Core Competencies

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 Nursing2. Management of Resources and Environment3. Health Education4. Legal Responsibility5. Ethico-moral Responsibility6. Personal and Professional Development7. Quality Improvement8. Research9. Record Management10. Communication11. 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 Competencies

Safe and quality nursing care 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 knowledge base on the health /illness status of individual / groups

Identifies the health needs of the patients / groups Explains the health status of the patients /groups

2. Provides sound decision making in the care of individuals / groups considering their beliefs and values

Identifies the problem Gathers data related to the problem Analyses the data gathered Selects appropriate action Monitors the progress of the action taken

3. Promotes safety and comfort of patients

Performs age-specific safety measures in all aspects of patient care Performs age-specific comfort measures in all aspects of patient care

4. Sets priorities in nursing care based on patients’ needs

Identifies the priority needs of patients Analyses the needs of patients Determines appropriate nursing care to be provided

5. Ensures continuity of care

Refers identified problem to appropriate individuals / agencies Establishes means of providing continuous patient care

6. Administers medications and other health therapeutics

Conforms to the 10 golden rules in medication administration and health therapeutics

7. Utilizes the nursing process as framework for nursing 7.1 Performs comprehensive and systematic nursing assessment

Obtains consent Completes appropriate assessment forms Performs effective assessment techniques Obtains comprehensive client information Maintains privacy and confidentiality Identifies health needs

7.2 Formulates a plan of care in collaboration with patients and other members of the health team

Includes patient and his family in care planning States expected outcomes of nursing intervention Develops comprehensive patient care plan Accomplishes patient centered discharge plan

7.3 Implements planned nursing care to achieve identified outcomes

Explains interventions to patients and his family before carrying them out Implements nursing intervention that is safe and comfortable Acts according to clients’ health condition and needs Performs nursing activities effectively and in a timely manner

7.4 Evaluates progress toward expected outcomes

Monitors effectiveness of nursing interventions Revises care plan when necessary

8. Responds to the urgency of the patient’s condition

Identifies sudden changes in the patient’s health conditions Implements immediate and appropriate intervention

COMMUNICATION

1. Establishes rapport with patients, significant others and members of the health team

Creates trust and confidence Listens attentively to client’s queries and requests Spends time with the client to facilitate conversation that allows client to express concerns

2. Identifies verbal and non-verbal cues

Interprets and validates client’s body language and facial expressions

3. Utilizes formal and informal channels

Makes use of available visual aids

4. Responds to needs of individuals, family, group and community

Provides reassurance through therapeutic, touch, warmth and comforting words of encouragement Readily smiles

5. Uses appropriate information technology to facilitate communication

Utilizes telephone, mobile phone, email and internet, and informatics Identifies significant others so that follow up care can be obtained Provides “ Holding” or emergency numbers for services

COLLABORATION AND TEAMWORK

1. Establishes collaborative relationship with colleagues and other members of the health team

Contributes to decision making regarding patients’ needs and concerns Participates actively in patient care management including audit 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

2. Collaborates plan of care with other members of the health team

Refers patients to allied health team partners Acts as liaison / advocate of the patient Prepares accurate documentation for efficient communication of services

HEALTH EDUCATION

1. Assesses the learning needs of the patient and family

Obtains learning information through interview, observation and validation Defines relevant information Completes assessment records appropriately Identifies priority needs

2. Develops health education plan based on assessed and anticipated needs

Considers nature of learner in relation to: social, cultural, political, economic, educational and religious factors.

3. Develops learning materials for health education

Involves the patient, family, significant others and other resources 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

4. Implements the health education plan

Provides for a conducive learning situation in terms of time and 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

5. Evaluates the outcome of health education

Utilizes evaluation parameters Documents outcome of care Revises health education plan when necessary

LEGAL RESPONSIBILITY

1. Adheres to practices in accordance with the nursing law and other relevant legislation including contracts, informed consent.

Fulfils legal requirements in nursing practice Holds current professional license Acts in accordance with the terms of contract of employment and other rules and regulations Complies with required continuing professional education 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

organizational policies and procedures, local and national

belongs Acts in accordance with the established norms of conduct of the institution / organization

3. Documents care rendered to patients

Utilizes appropriate patient care records and reports. 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 individual / groups

Renders nursing care consistent with the patient’s bill of rights: (i.e. confidentiality of information, privacy, etc.)

2. Accepts responsibility and accountability for own decision and actions

Meets nursing accountability requirements as embodied in the job description Justifies basis for nursing actions and judgment Projects a positive image of the profession

3. Adheres to the national and international code of ethics for nurses

Adheres to the Code of Ethics for Nurses and abides by its provision Reports unethical and immoral incidents to proper authorities

PERSONAL AND PROFESSIONAL DEVELOPMENT

1. Identifies own learning needs

Verbalizes strengths, weaknesses, limitations Determines personal and professional goals and aspirations

2. Pursues continuing education

Participates in formal and non-formal education Applies learned information for the improvement of care

3. Gets involved in professional organizations and civic activities

Participates actively in professional, social, civic, and religious activities Maintains membership to professional organizations Support activities related to nursing and health issues

4. Projects a professional image of the nurse

Demonstrates good manners and right conduct at all times Dresses appropriately Demonstrates congruence of words and action Behaves appropriately at all times

5. Possesses positive attitude towards change and criticism

Listens to suggestions and recommendations Tries new strategies or approaches Adapts to changes willingly

6. Performs function according to professional standards

Assesses own performance against standards of practice Sets attainable objectives to enhance nursing knowledge and skills Explains current nursing practices, when situations call for it

RECORDS MANAGEMENT

1. Maintains accurate and updated documentation of patient care

Completes updated documentation of patient care.

2. Records outcome of patient care

Utilizes a records system ex. Kardex or Hospital Information System (HIS)

3. Observes legal imperatives in record keeping

Observes confidentially and privacy of the patient’s records. Maintains an organized system of filing and keeping patients’ records in a designated area. Refrains from releasing records and other information without proper authority.

MANAGEMENT OF RESOURCES AND ENVIRONMENT

1. Organizes work load to facilitate patient care

Identifies tasks or activities that need to be accomplished Plans the performance of tasks or activities based on priorities Finishes work assignment on time

2. Utilizes resources to support patient care

Determines the resources needed to deliver patient care Controls the use of supplies and equipment

3. Ensures functioning of resources

Checks proper functioning of equipment Refers malfunctioning equipment to appropriate unit

4: Checks proper functioning of equipment

Determines tasks and procedures that can be safely assigned to other member of the team. Verifies the competency of the staff prior to delegating tasks

5: Maintains a safe environment

Observes proper disposal of wastes 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 quality improvement

Demonstrate knowledge of method appropriate for the clinical 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

2. Participates in nursing audits and rounds

Contributes relevant information about patient condition as well as unit 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 variances

Documents observed variance regarding patient care and submits 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

4. Recommends solutions to identified problems

Gives appropriate suggestions on corrective and preventive measures Communicates and discusses with appropriate groups. Gives an objective and accurate report on what was observed rather than an interpretation of the event.

RESEARCH

1. Gather data using different methodologies

Able to identify researchable problems regarding patient care 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

2. Recommends actions for implementation

Based on the analysis of data gathered, recommends practical solutions appropriate for the problem

3. Disseminates results of research findings

Able to talk about the results of findings to colleagues / patients / family and to others Endeavors to publish research

Submits research findings to own agencies and others as appropriate

4. Applies research findings in nursing practice

Utilizes findings in research in the provision of nursing care to individuals / groups / communities Makes use of evidence-based nursing to ameliorate nursing practice.

CORE COMPETENCIES OF DELIVERY ROOM NURSE

CORE COMPETENCIES PERFORMANCE INDICATORS

Safe and Quality Nursing CareDemonstrate knowledge base on the health / illness status of pregnant clients during labor and delivery

Identify the health needs of pregnant clients during labor and delivery

Explains the health status of pregnant clients during labor and delivery

Provides sound decision making in the care of pregnant clients during labor and delivery (and the newborn) considering their beliefs and values

Identifies the problem of the pregnant client during labor and delivery

Gathers data related to the client’s condition Analyzes the data gathered Selects appropriate action/s Monitors the progress of the action/s taken

Promotes safety and comfort of patients

Performs age-specific safety and comfort measures in all aspects of the pregnant client

Sets priorities in nursing care based on patients’ needs

Identifies the priority needs of the pregnant client Analyzes the needs of patients 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 and other health therapeutics

Conforms to the 10 golden rules in medication administration and health therapeutics for oxytocin, placental delivery, perineal 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 expected outcomes

Monitors effectiveness of nursing interventions to postpartum client

Revise care plan when necessaryResponds to the urgency of patients’ condition

Identifies sudden changes in the patients’ health conditions Implements immediate and appropriate intervention

Management of Resources and EnvironmentOrganizes work load to facilitate patient care


Utilizes resources to support patient care


Ensures functioning of resources

Checks proper functioning of equipment Refers malfunctioning equipment to appropriate unit

Delegates functions to other members of the health team

Determines tasks and procedures that can be safely assigned to other members of the team

Verifies the competency of the staff prior to delegating tasksMaintains a safe environment

Observes proper disposal of wastes Adheres to policies, procedures and protocols on prevention and

control of infection Defines steps to follow in case of fire, earthquake and other

emergency situationsHealth EducationAssesses the learning of the patient and family

Obtains learning information through interview, observation and validation

Defines relevant information Completes assessment records appropriately Identifies priority needs

Develops health educational plan based on assessed and anticipating needs

Considers nature of learner in relation to social, cultural, political, economic, educational and religious factors

Develops learning material for health education

Involves the patient, family, significant others and other resources

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 planImplements the health education plan

Provides for a conducive learning situation in terms of time and 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 health education

Utilizes evaluation parameters Documents outcome of care Revises health educational plan when necessary

Legal ResponsibilityAdheres to practices in accordance with the nursing law and other relevant legislation including contracts, informed consent

Fulfills legal requirements in nursing practice Holds current professional license Acts in accordance with the terms of contract of employment

and other rules and regulations Complies with required continuing professional education 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

formsAdheres to organizational policies and procedures, local and national

Articulates the vision, mission of the institution where one belongs

Acts in accordance with the establishes norms of conduct of the institution / organization

Documents care rendered to patients

Utilizes appropriate patient care records and reports Accomplishes accurate documentation in all matters concerning

patient care in accordance to the standards of nursing practiceEthico-Moral ResponsibilityRespects the rights of individual / groups

Renders nursing care consistent with the patient’s bill of rights (i.e. confidentiality of information, privacy, etc.)

Accepts responsibility and accountability for own decision and actions

Meets nursing accountability requirements as embodies in the job description

Justifies basis for nursing actions and judgment Projects a positive image of the profession

Adheres to the national and international code of ethics for nurses

Adheres to the Code of Ethics for Nurses and abides by its provision

Reports unethical and immoral incidents to proper authoritiesPersonal and Professional DevelopmentIdentifies own learning needs

Verbalizes strengths, weakness, limitations Determines personal and professional goals and aspirations

Pursues continuing education

Attends formal and non-formal education Applies learned information for the improvement of care

Gets involved in professional organizations and civic activities

Participates actively in professional, social, civic and religious activities

Maintains membership to professional organizations Support activities related to nursing and health issues

Projects a professional image of the nurse

Demonstrates good manners and right conduct at all times Dresses appropriately Demonstrates congruence of words and actions Behaves appropriately at all times

Possesses positive attitude towards change and criticism


Performs function according to professional standards

Assesses own performance against standards of practice

Quality ImprovementGathers data for quality improvement

Demonstrates knowledge of method appropriate for the clinical problems identifies

Detects variation in the vital signs of the patient and significant others regarding care rendered

Participates in nursing audits and rounds

Contributes relevant information about patient condition as well 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 othersIdentifies and reports variances

Documents observed variance regarding patient care and 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 identified problems

Gives appropriate suggestions on corrective and preventive measures

Communicates and discusses with appropriate groups Gives an objective and accurate report on what was observed

rather than an interpretation of the eventRecommends improvement of systems and processesGathers data using different methodologies

Able to identify researchable problems regarding patient care 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 gatheredRecommends actions for implementation


Disseminates results of research findings

Able to talk about the results of findings to colleagues / patients / family and to others

Endeavors to public research Submits research findings to own agencies and other as

appropriateApplies research findings in nursing practice

Incorporates findings in research in the provision of nursing care to individuals / groups / communities

Able to make meta-analysis of research findings to ameliorate nursing practice

ResearchGathers data using different methodologies

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 through simple explanation on the phenomena observed

Analyses data gatheredRecommends actions for implementation



Communicates results of findings to colleagues / patients / family and to others

Endeavors to public research Submits research findings to own agencies and others as


Utilizes findings in research in the provision of nursing care to individuals / groups / communities

Make use of evidence-based nursing to ameliorate nursing practice

Records ManagementMaintains accurate and updated documentation of patient care

Completes updated documentation of client’s care

Records outcome of patient care

Utilizes a records system e.g. Kardex or Hospital Information System (HIS)

Observes legal imperatives in records keeping

Observes confidentiality and privacy of the patient’s records Maintains an organized system of filing and keeping patient’s

records in a designated area Refrain from releasing records and other information without

proper authorityCommunicationEstablishes rapport with patients

Creates Trust and Confidence 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 client’s queries and requests

Spends time with the client to facilitate conversation that allows client to express concerns

Identifies verbal and non-verbal cues

Interprets and validates client’s body language and facial expressions

Utilizes formal and informal channels Makes use if available visual aids

Responds to needs of individuals, family, group and community

Provides reassurance through therapeutic touch, warm and comforting words of encouragement

Readily smilesUses appropriate information technology to facilitate communication

Utilizes telephone, cell phone, email and internet for disease information

Identifies a significant other so that follow up care can be obtained

Provides “Holding” or emergency numbers for services

Collaboration and TeamworkEstablishes collaborative relationship with colleagues and other members of the health team

Contributes to decision making regarding clients’ needs and concerns

Participates actively in patient care management including audit Recommends appropriate intervention to improve patient care Respect the role of other members of the health team Maintains good interpersonal relationship with clients,

colleagues and other members of the health teamCollaborates plan of care with other members of the health team

Refers patient’s to allied health team partners Acts as patient’s liaison / advocate of the client Prepares accurate documentation for efficient communication of

services

CORE COMPETENCIES OF NURSING PRACTICE IN NEWBORN CARE


Safe and Quality Nursing CareDemonstrate knowledge base in the health/illness status of individual/groups

Provides immediate newborn care: Performs APGAR scoring correctly Assess newborn reflexes 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 tappingo 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 blanketo Gives newborn a thorough, quick and proper initial oil batho Dries the newborn completelyo 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 procedureo Lifts and holds the newborn correctly and gently Takes anthropometric measurements correctly Weight

Length Head circumference Chest circumference Abdominal circumferenceo Inspects anus for patencyo Administers Vitamin K correctly as orderedo Takes appropriate identification mark (foot mark)o Applies diaper as neededo Takes vital signs (TPR) accuratelyo Puts newborn in designated cribs with droplight on Explains the health status of the patients/groups

Provides sound decision making in the case of individuals/groups

Identifies the problems in the immediate care of newborn Gathers data related to the problem Analyzes the data gathered Selects appropriate action

Promotes safety and comfort of patients

Performs age-specific safety measures in all aspects of patient care

Performs age-specific comfort measures in all aspects of patient care

Sets priorities in nursing care based on patient’s needs

Identifies the priority needs of the newborn Rooming in Feeding Latching Analyzes the needs of patients Determines appropriate nursing care to be provided

Ensures continuity of care

Refers identifies problem to appropriate individuals/agencies 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 referralAdministers medications and other health therapeutics

Conforms to the 10 golden rules in medication administration and health therapeutics

Utilizes the nursing process as framework for nursingPerforms Comprehensive and systematic nursing assessment

Obtains consent Completes appropriate assessment forms Performs effective assessment techniques 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 care in collaboration with patients and other members of the health team

Counsel the mother and significant members in the care of the newborn

States expected outcomes of nursing intervention Develops comprehensive patient care plan Accomplishes patient centered discharge plan

Implements planned nursing care to achieve identified outcomes

Explains interventions in the care of the newborn and his family before carrying them out

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



Responds to the urgency of the patient’s condition

Identifies sudden changes in the patients health conditions Implements immediate and appropriate intervention

Management of Resources and EnvironmentOrganizes work load to facilitate patient care





Check proper functioning of equipment Refers malfunctioning equipment to appropriate unit


Determines tasks and procedures that can be safely assigned to other member of the team

Verifies the competency of the staff prior to delegating tasksMaintains a safe environment

Observes proper disposal of wastes 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 EducationAssesses the learning of the patient and family


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 education plan based on assessed and anticipated needs

Considers nature of learner in relation to: Social, cultural, political, economic, educational, and religious

factors

Develops learning materials for health education

Involves the patient, family, significant others and other resources

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 planImplements the health education plan

Provides for a conducive learning situation (time and place) 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 feedingo Bathing Advisable time Method, if cord is intact Method, after cord has fallen off Prevention of drafts and unnecessary exposureo Diaperingo Lasette – Maternalo Clothing Dressing up the newborno Exposure to sunlight

Proper time and durationo Administration of ordered medication Frequency Amounto 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


Utilizes evaluation parameters Documents outcome Revises health education plan when necessary

Legal ResponsibilityAdheres to practices in accordance with the nursing law and other relevant legislation including contracts, informed consent.

Fulfills legal requirements in nursing practice Holds current professional License Acts in accordance with the terms of contract of employment

and other rules and regulations Complies with required continuing professional education 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

formsAdheres to organizational policies and procedures, local and national

Articulates the vision, mission of the institution where one belongs

Behaves in accordance with the established norms of conduct of the institution/organization

Shows membership of the accredited professional organization and a professional organization relevant to her practice.

Documents care rendered to patients

Utilizes appropriate patient care records and reports. Accomplishes accurate documentation in all matters concerning

patient care in accordance to the standards of nursing practice.Ethico-Moral Responsibility

Respects the right of individual/groups

Renders nursing care consistent with the patient’s bill of rights: (i.e. confidentiality of information, privacy, etc.)


Meets nursing accountability requirements as embodies in the job description

Justifies basis for nursing actions and judgment Projects a positive image of the profession

Adheres to the national and international code of ethics for nurses

Recites the Code of Ethics for Nurses and abides by its provision

Reports unethical and immoral incidents to proper authoritiesPersonal and Professional Development

Identifies own learning needs

Verbalizes strengths, weaknesses, limitations, goals and aspirations

Pursues continuing education Attends formal and non-formal education

Gets involved in professional organizations and civic activities

Participates actively in professional, social, civic, and religious activities

Maintains membership and/or support activities


Demonstrates good manners and right conduct (manner of dressing, speech, decorum) at all times



Performs function according to professional standards

Assesses own performance against standards of practice Sets attainable objectives to enhance nursing knowledge and

skills Explains current nursing practices when situations call for it


Demonstrate knowledge of method appropriate for the clinical 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 renderedParticipates in nursing audits and rounds

Contributes relevant information about patient condition as well 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 othersIdentifies and reports variances


Identifies actual and potential variance to patient care Reports actual and potential variance to patient care Submits report to appropriate groups within 24 hours



Communicates and discusses with appropriate groups. Gives an objective and accurate report on what was observed

rather than an interpretation of the eventRecommends improvement of systems and processesGather data using different methodologies


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 gatheredRecommends actions for implementation



Able to talk about the results of findings to colleagues/patients/family and to others

Endeavors to public research Submits research findings to own agencies and other as


Incorporates findings in research in the provision of nursing care to individuals/groups/communities

Able to make meta-analysis of research findings to ameliorate nursing practice

ResearchGathers data using different methodologies


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 gatheredRecommends actions for implementation

Based on the analysis of data gathered, recommends practical solutions appropriate for the problem.

Disseminates results or research findings

Discusses the results of findings to colleagues/patients/family and to others

Endeavor to publish research Submits research findings to own agencies and others as


Incorporates findings in research in the provision of nursing care to individuals/groups/communities

Able to make meta-analysis of research findings to ameliorate nursing practice.

Records ManagementMaintains accurate and updated documentation of patient care

Completes updated documentation of patient care Records pertinent observations and nursing care done 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 formRecords outcome of patient care

Utilizes a records system. E. Kardex or Hospital Information System (HIS)

Observes legal imperatives in records keeping

Observes confidentiality and privacy of the patient’s records Maintains an organized system of filing and keeping patient’s

records in a designated area Refrain from releasing records and other information without

proper authorityCommunication

Establishes rapport with patients

Creates TRUST and CONFIDENCE 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 client’s queries and requests

Spends time with the client to facilitate conversation that allows client to express concerns


Interprets and validates client’s body language and facial expression (IEC materials)

Utilizes formal and informal channels Makes use of available visual aids (IEC materials)

Responds to needs of individuals, family, group and community

Provides reassurance through therapeutic, touch, warm and comforting words or encouragement with a ready smile = EMPATHY

Uses appropriate information technology to facilitate communication

Utilizes telephone, cell phone, email, and internet for disease information

Identifies a significant other so that follow up care can be obtained

Provides “Holding” or emergency numbers for servicesCollaboration and Teamwork

Established collaborative relationship with colleagues and other members of the health team

Contributes to decision making regarding client’s needs and concerns

Participates actively in patient care management including audit Recommends appropriate intervention to improve patient care Respect the role of other members of the health team Maintains good interpersonal relationship with clients,

colleagues and other members of the health teamCollaborates plan of care with other members of the health team

Refers clients to allied health team partners Acts as liaison/advocate of the client Prepares accurate documentation for efficient communication of

services

INTRAOPERATIVE CORE COMPETENCIES


Safe and Quality Nursing CareDemonstrates knowledge based on the health/illness status of intraoperative clients

Identifies the health needs of surgical client in the operating room Recognize client conditions that need to be communicated to

the surgical team 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 making in the care of clients during surgery considering their beliefs and values

Identifies the problem of the surgical client during surgery Obtains comprehensive client’s information by checking the

preoperative checklist Assess client’s condition and relate to information obtained

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 surgeryPromotes safety and comfort of patients

Performs age-specific safety measures in all aspects of patient 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 operationSets priorities in nursing care based on patient’s needs

Identifies the priority needs of the patients Provide safety by identifying risks factors 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 care

Refers identified problem to appropriate members of the surgical 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 nurseAdministers medications and other health therapeutics

Conforms to the 10 golden rules in medication administration and health 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 process as framework for nursing performs a comprehensive and systematic nursing assessment of a surgical client

Obtains consent Ensures the identity of the client for surgery Assess patients clinical status, emotional and mental capacity

to sign the consent Informs client about the procedure, type of anesthesia, risk and

possible outcome 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 care in collaboration with patients and all the members of the health team

Includes the patient and his family in the plan of care States expected outcomes of nursing intervention Develops comprehensive nursing care plan Accomplishes patient-centered discharge plan

Implements planned nursing care to achieve identified outcomes

Explains interventions of patients and family before carrying out. Implements nursing interventions that are safe and comfortable Acts according to the client’s health condition and needs Performs nursing activities effectively and in a timely manner.



Responds to the urgency of the patient’s condition

Identifies sudden changes in the patient’s health conditions Monitoring of vital signs and identify possible 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 facilitate patient care

Identifies tasks or activities that need to be accomplishedCirculating 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




Checks proper functioning of equipment Prepares OR room, surgical instruments, sutures, sponges and

equipment in functional order Refers malfunctioning equipment to appropriate unit


Determines tasks and procedures that can be safely assigned to other members of the team

Verifies the competency of the staff prior to delegating of tasksMaintains a safe environment

Observes proper disposal of wastes–hazardous and non-hazardous 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 needs of the patient and family


Defines relevant information Complete assessment records appropriately Identifies priority needsPrioritize teaching needs for the client preparing for surgery

Develop health education plan based on assessed and anticipated needs

Considers nature of learner in relation to: social, cultural, political, economic, educational and religious factors

Develops learning materials for health education

Involves the patient, family, significant others Formulates a comprehensive health education plan with these

components: objectives, content, time allotment, teaching-learning resources and evaluation parameters

Provides for feedback to finalize plan Implements the health education plan

Provides for a conducive learning situation in terms of time and 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 educationResponds to inquiries of client prior to surgeryProvide post-op teachings to client as appropriate


Utilizes evaluation parameters Documents outcome of care Revises health education plan when necessary

Legal ResponsibilityAdheres to practices in accordance with the nursing law and other relevant legislation including contracts and informed consent.

Fulfills legal requirements in nursing practice Holds current professional License Acts in accordance with the terms of contract of employment and

other rules and regulations Complies with required continuing professional education 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

formsAdheres to organization policies and procedures both local and national

Articulates the vision, mission of the institution where one belongs Acts in accordance with the established norms of conduct of the

institution/ organization.Documents care rendered to patients

Utilizes appropriate patient care records and reports Accomplishes accurate documentation of all matters concerning

patient care in accordance to standards of nursing practiceEthico-Moral ResponsibilityRespects the rights of the OR client

Renders nursing care consistent with the patient’s bill of rights (confidentiality of information, privacy, etc.)

Observes the rights of an intra-operative clientConsider the religious, cultural values and beliefs of a surgical clientMaintains privacy and confidentiality of client’s information


Meets nursing accountability requirements as embodied in the job description

Justifies basis for nursing actions and judgment Projects a positive image of the profession Displays desirable attitudes and beginning competencies of an

OR nurseAdheres to the national and international code of ethics for nurses

Adheres to the Code of Ethics for Nurses and abides by its provision

Reports unethical and immoral incidents to proper authoritiesPersonal and Professional DevelopmentIdentifies own learning needs

Verbalizes strengths, weaknesses and limitations Determines personal and professional goals and aspirations

Pursues continuing education

Participates in formal and non-formal education Applies learned information for the improvement of care

Gets involved on professional organizations and civic activities

Participates actively in professional, social, civic and religious activities

Maintains membership to professional organizations Support activities related to nursing and health issues


Demonstrates good manners and right conduct at all times Dresses appropriately Demonstrates congruence of words and actions Behaves appropriately at all times


Listens to suggestions and recommendations Tries new strategies or approaches Adopts to changes willingly

Performs functions according to professional standards

Assesses own performance against standards of practice


Demonstrates knowledge of method appropriate to the clinical 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 audits and rounds

Contributes relevant information about patient condition as well as 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 othersIdentifies and Reports Variances


Identifies actual and potential variance to patient care Reports actual and potential variance to patient care Submits reports to appropriate groups within 24 hours



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 implementation

Based on analysis of data gathered, recommends practical solutions appropriate for the problem

Disseminates results of OR-related research finding

Communicates results of findings to colleagues/ patients/ family and to others

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 findings in nursing practice

Utilizes findings in research in the provision of nursing care to individuals/groups/communities

Make use of evidence-based nursing to ameliorate nursing practiceRecords ManagementMaintain accurate and updated documentation of patient care

Completes updated documentation of patient care Complete charting from start and end of anesthesia, incision and

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 bottleRecords outcome of patient care

Utilizes a records system ex. Kardex or Hospital information System (HIS Update all OR (logbook/computer records) including surgeons

KardexObserves legal imperatives in records keeping

Observes confidentiality and privacy of patient’s records Correct and complete records of operation

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

CommunicationEstablishes rapport with patients, significant others and members of

Creates trust and confidence Identifies and call patient with preferred name 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


Interprets and validates patient’s body language and facial expressions

Utilizes formal and informal channels Makes use of available visual aids

Responds to needs of individuals, family, group, and community

Provides re-assurance through therapeutic, touch, warmth and comforting words of encouragement\

Readily smilesUses appropriate information technology to facilitate communication

Utilizes telephone, mobile phone, email, internet and informatics Identifies significant others so that follow-up care can be obtained Provides “holding” or emergency numbers for services

Disseminates results on research finding

Communicates results of findings to colleagues/ patients/ family and to others

Endeavor to publish research Submits research findings to own agencies and other as appropriate

Applies research findings in nursing practice

Utilizes findings in research in the provision of nursing care to individuals/ groups/ communities

Make use of evidence-based nursing to ameliorate nursing practiceCollaboration and TeamworkEstablishes collaborative relationship with colleagues and other members of the health team

Contributes to decision-making regarding patient’s needs and concerns

Participates actively in patient care management including audit

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 teamCollaborates plan of care with other members of the health team

Refers patients to allied health team partners Acts as patient liaison/advocate Prepares accurate documentation for efficient communication of

services