1 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

Chapter 5 SUMMARY, CONCLUSION AND RECOMMENDATIONS In this chapter, the summary with its implications, conclusions of the findings as well as recommendations were developed in relation to the entire research study.

Summary This study was conducted to find out the performance of Registered Nurses Health Enhancement And Local Services (RN HEALS) Program at Dr. Paulino Garcia Memorial Research and Medical Center deployed from January to December 2013. Performances before and during the training, and at the present employment were considered all in staff nurse and RN HEALS employees' perspectives. One hundred three (103) nurses at Dr. Paulino J. Garcia Memorial Research and Medical Center were utilized as the client-respondents. Fifty three (53) of which were staff nurses and the remaining number were RN HEALS employees. The researcher used the descriptive type of research in accomplishing this manuscript with the use of questionnaire as instrument in data gathering. In data gathering, the researcher used a four-segment questionnaire. Segment A had been used in gathering information about the socio-demographic profile of the respondents. Segment B provided descriptions for performance before the training; segment C for the performance during the training; segment D for the performance at present employment. For segments B, C, and D the researcher provided the respondents with a Likert scale of 1-4. 1 corresponds for never, 2 for seldom, 3 for often, and 4 for

2 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

always. Two sets of questionnaires were prepared, one for RN HEALS employees and one for the staff nurses.

Findings 1. The Socio-Demographic Profile of Employees under the RN HEALS Program Majority of the employees of the RN HEALS program belonged to the 2225 years old group with 46 or 86.79% respondents. Further, 40 or 75.47%

belonged to the female group. Additionally, a vast number of RN HEALS employees belonged to the single category with a number of 48 or 90.57%, 47 or 88.68% had provided nursing services for 1-3 years, and 49 or 92.45%, were Bachelor's Degree Graduates. 2.1. Performance of the Employees under RN HEALS Program as Described by Themselves Before Their Training The responses on all the items pertaining to the performance of RN HEALS employees before their training got an overall weighted mean of 3.21 indicating that these items are Often done by RN HEALS employees. Among the identified items before their training, it was very remarkable that item number 12 Clarify doctors order before carrying them out got the highest weighted mean of 3.47 and was verbally interpreted as always. The least among the list, however, was item number 37 Identify own learning and training needs which had a weighted mean of 2.72 and was verbally interpreted as "Often".

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2.2. Performance of the Employees under RN HEALS Program as Described by Themselves During Their Training The responses on all the items pertaining to the performance of RN HEALS employees during their training got an overall weighted mean of 3.28 indicating that these items are Always done by RN HEALS employees. Among the identified items during their training, it was very remarkable that item number 10 Formulate nursing care plans according to patients needs and item number 12 "Clarify doctors order before carrying them out" both got the highest weighted mean of 3.55 and were verbally interpreted as "Always". The least among the list, however, was item number 37 Identify own learning and training needs which had a weighted mean of 2.75 and was verbally interpreted as "Often". 2.3. Performance of the Employees under RN HEALS Program as Described by Themselves at their Present Employment The responses on all the items pertaining to the performance of RN HEALS employees at their present employment got an overall weighted mean of 3.37 indicating that these items are Always done by RN HEALS employees. Among the identified items at their present employment, it was very remarkable that item number 12 Clarify doctors order before carrying them out and item number 17 "Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle" both got the highest weighted mean of 3.60 and were verbally interpreted as "Always". The least among the list, however, was item number 37 Identify

4 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL own learning and training needs which had a weighted mean of 2.79 and was verbally interpreted as "Often". 3.1. Performance of the Employees under RN HEALS Program as Described by Staff Nurses Before the Former's Training The responses on all the items pertaining to the performance of RN HEALS employees as perceived by staff nurses before the former's training got an overall weighted mean of 3.13 indicating that these items are Often done by RN HEALS employees. Among the identified items before the training of RN HEALS employees, staff nurses perceived that it was very remarkable that item number 5 Clarify doctors order before carrying them out got the highest weighted mean of 3.51 and was verbally interpreted as "Always". The least among the list, however, was item number 37 Identify own learning and training needs which had a weighted mean of 2.68 and was verbally interpreted as "Often". 3.2. Performance of the Employees under RN HEALS Program as Described by Staff Nurses During the Former's Training The responses on all the items pertaining to the performance of RN HEALS employees as perceived by staff nurses during the former's training got an overall weighted mean of 3.19 indicating that these items are Often done by RN HEALS employees. Among the identified items during the training of RN HEALS employees, staff nurses perceived that it was very remarkable that item number 12 Clarify doctors order before carrying them out got the highest weighted mean of 3.49 and was verbally interpreted as "Always". The least among the list, however, was item number 37 Identify

5 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL own learning and training needs which had a weighted mean of 2.79 and was verbally interpreted as "Often". 3.3. Performance of the Employees under RN HEALS Program as Described by Staff Nurses in the Former's Present Employment The responses on all the items pertaining to the performance of RN HEALS employees as perceived by staff nurses at the former's present employment got an overall weighted mean of 3.29 indicating that these items are Always done by RN HEALS employees. Among the identified items during the training of RN HEALS employees, staff nurses perceived that it was very remarkable that item number 21 Collaborate patient care with other members of the health care team got the highest weighted mean of 3.53 and was verbally interpreted as "Always". The least among the list, however, was item number 37 Identify own learning and training needs which had a weighted mean of 2.87 and was verbally interpreted as "Often".

Conclusions Based on the results and findings of the study, the following conclusions were drawn: 1. Majority of the employees of the RN HEALS program belonged to the 22-25 years old group, female, single, had provided nursing services for 1-3 years, and were Bachelor's Degree Graduates.

6 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

2. RN HEALS employees before their training often done the identified parameters. However, during their training and at their present employment, they were able to always perform the items identified. 3. RN HEALS employees before and during their training often done the identified parameters as perceived by staff nurses. However, at their present employment, they were able to always perform the items identified.

Recommendations: The following recommendations were made based on the findings of the study: 1. That hospital administrators should always find time to do the training needs assessment of the RN HEALS employees to make it certain that they were adequately and correctly exposed to areas that will stimulate them to grow professionally. This could be done prior to employees' training period, during the training period, and even after the training period.

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BIBLIOGRAPHY AHRQ PSNet Patient Safety Network (2012). Patient safety. Retrieved from http://psnet .ahrq.gov/glossary.aspx#P on August 20, 2013. Alexandropoulou M, Sourtzi P, Kalokerinou A. (2010). Health promotion practices and attitudes among nurses in special education schools in greece. Aspden P, Corrigan J, Wolcott J, et al., eds. (2004) Patient safety: achieving a new standard for care. Washington, DC: National Academies Press. Baggs, M. & Schmitt, G. (2008). Communication, Collaboration, and Teamwork among Health Care Professionals. Retrieved from http://cscc.scu.edu/trends/v21/v21 _3.pdf on Auugust 26, 2013. Boydell, V & Leary, M. (2011). Importance of identifying learning needs. Retrieved from https://www.google.com/#fp=8a62bfbedee28d38&psj=1&q=importance+of+ident ifying+learning+needs on August 21, 2013. Cassidy VR. (2010). Ethical responsibilities in nursing: research findings and issues. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/2030229 on August 22, 2013. Collins, S. (2009). Good communication helps to build a therapeutic relationship. Retrieved from http://www.nursingtimes.net/nursing-practice/clinicalspecialisms/educator s/good-communication-helps-to-build-a-therapeuticrelationship/5003004.article on August 15, 2013. Committee on the Quality of Health Care in America (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. De Casctro, A.B., Cabrera, S.L., Gee, G.C., Fujishiro, K., Tagalog, E.A. (2009). Occupational Health and Safety Issues Among Nurses in the Philippines. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797477/ on August 22, 2013. Dimitriadou A., Lavdaniti M., Theofanidis D., Psychogiou M., Minasidou Eu., Konstadinidou-Straukou A. Sapountzi-Krepia D.(2006). Interprofessional collaboration and collaboration among nursing staff members in northern greece. Retrieved from http://www.caringsciences.org/volume001/issue3/Vol1 _Issue3_06_Dimitriadou.pdf on August 22, 2013.

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Draper DA, Felland LE, Liebhaber A, Melichar L. (2010)The role of nurses in hospital quality improvement. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/ 18496934 on August 22, 2013. Guidelines of the Code of Ethics for Nurses, adopted may 1992 at the DNOs Congress Kurcgant P, Tronchin DMR, Melleiro MM. Indicators of Nurse' Performance- An analysis. Acta Paul Enferm. 2006;19(1):88-91. Lammintakanen, J. , Kivinen, Tuula (2012). Continuing professional development in nursing: does age matter?. Retrieved from http://www.emeraldinsight.com/ journals.htm?articleid=17004299 on August 23, 2013. Lohr K, Committee to Design a Strategy for Quality Review and Assurance in Medicare, eds. ( 2007) Medicare: a strategy for quality assurance, Vol. 1. Washington, DC: National Academy Press. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academy Press, 1990, p244. McCabe, C. (2004). Nurse-patient communication: an exploration of patients' experiences. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14687292 on August 22, 2013. McCann, F. (2012). Clarifying and clarification. Retrieved http://www.skillsyouneed.com/ ips/clarification.html on August 21, 2013. from

Mitchell PH, Lang NM. (2004). Framing the problem of measuring and improving healthcare quality: has the Quality Health Outcomes Model been useful? Med Care; 42:II4-11. Moore, C. (2007). Collaborative nursing practice. Retrieved from http://www.nurse together.com/tabid/103/itemid/356/Collaborative-Nursing-Practice.aspx on August 15, 2013. National Quality Forum (2004). National consensus standards for nursing-sensitive care: an initial performance measure set. Washington, DC: National Quality Forum; p. 40. National Quality Forum (2006). Standardizing a patient safety taxonomy: a consensus report. Washington, DC: National Quality Forum. Polit, D.F., Beck, C.T. (2008). Essentials of nursing research: appraising evidence for nursing practice 7th Edition. Lippincott, Williams, and Wilkins.

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Rainio AK, Ohinmaa AE. (2005). Assessment of nursing management and utilization of nursing resources with the RAFAELA patient classification system--case study from the general wards of one central hospital. Retrieved from http://www.ncbi.nlm. nih.gov/pubmed/15946275 on August 22, 2013. Roxburgh, M, Lauder, W, Topping, K, Holland, K, Johnson, M, Watson, R (2009) Early findings from an evaluation of a post-registration staff development programme: The Flying Start NHS initiative in Scotland, UK, Nurse Education in Practice, doi:10.1016/j.nepr.2009.03.015 Shojania KG, Duncan BW, McDonald KM, et al., eds. (2001). Making health care safer: a critical analysis of patient safety practices. Evidence Report/Technology Assessment No. 43 (Prepared by the University of California at San FranciscoStanford Evidence-based Practice Center under Contract No. 290-97-0013). Rockville, MD: Agency for Healthcare Research and Quality; AHRQ Publication No. 01-E058, Summary. Tan, C.B. (2010). Introduction to Nursing Research. CNE Publishing House, Manila, Philippines. World Health Organization (2008). Adelaide recommendations on healthy public policy. WHO, Geneva World Health Organization, 2011. Importance of health education in achieving millennium development goals. Retrieved from http://www.who.int/ topics/healtheducation/e n/ on August 24, 2012. Yeo, G., Charles, K., Johnson, M. (2003). Managing public sector records a study programme. International Records Management Trust. Retrieved from http://www.irmt.orgdocuments/educ_training/educ_resource/IRMT_ed_case_stud y_v2.pdf on August 22, 2012. Yildirim, A. & Ozkahraman, H. (2011). Critical thinking in nursing process and education. Turkey. International Journal of Humanities and Social Science Vol. 1 No. 13 (Special Issue ). September 2011

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Appendix 1 Permission Letter July 14, 2013

DR. HUBERTO F. LAPUZ (Sgd.) Chief of Hospital Dr. Paulino J. Garcia Memorial Research and Medical Center Cabanatuan City Thru: PINKY MIRIAM D. CANLAS, RN, MAN (Sgd.) Chief Nurse Sir: Christian Greetings in the name of our Lord, Jesus! I am a graduate student of Wesleyan University-Philippines taking up Master of Arts in Nursing. Currently, I am conducting my study on Performance Appraisal of Registered Nurses Health Enhancement and Local Services (RN HEALS) Program of Dr. Paulino J. Garcia Memorial Research and Medical Center" In line with this, may I request permission from your honourable office to please allow me to conduct the abovementioned study in your hospital. Rest assured that the information that would be collected will be treated with utmost confidentiality. Thank you very much and I am looking forward for your positive response. God bless you more. Respectfully yours, RAMIL V. GARCIA, RN (Sgd.) Researcher Noted by: ERLINDA C. DOMINGO, RN, MPH (Sgd.) Thesis Adviser DR. GENER S. SUBIA (Sgd.) Statistician DR. MA. VICTORIA PAZ B. PASCUAL (Sgd.) Dean, Graduate School

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Appendix 2 Cover Letter

July 14, 2013

Dear Colleague

Greetings! I am presently conducting a study on Performance Appraisal of Registered Nurses Health Enhancement and Local Services (RN HEALS) Program of Dr. Paulino J. Garcia Memorial Research and Medical Center" in partial fulfillment of the requirement for the degree Master of Arts in Nursing at Wesleyan University Philippines. In this connection, may I request your assistance by filling out the attached questionnaires, honestly and accurately. Please do not leave any item unanswered. Rest assured that all your answers will be treated with strict confidentiality. Thank you very much for your support and anticipated response.

Respectfully yours, Ramil V. Garcia RN (Sgd.)

Thesis Statistician: Prof. Gener Subia (Sgd.) Thesis Adviser: Prof. Erlinda Domingo (Sgd.)

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Appendix 3 Sample Questionnaire (For RN HEALS Employees)

PART I. SOCIO-DEMOGRAPHIC PROFILE OF THE REPONDENTS Directions: please read and supply the needed information on the blank provided by placing a check. Rest assured that your responses will be treated with utmost confidentiality 1. Name: ________________________ (optional) 2. Age: _______ 3. Sex: ( ) Male ( ) Female 4. Civil Status ( ) Single ( ) Married 5. Educational Attainment ( ) B.S. Nursing ( ) Masters DegreeGraduate ( ) Doctorate Degree Graduate 6. Length of experience ( ) less than a year ( ) 3-less than 5 years ( ) 1-less than 3 years ( ) more than 5years ( ) Widowed ( ) Separated

( )Masters degree Student ( )Doctorate Degree Student

Part II. Self Assessment on performance before the RN HEALS Program Directions: Place a check mark ( / ) on the space provided that corresponds to your answer 4 3 2 1 Always Often Sometimes Never All the time Most of the time Not all the Time Not at all

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4 3 2 1 BEFORE THE TRAINING Obtain a detailed patient history Perform case prioritization upon patient arrival Perform systematic head to toe assessment Formulate appropriate nursing diagnosis from the data obtained 5. Documents assessment for networking and referral 6. Explain to patients diagnostic procedures to be performed and the necessary preparation 7. Prepare the patient for diagnostic procedure after securing informed consent 8. Identify abnormal laboratory and other diagnostic finding 9. Identify expected outcomes of a holistic nursing intervention 10. Formulate nursing care plans according to patients needs 11. Implement the nursing care plan with the participation of the patients significant others 12. Clarify doctors order before carrying them out 13. Utilize infection control measure 14. Prioritize patient needs and provide them accordingly 15. Monitor patients progress 16. Gather feedback from the patient and the his/her significant others 17. Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle 18. Establish a trusting relationship to the patient including their significant others 19. Advocate patients rights 20. Secure patients informed consent after a thorough explanation of the procedure or treatment to be performed 21. Collaborate patient care with other members of the health care team 22. Regularly update the healthcare team with the patients progress 23. Participate in meetings and discussions on the patients condition and plan of care with other members of the health care team 24. Prioritize workload and utilizes time efficiently 25. Check the availability of medical supplies and medication 26. Monitor functionality of medical and non-medical equipment 27. Utilize medical and non medical supply appropriately 28. Address and reports potential risks observed in the work 1. 2. 3. 4.

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place 29. Document care rendered accurately following the rules implemented by the nursing division 30. Maintain confidentiality of patients records 31. Maintain strict compliance to hospital policies and regulations 32. Provide patient care in accordance with national laws on health 33. Identify topics appropriate for research 34. Participate in preparing a research proposal complying with the ethical principles in nursing research 35. Gather data using different methodologies 36. Able to performs and act as senior nurse whenever delegated 37. Identify own learning and training needs 38. Pursues continuing education 39. Participate in professional organizations 40. Provide nursing care that reflects values and respect for people regardless of their place of origin, race, politics, status, role, gender, culture, belief system and behavior 41. Accept accountability for own decisions

4 3 2 1 DURING THE TRAINING Obtain a detailed patient history Perform case prioritization upon patient arrival Perform systematic head to toe assessment Formulate appropriate nursing diagnosis from the data obtained 5. Documents assessment for networking and referral 6. Explain to patients diagnostic procedures to be performed and the necessary preparation 7. Prepare the patient for diagnostic procedure after securing informed consent 8. Identify abnormal laboratory and other diagnostic finding 9. Identify expected outcomes of a holistic nursing intervention 10. Formulate nursing care plans according to patients needs 11. Implement the nursing care plan with the participation of the patients significant others 12. Clarify doctors order before carrying them out 13. Utilize infection control measure 14. Prioritize patient needs and provide them accordingly 15. Monitor patients progress 16. Gather feedback from the patient and the his/her significant 1. 2. 3. 4.

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others 17. Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle 18. Establish a trusting relationship to the patient including their significant others 19. Advocate patients rights 20. Secure patients informed consent after a thorough explanation of the procedure or treatment to be performed 21. Collaborate patient care with other members of the health care team 22. Regularly update the healthcare team with the patients progress 23. Participate in meetings and discussions on the patients condition and plan of care with other members of the health care team 24. Prioritize workload and utilizes time efficiently 25. Check the availability of medical supplies and medication 26. Monitor functionality of medical and non-medical equipment 27. Utilize medical and non medical supply appropriately 28. Address and reports potential risks observed in the work place 29. Document care rendered accurately following the rules implemented by the nursing division 30. Maintain confidentiality of patients records 31. Maintain strict compliance to hospital policies and regulations 32. Provide patient care in accordance with national laws on health 33. Identify topics appropriate for research 34. Participate in preparing a research proposal complying with the ethical principles in nursing research 35. Gather data using different methodologies 36. Able to performs and act as senior nurse whenever delegated 37. Identify own learning and training needs 38. Pursues continuing education 39. Participate in professional organizations 40. Provide nursing care that reflects values and respect for people regardless of their place of origin, race, politics, status, role, gender, culture, belief system and behavior 41. Accept accountability for own decisions

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4 3 2 1 PRESENT EMPLOYMENT Obtain a detailed patient history Perform case prioritization upon patient arrival Perform systematic head to toe assessment Formulate appropriate nursing diagnosis from the data obtained 5. Documents assessment for networking and referral 6. Explain to patients diagnostic procedures to be performed and the necessary preparation 7. Prepare the patient for diagnostic procedure after securing informed consent 8. Identify abnormal laboratory and other diagnostic finding 9. Identify expected outcomes of a holistic nursing intervention 10. Formulate nursing care plans according to patients needs 11. Implement the nursing care plan with the participation of the patients significant others 12. Clarify doctors order before carrying them out 13. Utilize infection control measure 14. Prioritize patient needs and provide them accordingly 15. Monitor patients progress 16. Gather feedback from the patient and the his/her significant others 17. Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle 18. Establish a trusting relationship to the patient including their significant others 19. Advocate patients rights 20. Secure patients informed consent after a thorough explanation of the procedure or treatment to be performed 21. Collaborate patient care with other members of the health care team 22. Regularly update the healthcare team with the patients progress 23. Participate in meetings and discussions on the patients condition and plan of care with other members of the health care team 24. Prioritize workload and utilizes time efficiently 25. Check the availability of medical supplies and medication 26. Monitor functionality of medical and non-medical equipment 27. Utilize medical and non medical supply appropriately 28. Address and reports potential risks observed in the work 1. 2. 3. 4.

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place 29. Document care rendered accurately following the rules implemented by the nursing division 30. Maintain confidentiality of patients records 31. Maintain strict compliance to hospital policies and regulations 32. Provide patient care in accordance with national laws on health 33. Identify topics appropriate for research 34. Participate in preparing a research proposal complying with the ethical principles in nursing research 35. Gather data using different methodologies 36. Able to performs and act as senior nurse whenever delegated 37. Identify own learning and training needs 38. Pursues continuing education 39. Participate in professional organizations 40. Provide nursing care that reflects values and respect for people regardless of their place of origin, race, politics, status, role, gender, culture, belief system and behavior 41. Accept accountability for own decisions

18 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

Appendix 4 Sample Questionnaire (For Staff Nurses)

Directions: Place a check mark ( / ) on the space provided that corresponds to your answer 5 4 3 2 Always Often Sometimes Never All the time Most of the time Not all the Time Not at all

4 3 2 1 BEFORE THE TRAINING Obtain a detailed patient history Perform case prioritization upon patient arrival Perform systematic head to toe assessment Formulate appropriate nursing diagnosis from the data obtained 5. Documents assessment for networking and referral 6. Explain to patients diagnostic procedures to be performed and the necessary preparation 7. Prepare the patient for diagnostic procedure after securing informed consent 8. Identify abnormal laboratory and other diagnostic finding 9. Identify expected outcomes of a holistic nursing intervention 10. Formulate nursing care plans according to patients needs 11. Implement the nursing care plan with the participation of the patients significant others 12. Clarify doctors order before carrying them out 13. Utilize infection control measure 14. Prioritize patient needs and provide them accordingly 15. Monitor patients progress 16. Gather feedback from the patient and the his/her significant others 17. Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle 18. Establish a trusting relationship to the patient including their significant others 19. Advocate patients rights 20. Secure patients informed consent after a thorough explanation of the procedure or treatment to be performed 1. 2. 3. 4.

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21. Collaborate patient care with other members of the health care team 22. Regularly update the healthcare team with the patients progress 23. Participate in meetings and discussions on the patients condition and plan of care with other members of the health care team 24. Prioritize workload and utilizes time efficiently 25. Check the availability of medical supplies and medication 26. Monitor functionality of medical and non-medical equipment 27. Utilize medical and non medical supply appropriately 28. Address and reports potential risks observed in the work place 29. Document care rendered accurately following the rules implemented by the nursing division 30. Maintain confidentiality of patients records 31. Maintain strict compliance to hospital policies and regulations 32. Provide patient care in accordance with national laws on health 33. Identify topics appropriate for research 34. Participate in preparing a research proposal complying with the ethical principles in nursing research 35. Gather data using different methodologies 36. Able to performs and act as senior nurse whenever delegated 37. Identify own learning and training needs 38. Pursues continuing education 39. Participate in professional organizations 40. Provide nursing care that reflects values and respect for people regardless of their place of origin, race, politics, status, role, gender, culture, belief system and behavior 41. Accept accountability for own decisions

1. 2. 3. 4. 5. 6.

4 3 2 1 DURING THE TRAINING Obtain a detailed patient history Perform case prioritization upon patient arrival Perform systematic head to toe assessment Formulate appropriate nursing diagnosis from the data obtained Documents assessment for networking and referral Explain to patients diagnostic procedures to be performed

20 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

and the necessary preparation 7. Prepare the patient for diagnostic procedure after securing informed consent 8. Identify abnormal laboratory and other diagnostic finding 9. Identify expected outcomes of a holistic nursing intervention 10. Formulate nursing care plans according to patients needs 11. Implement the nursing care plan with the participation of the patients significant others 12. Clarify doctors order before carrying them out 13. Utilize infection control measure 14. Prioritize patient needs and provide them accordingly 15. Monitor patients progress 16. Gather feedback from the patient and the his/her significant others 17. Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle 18. Establish a trusting relationship to the patient including their significant others 19. Advocate patients rights 20. Secure patients informed consent after a thorough explanation of the procedure or treatment to be performed 21. Collaborate patient care with other members of the health care team 22. Regularly update the healthcare team with the patients progress 23. Participate in meetings and discussions on the patients condition and plan of care with other members of the health care team 24. Prioritize workload and utilizes time efficiently 25. Check the availability of medical supplies and medication 26. Monitor functionality of medical and non-medical equipment 27. Utilize medical and non medical supply appropriately 28. Address and reports potential risks observed in the work place 29. Document care rendered accurately following the rules implemented by the nursing division 30. Maintain confidentiality of patients records 31. Maintain strict compliance to hospital policies and regulations 32. Provide patient care in accordance with national laws on health

21 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

33. Identify topics appropriate for research 34. Participate in preparing a research proposal complying with the ethical principles in nursing research 35. Gather data using different methodologies 36. Able to performs and act as senior nurse whenever delegated 37. Identify own learning and training needs 38. Pursues continuing education 39. Participate in professional organizations 40. Provide nursing care that reflects values and respect for people regardless of their place of origin, race, politics, status, role, gender, culture, belief system and behavior 41. Accept accountability for own decisions 4 3 2 1 PRESENT EMPLOYMENT 1. Obtain a detailed patient history 2. Perform case prioritization upon patient arrival 3. Perform systematic head to toe assessment 4. Formulate appropriate nursing diagnosis from the data obtained 5. Documents assessment for networking and referral 6. Explain to patients diagnostic procedures to be performed and the necessary preparation 7. Prepare the patient for diagnostic procedure after securing informed consent 8. Identify abnormal laboratory and other diagnostic finding 9. Identify expected outcomes of a holistic nursing intervention 10. Formulate nursing care plans according to patients needs 11. Implement the nursing care plan with the participation of the patients significant others 12. Clarify doctors order before carrying them out 13. Utilize infection control measure 14. Prioritize patient needs and provide them accordingly 15. Monitor patients progress 16. Gather feedback from the patient and the his/her significant others 17. Disseminate information that will promotes health and healthy environment, preventive measures to illnesses and healthy lifestyle 18. Establish a trusting relationship to the patient including their significant others 19. Advocate patients rights 20. Secure patients informed consent after a thorough explanation of the procedure or treatment to be performed

22 WESLEYAN UNIVERSITYPHILIPPINES GRADUATE SCHOOL

21. Collaborate patient care with other members of the health care team 22. Regularly update the healthcare team with the patients progress 23. Participate in meetings and discussions on the patients condition and plan of care with other members of the health care team 24. Prioritize workload and utilizes time efficiently 25. Check the availability of medical supplies and medication 26. Monitor functionality of medical and non-medical equipment 27. Utilize medical and non medical supply appropriately 28. Address and reports potential risks observed in the work place 29. Document care rendered accurately following the rules implemented by the nursing division 30. Maintain confidentiality of patients records 31. Maintain strict compliance to hospital policies and regulations 32. Provide patient care in accordance with national laws on health 33. Identify topics appropriate for research 34. Participate in preparing a research proposal complying with the ethical principles in nursing research 35. Gather data using different methodologies 36. Able to performs and act as senior nurse whenever delegated 37. Identify own learning and training needs 38. Pursues continuing education 39. Participate in professional organizations 40. Provide nursing care that reflects values and respect for people regardless of their place of origin, race, politics, status, role, gender, culture, belief system and behavior 41. Accept accountability for own decisions