STANDARD NURSING PRACTICE: USE OF ELEVEN NURSING CORE

COMPETENCIES (RA 9173 Article 3 Section 9 (c))

A Research Study Presented to the
Faculty of Tarlac State University
College of Nursing
___________________________________
In Partial Fulfillment of the Requirements for the
Course Nursing Leadership and Management 107B
____________________________________
By:
Abad, Franz Gabriel A.
Basallote, Angel Rose F.
Basco, Rose Ann V.
Castro, Nicole Jade T.
Cortez, Cristine May B.
Cortez, Rachel Marie C.
Ordoa, Karen E.
Pasoquin, Hanna Joy D.
Punzalan, Jenny Lou D.
Valdez, Micah O.
4-A (A4)
March 2014

ACKNOWLEDGEMENT

The success of this study required the help of various individuals. Without them,
the researchers might not meet their objectives in doing this study. The researchers want
to give gratitude to the following people for their invaluable help and support:
To Jesus Christ, our Lord and Savior, for giving the wisdom, strength, support
and knowledge in exploring things; for the guidance is helping surpass all the trials that
the researchers encountered and for giving determination to pursue their studies and to
make this study possible.
To their Loving Parents, for giving support and encouragement to pursue their
study, for giving love and time for their children, for giving trust, love, and patience to
their children.
To Roberto O. Duaqui, for his kind, responsible and understanding adviser, who
was always there during the process of this study giving some advice and ideas to
accomplish this study.
To Mrs. Noemi Hurgo, the college Librarian, who allows the researchers to use
books and journals to the library that are needed in the study.

To the Tarlac State University - College of Nursing Family, the Dean, the
Faculty and Staff, for giving thoughts, advice and ideas for improvement of the study.

And lastly, to the people who helped and contribute great ideas and advices,
especially classmates and close friends for without them, this study would not be
possible.
The researchers would like to extend the deepest gratitude.

The Researchers

ABSTRACT

TITTLE: STANDARD NURSING PRACTICE: USE OF ELEVEN NURSING

CORE COMPETENCIES (RA 9173 Article 3 Section 9 (c))
RESEARCHERS:

Abad, Franz Gabriel A.

Basallote, Angel Rose F.
Basco, Rose Ann V.
Castro, Nicole Jade T.
Cortez, Cristine May B.
Cortez, Rachel Marie C.
Ordona, Karen E.
Pasoquin, Hanna Joy D.
Punzalan, Jenny Lou D.
Valdez, Micah O.
INSTITUTION: Tarlac State University

COURSE: College Of Nursing

The study determined the core competencies being observed by the nurses with
regards to the standard practice of nurses in surgery and medicine ward of the selected
hospitals, its extent and implication to nursing profession.
RA 9173 or the Philippine Act of 2002 has the primary purpose of providing
regulatory standards in Nursing Practice; this is under its Article 3 section 9 and
subsection (c) and in line with the PRC or Professional Regulation Commission and
Commission on Higher Education (CHED) nursing practice and nursing education must
go hand in hand for the achievement of quality nursing care for the nation.
The study was guided by Jean Watsons Human Caring model or the so called
Caring Science and in line with this the researchers made use of Descriptive design. The
respondents for this research were the surgery and medicine ward nurses of the selected
hospitals in Tarlac City. Descriptive method was used to determine the core competencies
being observed by the nurses through the use of questionnaires in the form of checklist.

The result of the study that 5 out of the 11 core competencies, which were Management
of Resources and Environment, Collaboration and Team Work, Legal Responsibility,
Ethico-Moral Responsibilities, and Records Management was unanimously observed by
the respondents on the other hand Research and Health Education were the two least
observed by the respondents. Specifically the competencies, implementing the education
plan in Health Education and recommending actions for implementation in Research.
And to further improve the eleven core competencies by the staff nurses, the researchers
would propose to the institution to conduct a self-awareness seminar, recommend to
adapt a program by completing a research study would endorse a seminar and training
workshop in improving the means of disseminating just and appropriate health education
to nurse-client interactions and for them to have this research as a basis for further
studies.

TABLE OF CONTENTS
Page
ACKNOWLEDGEMENT........................................................................................i

ABSTRACTii
TABLE OF CONTENTS........................................................................................iii
Chapter
1. THE PROBLEM AND ITS BACKGROUND........................................................1
Introduction..................................................................................................1
........................................................................................................................
Statement of the Problem.............................................................................3
Significance of the Study.............................................................................4
Scope & Delimitation..................................................................................4
2. REVIEW OF RELATED LITERATURE AND STUDIES.....................................5
3. METHODOLOGY.................................................................................................15
Research Design.........................................................................................15
Respondents...............................................................................................16
Sampling Technique...................................................................................16
Research Instruments.................................................................................16
Statistical Treatment...................................................................................17
4. RESULTS .21
5. DISCUSSION....43
BIBLIOGRAPHY..............................................................................................46

STANDARD NURSING PRACTICE: USE OF ELEVEN NURSING CORE

COMPETENCIES (RA 9173 Article 3 Section 9 (c))
Introduction
The Philippine Board of Nursing is an administrative body under the Professional
Regulation Commission that regulates the practice of nursing in the Philippines. One of
their primary purposes is to provide regulatory standards in the Practice of nursing. Under
the Republic Act 9173 also known as Philippine Act of 2002 Article III Sec. 9 Subsection
C it was said that nursing practice should be monitored and enforced to quality nursing
practice to ensure the maintenance of efficient, ethical and technical, moral and
professional standards in the nursing practice taking into the account of the health needs
of the nation and with its collaboration with Professional Regulation Commission and
Commission on Higher Education, nursing practice and nursing education should be
guided to achieve quality nursing care for the nation. Thus, they created a guideline on
both nursing education and nursing practice which is now known as the Eleven Nursing
Core Competencies. Eleven Nursing Core Competencies unifies framework of nursing
practice, education and regulation. It is also used as a tool for nurses performance
evaluation, basis for advance nursing performance and used in criteria for unethical and
unprofessional nursing practice. Standards of practice or so called standards of care are
guidelines used to determine what should a nurse or should not do (McMahon, 2014).
Threat to patients do not just include errors of health practitioners but also risk,
events, hazardous conditions and other circumstances that can lead to patient harm. A
threat to patient safety is one of the major public health problems because the quality of
the practice environment is an ethical issue due to its important effect on the quality of
patient care. It also affects nurses sense of health and wellbeing in the work place.
Research has shown that when staff and other resources are scare, nurses experience

frustration and ethical distress, which can interfere with the ability to provide safe and
ethical nursing care (Rodney, et. al., 2010).
Providing safe and quality care encompasses the other nursing core competencies,
in other words, as nurses fail to perform the first and significant competency on standard
nursing practice which is to promote safety, there could be a possibility of continued
misunderstanding of the greater effects of the numerous, complex health care systems and
the work environment. Examples are; hospital-acquired infections like catheter related
bloodstream infections with 70 percent of hospital-acquired bloodstream infections occur
in patients with venous catheters, Falls among hospital inpatients are common, generally
ranging from 2.3 to 7 falls per 1,000 patient-days. Approximately 30 percent of inpatient
falls result in injury, with 4 percent to 6 percent resulting in serious injury. These serious
fall-related injuries can include fractures, subdural hematomas, excessive bleeding, and
even death, and Medication errors which are unfortunately very common that occur in the
cases of 5 to 10 percent of patients admitted to hospitals (NPSF, 2014). And these could
result to first, procedure neglect, which refers to failures of health care staff to achieve
objective standards of care. Second, caring neglect, which refers to the behaviours that
lead patients and observers to believe that staffs have uncaring attitudes and the perceived
frequency of neglectful behaviour varies by observer. Patients and their family members
are more likely to report neglect than healthcare staff, and nurses are more likely to report
on the neglectful behaviours of other nurses than on their own behaviour. The causes of
patient neglect frequently relate to organizational factors (e.g. high workloads that
constrain the behaviours of healthcare staff, burnout), and the relationship between carers
and patients (Gillespie et. al 2013).

Statement of the Problem

1. What are the core competencies observed by the respondents in terms of?
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)

Safe and Quality Nursing Care

Management of Resources, Equipment and Environment
Health Education
Legal Responsibility
Ethico-Moral Responsibilities
Personal and Professional Development
Quality Improvement
Research
Records Management
Communication
Collaboration

2. What is the extent of the implementation of the core competencies among the
respondents in terms of?
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)

Safe and Quality Nursing Care

Management of Resources, Equipment and Environment
Health Education
Legal Responsibility
Ethico-Moral Responsibilities
Personal and Professional Development
Quality Improvement
Research
Records Management
Communication
Collaboration

3. What is the implication of the study to the Nursing Administration?

Significance of the Study
The results of the research will provide a basis in improving the quality of care
given by the staff nurse, also, to promote opportunities for meaningful and valuable
experiences, personal, spiritual growth, and self- actualization and to implement the

standard practice in managing accurate and organize patients information and the
responsibility to protect confidentiality between patient and health care team. Moreover,
it will serve as a basis for the development of learning activities in the enhancement of
quality care thru knowledge and skills in accord to the standard practice of nurses based
on the eleven nursing core competencies. And lastly it may contribute to the increase in
self-awareness, self-confidence, competence in dealing with patients within the area.
Scope and Delimitation
The study was focused on standard nursing practice based on the eleven nursing
core competencies of Article 3 Section 9 Subsection c of RA 9173 among the staff nurses
in selected Hospitals in Tarlac City. Namely; Tarlac Provincial Hospital with 17 staff
nurses, Ramos General Hospital with 10 staff nurses and Central Luzon Doctors
Hospital with 14 staff nurses. The study was conducted on March 14, 2014 and from
which data were collected, analyzed and interpreted among the staff nurses of surgical
and medicine ward of the said hospitals. Data gathering was limited to structured
questionnaire in the form of checklist based on CHED Memorandum Order (CMO) No. 5
Series of 2008 (Competency Standard for Nursing )
Definition of Terms
Core Competency- serves as the framework for educative and practice guidelines for
nurses for the quality care deliverance.
Standards of practice - guidelines used to determine what should a nurse or should not do
RA 9173 - The Philippine Nursing Act of 2002

II. Review of Related Literatures and Studies

Standards of practice or so called standards of care are guidelines used to
determine what a nurse should or should not do. Standards may be defined as a
benchmark of achievement which is based on a desired level of excellence. Standards of
care (SOCs) measure the degree of excellence in nursing care and describe a competent
level of nursing care. The standards of practice shall be considered as the baseline for
quality nursing care, be developed in relation to the law governing nursing practice, apply
to the registered nurse practicing in any setting and govern the practice of the licensee at
all levels of practice (McMahon, 2014). The associated ethical and safety standards are
closely governed at local, national and international levels and the ethical standards of
clinical trials are legally binding (Thompson, 2014).
Nursing practice is grounded in the values, knowledge and theories of
professional nursing practice. It emphasizes health promotion and the prevention of
illness, injury and complications for clients. NPs work with diverse client populations in
a variety of contexts and practice settings across the health illness continuum. They are a
resource to clients, other nurses and health care professionals, and they provide
leadership in advocating for clients (CNA, 2010).
The primary purpose of standards is to identify the level of performance expected
of RNs in their practice, against which actual performance can be measured. All
registered nurses are responsible for understanding the Standards and applying them to
their practice. The Standards are interrelated and intended to be sufficiently dynamic so
as to define safe, competent, and ethical practice across all practice settings and domains.

Standards for the practice of registered nurses are based on the following principles. First,
RN practice supports the well-being, dignity, and safety of every client, the client is the
central focus of RN practice and leads the process of decision-making related to care and
services, Public interest and safety are best served when RNs continually enhance
knowledge, skill and judgment, Quality practice environments support RNs in meeting
practice expectations, RNs believe in the philosophy of primary health care, and lastly
RNs recognize the influence of the social determinants of health in shaping the health
status of individuals and communities. The findings of extensive research, from
numerous studies, concur that passive dissemination of guidelines alone is usually
insufficient to change clinical behavior and practice (BMC, 2008). Good clinical practice
is a set of internationally recognized, ethical and scientific quality requirements which
must be observed for designing, conducting, recording and reporting clinical trials that
involve the participation of human subjects.
American Nurses Association (ANA) Standards of Professional performance in
Clinical Practice (2008) states that the nurse acts as a patient advocate and assists patients
in developing skills so that they can advocate for themselves. This patient advocacy is
necessary because disease almost always results in decreased independence, loss of
freedom and interference with the ability to make choices autonomously (ANA, 2008).
Competence can be seen as the ethical, knowledge and skills that are needed to
carry out the work; this implies a clear understanding of the work and therefore
competence done, and the context and which they are working. Ethical competence has
been described as psychological skill (Sporrong, 2007).

In practice, nurses may need to administer medications by routes and methods

that were not included in the experiences of their basic educational program. While
nurses will have learned the competencies associated with safe medication practices, they
may need additional knowledge to competently assume these responsibilities
(Barnsteiner, 2005). Establishing and sustaining healthy work environment used
standards that serve as a call to action for all nurses to improve care delivery while
reducing stressful environment that impede the health and safety of patients (Harder,
2005). Despite wide promulgation, guidelines have had limited effect on changing
professional behavior and practice. Most studies implemented by (CPG) Clinical Practice
Guidelines, strategies have focused on changing the performance of doctors, and a
minority has targeted nurses or other health professionals.
The nursing practice standards must apply at all times to all nurses regardless of
role, provide guidelines to assist nurses in decision-making, support nurses by outlining
practice expectations of the profession, inform the public and others about what they can
expect from practicing nurses and used as a legal reference for reasonable and prudent
practice (Edmonton, 2005).
Threat to patients not just include errors of health practitioners but also risk,
events, hazardous conditions and other circumstances that can lead to patient harm. A
threat to patient safety is one of the major public health problems. Assessment of patient
safety data is essential to the health care system it helps in the improvement of patient
safety by identifying all threats so that appropriate actions can be taken. In addition, these
data can be used for further analysis and research and as a guide to the design of safer
systems of care (William, 2004).

The Philippine Board of Nursing is an administrative body under the Professional

Regulation Commission that regulates the practice of nursing in the Philippines. One of
their primary purpose is to provide regulatory standards in the Practice of nursing, under
the Republic Act 9173 also known as Philippine Act of 2002 Article III Sec. 9 Subsection
C, it was said that nursing practice should be monitored and enforced to quality nursing
practice to ensure the maintenance of efficient, ethical and technical, moral and
professional standards in the nursing practice taking into the account of the health needs
of the nation. Eleven Nursing Core Competencies unifies framework of nursing practice,
education and regulation. Nursing Core Competencies used as a tool for nurses
performance evaluation, basis for advanced nursing performance and used in criteria for
unethical and unprofessional nursing practice. Thus, there are different literatures, studies
and issues with regards to the implication of the eleven Nursing Core Competencies were
reviewed such as of the following:
Safe and Quality Nursing Care: The biggest reasons for lawsuits against nurses include
medication errors, communication errors, failure to monitor and assess, failure to
properly advocate for the patient, working while impaired, whether by inadequate sleep
or inappropriate delegation and supervision (Phillips, 2014). A study entitled Patient
Safety and Quality: An evidence-based Handbook for Nurses, that nurse staffing is one
of a number of variables worthy of attention in safety practice and research. That staffing
influences at least some patient outcomes. It is essential to advancing the field that future
studies replicate, extend, and refine the current body of knowledge, making explicit how
characteristics of the workforce, now barely considered, in addition to the dose of the
nurse, are linked to processes of care that ultimately result in clinical outcomes (Clarke,
2008).

Management of Resources, Equipment and Environment:One study revealed how

human resources management is essential to any health care system and how it can
improve health care models. Challenges in the health care systems in Canada, the United
States of America and various developing countries are examined, with suggestions for
ways to overcome these problems through the proper implementation of human resources
management practices. Comparing and contrasting selected countries allowed a deeper
understanding of the practical and crucial role of human resources management in health
care. They concluded that Proper management of human resources is critical in providing
a high quality of health care. A refocus on human resources management in health care
and more research are needed to develop new policies. Effective human resources
management strategies are greatly needed to achieve better outcomes from and access to
health care around the world (Kabene, 2006). Factors such as staff shortage, cutbacks and
lack of support for nursing can negatively impact a practice environment and
significantly decreases a nurses job satisfaction. The quality of the practice environment
is an ethical issue because of its important effect on the quality of patient care. It also
affects nurses sense of health and wellbeing in the work place. Research has shown that
when staff and other resources are scare, nurses experience frustration and ethical
distress, which can interfere with the ability to provide safe and ethical nursing care
(Rodney, et. al., 2010).
Health Education: The education has a significant impact on the knowledge and
competencies of the nurse clinician, as it does for all health care providers, due to well
preparedness and able to meet the demands placed on todays nurse and for their critical
thinking, leadership, case management, health promotion, and for their ability to practice
across a variety inpatient and outpatient setting (Rosseter, 2014).

Legal Responsibility: There is an increase on deaths and injuries due to nursing mistakes
related to their failure to communicate to the patient, the nature of their job. The study
entitled Attitudes and barriers to incident reporting: a collaborative hospital study,
revealed that both doctors and nurses believe they should report most incidents, but
nurses do so more frequently than doctors. To improve incident reporting, especially
among doctors, clarification is needed of which incidents should be reported, the process
needs to be simplified, and feedback given to reporters (Evans et. al., 2006).The calls for
nurses to act on the issue regarding the increased number of deaths and injuries due to
nursing malpractice in the United States. Statistics on deaths and injuries due to nursing
mistakes; Impact of the failure of nurses to communicate to the patient the nature of their
job; Need for nurses to inform the public about the problems they face in the provision of
medical care (Fetter, 2004). Verbal orders should never be taken and telephone orders
should only be taken if the physician is not physically present. Nurses cognitively know
this but often in the interest of saving time may be tempted not to practice it. Nurses who
write orders for physicians are placing their license and their patients at risk. Orders
should be legibly written. The Massachusetts Hospital Coalition recommends physicians
use computers to directly order medications. However, such costly systems may take
years to implement. Until that occurs, nurses need to remember that it is their duty and
right to question physician orders that are illegible. Cefoxitan and Cefotetan may look
alike when hand written but confusing one drug for the other results in the patient
receiving the wrong medication (Cook, 2014).
Ethico-Moral Responsibilities: The issue of health care reform brings important ethical
issues of justice to the forefront, as individuals, communities, and the legislature struggle
with how to provide quality health care for the many without sacrificing the basic rights

of even the few. The June 2012 Supreme Court decision that upheld the constitutionality
of the Patient Protection and Affordable Care Act (PPACA), first enacted in 2010,
provides some guidance to states, insurers, employers, and consumers about what they
are required to do by 2014, when much of the law comes into force (Sorrell, 2012).
Cultural and individual health beliefs may interfere with medication self-management.
Previous negative experiences with medications side effects or ineffective medications
may diminish willingness to comply with the new regimen. People with chronic illness,
may have difficulties in modifying some health behaviours such as exercise, diet,
smoking, and alcohol ingestion. Nurses must respect the beliefs and choices of the patient
and must assess the degree of adherence, avoiding judging the patient (Kalogianni, 2012).
Nursing ethics is about much more than making decisions in difficult moral dilemmas.
While moral dilemmas certainly arise in health care, nursing ethics, to a large extent, is
about everyday interactions with patients, families and colleagues. Relational connections
with others are central to nurses ability to give safe, competent, compassionate and
ethical care because the strength of the moral community depends on such connections.
Development of a positive work environment starts with effective leadership, as it takes a
leader to make things happen. Managers are key, but individual staff nurses are also
responsible for demonstrating leadership in ethical practice. An environment in which
nurses support each other and celebrate nursing makes a healthier place to work. When
the team is supported and everyone works together toward patient good, patients are
better supported (Rodney, et. al., 2010).
Personal and Professional Development:A study suggested that individual nurses need
to self-reflect at the end of the workday by examining their actions and the dialogue they
had with others. All nurses, who follow through with self-reflection and those who do

not, need to "make a commitment to supportive colleagueship" and "refuse to get caught
up in workplace negativism" (Thomas, 2009).
Quality Improvement: According to the HSC study, hospital organizational cultures set
the stage for quality improvement, including nurses' involvement. Hospitals with
supportive leadership; a philosophy of quality as everyone's responsibility; individual
accountability; physician and nurse champions; and effective feedback reportedly offer
greater promise for successfully involving nurses in quality improvement activities. Even
when hospitals are committed to including nurses in quality improvement, they often face
various problems, including a shortage of nurses; growing demands to participate in
more, often duplicative, quality improvement activities; the burdensome nature of data
collection and reporting; and shortcomings of traditional nursing education in preparing
nurses for their evolving role in today's contemporary hospital setting, the study found.
The quality improvement isn't solely the domain of nurses, they are critical because of
their day-to-day patient responsibilities, and hospitals will need to guard against
diminishing nurses' involvement in quality improvement activities (Johnson, 2008).
Research: Ethical issues, conflicting values, and ambiguity in decision making, are
recurrently emerging from literature review on nursing research. Because of lack of
clarity in ethical standards, nurses must develop an awareness of these issues and an
effective framework to deal with problems involving human rights. This is necessary in
order to come into terms with the issue of the researcher's values relative to the
individual's rights versus the interests of society. Professional codes, laws, regulations,
and ethics committees can provide some guidance but the final determinant of how
research is performed, rests with the researcher's value system and moral code. To
prepare future nurses, ethics in research, must receive special attention in nursing

curricula. The criticism and uncertainties that arise should be rather encouraged than
suppressed in nursing education. Hunt suggests that in order to liberate nursing from its
"technocratic impasse" ethics should be broadly interpreted as an arena of new ideas
which can change professional hierarchies, to open cross-disciplinary discussions, and
question the concepts "abnormality", "patient" and " illness". He also declares that
nursing, not as a biomedical branch, but as a science and art of caring, is able to start the
redefinition of research in health care which was in the recent history dominated by the
biomedical "paradigm" (Fouka&Mantzorou, 2011).
Records Management:Record keeping is an essential part of nursing practice with
clinical and legal significance. Good quality record keeping is linked with improvements
in patient care, while poor standards of documentation are regarded as contributing to
poor quality nursing care. The quality of nursing documentation has consistently been
found to be failing to meet recommended standards (Prideaux, 2012).
Communication:There are many covert communication barriers between participants
and researchers that lead to misunderstandings. This prevents participants from making
the fully autonomous decisions sought for in the informed consent process. Some of those
barriers are related to cultural aspects such as language differences and religious dogma.
Others are related to the faith that participants have in science such as false expectations.
Having awareness of these types of barriers is crucial for both researchers and
participants. Misunderstandings concerning the experimental procedures can lead
participants to get involved in research projects that they dont approve of. Finding
themselves in this situation can have great effects on the psychological and physical
wellbeing of participants. For this reason, it is ethical for researchers to account and
correct for the misunderstandings in the informed consent process. This would ensure that

participants are treated according to the ethical standards set by the Belmont Report
(Bulger, 2002).
Collaboration: Intimidating behaviours, inappropriate hierarchies, and breakdown in
teamwork, lost of trust and disruptive behaviours lead to decrease morale, staff turnover
and frequent provider switching by patients, and patient death or injury. The inability to
have conversations with colleagues that address concerns about competence and
ineffective behaviours indicates a lack of trust and safety in work environments
(Fontaine, 2005).

Theoretical Framework
This study was guided by Jean Watsons Human Caring Model. This model has a
core concept that involves; first, relational caring for self and others based on moral,
ethical, philosophical foundation of love and values, second, transpersonal caring
relationship. A moral commitment to protect and enhance human dignity, respect others
and lastly the reflective or meditative approach which is the increasing consciousness and
presence to humanism of self and other
Watsons model is inclusive, circular and expansive, for it cultivates ones
spiritual development and sustains a helping-trusting, authentic caring relationship, being
present to, and supports the expression of positive and negative feelings, creatively uses
self and all ways of knowing as part of the caring process; engaging self in artistry of
caring-healing practices and engage in genuine teaching-learning experience that attends
to wholeness and meaning, attempting to stay within others frame of reference. And
creates healing environment at all levels, whereby wholeness, beauty, comfort, dignity,
and peace are potentiated (Watson, 2008)
III.Methodology
This chapter presents the methodology of the study which includes the research
design, description of the respondents, sampling procedure, research instrument, methods
in gathering data and statistical treatment that will used in conducting this study.
Research Design
The researchers used the descriptive method to determine the core competencies
observed by the nurses with regards to the nursing practice based on RA 9173 or the
Philippine Act of 2002.

According to Calderon et.al (2007) descriptive research describes and interprets

what is. It is concerned with conditions of relationships that exist; practices that prevail;
beliefs; processes that are going on; effects that are being felt, or trends that are
developing. The process of descriptive research goes beyond mere gathering and
tabulation of data. It involves the elements or interpretation of the meaning or
significance of what is described. Thus description is often combined with comparison
and contrast involving measurements, classifications, interpretation and evaluation.
Respondents
The respondents of this study were staff nurses from selected hospitals in Tarlac.
Namely, Tarlac Provincial hospital with 17 staff nurses, Ramos General Hospital with 10
staff nurses and Central Luzon Doctors Hospital with 14 staff nurses.
Sampling Procedure
Purposive Sampling also commonly called a judgmental sampling wherein
respondents are selected based on the knowledge of a population and the purpose of the
study. The subjects are selected because of some characteristics.
Research Instrument
Questionnaire was used in gathering the core competencies observed by the
respondents and to determine the extent of implementation of the core competencies. The
questionnaire was adapted to the eleven core competencies standard nursing practice in
the Philippines. The questionnaire was divided into two parts;

the eleven nursing

competencies observed by the respondents and extent of implementation of the core

competencies in terms of: safe and quality nursing care, management of resources and
environment, health education, legal responsibility, ethico-moral responsibility, personal
and professional development, quality improvement, research, records management,
communication and collaboration and teamwork.
The questionnaire was answered through checking the core competencies
observed by the respondents and the extent of implementation of the core competencies.
A Likert scale was utilized in this study. It is a common scaling technique which consists
of several declarative statements that express a viewpoint on a topic. The respondents are
asked to indicate how much they agree/disagree with the statements.
Data Gathering Procedure
The researchers provided a letter of permission to the Chief Nurses of the selected
hospitals seeking a request to conduct the study among the staff nurses that were assigned
in Surgery and Medicine Ward. The approval was presented to the respondents prior to
data gathering. Permission was also asked from the respondents prior to the data
gathering. The distribution was done personally and supplemented with explanation to let
the respondents understand the nature and purpose of the study and to assure them that all
answers will be treated with utmost confidentiality.
Statistical Treatment
In determining the total number of sample to be used in the study from the total
number of the population, Slovins formula was utilized.
n = N / (1 + N e2)

Where:
n = total number of samples in the study
N = total number of populations in the study
e = margin of error
In determining the number of representation in each category from the total number of
samples, frequency counts and percentage were utilized.
Percentage:
p = % = f x 100
n
Where:
P = percentage of samples in the study
f = frequency
N = total number of respondents
In describing the factors affecting the nursing students in making clinical case
study and their coping mechanisms used, mean was used. The mean is the average of the
scores mathematical center of a distribution. It is used with symmetrical interval or
ratio scores (Balayan, 2007).

Where:
= Population mean
x summation of all data values
N number of data in items in population
As to the coping mechanisms and how the students describe the factors, the Likert
3- point scale was used.

Category

Score

Interval

Always

2.5 3.00

Sometimes

1.50 2.49

Never

1.00 1.49

Legend:
A Always
S Sometimes
N Never
M Mean
VD Verbal Description
IV. Results
Table 1.

DISTRIBUTION OF THE RESPONDENTS ON SAFE AND QUALITY NURSING

CARE
I. Safe and Quality Nursing Care

(f)

1.

Do you demonstrate knowledge base on the health/illness status of

individual/group?

41

100

2.

Do you provide sound decision making in the care of individuals/group?

41

100

3.

Do you promote safety of the patient?

41

100

4.

Do you sets priorities in nursing care based on patients needs?

41

100

5.

Do you utilize nursing process as framework for nursing?

41

100

6.

Do you perform comprehensive and systematic Nursing assessment?

34

80.93

7.

Do you formulate a plan of care in collaboration with patients and other

members of the healthcare team?

29

70.93

8.

Do you evaluate progress toward expected outcomes?

38

92.68

9. Do you respond to the urgency of the patients condition?

38

92.68

10. Do you ensure continuity of care?

41

100

The table above showed that the highest competencies in safe and quality
nursing care were demonstrating knowledge base on the health/illness status of
individual/group, providing sound decision making in the care of individuals/group,
promoting safety of the patient, setting priorities in nursing care based on patients needs,
utilizing nursing process as framework for nursing, ensuring continuity of care all with 41
(100%) respondents each. The lowest competency was formulating a plan of care in
collaboration with patients and other members of the healthcare team with 29 (70.73%)
respondents. In the study of Clarke (2008) entitled Patient Safety and Quality: An
evidence-based Handbook for Nurses, that nurse staffing is one of a number of variables
worthy of attention in safety practice and research. That staffing influences at least some
patient outcomes. It is essential to advancing the field that future studies replicate, extend,
and refine the current body of knowledge, making explicit how characteristics of the

workforce, now barely considered, in addition to the dose of the nurse, are linked to
processes of care that ultimately result in clinical outcomes. According to Phillips (2014),
the biggest reasons for lawsuits against nurses include medication errors, communication
errors, failure to monitor and assess, and failure to properly advocate for the patient,
working while impaired, whether by inadequate sleep or inappropriate delegation and
supervision. In the study of Carayonet al (2007), interventions aimed at improving the
safety of care provided by nurses to criticalcare patients need provided by nurses to
critical care patients need to consider the work environment, in particular the various
types of workload.
Table 2.
DISTRIBUTION OF THE RESPONDENTSON MANAGEMENT OF
RESOURCES AND ENVIRONMENT
II. Management of Resources and Environment
1.

Do you organize work load to facilitate patient care?

(f)
41

%
100

Findings showed that all of the 41 (100%) respondents observed organized work
load to facilitate patient care management of resources and environment. One study
revealed how human resources management is essential to any health care system and
how it can improve health care models. It affects nurses sense of health and wellbeing in
the work place. According to Rodney, et. Al (2010) . Research has shown that when staff
and other resources are scare, nurses experience frustration and ethical distress, which
can interfere with the ability to provide safe and ethical nursing care. A study at a
Canadian (2004) teaching hospital explored the ethical issues in resource allocation and

utilization decisions faced by clinicians with management responsibilities, including

nurses. Ethical issues included fairness, concerns with preventing harm, respect for
consumer/patient choice, balancing the needs of different groups of patients, conflict
between financial incentives and patient needs, and professional autonomy.
Table 3.
DISTRIBUTION OF THE RESPONDENTS ON HEALTH EDUCATION
III. Health Education
1. Do you assess the learning of the patient and family?
2. Do you develop health education plan based on assess and anticipated
needs?
3. Do you implement the education plan?
4. Do you evaluate the outcome of health education?
5. Do you develop learning materials for health education?

(f)
29
30

%
70.73
73.17

24
26
28

58.54
63.41
68.29

Developing health education plan based on assesses and anticipated needs was the
highest competency in health education with a total of 30 (73. 17%) respondents, and the
lowest with 24 (58.54%) respondents was implementing the education plan. According to
Rosseter, (2014), the education has a significant impact on the knowledge and
competencies of the nurse clinician, as it does for all health care providers, due to well
preparedness and able to meet the demands placed on todays nurse and for their critical
thinking, leadership, case management, health promotion, and for their ability to practice
across a variety inpatient and outpatient setting.

Table 4.
DISTRIBUTION OF THE RESPONDENTSON LEGAL RESPONSIBILITY

IV. Legal Responsibility

1. Do you adhere to practices in accordance with the nursing law and other
relevant legislation including contracts, informed consents?
2. Do you adhere to organizational policies and procedures, local and national?
3. Do you document care rendered to patients?

(f)
41

%
100

41
41

100
100

Based on the table above the 41 (100%) respondents observed legal responsibility
by adhering to practices in accordance with the nursing law and other relevant legislation
including contracts, informed consents, adhering to organizational policies and
procedures, local and national, and documenting care rendered to patients. According to
McMahon, (2014) The standards of practice shall be considered as the baseline for
quality nursing care, be developed in relation to the law governing nursing practice, apply
to the registered nurse practicing in any setting and govern the practice of the licensee at
all levels of practice. According to Thompson (2014) The associated ethical and safety
standards are closely governed at local, national and international levels and the ethical
standards of clinical trials are legally binding. According to Edmonton (2005), the
nursing practice standards must apply at all times to all nurses regardless of role, provide
guidelines to assist nurses in decision-making, support nurses by outlining practice
expectations of the profession, inform the public and others about what they can expect
from practicing nurses and used as a legal reference for reasonable and prudent practice.

Table 5.
DISTRIBUTION OF THE RESPONDENTSON ETHICO-MORAL
RESPONSIBILITIES
V. Ethico-Moral Responsibilities
1. Do you respect the rights of individual/groups?
2. Do you accept responsibility for own decision and action?

(f)
41
41

%
100
100

All of the 41 (100%) respondents observed ethico-moral responsibilities by

respecting the rights of individual/groups, and accepting responsibility for own decision
and action. According to Kalogianni, (2012) Nurses must respect the beliefs and choices
of the patient and must assess the degree of adherence, avoiding judging the patient.
According to Rodney, et. al., (2010) Nursing ethics is about much more than making
decisions in difficult moral dilemmas. While moral dilemmas certainly arise in health
care, nursing ethics, to a large extent, is about everyday interactions with patients,
families and colleagues. Relational connections with others are central to nurses ability to
give safe, competent, compassionate and ethical care because the strength of the moral
community depends on such connections. A study at a Canadian (2004) teaching hospital
explored the ethical issues in resource allocation and utilization decisions faced by
clinicians with management responsibilities, including nurses. Ethical issues included
fairness, concerns with preventing harm, respect for consumer/patient choice, balancing
the needs of different groups of patients, conflict between financial incentives and patient
needs, and professional autonomy.

Table 6.
DISTRIBUTION OF THE RESPONDENTSON PERSONAL AND
PROFESSIONAL DEVELOPMENT
VI. Personal and Professional Development
1. Do you identifies own learning needs?
2. Do you pursue continuing education?
3. Do you get involved in the professional organizations and civil activities?
4. Do you project a professional image of a nurse?
5. Do you possess positive attitude towards change?
6. Do you perform function according to professional standards?

(f)
41
27
32
41
36
41

%
100
65.85
78.05
100
87.80
100

Results indicated that the highest personal and professional development

competencies were identifying own learning needs, projecting image of a professional
nurse, and performing function according to professional standards has a frequency of 41
(100%) respondents. The lowest competency was pursuing continuing education with a
total of 27 (65.85%) respondents. In the study of Thomas (2009) suggested that
individual nurses need to self-reflect at the end of the workday by examining their actions
and the dialogue they had with others. All nurses, who follow through with self-reflection
and those who do not need to "make a commitment to supportive colleagueship" and
"refuse to get caught up in workplace negativism".

Table 7.
DISTRIBUTION OF THE RESPONDENTSONQUALITY IMPROVEMENT
VII. Quality Improvement
1. Do you gather data for quality improvement?
2. Do you participate in nursing audits and rounds?
3. Do you identify and report variances?
4. Do you recommend solutions to identify problems?
5. Do you recommend action for implantation?
6. Do you recommend improvement of systems and processes?
7. Do you gather data using different methodologies?
8. Do you recommend actions for implementation?
9. Do you disseminate results of research findings?
10. Do you apply research findings in nursing practice?

(f)
32
41
41
33
27
24
28
24
34
41

%
78.05
100
100
80.49
65.85
58.54
68.29
58.54
82.93
100

In quality improvement, 41 (100%) respondents apply research findings in

nursing practice, identify and report variances, and participating in nursing audits and
rounds, while the lowest were recommending improvement of systems and processes,
actions for implementation with 24 (58.54%) each. According to the HSC study (2008).,
hospital organizational cultures set the stage for quality improvement, including nurses'
involvement. Hospitals with supportive leadership; a philosophy of quality as everyone's
responsibility; individual accountability; physician and nurse champions; and effective
feedback reportedly offer greater promise for successfully involving nurses in quality
improvement activities. Even when hospitals are committed to including nurses in quality
improvement, they often face various problems, including a shortage of nurses; growing
demands to participate in more, often duplicative, quality improvement activities; the
burdensome nature of data collection and reporting; and shortcomings of traditional
nursing education in preparing nurses for their evolving role in today's contemporary
hospital setting, the study found. The quality improvement isn't solely the domain of
nurses, they are critical because of their day-to-day patient responsibilities, and hospitals

will need to guard against diminishing nurses' involvement in quality improvement

activities.
Table 8.
DISTRIBUTION OF THE RESPONDENTSON RESEARCH
VIII. Research
1. Do you gather data using different methodologies?
2. Do you recommend actions for implementation?
3. Do you disseminate results of research findings?
4. Do you apply research findings in nursing practice?

(f)
28
24
34
41

%
68.29
58.54
82.93
100

In research, 41 (100%) respondents apply research findings in nursing practice,

while the lowest was recommending actions for implementation with 24 respondents
(58.54%). According to Fouka&Mantzorou, (2011),Ethical issues, conflicting values, and
ambiguity in decision making, are recurrently emerging from literature review on nursing
research. Because of lack of clarity in ethical standards, nurses must develop an
awareness of these issues and an effective framework to deal with problems involving
human rights. This is necessary in order to come into terms with the issue of the
researcher's values relative to the individual's rights versus the interests of society.
Professional codes, laws, regulations, and ethics committees can provide some guidance
but the final determinant of how research is performed, rests with the researcher's value
system and moral code. To prepare future nurses, ethics in research, must receive special
attention in nursing curricula. The criticism and uncertainties that arise should be rather
encouraged than suppressed in nursing education. Hunt suggests that in order to liberate
nursing from its "technocratic impasse" ethics should be broadly interpreted as an arena
of new ideas which can change professional hierarchies, to open cross-disciplinary
discussions, and question the concepts "abnormality", "patient" and " illness". He also

declares that nursing, not as a biomedical branch, but as a science and art of caring, is
able to start the redefinition of research in health care which was in the recent history
dominated by the biomedical "paradigm".
Table 9.
DISTRIBUTION OF THE RESPONDENTSONRECORDS MANAGEMENT
IX. Records Management
1. Do you maintain accurate documentation of patient care?
2. Do you records outcome of patient care?
3. Do you observe legal imperative in record keeping?

(f)
41
41
41

%
100
100
100

The table above showed that 41 (100%) respondents maintains accurate

documentation of patient care, records outcome of patient care and observes legal
imperative in record keeping. According to Prideaux (2012), record keeping is an
essential part of nursing practice with clinical and legal significance. Good quality record
keeping is linked with improvements in patient care, while poor standards of
documentation are regarded as contributing to poor quality nursing care. The quality of
nursing documentation has consistently been found to be failing to meet recommended
standards.
Table 10.
DISTRIBUTION OF THE RESPONDENTSONCOMMUNICATION
X. Communication
1. Do you use appropriate information technology to facilitate communication?
2. Do you establish rapport with patient?
3. Do you listen attentively to clients queries and request?
4. Do you identify verbal cues and nonverbal cues?
5. Do you utilize formal and informal channels?
6. Do you respond to needs of individuals, family, group and community?

(f)
41
41
36
38
38
33

%
100
100
87.80
92.68
92.68
80.49

Using appropriate information technology to facilitate communication and

establishing rapport with patient were the highest competency in communication with a
total of 41 (100%) frequency, and the lowest was listening attentively to clients queries
and request 36 (87.80%).
Table 11.
DISTRIBUTION OF THE RESPONDENTSON COLLABORATION AND TEAM
WORK
XI. Collaboration and Team Work
1. Do you establish collaborative relationship with colleagues and other member
of the health care team?
2. Do you collaborate plan of care with other members of the health care team?

(f)
41

%
100

41

100

All of the 41 (100%) respondents establishes collaborative relationship with

colleagues and other member of the health care team and collaborate plan of care with
other members of the health care team. Development of a positive work environment
starts with effective leadership, as it takes a leader to make things happen. Managers are
key, but individual staff nurses are also responsible for demonstrating leadership in
ethical practice. An environment in which nurses support each other and celebrate
nursing makes a healthier place to work. When the team is supported and everyone works
together toward patient good, patients are better supported. According to CIHC, (2008),
evidence demonstrates that inter professional collaborative patient-centred practice can
positively impact current health issues such as: wait times, healthy workplaces, health
human resource planning, patient safety, rural and remote accessibility, primary health
care, chronic disease management and population health and wellness.17 Collaborative

approaches can be successful in improving patient flow through the health-care system
with good results for the patient, the care providers and the system itself.
2. Extent of Implementation
A (2.5 3.00)

S (1.50 2.49)

N (1.0 1.49)

Table 12
TABLE OF SAFE AND QUALITY NURSING CARE
I.
1.

Safe and Quality Nursing Care

Do you demonstrate knowledge base

on the health/illness status of
individual/group?
2. Do you provide sound decision
making in the care of
individuals/group?
3. Do you promote safety of the patient?
4. Do you sets priorities in nursing care
based on patients needs?
5. Do you utilize nursing process as
framework for nursing?
6. Do you perform comprehensive and
systematic Nursing assessment?
7. Do you formulate a plan of care in
collaboration with patients and other
members of the healthcare team?
8. Do you evaluate progress toward
expected outcomes?
9. Do you respond to the urgency of the
patients condition?
10. Do you ensure continuity of care?
Grand Mean

Frequency
A
S
N
33
8
0

Mean
2.80

Verbal
Interpretation
Always

32

2.78

Always

41
39

0
2

0
0

3.00
2.95

Always
Always

41

3.00

Always

16

25

2.39

Always

31

10

2.76

Always

41

3.00

Always

34

2.83

Always

33

2.80
2.83

Always
Always

The table above showed that the highest competencies in safe and quality
nursing care were promoting safety of the patient, utilizing nursing process as framework
for nursing, and evaluating progress toward expected outcomes with a mean of (3.00) and
a verbal description of always. According to Rosseter (2014), that education has a

significant impact on the knowledge and competencies of the nurse clinician, as it does
for all health care providers, due to well preparedness and able to meet the demands
placed on todays nurse; also, for their critical thinking, leadership, case management,
and health promotion, and for their ability to practice across a variety inpatient and
outpatient setting. The lowest competency was performing comprehensive and systematic
Nursing assessment with a mean of (2.39) and a verbal description of always.
Table 13.
TABLE OF MANAGEMENT OF RESOURCES AND ENVIRONMENT
III.

1.

Management of Resources and

Environment
Do you organize work load to facilitate
patient care?
Grand Mean

Frequency
A
41

S
0

N
0

Mean

Verbal
Interpretation

3.00

Always

3.00

Always

Findings showed that organize work load to facilitate patient care management of
resources and environment had a mean of (3.00), with a verbal description of always. In
the study of Carayon et al (2007), interventions aimed at improving the safety of care
provided by nurses to critical care patients need provided by nurses to critical care
patients need to consider the work environment, in particular the various types of
workload. Researchers implemented a multidisciplinary structured process to evaluate
work shifts to enhance team communication. Benefits of the intervention included
increased satisfaction with team and reduction in physical and emotional exhaustion. This
multidisciplinary structured process was used to address the following issues: dealing
with pressure of ICUs teamwork, work roles, and organizational aspects.

Table 14.
TABLE OF HEALTH EDUCATION
V.
1.
2.
3.
4.
5.

Health Education
Do you assess the learning of the
patient and family?
Do you develop health education plan
based on assess and anticipated needs?
Do you implement the education plan?
Do you evaluate the outcome of health
education?
Do you develop learning materials for
health education?
Grand Mean

Frequency
A
S
N
17
24
0

Mean
2.41

Verbal
Interpretation
Sometimes

28

13

2.68

Always

15
11

26
30

0
0

2.37
2.27

Sometimes
Sometimes

31

10

2.76

Always

2.49

Sometimes

Developing learning materials for health education has the highest mean of (2.76),
with a verbal description of always. According to AmbrielMaji (2009) an effective good
nurse understands the importance of prioritizing their patients care, understanding what
responsibilities need to be taken care of, and which patients come first in the order of
care.
Evaluating the outcome of health education has the lowest mean of (2.27), with a
verbal description of sometimes. In which stated by Margaret Freda (2004) there are
many reason why education has become more difficult to accomplish. These includes the
huge influx of clients of varying cultures into virtually all health care systems the lack of
time available for patient education in tightly scheduled managed care visits, the dearth of
educational materials written at appropriate readability levels and/or in languages other
than English, and the lack of reimbursement for time spent on patient education. Also
that, many providers might not have specific training in the provision of patient education

or in the development of appropriate health educational materials for the population they
serve.
Table 15.
TABLE OF LEGAL RESPONSIBILITY
VII.
1.

2.
3.

Legal Responsibility
Do you adhere to practices in
accordance with the nursing law and
other relevant legislation including
contracts, informed consents?
Do you adhere to organizational
policies and procedures, local and
national?
Do you document care rendered to
patients?
Grand Mean

Frequency
A
S
N
41
0
0

Mean
3.00

Verbal
Interpretation
Always

41

3.00

Always

41

3.00

Always

3.00

Always

Based on the table of legal responsibility above, adhering to practices in

accordance with the nursing law and other relevant legislation including contracts,
informed consents, adhering to organizational policies and procedures, local and national,
and documenting care rendered to patients all have a mean of (3.00), with a verbal
description of always. According to the study of Evans et al (2006) most doctors and
nurses were aware that their hospital had an incident reporting system. Nurses were more
likely than doctors to know how to access a, to have ever completed a report, and to
know what to do with the completed report. She stated that to improve incident reporting,
especially among doctors, clarification is needed of which incidents should be reported,
the process needs to be simplified, and feedback given to reporters.

Table 16.
TABLE OF ETHICO-MORAL RESPONSIBILITIES
IX.
1.

Ethico-Moral Responsibilities
Do you respect the rights of
individual/groups?
Do you accept responsibility for own
decision and action?
Grand Mean

2.

Frequency
A
S
N
41
0
0
41

Mean
3.00

Verbal
Interpretation
Always

3.00

Always

3.00

Always

The table of ethico-moral responsibilities showed that, respecting the rights of

individual/groups, and accepting responsibility for own decision and action all have a
mean of (3.00), with a verbal description of always. It was mentioned by Jill Hughes
(2012) that nowadays, nurses are considered more professional and find themselves in
more autonomous roles. Thus, they are expected to make complex ethical decisions on
their own.
Table 17.
TABLE OF PERSONAL AND PROFESSIONAL DEVELOPMENT
XI.
1.
2.
3.
4.
5.
6.

Personal and Professional

Development
Do you identifies own learning needs?
Do you pursue continuing education?
Do you get involved in the professional
organizations and civil activities?
Do you project a professional image of
a nurse?
Do you possess positive attitude
towards change?
Do you perform function according to
professional standards?
Grand Mean

Frequency
A
S
N
41
0
0
12
29
0
37
4
0

Mean
3.00
2.29
2.90

Verbal
Interpretation
Always
Sometimes
Always

41

3.00

Always

38

2.93

Always

41

3.00

Always

2.85

Always

Results indicated that in personal and professional development, identifying own

learning needs, projecting image of a professional nurse, and performing function
according to professional standards has the highest mean of (3.00) each, with a verbal
description of always. According to the study of Janet Wood (2006), the participants
illustrated that engaging with continuous personal development reduced the stress they
experienced while they developed from a novice to become a competent member of the
multidisciplinary team. This study illustrates that undertaking continuous personal
development has helped participants to develop confidence and competence as well as
capability and job satisfaction.
The lowest was pursuing continuing education with a mean of (2.29), with a
verbal description of sometimes. Leaving the clinical area to attend courses and study
days separates the process of learning from the act of engaging with patients in the
practice setting. Evidence in this study illustrates that the need for support extends
beyond the transition period. Support can be offered with clinical supervision (Janet
Wood, 2006).

Table 18.
TABLE OF QUALITY IMPROVEMENT
XIII.
1.

Quality Improvement

Do you gather data for quality

improvement?
2. Do you participate in nursing audits
and rounds?
3. Do you identify and report variances?
4. Do you recommend solutions to
identify problems?
5. Do you recommend action for
implantation?
6. Do you recommend improvement of
systems and processes?
7. Do you gather data using different
methodologies?
8. Do you recommend actions for
implementation?
9. Do you disseminate results of research
findings?
10. Do you apply research findings in
nursing practice?
Grand Mean

Frequency
A
S
N
29
12
0

Mean
2.71

Verbal
Interpretation
Always

41

3.00

Always

41
29

0
12

0
0

3.00
2.71

Always
Always

40

2.98

Always

19

22

2.46

Sometimes

18

23

2.44

Sometimes

19

22

2.46

Sometimes

30

11

2.73

Always

41

3.00

Always

2.75

Always

In quality improvement, applying research findings in nursing practice identify

and report variances and participating in nursing audits and rounds have the highest mean
of (3.00), with a verbal description of always. In which as stated by Liz Lees (2013),
there should be no debate about whether or not nurses should be involved in ward rounds.
The only debate, perhaps, is how to reinvigorate the nurses role among what are often
regarded as competing priorities such as medicine rounds, theatre lists, observations
particularly if these are due to take place at the same time as the ward round. Nurses and
the multidisciplinary team are central to ward rounds. Nurses will delegate and/or lead
the actions that arise. The energy created by a well-run ward round will resonate across a
whole ward team, while a rushed round or one that has no nurse presence will have a
negative effect, such as the related actions maybe fragmented, while lowest was gathering

data using different methodologies with a mean of (2.44) and verbal description of
sometimes.
Table 19.
TABLE OF RESEARCH
XV.
1.
2.
3.
4.

Research
Do you gather data using different
methodologies?
Do you recommend actions for
implementation?
Do you disseminate results of research
findings?
Do you apply research findings in
nursing practice?
Grand Mean

Frequency
A
S
N
18
23
0

Mean
2.44

Verbal
Interpretation
Sometimes

19

22

2.46

Sometimes

30

11

2.73

Always

41

3.00

Always

2.66

Always

In research, applying research findings in nursing practice has the highest mean of
(3.00), with a verbal description of always. As explained by Squires (2011), they were
able to conclude that the extent to which nurses report research use in their daily practice
is, on average, moderate-high, and has remained fairly consistent over time into the early
2000s, when increasing awareness of the evidence-based practice movement have
influenced the number of reports published on research use alone. The lowest was
gathering data using different methodologies, with a mean of (2.44) and verbal
description of sometimes.
Table 20.
TABLE OF RECORDS MANAGEMENT
XVII.
1.
2.
3.

Records Management

Do you maintain accurate

documentation of patient care?
Do you records outcome of patient
care?
Do you observe legal imperative in
record keeping?
Grand Mean

Frequency
A
S
N
41
0
0

Mean
3.00

Verbal
Interpretation
Always

41

3.00

Always

41

3.00

Always

3.00

Always

The table of records management above showed that, maintaining accurate

documentation of patient care, recording outcome of patient care and observing legal
imperative in record keeping all have a mean of (3.00), with a verbal description of
always. However, according to Loudon (2006), the results of the study found that the
standard to be poor and strongly recommended that corrective action be taken. The key
issues to be addressed were: the low priority given to records management; lack of
awareness of the importance of good-record keeping; the lack of information-sharing
between professions and work units; the tendency to treat records as personal rather than
corporate assets; the lack of coordination between paper and electronic information
strategies; and the need to maintain confidentiality while legitimately freeing
information.
Also, according to Mackay (2004), there has been similar consistency in the
shortcomings identified by inquiries into homicides by people with mental illness over
past 10 years. Findings that emerge again and again include: a lack of clarity in the
planning and coordination of care; poor recordkeeping; inadequate communication
between key players, be they professionals, agencies or families; and poor
implementation of statutory obligations and national and local guidance. These result
from the problems of multidisciplinary and multi-agency working when explicit priority
is not given to recording and communicating activity to an accepted standard.

Table 21.
TABLE OF COMMUNICATION
XIX.
1.

2.
3.
4.
5.
6.

Communication

Do you use appropriate information

technology to facilitate
communication?
Do you establish rapport with patient?
Do you listen attentively to clients
queries and request?
Do you identify verbal cues and
nonverbal cues?
Do you utilize formal and informal
channels?
Do you respond to needs of individuals,
family, group and community?
Grand Mean

Frequency
A
S
N
41
0
0

Mean
3.00

Verbal
Interpretation
Always

41
29

0
12

0
0

3.00
2.71

Always
Always

32

2.78

Always

34

2.83

Always

25

16

2.61

Always

2.82

Always

Using appropriate information technology to facilitate communication and

establishing rapport with patient have the highest mean in communication with a mean of
(3.00), with a verbal description of always. As mentioned by Bahrami (2011), participants
believed that the main reason for differences that exist between patients and nurses
perceptions is poor relationship and rapport. A poor relationship and rapport can lead to
ineffective communication. Therefore, this supports a need for nurses to develop a more
holistic relationship and stronger rapport with patients. The lowest was responding to
needs of individuals, family, group and community, with a mean of (2.61) and verbal
description of always.

TABLE OF COLLABORATION AND TEAM WORK

TABLE 2.11
XXI.
1.

2.

Collaboration and Team

Work
Do you establish collaborative
relationship with colleagues and
other member of the health care
team?
Do you collaborate plan of care
with other members of the health
care team?
Grand Mean

Frequency
A
S
N
41
0
0

41

Mean
3.00

Verbal
Interpretation
Always

3.00

Always

3.00

Always

In collaboration and teamwork, establishing collaborative relationship with

colleagues and other member of the health care team and collaborating plan of care with
other members of the health care team both have a mean of (3.00) and a verbal
description of always. Wherein, as stated by Lindeke (2005), emphasized that
interdisciplinary collaboration help to keep patient well-being central inspite of economic
pressures. Mature, motivated health care professional teams must work together to thrive
by fostering self-awareness and preventing burnout. Effective, collaborative partners will
waste little time posturing and will instead focus their attention on issues of importance.
Leaders of collaborative teams will be optimistic and positive, inspiring hope in others
when change is unsettling.

V. Discussion
SUMMARY OF FINDINGS
1. The research study showed that 5 out of the 11 core competencies and their
competencies within, namely Management of Resources and Environment,
Collaboration and Team Work, Legal Responsibility, Ethico-Moral Responsibilities,
and Records Management were unanimously observed by the 41 (100%) respondents
in their line of practice, followed by Safe and Quality Nursing Care, Communication,
Personal and Professional Development, and Quality Improvement. The core
competencies Research and Health Education were the two least observed by the
respondents. Specifically the competencies, implementing the education plan in
Health Education and recommending actions for implementation in Research with
only 24 (58.24%) respondents each.
2. The findings of the research study presented that 6 out of the 11 core competencies
(Management of Resources and Environment, Legal Responsibility, Ethico-Moral
Responsibilities, Records Management, Communication, and Collaboration and Team
Work) had a grand meanof (3.00) with a verbal description of always in all of its
competencies, meaning all of the 41 respondents always implement the 6 core
competencies. Followed by, Personal and Professional Development (2.85), Safe and
Quality Nursing Care (2.83), Quality Improvement (2.75), and Research (2.66),
which all have a verbal description of always. The least implemented was the core
competency Health Education (2.49) with a verbal description of sometimes.
CONCLUSION

1. Based from the findings, the researchers concluded that five out of the eleven core
competencies were unanimously observed all of the respondents in their line of
practice, which is Management of Resources and Environment, Collaboration and
Team Work, Legal Responsibility, Ethico-Moral Responsibilities, and Records
Management, followed by Safe and Quality Nursing Care, Communication, and
Personal and Professional Development, and Quality Improvement. The core
competencies Research and Health Education were the two least observed and
practiced by the respondents. Specifically the competencies, implementing the
education plan in Health Education and recommending actions for implementation in
Research
2. The findings of the research study established that Management of Resources and
Environment,

Legal

Responsibility,

Ethico-Moral

Responsibilities,

Records

Management, Communication, and Collaboration and Team Work, were always

implemented by the respondents, followed by Personal and Professional
Development, Safe and Quality Nursing Care, Quality Improvement and Research.
The least implemented was the core competency of Health Education.

RECOMMENDATION
1. As a basis for a research study to the institutions nursing administration in validating
the competencies of their staff nurses, as well as to help them develop interventions in
the competencies lacking.

2. Implementing a program on research by requiring various research studies to the staff

nurses per shift in the different wards in the. To enhance the research core
competencies of the staff nurses in their institution.
3. A seminar and training workshop in improving the means of disseminating just and
appropriate health education, as well as in improving nurse-client interactions.
Implications to Nursing Practice
The Healthcare system is rapidly evolving, through breakthrough medical
researchers, procedures, innovations, etc. The Nurses are a vital cog to this machinery,
who must adapt or align their practice in accordance to the Standards of Nursing Practice
and here in the Philippines: The Eleven Core Competencies of Nursing Practice. The
research study showed that there is an area of concern in Research, Health Education and
Quality Improvement with these three Core Competencies lacking in the Nursing Practice
the Nurses will suffer, especially in terms of improving themselves in evidenced-based
practice, providing appropriate health education to clients and continuing improvement in
the quality of Nurses based on their knowledge and skills in their practice. Future
research must be done to validate the results of the study in preserving and improving the
quality of Nursing Practice in the Philippines.

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