SCHOOL OF NURSING

COMPETENCY APPRISAL I
1ST SEMETER S.A. 2019-2020

TOPIC I. PRELIM: LEGAL BASES

Article 3 Sec.9 (c) of R.A. 9173/ “Philippine Nursing Act 2002” Board shall monitor & enforce quality
standards of nursing practice necessary to ensure the maintenance of efficient, ethical and technical,
moral and professional standards in the practice of nursing taking into account the health needs of the
nation.

SIGNIFICANCE OF CORE COMPETENCY STANDARDS

1. Unifying framework for nursing practice, education, regulation
2. Guide in nursing curriculum development
3. Framework in developing test syllabus for nursing profession entrants
4. Tool for nurses’ performance evaluation
5. Basis for advanced nursing practice, specialization
6. Framework for developing nursing training curriculum
7. Public protection from incompetent practitioners
8. Yardstick for unethical, unprofessional nursing practice

I. SAFE AND QUALITY NURSING CARE

CORE COMPETENCY 1:
Demonstrate knowledge based on health/illness status of individual/ groups

Indicators :
○ Identifies health needs of patients/groups
○ Explains patient/group status

CORE COMPETENCY 2:
Provides sound decision making in care of individual/groups considering their beliefs, values

Indicators :
○ Problem identification
○ Data gathering related to problem
○ Data analysis
○ Selection appropriate action
○ Monitor progress of action taken

CORE COMPETENCY 3:
Promotes patient safety and comfort

Indicators :
○ Performs age-specific safety measures and comfort measure in all aspects of patient care

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CORE COMPETENCY 4:
Priority setting in nursing care based on patients’ needs

Indicators :
○ Identifies priority needs of patients
○ Analysis of patients’ needs
○ Determine appropriate nursing care to be provided

CORE COMPETENCY 5:
Ensures continuity of care

Indicators :
○ Refers identified problems to appropriate individuals/ agencies
○ Establish means of providing continuous patient care

CORE COMPETENCY 6:
Administers medications and other health therapeutics

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

CORE COMPETENCY 7:
Utilizes nursing process as framework for nursing. Performs comprehensive, systematic nursing
assessment

Indicators :
○ Obtains consent
○ Complete appropriate assessment forms
○ Performs effective assessment techniques
○ Obtains comprehensive client information
○ Maintains privacy and confidentiality
○ Identifies health needs

CORE COMPETENCY 8:
Formulates care plan in collaboration with patients, other health team members

Indicators :
○ Includes patients, family in care planning
○ States expected outcomes in nursing interventions
○ Develops comprehensive patient care plan
○ Accomplishes patient centered discharge plan

CORE COMPETENCY 9:
Implements NCP to achieve identified outcomes

Indicators :
○ Explain interventions to patient, family before carrying them out
○ Implement safe, comfortable nursing interventions
○ Acts according to client’s health conditions, needs
○ Performs nursing interventions effectively and in timely manner

CORE COMPETENCY 10:

Implements NCP progress toward expected outcomes

Indicators :
○ Monitors effectiveness of nursing interventions
○ Revises care plan PRN

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CORE COMPETENCY 11:
Responds to urgency of patient’s condition

Indicators :
○ Identifies sudden changes in patient’s health conditions
○ Implements immediate, appropriate interventions

II. MANAGEMENT OF RESOURCES AND ENVIRONMENT

CORE COMPETENCY 1:
Organizes workload to facilitate patient care

Indicators:
○ Identifies task or activities that need to be accomplished
○ Plans the performance of task or activities based on priority
○ Finishes work assignment on time

CORE COMPETENCY 2:
Utilizes resources to support patient care

Indicators:
○ Determines the resources needed to deliver patient care
○ Control the use of equipment

CORE COMPETENCY 3:
Ensures the functioning of resources
Indicators:
○ Check proper functioning of the equipment○ Refers Malfunctioning equipment to appropriate unit

CORE COMPETENCY 4:
Check the Proper functioning of the Equipment

Indicators:
○ Determines the task and procedures that can be safely assigned to the other members of the team
○ Verifies the competence of the staff prior to delegating tasks

CORE COMPETENCY 5:
Maintains safe Environment

Indicators:
○ Observe proper disposal of waste
○ Adheres to policies, procedures and protocols on prevention and control of infection
○ Defines steps to follow in case of fire , earthquake and other emergency situation

III. HEALTH EDUCATION

CORE COMPETENCY 1:
Assesses the learning needs of the patient and the family

Indicators:
○ Obtains learning information through interview, observation and validation
○ Defines relevant information
○ Completes assessment records appropriately
○ Identify priority needs

CORE COMPETENCY 2:

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Develops Health Education plan based on assessed and anticipated needs.

Indicators:
○ Considers nature of the learner in relation to social, cultural, political, economic, educational, and
religious factor

CORE COMPETENCY 3:
Develops learning material for health education

Indicators:
○ Involves the patient, family and significant others and other resources
○ Formulates a comprehensive health educational plan with the following components , objectives,
content and time allotment
○ Teaching-learning resources and evaluation parameters
○ Provides for feedback to finalize plan

CORE COMPETENCY 4:
Implements the health Education Plan

Indicators:
○ Provides for conducive learning situation in terms of timer and place
○ Considers client and family preparedness○ Utilize appropriate strategies

○ Provides reassuring presence through active listening, touch and facial expression and gestures
○ Monitors client and family’s responses to health education

CORE COMPETENCY 5:
Evaluates the outcome of health Education

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

IV. ETHICO-MORAL RESPONSIBILITY

CORE COMPETENCY 1:Respects the rights of individual/ groups

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

CORE COMPETENCY 2
Accepts responsibility & accountability for own decisions and actions

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

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

Indicators:
○ Adheres to the Code of Ethics for Nurses and abides by its provisions
○ Reports unethical and immoral incidents to proper authorities

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V. LEGAL RESPONSIBILITY

CORE COMPETENCY 1:
Adheres to practices in accordance with the nursing law and other relevant legislation including contract
and informed consent.

Indicators:
○ Fulfill legal requirements in Nursing Practice
○ Holds current professional license
○ Acts in accordance with the terms of contract of employment and other rules and regulation
○ Complies with the required CPE
○ Confirms information given by the doctor for informed consent
○ Secures waiver of responsibility for refusal to undergo treatment or procedures
○ Check the completeness of informed consent and other legal forms

CORE COMPETENCY 2:
Adheres to organizational policies and procedures, local and national

Indicators:
○ Articulates the vision and mission of the institution where one belongs
○ Acts in accordance with the established norms and conduct of the institution/ organization

CORE COMPETENCY 3:
Document care rendered to patients.

Indicators:
○ Utilizes appropriate patient care records and reports
○ Accomplish accurate documentation in all matters concerning patient care in accordance with the
standard of nursing practice.

VI. PERSONAL & PROFESSIONAL DEVELOPMENT

CORE COMPETENCY 1
Identifies own learning needs

Indicators:
○ Verbalizes strengths, weaknesses, limitations.
○ Determines personal and professional goals and aspirations.

CORE COMPETENCY 2
Pursues continuing education

Indicators:
○ Participates in formal and non-formal education.
○ Applies learned information for the improvement of care.
CORE COMPETENCY 3

Gets involved in professional organizations and civic activities

Indicators:
○ Participates actively in professional, social, civic and religious activities
○ Maintain membership to professional organizations
○ Support activities related to nursing and health issues

CORE COMPETENCY 4
Projects a professional image of nurse

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Indicators:
○ Demonstrate good manners and right conduct at all times.
○ Dresses appropriately.
○ Demonstrates congruence of words and actions.
○ Behaves appropriately at all times.

CORE COMPETENCY 5
Possesses positive attitude towards change and criticism
Indicators:
○ Listens to suggestions and recommendations.
○ Tries new strategies or approaches.
○ Adapts to changes willingly.

CORE COMPETENCY 6
Performs function according to professional standards

Indicators:
○ 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.

VII. RESEARCH

CORE COMPETENCY 1:
Gathers data using different methodologies

Indicators:
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 simple explanation on the phenomena
observed
Analyzes data gathered

CORE COMPETENCY 2:
Recommends actions for implementation

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

CORE COMPETENCY 3:
Disseminates results of research findings

Indicators:
Communicates results of findings to colleagues/patients/family and to others
Endeavors to publish research
Submits research findings to own agencies and others as appropriate

CORE COMPETENCY 4:
Applies research findings in nursing practice

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

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VIII. RECORDS MANAGEMENT

CORE COMPETENCY 1:

Maintains accurate and updated documentation of patient care

Indicator:
Completes updated documentation of patient care

CORE COMPETENCY 2:
Records outcome of patient care

Indicator:
Utilizes a record system

CORE COMPETENCY 3:
Observes legal imperatives in recording keeping

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

IX. COMMUNICATION

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

Indicators:
○ 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 concern.

CORE COMPETENCY 2:
Identifies verbal and non-verbal cues

Indicator:
○ Interprets and validates client’s body language and facial expression

CORE COMPETENCY 3:
Utilizes formal and informal channels

Indicator:
○ Makes use of available visual aids

CORE COMPETENCY 4:
Responds to needs of individuals, family, group and community

Indicator:
○ Provides re- assurance through therapeutic, touch, warmth and comforting words of encouragement
○ Readily smiles

CORE COMPETENCY 5:
Uses appropriate information technology to facilitate communication

Indicator:
○ Utilizes telephone, mobile phone, email and internet, and informatics

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○ Identifies a significant other so that follow up care can be obtained
○ Provides “holding” or emergency numbers of services

X. COLLABORATION and TEAMWORK

CORE COMPETENCY 1:
Establishes collaborative relationship with colleagues and other members of the health team

Indicators:
○ Contributes to decision making regarding patients” needs and concerns
○ Participates actively in patients care management including audit
○ Recommends appropriate intervention to improve patient care
○ Respects the role of the other members of the health team

○ Maintains good interpersonal relationships with patients, colleagues and other members of the health
team

CORE COMPETENCY 2:
Collaborates plan of care with other members of the health team

Indicator:
○ Refers patients to allied health team partners
○ Acts liaison / advocate of the patients
○ Prepares accurate documentation of efficient communication of services

XI. QUALITY IMPROVEMENT

CORE COMPETENCY 1:
Gathers data for quality improvement

Indicators:
Demonstrates 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

CORE COMPETENCY 2:
Participates in nursing audits and rounds

Indicators:
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 about what is relevant to his condition
Documents and records all nursing care and actions
Performs daily check of patient records/condition
Completes patients records
Actively contributes relevant information of patients during rounds thru readings and sharing with others

CORE COMPETENCY 3:
Identifies and reports variances

Indicators:
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

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CORE COMPETENCY 4:
Recommends solutions to identified problems

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

PREPARED BY:
MARILYN M. SANTOS,R.N MAN. PhD.
LEVEL IV FACULTY

NOTED BY:
TRINA TAN R.N MAN.
LEVEL IV CLINICAL COORDINATOR

APPROVED BY:
TITA C. YAP, RN. MAN. EdD.
Dean, school of nursing.

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 SCHOOL OF NURSING
COMPETENCY APPRAISAL I
1ST SEMESTER S.A. 2018-2019

TOPIC: PRELIM Gordon’s Functional Health Pattern

A. Health Perception and Management
Prior to admission:
• Can only recall being immunized with BCG and DPT
• Rarely visits a doctor to have a check-up and seek for medical assistance
• Uses herbal medicines such as oregano, guava, bitter gourd, and ginger
• Buys and takes over the counter drugs such as Solmux, Neozep, Biogesic, Mefenamic acid,
Diatabs, and Loperamide.
• Stopped taking multivitamins Enervon
• When sick, goes to the manghihilot or just waits for the sickness to heal
• Practices healthy lifestyle and depends on fruits and vegetables
• No vices since young such as drinking alcoholic beverages and smoking cigarette
• After experiencing difficulty in defecating, she decided to see a physician
During hospitalization:
• Oriented
• Conscious and coherent
• Concerns for her surgical site after incision and repair
• Willing to accept and listen to health teachings
• Shows interest to recover easily and fast
• Always prays to God
B. Nutrition/ Metabolism
Prior:
• Eats more of fruits and vegetables
• Eats her meals 3x a day with snack in between
• Can drink up to 1.5L of water or 4-5 glasses a day
• Drinks coffee in the morning and in the afternoon
• Claimed to be allergic on shrimps and claimed to have good appetite
During:
• Weight: 41 kg
• Height: 4 ft and 10 in
2
• Normal Body Mass Index; BMI = 18.89 kg/m
0
• Average Body Temperature is 36 C
• Able to fast in preparation for surgical procedure
0
• Before operation, being infused with an IVF of D NM 1L x 16 hooked at her left cephalic vein
5

10
 • After operation, being infused with an IVF of PLR 1L x 8 hours as main line hooked at her left
cephalic vein with a side drip of PNSS 500mL + 2 ampules Voltaren at 20cc/hr and an IVF of
PNSS 1L x KVO hooked at her right cephalic vein with a side drip of 2units PRBC
• On NPO

C. Elimination
Prior:
• She voids 4-5 times a day
• Her urine color is yellow which is dark most of the times
• There is no burning sensation/ pain felt during urination
• She usually moves her bowel every morning
• With brown and formed stools. But recently, she is having difficulty in defecating
• The impression to the result of the ultrasound of her whole abdomen is to consider ileus; partial
obstruction and fecal stasis
During:
• No pain or burning sensation during urination
• Before operation, she experienced vomiting with yellowish vomitus and hasn’t move her bowel
all throughout the 8 hour shift
• After undergoing the surgical procedure, a nasogastric tube is used which is attached to a
drainage bottle; a colostomy is present attached to a colostomy bag
• After operation, a foley catheter was used which is attached to the uro bag draining well with
dark yellow urine with an output of 175 cc was taken after the shift
D. Activity/Exercise
Prior:
• The patient ambulates within the house
• She does household chores
• She takes a walk at their subdivision to visit the neighbors and buy at the store
• She does simple exercises on the upper and lower extremities by means of shaking and
stretching
• Able to bathe herself
During:
• Reaction to stimuli are slower
• Decreased strength; becomes weak in prolonged activities
• Decreased speed of movement
• Limited range of motion
• Radial pulse rate easily palpable and heard
• PR: 70 bpm
• RR:18 cpm
• BP: 110/80 mmHg
• Before operation, patient can turn to sides with slight discomfort and can ambulate with
assistance
• After operation, patient is on bed rest; flat on bed and shows evidence of weakness
• Steady and in deep sleep for 4 hours
E. Sexuality/ Reproductive
• Married
• A mother of 4 children
• Menarche was on the year 1938 when she was 11 years old
• On her menopausal stage
• She has no history of Sexually Transmitted Disease or any disease affecting her genitals
F. Cognitive/Perceptual
Prior:
• No sensory deficits but functions are diminished due to age
• Oriented to people, time, and place
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 • Responds to stimuli verbally and physically
• Pain felt radiating on the abdomen
During:
• Pre-operative Phase
• Before operation, she verbalized, “Sakit kaayo akong tiyan tapos butod ko. Magbalik-balik ang
sakit.”

• She rated pain as 8, from a pain scale of 1-10, 10 as the highest possible pain perceived
• She claimed that pain starts at the right upper quadrant and radiates all throughout the
abdomen
• Claimed pain to be intermittent
• In normal thought process
Post-operative Phase
• “Akong tahi, nagasakit pa.”, as verbalized
• Felt pain around the surgical site
• Slight facial grimacing
• Can respond to stimuli verbally and physically with weakness noted
• Believes that pain felt is due to post-operative experience
G. Roles/Relationship
Prior:
• Married
• With 4 children
• Lives with the youngest child
• Close to her grandchildren
• Loves her family so much
• Well – supported and loved by her family with close relationship
During:
• Well – supported by the family
• Still plays the role of a mother despite condition by means of reminding important matters to
her children
H. Self-Perception/Self-Concept
Prior:
• Manages to practice healthy lifestyle so as not to seek medical assistance
• Recently, she believed that admission will be helpful to assist her in her needs, to alleviate the
pain she felt, and to correct her bowel
• Hopeful to be relieved and treated
During:
• Though weak, she still manages to appear calm and relaxed
• Agreed to be operated and undergo surgery and gives her trust to the surgical team
• Hopeful and positive to have a successful operation
• Before operation, she prays all the time
• She desires that no complications will arise after the surgery
• Major concern is her recovery
I. Value/Belief
Prior:
• A Roman Catholic
• Have strong faith in God
• She always brings with her the rosary and always prays at night
• She goes to the church with her youngest child and her grandchildren to attend the mass every
Sunday
During:
• No restrictions in the procedure brought by religion
• The admission and surgery don’t interfere with spiritual practices
J. Coping/Stress
Prior:
• Copes up with stress by doing household chores and by taking a nap or sleep
• Copes up with problems by talking about it with the family and finds ways to resolve it together
• No traumatic events experienced before

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 • Reason for admission is to alleviate the pain and correct her bowel
• Went to hospital and sought for medical assistance after experiencing inability of defecating
During:
• Takes a nap and rests when tired
• Verbalizes desires to recover
• Able to accept situation by cooperating with the medical advices and procedures
K. Sleep/Rest
Prior:
• Can sleep for 7-9 hours per night
• Straight hours of sleep
• Her earliest time in going to sleep is at 9:30 PM
• Latest time in waking up is at 6:30 AM
• She sometimes takes a nap at noon for about 1-3 hours
• No difficulties in going to sleep
• Doesn’t uses any medication to promote sleep
During:
• Sleeps at 8:00 PM
• Wakes up at 6:00 AM
• Can consume 10 hours of sleep
• Sometimes, she is distracted and sleep is interrupted due to pain, administration of medication
and visitors
• With rest intervals, usually naps for 4 hours
L. Medication History
Prior:
• Took Bentyl and Loperamide
During:
• Pre-operative Phase
0
• IVF of D NM 1L x 16
5
• Completed 6 doses of Kalium Durule 1 tab TID
• Completed 3 doses of Senokot Forte 2 tabs BID
• Administered with Motillium 10 mg 1 tab TID
• Nexium 40 mg 1 tab OD
• Lactulose 30 cc
Post-operative Phase
• IVF of PLR 1L x 8 hours as main line with a side drip of PNSS 500mL + 2 ampules Voltaren at
20cc/hr
• PNSS 1L x KVO with a side drip of 2units PRBC
• On NPO
0
• Administered with Cefuroxime 750 mg q8 IVTT
0
• Metronidazole 500 mg q8 @ am
• Omepron OD 40 mg IVTT
• Voltaren 20 cc/hr
nd 0
• 2 dose of 12 doses Nalbuphine 5 mg q6 IVTT
0
• Nebulized with Convibent q8 em List

PREPARED BY:
MARILYN M. SANTOS,R.N MAN. PhD.
LEVEL IV FACULTY

NOTED BY:

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TRINA TAN R.N MAN.
LEVEL IV CLINICAL COORDINATOR

APPROVED BY:
TITA C. YAP, RN. MAN. EdD.
Dean, school of nursing.

14