset of

medical waste that portion of medical waste that has the

potential to transmit an infectious disease, (Ibid).

Radioactive wastes. This refers to the solid, liquid,

and gaseous waste contaminated with radionuclides generated

from vitro analysis of body tissues and fluids, in vivo body

organ imaging and tumor localization, and therapeutic

procedures, (Ibid).

Recycling. This refers to the actual collection,

sorting, and processing of discarded materials that will

serve as the raw material for new products.

Reduction. This refers to a set of methods and

strategies to decrease the volume of waste generated at the

source or in actual use.

 13

Reuse. This refers to a set of decisions or strategies

to prolong the life of a material. Such strategies can

result in cost savings, waste volume reduction, and resource

preservation. Such actions include: switching to reusable

diapers or gowns, purchasing equipment that can be easily

re-sterilized and reissued for use, and initiating simple

programs such as collecting scrap paper to be remade into

notepads. The remanufacture of items (for example, computer

ribbons and cartridges from laser printers and copiers) is

also a function of reuse.

Segregation. This refers to the actual separation of

different waste products or materials into different

category such as: pathological wastes, infectious wastes,

sharps that includes needles, syringes, scalpels, saws and

other items that could cut or puncture, pharmaceutical

wastes product, radioactive wastes, and chemical waste

products (Environmental Health and Services, 1994).

Waste Management Practices. This refers to the means

and method of waste segregation and disposal of the

Camarines Norte Provincial Hospital.

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ENDNOTES

Robert J. Mann, Waste Reduction Manual for Hospitals

and Health Care Facilities, Environmental Excellence
Resources, Bridging the Gap, Inc., 2004.

Elmart C. Humes, Designating Dangerous Waste, Ecology

Fact Sheet; Washington State Department of Ecology;
Publication #96-436, revised October, 2004

Director Corazon Davis, Health Care Without Harm,

(DENR-NCR), Feb. 21, 2007.
 15

T. Brooks; Medical Waste Management: It’s Not Just for

Hospitals, ACSs Can Investigate Alternatives to Hauling,
Incineration; SurgiCenter Online, 2007.

Roberto M. Santiago, M.D., Environmental Health and

Services, Training Guide on Hospital Waste Management,
Department of Health, Manila, 1994.

surgicenteronline.com

Chapter II

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the literature and studies that

focuses on the waste management of Camarines Norte

Provincial Hospital in Daet, Camarines Norte.

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Related Literature

There are numerous definitions of what exactly

constitutes waste, and many classifications, which attempt

to categorize waste flows. According to the European

Environmental Protection Act (2000), “waste is any

substance, which constitutes scrap material or any effluent

or other unwanted surplus substance arising from the

application of a process, or any substance or article, which

requires to be disposed of as being broken, worn out,

contaminated or otherwise spoiled.”

The following classifications of waste were adopted by

the Department of Health (Environmental Health Service) and

promulgated as guidelines (Manual on Hospital Waste

Management) for all hospitals and other health care

facilities: 1.) Pathological wastes consist of tissues,

organs, body parts, human fetuses and animal carcasses; and

most blood and body fluids, 2.) Infectious waste contains

pathogens in sufficient concentration or quantity that

exposure to it could result in disease. This category

includes cultures and stock of infectious agents from

laboratory work, waste from surgery and autopsies on

patients with infectious diseases, waste from infected

patients in isolation wards, waste that has been in contact

 17

with infected patients undergoing hemodialysis (e.g.

dialysis equipment such as tubing and filters, disposable

towels, gowns and aprons, gloves and laboratory coats) and

waste that has been in contact with animals inoculated with

an infectious agent or suffering from an infectious disease,

3.) Sharps include needles, syringes, scalpels, saws,

blades, broken glass, nails and other items that could cause

a cut or puncture, 4.) Pharmaceutical wastes include

pharmaceutical products, drugs, and chemical that have been

returned from wards, have been spilled, are outdated or

contaminated, or are to be discarded because they are no

longer required, 5.) Radioactive wastes include solid,

liquid, and gaseous waste contaminated with radionuclides

generated from vitro analysis of body tissues and fluids, in

vivo body organ imaging and tumor localization, and

therapeutic procedures, 6.) Chemical wastes comprise

discarded, solid, liquid, and gaseous chemicals, for example

from diagnostic and experimental work, and cleaning,

housekeeping and disinfecting procedures Chemical waste may

be hazardous or non- hazardous. For the purpose of choosing

the most appropriate waste handling method, hazardous

chemical waste is considered to be waste when it is: a)

toxic, b) corrosive (acid of pH<2.0 and bases of pH>12.0),

 18

c) flammable -reactive (explosive, waster reactive, shock

sensitive), d) genotoxic (carcinogenic, mutagenic,

teratogenic or otherwise capable of genetic material), for

example cytotoxic drugs (U.S. Environmental Protection

Agency, 2000).

These hazardous wastes can affect the environment in

different ways. An individual can experience multiple

exposures through the food, air, and drinking water. The

effect on general population can mainly be through: a)

Chronic exposure, when individuals are exposed over a

prolonged time to small amounts of substances in ground

water, the food chain, and the air; or b) Acute exposure:

when individuals are exposed for a shorter period to larger

amounts. This is mainly to be from occupational exposure,

when waste handlers come into contact with significant

volumes of infectious waste and any reaction products (U.S.

Environmental Protection Agency, 2000).

The risk of accidents, transmission of diseases and

environmental pollution increases with unsatisfactory

handling, storage, transport and disposal of hospital

wastes. To ensure health and other environmental protection,

hazardous and non-hazardous wastes need to be handled and

disposed of in a sanitary manner.

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Hospital Waste Management involves five (5) major

components namely: a) handling, b) storage, c) pre-

treatment, d) collection and transport, and e) disposal

system. Since most of the wastes generated in hospitals are

hazardous or potentially hazardous, health personnel should

strictly follow standard guidelines and procedures for each

of the components.

The basic steps of a waste assessment include: a)

survey employees regarding waste generation and potential

waste reduction, b) examine your facility records, c)

conduct a facility walk-through and interview employees, d)

perform a waste sort (if the situation requires), and e)

produce a Waste Assessment Report that formalizes decisions

taken concerning recycling and waste reduction.

Basel Action Network (2002) made basic recommendations

to guide and stimulate better and more specific planning and

action programs at the municipal government level and then

at the level of individual health care facilities, such

that: 1) Clearly Define the Problem; 2) Focus on Segregation

First; 3) Institute a Sharps Management System; 4) Keep

Focused On Reduction; 5) Ensure Worker Safety through

Education, Training and Proper Personal Protective

Equipment; 6) Provide Secure Collection and Transportation;

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7) Require Plans and Policies; 8) Invest In Training and

Equipment for Reprocessing of Supplies; 9) Invest in

Environmentally Sound & Cost Effective Medical Waste

Treatment and Disposal Technologies; 10) Develop an

Infrastructure for the Safe Disposal and Recycling For

Hazardous Materials; and 11) Develop an Infrastructure for

Safe Disposal for Municipal Solid Waste.

Health care facilities need to be able to tie into a

municipal system of proper waste management to ensure that

they are meeting their mission of providing for the public

health. Until such an infrastructure exists there are

numerous decisions and actions that any hospital can make to

begin the process of improving their waste management

practices and ensuring public health and worker safety

today.

Related Studies

There are only few studies conducted on the area of

waste management practices in hospitals and some of them are

gathered here.

The study of Guinto (2005) was focused on the case of

two hospitals in Manila where she found out some

mismanagement in terms of waste management such as all

 21

hospital wastes are collected daily by a janitor without

personal protective equipment. The janitor collects wastes

from the kitchen, wards, laboratory, emergency room,

operating room, delivery room and administration offices and

put them together in a big carton box and worst she found

out that the wastes are dumped near the shallow well. She

recommends a thorough inspection and evaluation of hospitals

in Metro Manila and even all the hospitals in the country.

Meanwhile, the study of Cainto (2006) focused on the

waste products generated by most hospitals in the country

and he acknowledge certain categories from different

hospitals to be the most hazardous and potentially dangerous

of all wastes arising in the community. The result of the

disposal of clinical wastes is very unsatisfactory.

In 2002, a study conducted by O’Connor et al in a

general surgery units with 550 bed capacity in a hospital in

USA tested whether janitors and staff nurses cleanliness

could provide improvement to surgical patients and to

identify whether this increase their health condition. A

multifocal intervention was implemented to serve as

motivation and at the same time educate staff in rendering

proper waste management and to increase sanitation levels.

As a result, patient recovery increases without affecting

 22

other areas of nurses’ work, patient hospital stays were

shortened and there was a decrease in the use of sedative

and hypnotic medications.

In a hospital sanitation survey conducted by the

American Academy of Environmental Protection and Sanitation

(DynoMed.com, 2002) revealed that less than 40% of hospitals

follows a proper standards of waste management, collection

and disposal. And worst, most hospitals do not have proper

sanitation equipment leading to increase mortality and

dissatisfaction from the patients.

In terms of waste management program, Dinman, et.al.

(2003) developed a descriptive study to determine what waste

management program is the best and suited for most of the

hospitals. He suggested that there is no single formula to

contain and properly implement waste disposal program

because most hospitals follows a different structures and

cases. He further pointed out that the best method of waste

management depends on the awareness and proper education of

all of the hospital staff followed by an effective and

efficient health and sanitation delivery system.

Synthesis of the Art

 23

The review of related literature and studies found to

be similar in varying degrees to the purpose of the study.

Involved are the waste management practices of hospitals

from different countries and suggestions and recommendations

on how to improve the solid waste management system.

The study of Guinto (2005) is somewhat similar on the

purpose of identifying waste management practices of

hospitals. It differs only on the method used and the area

of focus presented by the present study.

Meanwhile, the topic on the hospital waste system by

Cainto (2006) found to be similar because it includes the

identification of responsible hospital units or departments

in-charge of waste management and details of their tasks and

duties and their actual performance in terms of waste

segregation, storage, collection methods, transport and

disposal arrangements and treatment (in-house) facilities.

It discusses the actual roles, tasks, responsibilities and

activities of hospital personnel and their linkages or

relationships with non-hospital persons or entities involved

in the disposition of waste. The study also acknowledge

hazardous wastes disposed by hospitals. However, the study

of Cainto (2005) is different on the scope and locale of the

 24

present study. His findings may not be true to the study at

hand.

The topic on waste flow and its impact on the surgery

patients presented by O’Connor et al (2002) is somewhat

similar because it discusses the various stages of waste

management, formal or informal from the hospital through the

intermediate handlers to final disposal. It discusses the

role of the formal and informal collection systems and the

estimated volume of hospital waste by types or components as

well as the types of hospital waste and/or equipment being

reused or recycled. This also focused on the impact of

proper waste management on the recovery of surgical

patients. However, the present study delve on the waste

management practices and not only exclusive on surgical

patients, therefore that is the difference of the present

study.

Meanwhile, the survey conducted by DynoMed.com (2002)

was similar on a particular point, it follows through the

waste management system and standards. However, it differs

from the present study due to its limited point of view.

At the last part of the related studies, the study

conducted by Dinman et. al. (2003) is somewhat similar

because it also focused on waste management program. However

 25

it is different because it does not give a thorough analysis

and a concrete program to be used in the hospitals.

Gaps to be bridged by the Study

The related studies and literature possess similarities

as well as differences with the current study. In this

study, a waste management practices of the Camarines Norte

Provincial Hospital was introduced. Also, the current study

addressed the need for proper segregation, collection,

disposal and recycling of the wasted produce from the

hospital in the different wards and sections to avoid

problems that may arise from mishandling and contamination

from the waste produce. This study is very important to

determine the sanitation and to provide an investigation on

the status of the Provincial Hospital of Daet, Camarines

Norte in terms of health and sanitation. Hence, this is the

research gap that the researcher is trying to bridge.

 26

Theoretical Framework

This study utilizes the theory of Florence Nightingale

on the concept of manipulating the physical environment as

the major component of nursing care. She stressed the

importance of pure air, pure water, efficient drainage,

cleanliness, and light. The goal of the nurse is to assist

the patient in staying in balance and if the environment of

the client is out of balance, the client expends unnecessary

energy.

In connection with the current study, the aim of the

present manuscript is to identify the waste management

practices of CNPH. This aimed at reducing the mortality rate

of the hospital and increase patient satisfaction and

avoiding possible hazards that will be brought up by

infection because of a dirty and poor environment. The

 27

concept of Florence Nightingale presupposes the same idea

and promotes cleanliness and vitality to the patients

utilizing good condition with the proper use of fresh air,

light, warmth, cleanliness, quietness and the proper

selection and administration. Thus, it is the belief and

hope of the researchers that this will be of impact not only

to the outcome of the research but also to the

administration of the Camarines Norte Provincial Hospital.

FLORENCE NIGHTINGALE
(Notes in Nursing)

PERSON HEALTH

ENVIRONMEN
T

PROPER WASTE MANAGEMENT

PRACTICES
 28

INCREASED PATIENT’S
SATISFACTION AND REDUCE
RISK OF MORTALITY

Figure 2. Theoretical Paradigm of the Study

Conceptual Framework

This study aimed to determine the existing waste

management practices of Camarines Norte Provincial Hospital

in Daet, Camarines Norte and through its hospital

management, janitors and hospital staffs – the expected

output is to improve the existing waste management practices

through the use of proper and adequate tools, facilities and

means of waste disposal. The proposed waste management

practice is designed to enhance the existing procedure and

to increase the satisfaction of patients for sanitation,

security and comfort.

Figure 2 shows the conceptual framework of the study.

A hospital is viewed as an open system and as such it

maintains a dynamic relationship with its environment. It

 29

has the capacity to receive inputs and transforms them into

outputs.

The input of the study are those elements who is going

to enter the system to achieve a common goal of enhancing

the waste management system. They are the hospital

management, janitors, staffs, and even the proposed waste

management system served as a guide to contribute to the

realization of the objectives of the study.

The process is the actual utilization of the proper

waste management practices along the four dynamic areas:

segregation, disposal, collection and recycling. It was

presumed that the process will reach to determine the

outcome of the study.

The output is the result of the process. To be able to

arrive at the output it should be maintained in religious

with the common standards and procedures of proper waste

management system. It viewed that the outcome will help the

hospital improve the existing waste management practices.

Alongside, there is continuous evaluation of the system and

the result of the evaluation through feedback may determine

the strengths and weaknesses of the waste management

practices. If the evaluation result comes out to be

negative, the waste management practice can be revised and

 30

put into the system again and if it is positive, it may be

an input and the cycle is repeated.

The impact may be the ultimate result expected from the

findings of the study aimed at the satisfaction of patients

and the hospital staff.

INPUT PROCESS OUTPUT

Profile of the
Respondents
Interviews, Increased
Patient
Utilization of Administration Satisfaction
proper waste and
management of
Sanitation
Measures questionnaires,
in Camarines
undertaken to
ensure proper Norte
Analysis, and
waste management Provincial
Interpretation Hospital

of data

FEEDBACK
 31

Figure 2. Conceptual Paradigm of the Study

ENDNOTES

50 Simple Things You Can Do to Save the Earth. The

Earth Works Group. Earth Works Press, Inc., Berkeley,
California, 1991.

The Green Letter, The Hands-On Journal for

Environmentally Conscious Companies. Tilden Press, Inc.

Guides to Pollution Prevention: Selected Hospital

Waste Streams. U. S. Environmental Protection Agency,
Office of Solid Waste and Emergency Response, June 1990.
EPA/625/7-90/009.

Guide for Reducing Solid Waste. U.S. Environmental

Protection Agency, Office of Solid Waste and Emergency
Response, November 1993. EPA/530-K-92-004.

Hospital Plastics Characterization and Recycling

Feasibility Study. Cascadia Consulting Group, for the
American Plastics Council.

Office Paper Recycling, An Implementation Manual. U.S.

Environmental Protection Agency, Office of Solid Waste and
Emergency Response, January 1990. EPA/530-SW-90-001.
 32

The United States Conference of Mayors Office Paper

Recycling Guide. National Office Paper Recycling Project, ,
2001.

American Society for Healthcare Environmental Services

An Ounce of Prevention: Waste Reduction Strategies for
Health Care Facilities. , 2003

David Biddle. Recycling for Profit: The New Green

Frontier. Harvard Review, November-December 2003.

E.V. Guinto, Case Study of Hospitals in Metro Manila

Utilizing Waste Management Program, University of the East,
Manila Philippines, 2005.

E.O. Cainto, Waste Reduction and an Analysis of Bio-

Hazards Wastes Disposed by Hospitals in the Philippines.
Masters of Arts in Nursing, University of the East,
Philippines, 2006.

F.W. O’Connor, E.C. Devine, T.D. Cook, V.A. Wenk, T.R.

Curtin, Enhancing Surgical Patients’ Recovery through
Sanitation and Cleanliness: Evaluation and Intervention,
Patient Education and Counseling, 2002.

Hospital Sanitation Survey, Dynomed.com, 2002

S.K. Dinman, K.D. Fosbinder, M. Williams, M. Warrick,

Implementing a Waste Management Program to Improve Hospital
Output. The Journal of Nursing Administration, 2003.
 33

Chapter III

Research Design and Methodology

This chapter presents the research design, the sources

of data and the instrument used. The data gathering

procedure and the statistical treatment of data will also be

discussed.

Research Design

The study will use both the descriptive and documentary

type of research. Descriptive research involves the

collection of data in order to describe the hypothesis to

answer questions concerning the current status of study.

Descriptive research describes a behavior or condition. 1 The

data are collected using questionnaires, observations and/or

interviews. To describe the descriptive method used,

informal interview will be conducted to gather relevant data

from the respondents of the study. This will help the

researchers identify the current state of the Camarines

Norte Provincial Hospital and determine areas of concern

relative to the data needed for the study.

Documentary research involves the use of texts and

documents as source materials like government publications,

newspapers, certificates, census publications, novels, film

 34

and video, paintings, personal photographs, diaries and

innumerable other written, visual and pictorial sources in

paper, electronic, or other hard copy form. The documentary

type of research focused on the different laws, brochures,

articles and studies which were assessed and evaluated to

gather additional data to support the analysis and

interpretation of data.

Sources of Data

The study secured its data from two main sources:

primary and secondary sources. Primary sources were the

respondents themselves constituting the Nurses and the

Janitors of Camarines Norte Provincial Hospital. Meanwhile,

the secondary sources were documents, which were probed and

evaluated. Books, articles, pamphlets and magazines, as well

as various websites on the internet, on the above topic,

particularly on the waste management areas of hospitals not

only in the province or in the Philippines but on the whole

nation as well.
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Population and Sample of the Study

The respondents of the study are the Chief Nurse of

Camarines Norte Provincial Hospital and janitors are

directly dealing with the waste management system.

Research Instrument

The questionnaire will serve as the main data gathering

tool of the study. It will be distributed to all the

respondents of the study. During the distribution the

researchers will supervise the respondents in answering the

questionnaire as to help them understand and answer better

the research instrument.

Validation of the Research Instrument

The researchers will submit the questionnaire to her

adviser for corrections and suggestions. Then, the

researchers will pre-test the instrument. The dry run will

be conducted at Camarines Norte Provincial Hospital, where a

group of ten (10) respondents will be asked and assessed the

prepared tool. After this stage, the respondents will give

several inputs and suggestions for the improvement of the

prepared tool.
 36

These suggestions and comments will be incorporated in

the final copy of the questionnaire. Hence, the research

tool will be considered valid.

Data Gathering Process

The researchers will make use of scheduling and

planning of activities to be done to eliminate problems with

time. The primary concern of the researchers is to determine

the existing waste management practices of Camarines Norte

Provincial hospital in Daet, Camarines Norte.

The data will be collected through the use of a

questionnaire method, given at the hospital staff especially

the janitor and utility persons who are directly involve in

the waste delivery system in order to ensure control,

validity and reliability of the information required. The

questionnaire will be shown first to experts for critiquing;

they are all professors in the school. After the validation

of the instrument, the questionnaire will be distributed to

the respondents to elicit the data gathered needed in the

study. After the retrieval, the results will be tallied and

the data will be statistically treated. Then, a thorough

analysis will be done in interpreting the findings.

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Statistical Tools

The study is purely descriptive and documentary type.

The statistical tools will use frequency, percentage

technique and ranking. Frequency count is the numerical

tabulation of the number of times an element appears in a

survey to determine the order of preferences. This is the

most straightforward approach to working with quantitative

data. Items are classified according to a particular scheme

and an arithmetical count is made of the number of items

within the text which belong to each classification in the

scheme.

Percentage is a proportion or share in relation to a

whole while ranking is defined as the position on a scale in

relation to others. This will also be used to determine the

relative position of one item from the other item.

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ENDNOTES

Robert M. Guilford and Wiliam S. Frucher, Modern

Statistics with Analytical Geometry, National Bookstore:
Philippines, 2003.

Siegel, Educational Statistics, Rex Publishing House,

2003.

Cesar M. Mercado, Ph.D, A New Approach to Social

Research/Thesis Writing, (Bonifacio House, UP, Diliman,
Quezon City: Development Consultant for Asia African Pacific
(DCAAP), 2004)

Cynthia E. Ledbetter Research Design and Methodology.

Merrill: Columbus, OH, 2001. P. 78

Sharon Merriam, Qualitative Research and Case Study

Application in Education, San Francisco: Jossey-Bass, 2000
p. 146.
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