Written Report on ADPCN Core Competencies

In Partial Fulfillment of the Requirements for Nursing 699 Nursing Law

Presented To the Graduate School of Nursing

Submitted to:

Patria V. Manalaysay, RN MAN PhD

Submitted by:

Ma. Concha Arandia, RN

Camille Bianca Castaňeda, RN

Al Dino Macavinta, RN

Ateneo De Davao University

E. Jacinto Street, Davao City

December 11, 2010

 CORE COMPETENCY GUIDE FOR NURSING PRACTICE IN THE PHILIPPINES

1. Safe and Quality Nursing

2. Management of Resources and Environment
3. Health Education
4. Legal Responsibility
5. Ethico-moral Responsibility
6. Personal and Professional Development
7. Quality Improvement
8. Research
9. Record Management
10. Communication
11. Collaboration and Teamwork

Patient Care Competencies is a cluster of key areas of responsibility which serves as

the core of competencies which includes safe and quality care, communication, collaboration and
teamwork and health education.

Empowering Competencies is a cluster of key areas of responsibility that mandate

compliance to the standards of legal, ethico-moral-spiritual responsibilities and personal and
professional development.

Enhancing Competencies is a cluster of key areas of responsibility that ensures

excellent performance of the patient care competencies which includes research and quality
improvement.

Enabling Competencies is a cluster of key areas of responsibility that provide support

to the effective and efficient performance of the patient care competencies which includes
management of resources and environment and records management.

Key Areas of Responsibilities

Patient Care  Safe and quality nursing care

Competencies  Communication
 Collaboration and teamwork
 Health Education
Empowering  Legal responsibility
 Ethico-moral responsibility
 Personal and professional development
Enhancing  Record management
 Management of resources and environment
Enabling  Quality Improvement
 Research
SAFE AND QUALITY NURSING CARE

Core Competency Indicators

1: Demonstrates Identifies the health needs of the patients / groups
knowledge base on the Explains the health status of the patients /groups
health /illness status of
individual / groups
2. Provides sound Identifies the problem
decision making in the Gathers data related to the problem
care of individuals / Analyses the data gathered
groups considering their Selects appropriate action
beliefs and values Monitors the progress of the action taken
3. Promotes safety and Performs age-specific safety measures in all aspects of patient care
comfort of patients Performs age-specific comfort measures in all aspects of patient care

4. Sets priorities in Identifies the priority needs of patients

nursing care based on Analyses the needs of patients
patients’ needs Determines appropriate nursing care to be provided
5. Ensures continuity of Refers identified problem to appropriate individuals / agencies
care Establishes means of providing continuous patient care
6. Administers Conforms to the 10 golden rules in medication administration and
medications and other health therapeutics
health therapeutics
7. Utilizes the nursing Obtains consent
process as framework for Completes appropriate assessment forms
nursing Performs effective assessment techniques
7.1 Performs Obtains comprehensive client information
comprehensive and Maintains privacy and confidentiality
systematic nursing Identifies health needs
assessment
7.2 Formulates a plan of Includes patient and his family in care planning
care in collaboration States expected outcomes of nursing intervention
with patients and other Develops comprehensive patient care plan
members of the health Accomplishes patient centered discharge plan
team
7.3 Implements Explains interventions to patients and his family before carrying them
planned nursing out
care to achieve Implements nursing intervention that is safe and comfortable
identified outcomes Acts according to clients’ health condition and needs
Performs nursing activities effectively and in a timely manner
7.4 Evaluates progress Monitors effectiveness of nursing interventions
 toward expected Revises care plan when necessary
outcomes
8. Responds to the Identifies sudden changes in the patient’s health conditions
urgency of the patient’s Implements immediate and appropriate intervention
condition

COMMUNICATION

1. Establishes rapport Creates trust and confidence

with patients, significant Listens attentively to client’s queries and requests
others and members of Spends time with the client to facilitate conversation that allows client
the health team to express concerns
2. Identifies verbal and Interprets and validates client’s body language and facial expressions
non-verbal cues
3. Utilizes formal and Makes use of available visual aids
informal channels
4. Responds to needs of Provides reassurance through therapeutic, touch, warmth and
individuals, family, group comforting words of encouragement
and community Readily smiles
5. Uses appropriate Utilizes telephone, mobile phone, email and internet, and informatics
information technology to Identifies significant others so that follow up care can be obtained
facilitate communication Provides “ Holding” or emergency numbers for services

COLLABORATION AND TEAMWORK

1. Establishes Contributes to decision making regarding patients’ needs and concerns

collaborative relationship Participates actively in patient care management including audit
with colleagues and other Recommends appropriate intervention to improve patient care
members of the health Respect the role of other members of the health team
team Maintains good interpersonal relationship with patients, colleagues and
other members of the health team
2. Collaborates plan of Refers patients to allied health team partners
care with other members Acts as liaison / advocate of the patient
of the health team Prepares accurate documentation for efficient communication of
services

HEALTH EDUCATION
1. Assesses the learning Obtains learning information through interview, observation and
needs of the patient and validation
family Defines relevant information
Completes assessment records appropriately
Identifies priority needs
2. Develops health Considers nature of learner in relation to: social, cultural, political,
education plan based on economic, educational and religious factors.
assessed and anticipated
needs
3. Develops learning Involves the patient, family, significant others and other resources
materials for health Formulates a comprehensive health education plan with the following
education components: objectives, content, time allotment, teaching-learning
resources and evaluation parameters
Provides for feedback to finalize the plan
4. Implements the health Provides for a conducive learning situation in terms of time and place
education plan Considers client and family’s preparedness
Utilizes appropriate strategies
Provides reassuring presence through active listening, touch, facial
expression and gestures
Monitors client and family’s responses to health education
5. Evaluates the Utilizes evaluation parameters
outcome of health Documents outcome of care
education Revises health education plan when necessary

LEGAL RESPONSIBILITY

1. Adheres to practices in Fulfils legal requirements in nursing practice

accordance with the Holds current professional license
nursing law and other Acts in accordance with the terms of contract of employment and other
relevant legislation rules and regulations
including contracts, Complies with required continuing professional education
informed consent. Confirms information given by the doctor for informed consent
Secures waiver of responsibility for refusal to undergo treatment or
procedure
Checks the completeness of informed consent and other legal forms
2. Adheres to Articulates the vision, mission of the institution where one belongs
organizational policies Acts in accordance with the established norms of conduct of the
and procedures, local and institution / organization
national
3. Documents care Utilizes appropriate patient care records and reports.
rendered to patients Accomplishes accurate documentation in all matters concerning patient
care in accordance to the standards of nursing practice.
ETHICO-MORAL RESPONSIBILITY

1. Respects the rights of Renders nursing care consistent with the patient’s bill of rights: (i.e.
individual / groups confidentiality of information, privacy, etc.)
2. Accepts responsibility Meets nursing accountability requirements as embodied in the job
and accountability for description
own decision and actions Justifies basis for nursing actions and judgment
Projects a positive image of the profession
3. Adheres to the Adheres to the Code of Ethics for Nurses and abides by its provision
national and international Reports unethical and immoral incidents to proper authorities
code of ethics for nurses

PERSONAL AND PROFESSIONAL DEVELOPMENT

1. Identifies own Verbalizes strengths, weaknesses, limitations

learning needs Determines personal and professional goals and aspirations
2. Pursues continuing Participates in formal and non-formal education
education Applies learned information for the improvement of care
3. Gets involved in Participates actively in professional, social, civic, and religious
professional activities
organizations and civic Maintains membership to professional organizations
activities Support activities related to nursing and health issues
4. Projects a professional Demonstrates good manners and right conduct at all times
image of the nurse Dresses appropriately
Demonstrates congruence of words and action
Behaves appropriately at all times
5. Possesses positive Listens to suggestions and recommendations
attitude towards change Tries new strategies or approaches
and criticism Adapts to changes willingly
6. Performs function Assesses own performance against standards of practice
according to professional Sets attainable objectives to enhance nursing knowledge and skills
standards Explains current nursing practices, when situations call for it

RECORDS MANAGEMENT

1. Maintains accurate and Completes updated documentation of patient care.

updated documentation
of patient care
2. Records outcome of Utilizes a records system ex. Kardex or Hospital Information System
patient care (HIS)
3. Observes legal Observes confidentially and privacy of the patient’s records.
imperatives in record Maintains an organized system of filing and keeping patients’ records
keeping in a designated area.
Refrains from releasing records and other information without proper
authority.

MANAGEMENT OF RESOURCES AND ENVIRONMENT

1. Organizes work load Identifies tasks or activities that need to be accomplished

to facilitate patient care Plans the performance of tasks or activities based on priorities
Finishes work assignment on time
2. Utilizes resources to Determines the resources needed to deliver patient care
support patient care Controls the use of supplies and equipment
3. Ensures functioning Checks proper functioning of equipment
of resources Refers malfunctioning equipment to appropriate unit
4: Checks proper Determines tasks and procedures that can be safely assigned to other
functioning of equipment member of the team.
Verifies the competency of the staff prior to delegating tasks
5: Maintains a safe Observes proper disposal of wastes
environment Adheres to policies, procedures and protocols on prevention and
control of infection
Defines steps to follow in case of fire, earthquake and other emergency
situations.

QUALITY IMPROVEMENT

1. Gathers data for Demonstrate knowledge of method appropriate for the clinical problems
quality improvement identified
Detects variation in the vital signs of the patient from day to day
Reports necessary elements at the bedside to improve patient stay at
hospital
Solicits feedback from patient and significant others regarding care
rendered
2. Participates in nursing Contributes relevant information about patient condition as well as unit
audits and rounds condition and patient current reactions
Shares with the team current information regarding particular patients
 condition
Encourage the patient to speak about what is relevant to his condition
Documents and records all nursing care and actions
Performs daily check of patients records / condition
Completes patients records
Actively contributes relevant information of patients during rounds thru
readings and sharing with others
3. Identifies and reports Documents observed variance regarding patient care and submits to
variances appropriate group within 24 hours
Identifies actual and potential variance to patient care
Reports actual and potential variance to patient care
Submits reports to appropriate groups within 24 hours
4. Recommends Gives appropriate suggestions on corrective and preventive measures
solutions to identified Communicates and discusses with appropriate groups.
problems Gives an objective and accurate report on what was observed rather
than an interpretation of the event.

RESEARCH

1. Gather data using Able to identify researchable problems regarding patient care and
different methodologies community health
Identify appropriate methods of research for a particular patient /
community problem
Combines quantitative and qualitative nursing design thru simple
explanation on the phenomena observed
Analyzes data gathered
2. Recommends actions Based on the analysis of data gathered, recommends practical solutions
for implementation appropriate for the problem
3. Disseminates results Able to talk about the results of findings to colleagues / patients / family
of research findings and to others
Endeavors to publish research
Submits research findings to own agencies and others as appropriate
4. Applies research Utilizes findings in research in the provision of nursing care to
findings in nursing individuals / groups / communities
practice Makes use of evidence-based nursing to ameliorate nursing practice.

CORE COMPETENCIES OF DELIVERY ROOM NURSE

CORE
PERFORMANCE INDICATORS
COMPETENCIES
Safe and Quality Nursing Care
Demonstrate knowledge • Identify the health needs of pregnant clients during labor and
base on the health / illness delivery
status of pregnant clients • Explains the health status of pregnant clients during labor and
during labor and delivery delivery
Provides sound decision • Identifies the problem of the pregnant client during labor and
making in the care of delivery
pregnant clients during • Gathers data related to the client’s condition
labor and delivery (and • Analyzes the data gathered
the newborn) considering • Selects appropriate action/s
their beliefs and values • Monitors the progress of the action/s taken
Promotes safety and • Performs age-specific safety and comfort measures in all aspects
comfort of patients of the pregnant client
Sets priorities in nursing • Identifies the priority needs of the pregnant client
care based on patients’ • Analyzes the needs of patients
needs • Determines appropriate nursing care to be provided
Ensures continuity of care • Refers identified problem to appropriate individuals / agencies
• Establishes means of providing continuous patient care
Administers medications • Conforms to the 10 golden rules in medication administration
and other health and health therapeutics for oxytocin, placental delivery, perineal
therapeutics repair and care, fundus monitoring, vaginal bleeding,
positioning, and emotional support
• Acts according to clients’ health conditions and needs
• Performs nursing activities effectively and in a timely manner
Evaluates progress toward • Monitors effectiveness of nursing interventions to postpartum
expected outcomes client
• Revise care plan when necessary
Responds to the urgency • Identifies sudden changes in the patients’ health conditions
of patients’ condition • Implements immediate and appropriate intervention
Management of Resources and Environment
Organizes work load to • Identifies tasks or activities that need to be accomplished
facilitate patient care • Plans the performance of tasks or activities based on priorities
• Finishes work assignment on time
Utilizes resources to • Determines the resources needed to deliver patient care
support patient care • Controls the use of supplies and equipment
Ensures functioning of • Checks proper functioning of equipment
resources • Refers malfunctioning equipment to appropriate unit
Delegates functions to • Determines tasks and procedures that can be safely assigned to
other members of the other members of the team
health team • Verifies the competency of the staff prior to delegating tasks
Maintains a safe • Observes proper disposal of wastes
environment • Adheres to policies, procedures and protocols on prevention and
control of infection
• Defines steps to follow in case of fire, earthquake and other
 emergency situations
Health Education
Assesses the learning of • Obtains learning information through interview, observation and
the patient and family validation
• Defines relevant information
• Completes assessment records appropriately
• Identifies priority needs
Develops health
educational plan based on • Considers nature of learner in relation to social, cultural,
assessed and anticipating political, economic, educational and religious factors
needs
Develops learning • Involves the patient, family, significant others and other
material for health resources
education • Formulates a comprehensive health educational plan with the
following components: objectives, content, time allotment,
teaching-learning resources and evaluation parameters
• Provides for feedback to finalize the plan
Implements the health • Provides for a conducive learning situation in terms of time and
education plan place
• Considers client and family’s preparedness
• Utilizes appropriate strategies
• Provides reassuring presence through active listening, touch,
facial expressions and gestures
• Monitors client and family’s responses to health education
Evaluates the outcome of • Utilizes evaluation parameters
health education • Documents outcome of care
• Revises health educational plan when necessary
Legal Responsibility
Adheres to practices in • Fulfills legal requirements in nursing practice
accordance with the • Holds current professional license
nursing law and other • Acts in accordance with the terms of contract of employment
relevant legislation and other rules and regulations
including contracts, • Complies with required continuing professional education
informed consent • Confirms information given by the doctor for informed consent
• Secures waiver of responsibility for refusal to undergo treatment
or procedure
• Checks the completeness of informed consent and other legal
forms
Adheres to organizational • Articulates the vision, mission of the institution where one
policies and procedures, belongs
local and national • Acts in accordance with the establishes norms of conduct of the
institution / organization
Documents care rendered • Utilizes appropriate patient care records and reports
to patients • Accomplishes accurate documentation in all matters concerning
 patient care in accordance to the standards of nursing practice
Ethico-Moral Responsibility
Respects the rights of • Renders nursing care consistent with the patient’s bill of rights
individual / groups (i.e. confidentiality of information, privacy, etc.)
Accepts responsibility and • Meets nursing accountability requirements as embodies in the
accountability for own job description
decision and actions • Justifies basis for nursing actions and judgment
• Projects a positive image of the profession
Adheres to the national • Adheres to the Code of Ethics for Nurses and abides by its
and international code of provision
ethics for nurses • Reports unethical and immoral incidents to proper authorities
Personal and Professional Development
Identifies own learning • Verbalizes strengths, weakness, limitations
needs • Determines personal and professional goals and aspirations
Pursues continuing • Attends formal and non-formal education
education • Applies learned information for the improvement of care
Gets involved in • Participates actively in professional, social, civic and religious
professional organizations activities
and civic activities • Maintains membership to professional organizations
• Support activities related to nursing and health issues
Projects a professional • Demonstrates good manners and right conduct at all times
image of the nurse • Dresses appropriately
• Demonstrates congruence of words and actions
• Behaves appropriately at all times
Possesses positive attitude • Listens to suggestions and recommendations
towards change and • Tries new strategies or approaches
criticism • Adapts to changes willingly
Performs function
according to professional • Assesses own performance against standards of practice
standards
Quality Improvement
Gathers data for quality • Demonstrates knowledge of method appropriate for the clinical
improvement problems identifies
• Detects variation in the vital signs of the patient and significant
others regarding care rendered
Participates in nursing • Contributes relevant information about patient condition as well
audits and rounds as unit condition and patient current reactions
• Shares with the team current information regarding particular
patients condition
• Encourages the patient to speak what is relevant to his condition
• Documents and records all nursing care and actions
• Performs daily check of patients’ records / condition
• Completes patients’ records
 • Actively contributes relevant information of patients during
rounds through readings and sharing with others
Identifies and reports • Documents observed variance regarding patient care and
variances submits to appropriate group within 24 hours
• Identifies actual and potential variance to patient care
• Reports actual and potential variance to patient care
• Submits report to appropriate groups within 24 hours
Recommends solutions to • Gives appropriate suggestions on corrective and preventive
identified problems measures
• Communicates and discusses with appropriate groups
• Gives an objective and accurate report on what was observed
rather than an interpretation of the event
Recommends
improvement of systems
and processes
Gathers data using • Able to identify researchable problems regarding patient care
different methodologies and community health
• Identify appropriate methods of research for a particular
patient / community problem
• Combines quantitative and qualitative nursing design through
simple explanation of the phenomena observed
• Analyses data gathered
Recommends actions for • Based on the analysis of data gathered, recommends practical
implementation solutions appropriate for the problem
Disseminates results of • Able to talk about the results of findings to colleagues /
research findings patients / family and to others
• Endeavors to public research
• Submits research findings to own agencies and other as
appropriate
Applies research findings • Incorporates findings in research in the provision of nursing
in nursing practice care to individuals / groups / communities
• Able to make meta-analysis of research findings to ameliorate
nursing practice
Research
Gathers data using • Identifies researchable problems regarding patient care and
different methodologies community health
• Identifies appropriate methods of research for a particular
patient / community problem
• Combines quantitative and qualitative nursing design through
simple explanation on the phenomena observed
• Analyses data gathered
Recommends actions for • Based on the analysis of data gathered, recommends practical
implementation solutions appropriate for the problem
Disseminates results of • Communicates results of findings to colleagues / patients /
research findings family and to others
• Endeavors to public research
• Submits research findings to own agencies and others as
appropriate
Applies research findings • Utilizes findings in research in the provision of nursing care to
in nursing practice individuals / groups / communities
• Make use of evidence-based nursing to ameliorate nursing
practice
Records Management
Maintains accurate and
updated documentation of • Completes updated documentation of client’s care
patient care
Records outcome of • Utilizes a records system e.g. Kardex or Hospital Information
patient care System (HIS)
Observes legal • Observes confidentiality and privacy of the patient’s records
imperatives in records • Maintains an organized system of filing and keeping patient’s
keeping records in a designated area
• Refrain from releasing records and other information without
proper authority
Communication
Establishes rapport with • Creates Trust and Confidence
patients • Greets client in an open and respectful manner
• Asks clients about themselves
• Tells client about choices depending on clients needs
• Helps client make an informed choice
• Explains fully how to choose options
• Returns visits for future consultation
Listens attentively to
• Spends time with the client to facilitate conversation that allows
client’s queries and
client to express concerns
requests
Identifies verbal and non- • Interprets and validates client’s body language and facial
verbal cues expressions
Utilizes formal and
• Makes use if available visual aids
informal channels
Responds to needs of • Provides reassurance through therapeutic touch, warm and
individuals, family, group comforting words of encouragement
and community • Readily smiles
Uses • Utilizes telephone, cell phone, email and internet for disease
appropriate
information technology to information
facilitate communication • Identifies a significant other so that follow up care can be
obtained
• Provides “Holding” or emergency numbers for services
Collaboration and Teamwork
Establishes collaborative • Contributes to decision making regarding clients’ needs and
relationship with concerns
colleagues and other • Participates actively in patient care management including audit
members of the health • Recommends appropriate intervention to improve patient care
team • Respect the role of other members of the health team
• Maintains good interpersonal relationship with clients,
colleagues and other members of the health team
Collaborates plan of care • Refers patient’s to allied health team partners
with other members of the • Acts as patient’s liaison / advocate of the client
health team • Prepares accurate documentation for efficient communication of
services

CORE COMPETENCIES OF NURSING PRACTICE IN NEWBORN CARE

CORE
PERFORMANCE INDICATORS
COMPETENCIES
Safe and Quality Nursing Care
Demonstrate knowledge • Provides immediate newborn care:
base in the health/illness • Performs APGAR scoring correctly
status of  Assess newborn reflexes
individual/groups • Establishes and maintains patent airway
 Places newborn in trendelenburg/sideways position
 Suctions mouth and nose of the newborn gently according to
hospital/health agency procedure
 Initiates crying through gentle tapping
o Regulates body temperature (Thermoregulation)
 Keeps newborn warm (thermoregulation)
 Places baby under droplight
 Gives oil bath according to institutional policy
 Keeps baby warm by wrapping up with a blanket
o Gives newborn a thorough, quick and proper initial oil bath
o Dries the newborn completely
o Administer Crede’s prophylaxis according to health agency’s
policy
 Inspects for the presence of 2 arteries and 1 vein of the
umbilical cord
 Dresses/clamps/ligates cord aseptically and correctly according
to hospital/agency’s procedure
o Lifts and holds the newborn correctly and gently
 Takes anthropometric measurements correctly
• Weight
 • Length
• Head circumference
• Chest circumference
• Abdominal circumference
o Inspects anus for patency
o Administers Vitamin K correctly as ordered
o Takes appropriate identification mark (foot mark)
o Applies diaper as needed
o Takes vital signs (TPR) accurately
o Puts newborn in designated cribs with droplight on
• Explains the health status of the patients/groups
Provides sound decision • Identifies the problems in the immediate care of newborn
making in the case of • Gathers data related to the problem
individuals/groups • Analyzes the data gathered
• Selects appropriate action
Promotes safety and • Performs age-specific safety measures in all aspects of patient
comfort of patients care
• Performs age-specific comfort measures in all aspects of patient
care
Sets priorities in nursing • Identifies the priority needs of the newborn
care based on patient’s • Rooming in
needs • Feeding
• Latching
• Analyzes the needs of patients
• Determines appropriate nursing care to be provided
Ensures continuity of • Refers identifies problem to appropriate individuals/agencies
care • Establishes means of providing continuous patient care
• Referral of abnormalities (if present)
• Reports any sign of abnormalities or deviation to the
pediatrician
• Gives brief and accurate report on the condition of the newborn
being cared through proper endorsement and referral
Administers medications
• Conforms to the 10 golden rules in medication administration
and other health
and health therapeutics
therapeutics
Utilizes the nursing
process as framework
for nursing
Performs • Obtains consent
Comprehensive and • Completes appropriate assessment forms
systematic nursing • Performs effective assessment techniques
assessment • General Assessment
 Whole body assessment for abnormalities
  Performs and interprets APGAR scoring
 Takes vital signs (Temperature per axilla) accurately
 Takes anthropometric measurements correctly
• Birth length
• Weight
• Head Circumference
• Chest Circumference
 Check patency of the rectum using the smallest rubber catheter
• Obtains comprehensive client information
• Maintains privacy and confidentiality
• Identifies health needs
Formulates a plan of • Counsel the mother and significant members in the care of the
care in collaboration newborn
with patients and other • States expected outcomes of nursing intervention
members of the health • Develops comprehensive patient care plan
team • Accomplishes patient centered discharge plan
Implements planned • Explains interventions in the care of the newborn and his family
nursing care to achieve before carrying them out
identified outcomes • Implements nursing intervention that is safe and comfortable
• Acts according to client’s health condition and needs
• Performs nursing interventions effectively and in a timely
manner
• Routine newborn care
• Applies (Crede’s) prophylaxis in the eyes
• Performs cord care aseptically following hospital policy
• Administers Vitamin K (1mg/ml) into the lateral anterior thigh
or vastus lateralis
• Identification of the newborn
• Places identification tag according to hospital policy
• Foot printing of the newborn
Evaluates progress
• Monitors effectiveness of nursing interventions
toward expected
outcomes • Revises care plan when necessary
Responds to the urgency • Identifies sudden changes in the patients health conditions
of the patient’s condition • Implements immediate and appropriate intervention
Management of Resources and Environment
Organizes work load to • Identifies tasks or activities that need to be accomplished
facilitate patient care • Plans the performance of tasks or activities based on priorities
• Finishes work assignment on time
Utilizes resources to • Determines the resources needed to deliver patient care
support patient care • Controls the use of supplies and equipment
Ensures functioning of • Check proper functioning of equipment
resources • Refers malfunctioning equipment to appropriate unit
 Delegates functions to • Determines tasks and procedures that can be safely assigned to
other members of the other member of the team
health team • Verifies the competency of the staff prior to delegating tasks
Maintains a safe • Observes proper disposal of wastes
environment • Adheres to policies, procedures and protocols on prevention and
control of infection
• Defines steps to follow in care of fire, earthquake and other
emergency situations.
Health Education
Assesses the learning of • Obtains learning information through interview, observation and
the patient and family validation
• Identifies health education needs of client regarding continuity
of care at home:
• Asks the patient what they know about infant care (knowledge
assessment)
• Encourages patient to verbalize concerns such as fears or
inhibitions regarding infant care
• Defines relevant information
• Completes assessment records appropriately
• Identifies priority needs
• Example: Importance of breastfeeding maternal-fetal bonding
Develops health
• Considers nature of learner in relation to:
education plan based on
assessed and anticipated • Social, cultural, political, economic, educational, and religious
needs factors
Develops learning • Involves the patient, family, significant others and other
materials for health resources
education • Formulates a comprehensive health education plan with the
following components: objectives, content, time allotment,
teaching-learning resources and evaluation parameters
• Provides for feedback to finalize the plan
Implements the health • Provides for a conducive learning situation (time and place)
education plan • Considers client and family’s preparedness
• Utilizes appropriate strategies
• Develops discharge instructions for patient on the following:
o Feeding instructions on breastfeeding or bottle feeding
 Kind of formula if not breastfeeding
 Amount to be given per feeding
 Dilution/ratio/proportion of formula
 Proper sterilization techniques, if not breastfeeding
 Burping every after feeding
 Frequency of feeding
o Bathing
 Advisable time
  Method, if cord is intact
 Method, after cord has fallen off
 Prevention of drafts and unnecessary exposure
o Diapering
o Lasette – Maternal
o Clothing
 Dressing up the newborn
o Exposure to sunlight
 Proper time and duration
o Administration of ordered medication
 Frequency
 Amount
o Appointment for well baby check-up
• Provides reassuring presence through active listening, touch,
facial expression and gestures
• Monitors client and family’s responses to health education
Evaluates the outcome • Utilizes evaluation parameters
of health education • Documents outcome
• Revises health education plan when necessary
Legal Responsibility
Adheres to practices in • Fulfills legal requirements in nursing practice
accordance with the • Holds current professional License
nursing law and other • Acts in accordance with the terms of contract of employment
relevant legislation and other rules and regulations
including contracts, • Complies with required continuing professional education
informed consent. • Confirms information given by the doctor for informed consent
• Secures waiver of responsibility for refusal to undergo treatment
or procedure
• Checks the completeness of informed consent and other legal
forms
Adheres to • Articulates the vision, mission of the institution where one
organizational policies belongs
and procedures, local • Behaves in accordance with the established norms of conduct of
and national the institution/organization
• Shows membership of the accredited professional organization
and a professional organization relevant to her practice.
Documents care • Utilizes appropriate patient care records and reports.
rendered to patients • Accomplishes accurate documentation in all matters concerning
patient care in accordance to the standards of nursing practice.
Ethico-Moral Responsibility
Respects the right of • Renders nursing care consistent with the patient’s bill of rights:
individual/groups (i.e. confidentiality of information, privacy, etc.)
Accepts responsibility • Meets nursing accountability requirements as embodies in the
and accountability for
 own decision and job description
actions • Justifies basis for nursing actions and judgment
• Projects a positive image of the profession
Adheres to the national • Recites the Code of Ethics for Nurses and abides by its
and international code of provision
ethics for nurses • Reports unethical and immoral incidents to proper authorities
Personal and Professional Development
Identifies own learning • Verbalizes strengths, weaknesses, limitations, goals and
needs aspirations
Pursues continuing
• Attends formal and non-formal education
education
Gets involved in
• Participates actively in professional, social, civic, and religious
professional
activities
organizations and civic
activities • Maintains membership and/or support activities
Projects a professional • Demonstrates good manners and right conduct (manner of
image of the nurse dressing, speech, decorum) at all times
Possesses positive • Listens to suggestions and recommendations
attitude towards change • Tries new strategies or approaches
and criticism • Adapts to changes willingly
Performs function • Assesses own performance against standards of practice
according to • Sets attainable objectives to enhance nursing knowledge and
professional standards skills
• Explains current nursing practices when situations call for it
Quality Improvement
Gathers data for quality • Demonstrate knowledge of method appropriate for the clinical
improvement problems identified
• Detects variation in the vital signs of the patient from day to day
• Reports necessary elements at the bedside to improve patient
stay at hospital
• Solicits feedback from patient and significant others regarding
care rendered
Participates in nursing • Contributes relevant information about patient condition as well
audits and rounds as unit condition and patient current reactions
• Shares with the team current information regarding particular
patients condition
• Speaks for the patient what is relevant to his condition
• Documents and records all nursing care and actions
• Performs daily check of patients records/condition
• Completes patient records
• Actively contributes relevant information of patients during
rounds thru readings and sharing with others
Identifies and reports • Documents observed variance regarding patient care and
variances submits to appropriate group within 24 hours
 • Identifies actual and potential variance to patient care
• Reports actual and potential variance to patient care
• Submits report to appropriate groups within 24 hours
Recommends solutions • Gives appropriate suggestions on corrective and preventive
to identified problems measures
• Communicates and discusses with appropriate groups.
• Gives an objective and accurate report on what was observed
rather than an interpretation of the event
Recommends
improvement of systems
and processes
Gather data using • Able to identify researchable problems regarding patient care
different methodologies and community health
• Identify appropriate methods of research for a particular
patient/community problem
• Combines quantitative and qualitative nursing design thru
simple explanation on the phenomena observed.
• Analyzes data gathered
Recommends actions for • Based on the analysis of data gathered, recommends practical
implementation solutions appropriate for the problem
Disseminates results of • Able to talk about the results of findings to
research findings colleagues/patients/family and to others
• Endeavors to public research
• Submits research findings to own agencies and other as
appropriate
Applies research • Incorporates findings in research in the provision of nursing
findings in nursing care to individuals/groups/communities
practice • Able to make meta-analysis of research findings to ameliorate
nursing practice
Research
Gathers data using • Able to identify researchable problems regarding patient care
different methodologies and community health
• Identifies appropriate methods of research for a particular
patient/community problem
• Combines quantitative and qualitative nursing design thru
simple explanation on the phenomena observed
• Analyzes data gathered
Recommends actions for • Based on the analysis of data gathered, recommends practical
implementation solutions appropriate for the problem.
Disseminates results or • Discusses the results of findings to colleagues/patients/family
research findings and to others
• Endeavor to publish research
• Submits research findings to own agencies and others as
appropriate
 Applies research • Incorporates findings in research in the provision of nursing
findings in nursing care to individuals/groups/communities
practice • Able to make meta-analysis of research findings to ameliorate
nursing practice.
Records Management
Maintains accurate and • Completes updated documentation of patient care
updated documentation • Records pertinent observations and nursing care done
of patient care • Apply name tag on the crib with the following information
• Name and gender of the baby
• Name of the mother
• Attending physician
• Anthropometric measurements
• Secure information necessary for registration
• Name of parent
• Marriage contract where applicable
• Birth registration form
Records outcome of • Utilizes a records system. E. Kardex or Hospital Information
patient care System (HIS)
Observes legal • Observes confidentiality and privacy of the patient’s records
imperatives in records • Maintains an organized system of filing and keeping patient’s
keeping records in a designated area
• Refrain from releasing records and other information without
proper authority
Communication
Establishes rapport with • Creates TRUST and CONFIDENCE
patients • Greets client in an open and respectful manner
• Asks clients about themselves
• Tells client about choices depending on client’s needs
• Helps client make an informed choice
• Explains fully how to choose options
• Returns visits for future consultation
Listens attentively to
• Spends time with the client to facilitate conversation that allows
client’s queries and
client to express concerns
requests
Identifies verbal and • Interprets and validates client’s body language and facial
non-verbal cues expression (IEC materials)
Utilizes formal and
• Makes use of available visual aids (IEC materials)
informal channels
Responds to needs of • Provides reassurance through therapeutic, touch, warm and
individuals, family, comforting words or encouragement with a ready smile =
group and community EMPATHY
Uses appropriate • Utilizes telephone, cell phone, email, and internet for disease
information technology information
to facilitate • Identifies a significant other so that follow up care can be
 communication obtained
• Provides “Holding” or emergency numbers for services
Collaboration and Teamwork
Established • Contributes to decision making regarding client’s needs and
collaborative concerns
relationship with • Participates actively in patient care management including audit
colleagues and other • Recommends appropriate intervention to improve patient care
members of the health • Respect the role of other members of the health team
team • Maintains good interpersonal relationship with clients,
colleagues and other members of the health team
Collaborates plan of care • Refers clients to allied health team partners
with other members of • Acts as liaison/advocate of the client
the health team • Prepares accurate documentation for efficient communication of
services

INTRAOPERATIVE CORE COMPETENCIES

CORE
PERFORMANCE INDICATORS
COMPETENCIES
Safe and Quality Nursing Care
Demonstrates • Identifies the health needs of surgical client in the operating room
knowledge based on the  Recognize client conditions that need to be communicated to
health/illness status of the surgical team
intraoperative clients • Explains the health status of the client for surgery
 Determine personal factors that increase the client’s risk for
compilation during surgery
Provides sound decision • Identifies the problem of the surgical client during surgery
making in the care of • Obtains comprehensive client’s information by checking the
clients during surgery preoperative checklist
considering their beliefs
 Assess client’s condition and relate to information obtained
and values
from the chart
• Gathers data related to the problem
Assess emotional, socio-economic, religious and cultural factors
related to surgery
• Analyzes the data gathered
Prioritize needs/ or problems of clients in the operating room
• Selects appropriate actions
Provides appropriate nursing interventions based on identified needs
• Monitors the progress of the action taken
 Determine client’s response to surgery
Promotes safety and • Performs age-specific safety measures in all aspects of patient
comfort of patients care
 Transports/assists safe transfer of client from the unit to the
Operating Room
 Transport safety from stretcher to OR bed; OR bed to
stretcher; stretcher to RR bed
 Monitors and secures patient safety during transport
 Applies/assists in the application of monitoring devices and
maintains functionality
 (e.g. IVF; NGT; Indwelling catheter; chest tube-drainage;
pulse oximeter
 Monitors client vital signs
 Places proper grounding pad under the patient for electro-
surgical procedure
 Provides physical comfort utilizing comfort
devices/techniques
 Supports client and assist anaesthesiologist during
induction of anesthesia
 Assist in proper and safe positioning of clients in
preparation for surgery according to the surgical procedure or
surgeons preference;
 proper placement of straps
 adjustments in OR bed and its supportive accessories
 Provides needed blankets and sheets for effective thermoregulation
and privacy
 Maintains strict surgical asepsis
 Observes universal precautions in the handling of body fluids
 Prepares correct and complete set-up, supplies and equipment for the
scheduled operation
Sets priorities in nursing Identifies the priority needs of the patients
care based on patient’s  Provide safety by identifying risks factors
needs related to injury during surgery such as positioning; faulty
equipment and the use of sharps and instrumentation
Analyzes the needs of the patients
Determines appropriate nursing care to be provided
Ensures continuity of • Refers identified problem to appropriate members of the surgical
care team
 Reports accurately deviations on normal airway, breathing and
circulation problems
• Establishes means of providing patient care
 Calls patient by preferred name
 Orients client by introducing self and other members of OR
team
 Maintains complete documentation and endorsement of the
 surgical patient to PACU nurse

Administers medications • Conforms to the 10 golden rules in medication administration and

and other health health therapeutics
therapeutics  Administers/executes legal orders of the
surgeon/anesthesiologist utilizing the principles in drug
administration and carries out other appropriate
nursing/medical interventions accurately and timely.
Utilizes the nursing • Obtains consent
process as framework  Ensures the identity of the client for surgery
for nursing performs a  Assess patients clinical status, emotional and mental capacity
comprehensive and to sign the consent
systematic nursing  Informs client about the procedure, type of anesthesia, risk and
assessment of a surgical possible outcome
client  Consent has been correctly signed and witnessed
 Observes proper procedure for obtaining informed consent and
aware of its legal implications
• Completes appropriate assessment forms
 Operating Room checklist has been completed and signed
• Obtains comprehensive client information
 Checks completeness of patients records and results of
diagnostic and laboratory tests
 Completes pre-operative checklist
• Maintains privacy and confidentiality
 All information related to patient and procedures has dealt with
confidentiality
 Maintains privacy, bed sheet and blanket to cover patient to
avoid over exposure
Identifies health needs
 Recognize clinical manifestations related to malignant
hyperthermia
 Assess specific problems related to positioning during the
surgical procedure
Formulates a plan of • Includes the patient and his family in the plan of care
care in collaboration • States expected outcomes of nursing intervention
with patients and all the • Develops comprehensive nursing care plan
members of the health • Accomplishes patient-centered discharge plan
team
Implements planned • Explains interventions of patients and family before carrying out.
nursing care to achieve • Implements nursing interventions that are safe and comfortable
identified outcomes • Acts according to the client’s health condition and needs
• Performs nursing activities effectively and in a timely manner.
Evaluates progress
• Monitors effectiveness of nursing interventions
toward expected
outcomes • Revises care plan when necessary
Responds to the urgency • Identifies sudden changes in the patient’s health conditions
of the patient’s  Monitoring of vital signs and identify possible
condition alterations, watch out for possible alarm in a properly
calibrated monitoring equipment
 Pain sensations
 Bleeding
• Implements immediate and appropriate interventions
 Administer medications as ordered
 Administer oxygen and suctioning as
needed
 Reposition patient as needed
 Immediate referral
Management of Resources and Environment
Organizes work load to • Identifies tasks or activities that need to be accomplished
facilitate patient care Circulating Role
 Checks OR for
appropriate temperature, humidity, light, ventilation
 Checks and adjusts
equipment needed for the procedure
 Checks availability of
supplies
 Secures specimens
Scrub Nurse
 Prepares instruments and needed supplies for the
scheduled procedure
 Checks and open sterile pack
 Prepares right sizes of gown and gloves
 Scrub hands thoroughly
 Wears gown and gloves following strict surgical asepsis
 Familiarizes with the instruments and supplies correctly
and safely
 Maintains integrity, safety and efficiency of the sterile field
 Performs counting of instruments and sponges
• Plans the performance of tasks or activities based on priorities
• Finishes work assignment on time
Utilizes resources to • Determines the resources needed to deliver patient care
support patient care  Controls the use of supplies and equipment
Ensures functioning of • Checks proper functioning of equipment
resources  Prepares OR room, surgical instruments, sutures, sponges
and equipment in functional order
• Refers malfunctioning equipment to appropriate unit
Delegates functions to • Determines tasks and procedures that can be safely assigned to
other members of the other members of the team
health team • Verifies the competency of the staff prior to delegating of tasks
Maintains a safe • Observes proper disposal of wastes–hazardous and non-hazardous
environment • Adheres to policies, procedures and protocols on prevention and
control of infection
 Observes protocols in unrestricted, semi-restricted and
restricted areas in the OR
 Performs proper disinfection and sterilization protocols.
• Defines steps to follow in case of fire, earthquake and other
emergency
 Awareness of the institutional evacuation and location plan,
both for fire, earthquake and other major emergencies

Health Education
Assesses the learning • Obtains learning information through interview, observation and
needs of the patient and validation
family • Defines relevant information
• Complete assessment records appropriately
• Identifies priority needs
Prioritize teaching needs for the client preparing for surgery
Develop health
education plan based on • Considers nature of learner in relation to: social, cultural, political,
assessed and anticipated economic, educational and religious factors
needs
Develops learning • Involves the patient, family, significant others
materials for health • Formulates a comprehensive health education plan with these
education components: objectives, content, time allotment, teaching-learning
resources and evaluation parameters
• Provides for feedback to finalize plan
Implements the health • Provides for a conducive learning situation in terms of time and
education plan place
• Considers client and family’s preparedness
• Utilizes appropriate strategies
• Provides reassuring presence through active listening, touch, facial
expression and gestures
• Monitors client and family’s responses to health education
Responds to inquiries of client prior to surgery
Provide post-op teachings to client as appropriate
Evaluates the outcome • Utilizes evaluation parameters
of health education • Documents outcome of care
 • Revises health education plan when necessary
Legal Responsibility
Adheres to practices in • Fulfills legal requirements in nursing practice
accordance with the • Holds current professional License
nursing law and other • Acts in accordance with the terms of contract of employment and
relevant legislation other rules and regulations
including contracts and • Complies with required continuing professional education
informed consent. • Confirms information given by the doctor for informed consent
• Secures waiver of responsibility for refusal to undergo treatment or
procedure
• Checks the completeness of informed consent and other legal
forms
Adheres to organization • Articulates the vision, mission of the institution where one belongs
policies and procedures • Acts in accordance with the established norms of conduct of the
both local and national institution/ organization.
Documents care • Utilizes appropriate patient care records and reports
rendered to patients • Accomplishes accurate documentation of all matters concerning
patient care in accordance to standards of nursing practice
Ethico-Moral Responsibility
Respects the rights of • Renders nursing care consistent with the patient’s bill of rights
the OR client (confidentiality of information, privacy, etc.)
Observes the rights of an intra-operative client
Consider the religious, cultural values and beliefs of a surgical client
Maintains privacy and confidentiality of client’s information
Accepts responsibility • Meets nursing accountability requirements as embodied in the job
and accountability for description
own decision and • Justifies basis for nursing actions and judgment
actions • Projects a positive image of the profession
Displays desirable attitudes and beginning competencies of an
OR nurse
Adheres to the national • Adheres to the Code of Ethics for Nurses and abides by its
and international code of provision
ethics for nurses • Reports unethical and immoral incidents to proper authorities
Personal and Professional Development
Identifies own learning • Verbalizes strengths, weaknesses and limitations
needs
• Determines personal and professional goals and aspirations
Pursues continuing • Participates in formal and non-formal education
education • Applies learned information for the improvement of care
Gets involved on • Participates actively in professional, social, civic and religious
professional activities
organizations and civic • Maintains membership to professional organizations
activities • Support activities related to nursing and health issues
Projects a professional • Demonstrates good manners and right conduct at all times
image of the nurse • Dresses appropriately
• Demonstrates congruence of words and actions
• Behaves appropriately at all times
Possesses positive • Listens to suggestions and recommendations
attitude towards change • Tries new strategies or approaches
and criticism • Adopts to changes willingly
Performs functions
according to • Assesses own performance against standards of practice
professional standards
Quality Improvement
Gathers data for quality • Demonstrates knowledge of method appropriate to the clinical
improvement problems identified
• Detects variations in the vital signs of the patient from day to day
• Reports necessary elements at the bedside to improve patient stay
at hospital
• Solicits feedback from patient and significant others regarding care
rendered.
Participates in nursing • Contributes relevant information about patient condition as well as
audits and rounds patient’s reactions
• Identifies sudden changes in vital signs and response of the client
to surgery
• Shares with the team regarding current information on patient’s
condition
• Shares relevant information to the clinical instructor/preceptor and
concerned members of the OR team regarding the condition of the
client.
• Encourages the patient to speak what is relevant to his condition
• Documents and records all nursing care and actions
• Performs daily check of patient’s records/condition
• Completes patient’s records
• Actively contributes relevant information of patients during rounds
thru reading and sharing with others
Identifies and Reports • Documents observed variance regarding patient care and submits
Variances to appropriate group within 24 hours
• Identifies actual and potential variance to patient care
• Reports actual and potential variance to patient care
• Submits reports to appropriate groups within 24 hours
Recommends solutions • Gives appropriate suggestions on corrective and preventive
to identified problems measures
• Communicates and discussions with appropriate groups
• Gives an objective and accurate report on what was observed rather
than an interpretation of the event.
Research
• Identifies researchable problems regarding patient care and
 community health
• Identifies appropriate methods of research for a particular
patient/community problem
• Combines quantitative and qualitative nursing design thru sample
explanation on the phenomena observed
• Analyzes data gathered
Recommends actions for • Based on analysis of data gathered, recommends practical solutions
implementation appropriate for the problem
Disseminates results of • Communicates results of findings to colleagues/ patients/ family
OR-related research and to others
finding • Shares relevant research findings from journal readings/literature
search
• Endeavors to publish research
• Submits research findings to own agencies and other as appropriate
Applies research • Utilizes findings in research in the provision of nursing care to
findings in nursing individuals/groups/communities
practice • Make use of evidence-based nursing to ameliorate nursing practice
Records Management
Maintain accurate and • Completes updated documentation of patient care
updated documentation  Complete charting from start and end of anesthesia, incision and
of patient care closure of skin
 Complete list of supplies used during operation
 Document site of cautery pad and dressing used
 Documentation approximate blood loss from the gauze, wash
out and from suction bottle
Records outcome of • Utilizes a records system ex. Kardex or Hospital information
patient care System (HIS
 Update all OR (logbook/computer records) including surgeons
Kardex
Observes legal • Observes confidentiality and privacy of patient’s records
imperatives in records  Correct and complete records of operation
keeping • Maintains an organized system of filing and keeping records in a
designated area
 Records are kept safety
• Refrains from releasing records and other information without
proper authority
 Limited access to proper personnel only
Communication
Establishes rapport with • Creates trust and confidence
patients, significant  Identifies and call patient with preferred name
others and members of  Introduce self and other members of the team
the health team • Listens attentively to client’s queries and request
• Utilizes effective communication when teaching clients and family
members about what to expect during the surgical experience.
 • Spends time with the client to facilitate conversation that allows
client to express concerns
 Stay with the patient until induction of anesthesia
Identifies verbal and • Interprets and validates patient’s body language and facial
non-verbal cues expressions
Utilizes formal and
• Makes use of available visual aids
informal channels
Responds to needs of • Provides re-assurance through therapeutic, touch, warmth and
individuals, family, comforting words of encouragement\
group, and community • Readily smiles
Uses appropriate
• Utilizes telephone, mobile phone, email, internet and informatics
information technology
• Identifies significant others so that follow-up care can be obtained
to facilitate
communication • Provides “holding” or emergency numbers for services
Disseminates results on • Communicates results of findings to colleagues/ patients/ family
research finding and to others
• Endeavor to publish research
• Submits research findings to own agencies and other as appropriate
Applies research • Utilizes findings in research in the provision of nursing care to
findings in nursing individuals/ groups/ communities
practice • Make use of evidence-based nursing to ameliorate nursing practice
Collaboration and Teamwork
Establishes collaborative
relationship with • Contributes to decision-making regarding patient’s needs and
colleagues and other concerns
members of the health • Participates actively in patient care management including audit
team
• Recommends appropriate intervention to improve patient care
• Respect the role of other members of the health team
• Maintains good interpersonal relationship with patients, colleagues
and other members of the health team
Collaborates plan of • Refers patients to allied health team partners
care with other members • Acts as patient liaison/advocate
of the health team • Prepares accurate documentation for efficient communication of
services