chapter 2 and 3(edited)

8/12/2019 Chapter 2 and 3(Edited)

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CHAPTER 2

REVIEW OF RELATED LITERATURE

This chapter aims to present the related literature borrowed materials written by

authorities in the field which the current study discussed.

Related Literature

Definition of competency

The number of definitions and descriptions of the term competence is innumerable,

and, therefore, impossible to cover all of the variations. As a result, a select few have been

chosen to reflect the aspects most often related to nursing and the health care education

environment. According to Norman (1985) competency is more than knowledge. It includes the

understanding of knowledge, clinical, technical, and communication skills, and the ability to

problem solve through the use of clinical judgment. Axley (2009) noted that competency is

clearly more than the mere attainment of skills as it also involves other qualities such as

attitudes, motives, personal insightfulness, interpretative ability, receptivity, maturity, and self-

assessment (p. 218). Black and Wolf (1990) describe competence as the ability to perform in

effective ways on different occasions including in differing and unexpected contexts [cited in

While, 1994]. However, even if performance can be measured, there is a lack of evidence to

suggest that good performance is always an adequate indicator of high degrees of competence

[Stedman 1985, cited in While 1994, 9]. This example illustrates the case of a false positive

where a nurse can answer a question correctly on an exam but from a false premise. A false


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negative example is that of a nurse who may have the skill or knowledge to perform a task but

fails to perform the task correctly in an examination situation. These examples suggest that

performance alone may not be an adequate indicator of competence.

According to Rhodes (2011), that with competence comes confidence, once a nurse is

competent in critical thinking, clinical judgment, and performing skills, the nurse would become

confident. Competencies can be thought of as underlying characteristics of individuals that result

in effective performance. Competencies delineate the unique aspects of a particular area of

practice and provide a model for entry into that practice (Emergency Nurses Association,2008).

Competency standards are necessary balance against an over intellectual approach to education

and practice in nursing (Eraut, 1998) A nurse is competent when (s)he possesses the skills and

abilities required for lawful, safe and effective professional practice without direct supervision

The registered nurse practises independently and interdependently, assuming accountability and

responsibility for their own actions and delegation of care to enrolled nurses and health care

workers. Thus, nurses needs to be competent in terms of knowledge, skills and attitude.

Legal basis for nursing core competencies

According to Article 3 Sec.9 (c) of R.A. 9173/ Philippine Nursing Act 2002

Board shall monitor & enforce quality standards of nursing practice necessary to ensure the

maintenance of efficient, ethical and technical, moral and professional standards in the practice

of nursing taking into account the health needs of the nation this serve as the legal basis of core

competency in nursing practice. That serves as a unifying framework for nursing practice,

education, regulation; guide in nursing curriculum development; framework in developing test


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syllabus for nursing profession entrants; tool for nurses performance evaluation; basis for

advanced nursing practice, specialization; framework for developing nursing training curriculum;

public protection from incompetent practitioners and Yardstick for unethical, unprofessional

nursing practice.

According to Board of Nursing, Board Resolution No. 425 Series of 2003, Republic Act

9173, Article 5 Sec. 25 Nursing Education Program, The nursing education program shall

provide sound general and professional foundation for the practice of nursing taking into

consideration the learning outcomes based on national and universal nursing core competencies.

The learning experience shall adhere strictly to specific requirements embodied in the prescribed

curriculum as promulgated by the Commission on Higher Educations policies and standards of

nursing education.

According to Ched Memorandum Order, No.14, Series of 2009, Article 1 Sec.1, .BSN

program therefore, aims to prepare a nurse, who, upon completion of the program, demonstrate

beginning professional development and utilizes research findings in the practice of the

profession.

According to Ched Memorandum Order, No.14, Series of 2009, Article III Sec.4, BSN

program provides intensive nursing practicum that will refine clinical skills from the first year

level to ensure basic clinical competencies required of the beginning nurse practitioner.

According to Ched Memorandum Order, No.14, Series of 2009, Article III Sec. 4.1, BSN

program aims to produce nurse who is able to perform the competencies under each of key areas

of responsibility as enumerated in Article IV sec 5 herein.


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Standards of Practice and Competency

According to American Nurses Association (2010), The Standards of Practice

describe a competent level of nursing care as demonstrated by the critical thinking model known

as the nursing process. The nursing process includes the components of assessment, diagnosis,

outcomes identification, planning, implementation, and evaluation. Accordingly, the nursing

process encompasses significant actions taken by registered nurses and forms the foundation of

the nurses decision-making.

According to American Nurses Association (ANA) Standards of Professional

Performance describes a competent level of behavior in the professional role, including activities

related to quality of care, performance appraisal, education, collegiality, ethics, collaboration,

research, and resource utilization, this document serves as objective guidelines for nurses to be

accountable for their actions, their patients, and their peers. The standards provide a method to

assure clients that they are receiving high-quality care, that the nurses know exactly what is

necessary to provide nursing care, and that measure are in place to determine whether the care

meets the standards.

Ethics and Competence

Ethics and competence involve two related aspects; first is the ethical nurse who practices

competently and second, there is a component of being ethically competent. The development of

ethical competence is of importance when it comes to being able to both reduce practice errors

and retain nurses in health care. Ethics in perioperative practice has become especially prominent


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as a focus on patient safety has come to the forefront. Perioperative nurses have a tradition of

promoting patient safety by intervening to minimize the risks related to surgical infection and

injury (Beyea, 2002). The action of intervening in high-risk situations may be motivated by

practice standards, professional duty, ethical values and beliefs. When surgical errors happen,

there is the responsibility or duty to report the errors and that is where the ethical imperative

enters into nursing practice. Ethical practice is important to nursing as it underpins the fiber of

the practice itself by providing an action guide for nurses. With the increased awareness of

medical malpractice in general, and surgical or perioperative errors in particular, it has become

imperative for nurses to be able to speak out when errors, or the potential for errors, become

evidenced. According to Hettiarchy (2001), surgical errors often appear the worstthe end

points in surgery are often more concrete and immediate than in medicine survival or death,

cure or failure.

The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive

Statements (2001) third provision asserts that the nurse promotes, advocates for, and strives to

protect the health, safety, and rights of the patient. This relates to the ANA Code statement that

as an advocate for the patient, the nurse must be alert to and take appropriate action regarding

any instances of incompetent, unethical, illegal, or impaired practice... (p. 14). This provision

specifically directs nurses to take some type of action to support the rights of their patients. The

concept of ethics as an action guide is inherent in nursing practice and nursing practice involves

nurses having the power and knowledge to competently care for patients.


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Working position and Competence

The competence, as well as the incompetence, of staff nurses has been studied for years.

It is, and always will be, a concern of many who advocate for safe patient care and outcomes.

Activities related to identifying and establishing nursing competencies have been the focus of

state nursing associations, regulatory boards, educators, professional associations, external

stakeholders and individual registered nurses. The Washington State Nurses Association

(WSNA) put forth recommendations that nurses from all practice areas must be actively involved

in decisions about professional competence determination within their own practice settings. As

a constituent of the American Nurses Association, the Washington State Nurses Association

supports continued efforts by ANA to define continued competency in nursing, as well as

continuing efforts by individual registered nurses to participate in activities related to

competency in their workplace settings. The ANA Code presently supports the concept of

continued competency in nursing for Nurses and professional nursing standards within the

discipline of nursing.

Hasson and Arnetz (2008) in a study of nursing staff competence, work strain, stress and

satisfaction in elderly care found that the lack of competence development, high levels of work

strain and low levels of work satisfaction among nursing staff have been associated with high

turnover. Nursing staff perceptions of their competence, work strain, stress and satisfaction were

measured by questionnaire. In general, staff in home-based care reported significantly less

sufficient knowledge compared with staff in nursing homes. Obviously this information has

relevance to clinical practice as lack of competence development may have significant negative

implications for work satisfaction.


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A 2006 study by Farrand, McMullan, Jowett, and Humphreys sought to examine whether

the implementation of competency recommendations has led to improvements in the confidence

of nursing students in their clinical skills. They found the positive effect that the competency

recommendations had upon levels of confidence in nursing practice. Not surprisingly, they

discovered that there is a relationship between competence and confidence.

The rapid expansion of computer-driven technologies into multiple aspects of modern health care

suggests that many of the important competencies of the 21st century nurse will encompass

mastery of computer technology.

Little agreement was found regarding specific computer-focused competencies necessary

for nurses. Taken as a whole, however, there is consensus that the computer-competent nurse

possesses a general knowledge and understanding of computer technology, coupled with a

positive attitude toward computers and software. In addition, such a nurse is skillful in the use of

computer hardware and software and able to grasp how such technology benefits nursing, patient

care and the overall health care environment.

Traditionally, emotional competencies may have been placed under the umbrella called,

professionalism; a term often overused and under-explained by nursing faculty when

communicating about soft skills, or emotional competencies. Performance criteria inherent to

professionalism such as self-awareness, initiative, empathy, conflict management, integrity,

team management and other emotional competencies commonly referred to as soft people

skills are typically missing from the evaluation checklist. In fact, these soft people skills are

often cited by administrators as being noticeably missing from nursing practice. Yet, the very

skills necessary to manage self and others are grounded in emotional competence and are


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essential to the delivery of excellent patient care. The competence of the clinical nurse

encompasses a wide variety of practice areas from generic to specialty.

There is much room for further research when examining the intricacies of competence (e.g.

emotional to technical).

Competence based on the Level of Experience

According to Patricia Benner in her theory of from Novice to Expert model nurses was

classified based on their level of nursing experience. This composed of five levels, as the

individual progress through these levels, they demonstrate changes using experiences. Second,

they move from analytic, rule based thinking to intuition. Third, the learners perception changes

from a situation composed of equally relevant parts to a complex whole in which certain parts

are more relevant than others. Fourth, they move from a detached observer to an actively

involved performer. (Benner & Wrubel 1989).

Stage I (Novice), they are the beginners, they have no experience of the situations in

which they are expected to perform. Novices are taught rules to help them perform. The rules

are context-free and independent of specific cases; hence the rules tend to be applied universally.

The rule-governed behaviour typical of the novice is extremely limited and inflexible. As such,

novices have no life experience in the application of rules. Stage II (Advance Beginner), they

are those who can demonstrate marginally acceptable performance, those who have coped with

enough real situations to note, or to have pointed out to them by a mentor, the recurring

meaningful situational components. These components require prior experience in actual

situations for recognition. Principles to guide actions begin to be formulated. The principles are

based on experience. Stage III (Competent ), nurse who has been on the job in the same or


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similar situations two or three years, develops when the nurse begins to see his or her actions in

terms of long-range goals or plans of which he or she is consciously aware. For the competent

nurse, a plan establishes a perspective, and the plan is based on considerable conscious, abstract,

analytic, contemplation of the problem, The Conscious, deliberate planning that is characteristic

of this skill levels help achieve efficiency and organization. The competent nurse lacks the speed

and flexibility of the proficient nurse but does have a feeling of mastery and the ability to cope

with and manage the many contingencies of clinical nursing. The competent person does not yet

have enough experience to recognize a situation in terms of an overall picture or in terms of

which aspects are most salient, most important. Stage IV( Proficient), proficient performer

perceives situations as whole rather than in terms of chopped up parts or aspects, and

performance is guided by maxims. Proficient nurses understand a situation as a whole because

they perceive its meaning in terms of long term goals. The proficient nurse learns from

experience what typical events to expect in a given situation and how plans need to be modified

in response to these events. The proficient nurse can now recognize when the expected normal

picture does not materialize. The holistic understanding improves the proficient nursesdecision

making; it becomes less labored because the nurse now has a perspective on which of the many

existing attributes and aspects in the present situation are the important ones. Stage V (The

Expert), expert performer no longer relies on an analytic principle (rule, guideline, maxim) to

connect her or his understanding of the situation to an appropriate action. The expert nurse, with

an enormous background of experience, now has an intuitive grasp of each situation and zeroes

in the accurate region of the problem without wasteful consideration of a large range of

unfruitful, alternative diagnosis and solutions. The expert operates from a deep understanding of

the total situation.


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Related Studies

A study of Flanagan et al 2000 describes an approach to work- based learning and

competence assessment and recommended that the nurse education needs to work towards work-

based approaches to education and training which form a basis for equal partnerships between

service providers and higher education.

A study of Kalb et al, 2006, it shows that the competence assessment tool has strong

support from supervisors and nurses believe tool effectively describes/evaluates their practice.

A descriptive study of Meretoja et al, 2004, with population of 593 Registered nurses

shows that the operating room nurses reported lower levels of competence and lower frequency

of using competencies in several categories and have a positive correlations between age and

length of work experience and level of competence. The study recommended that the

Competence assessment should be continuous and a tool to recognise and reward nurses.

According to the comparative study of Meretoja and Leino-Kilpi 2003, with population

of 81Nurses and 81 managers, shows that the overall level of competence rated as good by both

nurses and manager. Overall, managers rated nurse competence higher (70.8 19.3 vs. 63.9

13.7) (p


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According to Meretoja et al 2004, a descriptive study with the population of 498 nurses

shows that there is high level of self-assessed competence and higher frequency of use correlated

with higher level of competence. The age and length of work experience had a positive but not

strong correlation with level of competence. The study recommended that there must be further

concept analysis of nurse competence and need for more research to explore connection between

nurse competence, nursing outcomes and quality of care.

Synthesis

The definition of competency according to Axley (2009), noted that competency is

clearly more than the mere attainment of skills as it also involves other qualities such as

attitudes, motives, personal insightfulness, interpretative ability, receptivity, maturity, and self-

assessment (p. 218). And according to Rhodes (2011), that with competence comes

confidence, once a nurse is competent in critical thinking, clinical judgment, and performing

skills, the nurse would become confident.

In legal basis for nursing core competencies which is Republic Act 9173 Philippine

Nursing Act 2002, Board shall monitor & enforce quality standards of nursing practice

necessary to ensure the maintenance of efficient, ethical and technical, moral and professional

standards in the practice of nursing taking into account the health needs of the nation this serve

as the legal basis of core competency in nursing practice.

In standard of practice and competency, according to American Nurses Association

(ANA) Standard of Practice describe a competent level of nursing care as demonstrated by the


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critical thinking model known as the nursing process. And also the ANA Standards of

Professional Performance describes a competent level of behavior in the professional role,

including activities related to quality of care, performance appraisal, education, collegiality,

ethics, collaboration, research, and resource utilization, this document serves as objective

guidelines for nurses to be accountable for their actions, their patients, and their peers.

In ethics and competence, the American Nurses Association (ANA) Code of Ethics for

Nurses with Interpretive Statements (2001) third provision asserts that the nurse promotes,

advocates for, and strives to protect the health, safety, and rights of the patient. This relates to the

ANA Code statement that as an advocate for the patient, the nurse must be alert to and take

appropriate action regarding any instances of incompetent, unethical, illegal, or impaired

practice... (p. 14).

In competence based on the level of experience, according to Patricia Benner in her

theory of from Novice to Expert model a nurse was classified based on their level of nursing

experience. This composed of five levels, as the individual progress through these levels, they

demonstrate changes using experiences. Second, they move from analytic, rule based thinking to

intuition. Third, the learners perception changes from a situation composed of equally relevant

parts to a complex whole in which certain parts are more relevant than others. Fourth, they move

from a detached observer to an actively involved performer. (Benner & Wrubel 1989).


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Theoretical framework

The study is focus on the level of awareness of the Filipino nurses on the nursing core

competencies and the extent of its application in the nursing care practice. The study was based

on the relevant theories such as the following:

Nursing Core competency Model is a competency-based education and practice

partnership model, created by The Massachusetts Department of higher Education in response to

the challenge of increasing capacity of nurses; it says that nursing core competency is come-out

with the foundation of nursing knowledge. Nursing is a scholarly profession and practice-based

discipline and is built on a foundation of knowledge that reflects nursings dual components of

science and art. Nursing knowledge in conjunction with a liberal education prepares learners to

enter practice with identified core competencies.

A solid base in liberal education provides the distinguishing cornerstone for the study and

practice of professional nursing (American Association of Colleges of Nursing [AACN], 2008,

p. 11). A strong foundation in liberal arts includes a general education curriculum that provides

broad exposure to multiple disciplines and ways of knowing. As defined by the Association of

American Colleges and Universities (AAC&U), a liberal education is one that intentionally

fosters, across multiple fields of study, wide ranging knowledge of science, cultures, and society;

high level intellectual and practical skills; an active commitment to personal and social

responsibility; and the demonstrated ability to apply learning to complex problems and

challenges (AAC&U, 2007, p. 4). A liberal education includes both the sciences and the arts

(AACN, 2008, p.10).


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As a scientific discipline, nursing draws on a discrete body of knowledge that

incorporates an understanding of the relationships among nurses, patients, and environments

within the context of health, nursing concepts and theories, and concepts and theories derived

from the basic sciences, humanities, and other disciplines. The science of nursing is applied in

practice through a critical thinking framework known as the nursing process that is composed of

assessment, diagnosis, planning, implementation, and evaluation. The steps of the nursing

process serve as a foundation for clinical decision-making and evidence-based practice. Nurses

use critical thinking to integrate objective data with knowledge gained from an assessment of the

subjective experiences of patients and groups, and to apply the best available evidence and

research data to the processes of diagnosis and treatment. Nurses use clinical reasoning to

respond to the needs of the populations they serve and to develop strategies to support optimal

outcomes that are most appropriate to the patient or situation while being mindful of resource

utilization. Nurses continually evaluate the quality and effectiveness of nursing practice and seek

to optimize outcomes (American Nurses Association [ANA], 2004).

Likewise, The Quality and Safety Education in Nursing (QSEN) led by Dr. Linda

Cronenwett, identified the knowledge, skills, and attitudes (KSAs) that nurses must possess to

deliver safe, effective care (Smith, Cronenwett, & Sherwood, 2007)


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Research Paradigm

This study will be conducted based on the facts and informations acquired from nursing

personnel of Dr. Paulino J. Garcia Memorial Research and Medical Center through direct

distribution of questionnaires. This study focuses on the Level of Awareness and Extent of

Application of the Nursing Core Competencies in Selected Hospitals in Nueva Ecija: A Basis for

Performance Evaluation of Nursing Service

The study discussed the nursing core competency being practiced by the nursing

personnel, to determine the level of awareness, extent of application, compliance and to improve

the performance of nursing service. The following is the paradigm of the study


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Figure 1. Paradigm of the Study

1. Respondents Profile

age gender working position working area years of service/experience time shifting highest educational

attainment

2. Level of Awareness in the

nursing core competencies in

terms of:

Safe and quality nursingpractice

Communication Collaboration and

teamwork

Health education Legal responsibility Ethicomoral

responsibility

Personal and professionaldevelopment

Record management Management of resources

and environment

Quality improvement

Research3. Extent of application of the

nursing core competencies by the

nursing personnel in terms of:

Safe and quality nursingpractice

Communication Collaboration and

teamwork

Health education Legal responsibility Ethicomoral

responsibility Personal and professional

development

Record management Management of resources

and environment

Quality improvement Research

Assessment

Data areobtained by

providing set of

questionnaires

to each

respondent.

Analysis

Statisticaltreatment is

provided to

show accurate

data.

1. Determines the

evaluation in terms

of:

Level ofawareness

Extent ofapplication

Compliance

2. Improved

performance of

nursing service.

INPUT PROCESS OUTPUT


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Findings of the Study

The findings of this review mirror those of previous reviews of the literature about the

competency in nursing. While a range of competency indicators were identified, few of the

articles included described the competence of nurses to ensure nursing standard practice. Given

the current lack of empirical evidence in this area, there is an opportunity to include some form

of evaluation component into the competency framework that may contribute valuable

information to the hospital. In broad terms, competency standards recommend expected levels of

knowledge, attitudes, skills and behaviours. Competencies for professional nursing should reflect

the multifaceted nature of nursing practice.


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CHAPTER 3

METHODOLOGY

This chapter is concerned with the presentation of the method and procedures used in

gathering, consolidating, and statistically quantifying the information which served as basis for

the establishment of the trend of reactions to be discussed in the study.

Research Design

The researchers will use a descriptive method of research to obtain information about the

awareness and extent of application of the 11 nursing core competencies in nursing practice in a

selected hospital in particular. They will utilize a quantitative research to comprehensively

present and statistically interpret the data yielded from the participants. Furthermore, they will

apply a survey research, through paper-pen questionnaire to study a representative characteristic

of nurses regarding their awareness and extent of application of 11 nursing core competencies in

nursing practice in a hospital set-up.

Participants/Respondents of the Study

The participants will be the nursing personnel of Dr. Paulino J. Garcia Memorial

Research and Medical Center. These will include the nurse supervisors, staff nurses assigned

from the different areas as well as the RN Heals. The participants are limited only from the

population of 326 nurses who are working on a regular basis. The researchers will not include

those nurses who are volunteers and trainees on the said hospital.


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Sampling Procedure

The researchers plan to obtain the samples by means of stratified random sampling.

Using the stratified random sampling, the researchers will first divide the population into groups

based on a relevant characteristic that is according to employment status. After doing so, the

group will be divided further from their working area the staff nurses and the RN Heals in

particular, then each group will be divided again according to participants gender: male and

female. The researchers will then select the sample population within each subgroup to ensure

that the primary group are adequately represented. Since, there is only one Nurse VII, one Nurse

VI, two Nurse IV, and eight Nurse III, the researchers will consider all of them as a sample in the

group that they represent because they are very few. Then the rest of the group will be randomly

selected using either the hat-and-draw method or a random number table. The researchers will

select randomly the requisite number of males and do the same for the females of each subgroup

of nursing personnel. The number of sections drawn from the population will be determined by

using the Slovins formula: n=N/1+Ne2, wheren is the number of sample, N is the number of

population and eis the margin of error. The researchers will use .05 as a margin of error in the

study. A total of 184 sample participants will be included in the study, since the researchers will

not include Nurse VII, Nurse VI, Nurse IV and Nurse III in random selection of sample.

Instrumentation

The researchers will primarily use a questionnaire, a paper-and-pencil self-report

instrument in gathering data for the study. They will use formulated questionnaire by the

researchers that will depict the level of awareness and extent of application of 11 nursing core

competencies in nursing practice in the hospital. The formulated questionnaire will be based on

PRCBON National Core Competency Standards of Filipino Nurses latest edition. It will consist


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of three parts. The first part will consist of the personal profile of the participants, which includes

the age, gender, position, working area, year(s) of experience, time shifting and highest

educational attainment; the second part will contain the questions that will measure the level of

awareness and the third part will contain the questions also the extent of application of the

participants to the 11 nursing core competencies in the hospital. The researchers will use the

Likert Scale as a tool to measure the level of awareness and extent of application of the

participants.

Table 1. Likert Scale to be Used in Interpreting Weighted Mean on Level of Awareness

Unit Weight : Weighted Mean Verbal Interpretation Meaning

5 : 4.55.49 Extremely Aware Very conscious at all times

4 : 3.5 - 4.49 Moderately Aware Conscious

3 : 2.5 - 3.49 Somewhat Aware Fairly conscious

2 : 1 .5 - 2.49 Slightly Aware Minimal consciousness

1 : 0.491.49 Not at all Aware Not at all conscious

Table2. Likert Scale to be used in Interpreting Weighted Mean on Extent of Application

Unit Weight : Weighted Mean Verbal Interpretation Meaning

5 : 4.55.49 Every time On all occasion, repeatedly

4 : 3.5 - 4.49 Almost Every time Frequently, in many instances

3 : 2.5 - 3.49 Sometimes Occasionally

2 : 1 .5 - 2.49 Almost Never Seldom, not often, in frequent

1 : 0.491.49 Never Not at all , surely not

Data Gathering Procedure

First, the researcher will formulate a questionnaire that will describe the level of

awareness and extent of application of 11 nursing core competencies in nursing practice in the

hospital. The questionnaire will be laboriously checked and validated by the adviser. After

examining, the corrected instrument will be reproduced for pilot testing to selected nurses who


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will not be included to the sample, to figure out if there will be still questions necessary for

revisions and corrections. Then, after the formulated questionnaire has been proven and

corrected, the researchers will seek the approval of Mrs. Pinky Miriam D. Canlas, the Chief

Nurse of Dr. Paulino J. Garcia Memorial Research and Medical Center, to allow the researchers

to conduct the study and to distribute the formulated questionnaire to the participants.

A letter to the participants will then be given to them requesting for their participation in

answering the questionnaires. After that, the researchers will distribute the questionnaires to

them and will be collected after they answered all the questions. The administered questionnaire

will then be retrieved with the reactions to the items being tallied, consolidated, and presented in

tabular form and to be used as basis for establishing the general sentiment of the participants

towards the topics opened for evaluation in the study.

The actual data collection will be held on August 2013 in Dr. Paulino J. Garcia Memorial

Research and Medical Center at Cabanatuan City, Nueva Ecija.


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Statistical Tools

To interpret the findings and data gathered, frequency count and percentage will be used

to determine the profile variables of the participants.

% = F/N x 100

Where:

% = Percentage

F = Frequency of each item or response

N= Total number of participants

The weighted mean will reveal the overall average of the responses of the participants. It

will be used to address their answers on the level of awareness and extent of application of 11

nursing core competencies in nursing practice.

x= Wi/Xi

n

Where: x = weighted mean

Wi = weight of each item value

Xi = total number of participants

n = total number of weights

In dealing with the significant relationship between the profile variables and the level of

awareness of the participants on 11 nursing core competencies in nursing practice in a hospital

setting the researchers will use chi square. The chi-square is the sum of the squared difference


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between observed (o) and the expected (E) data (or the deviation, d), divided by the expected

data in all possible categories.

X2

= (o-E)2

E

Where:

X2

= Chi square

O = Observed data

E = Expected data

The researchers will use t-test to calculate the significant difference between the level of

awareness and extent of application of the 11 nursing core competencies in nursing practice. This

will be used in testing the significance of a correlation between the observed data from the

participants. In simple terms, the t-test compares the actual difference between two means in

relation to the variation in the data.

t = x1-x2

d

Where

t = test of correlation

x1 = sample mean 1

x2 = sample mean 2

d = standard deviation of the difference between the means


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Central Luzon Doctors Hospital-Educational Institution

Master of Science in Nursing

Tarlac City, Tarlac

July, 2013

Pinky Miriam D. Canlas, R.N., M.A.N.

Chief Nurse, Dr. Paulino J. Garicia Memorial Research and Medical Center

Cabanatuan City, Nueva Ecija

Dear Madam:

The undersigned are Master of Science in Nursing Students of Central Luzon Doctors HospitalEducational Institution and are undergoing a research study entitled Level of Awareness and

Extent of Application of the Nursing Core Competencies in Selected Hospitals in Nueva

Ecija: A Basis for Performance Evaluation of Nursing Service as a partial fulfilment of thesubject Nursing Research.

In this connection, the researchers are soliciting your favorable permission to allow us to conduct

a survey among the fellow nurses as our correspondent. We have prepared questionnaires forthem to answer

We assure that the findings of the study will benefit everybody; especially the nurses and alsothat information to be provided by your nursing personnel will be held in strictest confidence and

shall serve no purpose except of the study.

We hoped that this request will merit consideration and favorable action from your honorableoffice.

Thank you very much.

Respectfully yours,

The Researchers

Noted by:JAY MANUEL T. GALEON, MSN, MAN

Research Professor

Approved by:

PINKY MIRIAM D. CANLAS, R.N., M.A.N.

Chief Nurse


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August, 2013

Dear Respondents,

We, Second Year Master of Science in Nursing Students of Central Luzon Doctors Hospital

Educational Institution are presently conducting a research entitled Level of Awareness and

Extent of Application of the Nursing Core Competencies in Selected Hospitals in Nueva

Ecija: A Basis for Performance Evaluation of Nursing Service, as a requirement of the

subject Nursing Research.

Therefore, we would like to ask for your assistance in answering this survey questionnaire. Your

honest answer will be very much appreciated. Rest assured that your responses would be kept

confidential.

Thank you very much for your time and cooperation.

Respectfully yours,

The Researchers


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LEVEL OF AWARENESS AND EXTENT OF APPLICATION OF THE NURSING

CORE COMPETENCIES IN SELECTED HOSPITALS IN NUEVA ECIJA:

A BASIS FOR PERFORMANCE EVALUATION

OF NURSING SERVICE

1. Respondents Profile

Name (Optional): ________________________ Age: __________ Gender: __________Position: _____________ Working Area: _____________ Year(s) of Experience: ______

Time Shifting: __________ Highest Educational Attainment: _______________________

2. What is your the level of awareness on 11 nursing core competencies in your nursing

practice in this hospital?

Direction: Below are items on the question about the 11 nursing core competencies to test thelevel of awareness. Please put (/) check mark to choose any of the number to the space provided

to best express your honest opinion by using the following scale:

Category Weight

Extremely Aware 5Moderately Aware 4

Somewhat Aware 3

Slightly Aware 2Not at all Aware 1

I. PATIENT CARE COMPETENCIES

1.1. Safe and quality nursing practice 5 4 3 2 11.1a.Demonstrates knowledge base on the health /illness

status of individual / groups

1.1b.Provides sound decision making in the care of

individuals / families/groups considering their beliefs

and values

1.1c. Promotes safety and comfort and privacy of clients

1.1d. Sets priorities in nursing care based on clients needs

1.1e. Ensures continuity of care

1.1f. Administers medications and other health therapeutics

1.1g. Utilizes the nursing process as framework for nursing

1.1g.1Performs comprehensive and systematic nursingassessment

1.1g.2 Formulates a plan of care in collaboration with

clients and other members of the health team

1.1g.3Implements planned nursing care to achieve

identified outcomes

1.1g.4Evaluates progress toward expected outcomes

1.2 Communication 5 4 3 2 1


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1.2a.Establishes rapport with client, significant others and

members of the health team

1.2b. Identifies verbal and non-verbal cues

1.2c. Utilizes formal and informal channels

1.2d. Responds to needs of individuals, family, group and

community1.2e. Uses appropriate information technology to facilitate

communication

1.3 Collaboration and Teamwork 5 4 3 2 1

1.3a. Establishes collaborative relationship with colleagues

and other members of the health team

1.3b.Collaborates plan of care with other members of the

health team

1. 4 Health Education 5 4 3 2 1

1.4a.Assesses the learning needs of the client-partner/s

1.4b.Develops health education plan based on assessed and

anticipated needs1.4c.Develops learning materials for health education

1.4d.Implements the health education plan

1.4e.Evaluates the outcome of health education

II. EMPOWERING COMPETENCIESPOW

1.5 Legal Responsibility 5 4 3 2 1

1.5a.Adheres to practices in accordance with the nursing

law and other relevant legislation including contracts,

informed consent.

1.5b.Adheres to organizational policies and procedures,

local and national1.5c.Documents care rendered to clients

1.6 Ethico-moral Responsibility 5 4 3 2 1

1.6a. Respects the rights of individual / groups

1.6b.Accepts responsibility and accountability for owndecision and actions

1.6c.Adheres to the national and international code of ethicsfor nurses

1.7 Personal and Professional Development 5 4 3 2 1

1.7a.Identifies own learning needs

1.7b.Pursues continuing education

1.7c.Gets involved in professional organizations and civic

activities

1.7d.Projects a professional image of the nurse

1.7e.Possesses positive attitude towards change andcriticism

1.7f.Performs function according to professional standards


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III. ENHANCING COMPETENCIES

1.8 Records Management 5 4 3 2 1

1.8a.Maintains accurate and updated documentation of

client care

1.8b.Records outcome of client care

1.8c.Observes legal imperatives in record keeping1.9 Management of Resources and Environment 5 4 3 2 1

1.9a.Organizes work load to facilitate client care

1.9b.Utilizes financial resources to support client care

1.9c.Establishes mechanism to ensure proper functioning of

equipment

1.9d.Maintains a safe environment

IV. ENABLING COMPETENCIES

1. 10 Quality Improvement 5 4 3 2 1

1.10a.Gathers data for quality improvement

1.10b.Participates in nursing audits and rounds1.10c.Identifies and reports variances

1.10d.Recommends solutions to identified problems

1.11 Research 5 4 3 2 1

1.11a.Gather data using different methodologies

1.11b.Analyzes and interprets data gathered

1.11c.Recommends actions for implementation

1.11d.Disseminates results of research findings

1.11e.Applies research findings in nursing practice

3. How often do the participants apply the nursing core competencies in their nursing

practice?

Direction: Below are items on the question about the 11 nursing core competencies use in

nursing practice. Please put (/) check mark to choose any of the number to the space provided to

best express your honest opinion by using the following scle:

Category Weight

Every time 5

Almost Every time 4

Sometimes 3Almost Never 2

Never 1

I. PATIENT CARE COMPETENCIES

2.1. Safe and quality nursing practice 5 4 3 2 1

2.1a.Demonstrates knowledge base on the health /illnessstatus of individual / groups

2.1b.Provides sound decision making in the care ofindividuals / families/groups considering their beliefs


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and values

2.1c. Promotes safety and comfort and privacy of clients

2.1d. Sets priorities in nursing care based on clients needs

2.1e. Ensures continuity of care

2.1f. Administers medications and other health therapeutics

2.1g. Utilizes the nursing process as framework for nursing2.1g.1Performs comprehensive and systematic nursing

assessment

2.1g.2 Formulates a plan of care in collaboration with

clients and other members of the health team

2.1g.3Implements planned nursing care to achieve

identified outcomes

2.1g.4Evaluates progress toward expected outcomes

2.2 Communication 5 4 3 2 1

2.2a.Establishes rapport with client, significant others andmembers of the health team

2.2b. Identifies verbal and non-verbal cues2.2c. Utilizes formal and informal channels

2.2d. Responds to needs of individuals, family, group and

community

2.2e. Uses appropriate information technology to facilitate

communication

2.3 Collaboration and Teamwork 5 4 3 2 1

2.3a. Establishes collaborative relationship with colleagues

and other members of the health team

2.3b.Collaborates plan of care with other members of the

health team

2. 4 Health Education 5 4 3 2 12.4a.Assesses the learning needs of the client-partner/s

2.4b.Develops health education plan based on assessed and

anticipated needs

2.4c.Develops learning materials for health education

2.4d.Implements the health education plan

2.4e.Evaluates the outcome of health education

II. EMPOWERING COMPETENCIESPOW

2.5 Legal Responsibility 5 4 3 2 1

2.5a.Adheres to practices in accordance with the nursing

law and other relevant legislation including contracts,

informed consent.

2.5b.Adheres to organizational policies and procedures,

local and national

2.5c.Documents care rendered to clients

2.6 Ethico-moral Responsibility 5 4 3 2 1

2.6a. Respects the rights of individual / groups


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2.6b.Accepts responsibility and accountability for own

decision and actions

2.6c.Adheres to the national and international code of ethics

for nurses

2.7 Personal and Professional Development 5 4 3 2 1

2.7a.Identifies own learning needs2.7b.Pursues continuing education

2.7c.Gets involved in professional organizations and civic

activities

2.7d.Projects a professional image of the nurse

2.7e.Possesses positive attitude towards change andcriticism

2.7f.Performs function according to professional standards

III. ENHANCING COMPETENCIES

2.8 Records Management 5 4 3 2 1

2.8a.Maintains accurate and updated documentation ofclient care

2.8b.Records outcome of client care

2.8c.Observes legal imperatives in record keeping

2.9 Management of Resources and Environment 5 4 3 2 1

2.9a.Organizes work load to facilitate client care

2.9b.Utilizes financial resources to support client care

2.9c.Establishes mechanism to ensure proper functioning of

equipment

2.9d.Maintains a safe environment

IV. ENABLING COMPETENCIES2. 10 Quality Improvement 5 4 3 2 1

2.10a.Gathers data for quality improvement

2.10b.Participates in nursing audits and rounds

2.10c.Identifies and reports variances

2.10d.Recommends solutions to identified problems

2.11 Research 5 4 3 2 1

2.11a.Gather data using different methodologies

2.11b.Analyzes and interprets data gathered

2.11c.Recommends actions for implementation

2.11d.Disseminates results of research findings

2.11e.Applies research findings in nursing practice

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