HYPERTENSION

 The amount of resistance of blood pumping through the body/arteries.

 Hypertension is defined as a systolic blood pressure greater than 140 mmHg and a diastolic
pressure of more than 90 mmHg.
 This is based on the average of two or more accurate blood pressure measurements during two
or more consultations with the healthcare provider.
 The definition is taken from the Seventh Report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure.

Unfortunately, HTN is known as the SILENT KILLER. When a patient starts to have signs and symptoms
with hypertension, major organs have already been affected (a person can have it for years without
knowing it).
Pathophysiology
In a normal circulation, pressure is transferred from the heart muscle to the blood each time the heart
contracts and then pressure is exerted by the blood as it flows through the blood vessels.
The pathophysiology of hypertension follows.
 Hypertension is a multifactorial
 When there is excess sodium intake, renal sodium retention occurs, which increases fluid
volume resulting in increased preload and increase in contractility.
 Obesity is also a factor in hypertension because hyperinsulinemia develops and structural
hypertrophy results leading to increased peripheral vascular resistance.
 Genetic alteration also plays a role in the development of hypertension because when there is
cell membrane alteration, functional constriction may follow and also results in increased
peripheral vascular resistance.

Causes
Hypertension has a lot of causes just like how fever has many causes. The factors that are implicated
as causes of hypertension are:
  Increased sympathetic nervous system activity. Sympathetic nervous system activity
increases because there is dysfunction in the autonomic nervous system.
 Increase renal reabsorption. There is an increase reabsorption of sodium, chloride, and
water which is related to a genetic variation in the pathways by which the kidneys handle
sodium.
 Increased RAAS activity. The renin-angiotensin-aldosterone system increases its activity
leading to the expansion of extracellular fluid volume and increased systemic vascular
resistance.
 Decreased vasodilation of the arterioles. The vascular endothelium is damaged because of
the decrease in the vasodilation of the arterioles.

To remember organs in involved: “Can’t eat your CAKE and have it too.”
 Cardiac system: congestive heart failure (due to the overworking of the heart muscle which
makes it become enlarged)
 brAin: stroke (increase pressure weakens blood vessels which can cause a clot to form or for
them to rupture)
 Kidneys: renal failure (weakens and narrows the arteries to the kidneys and the kidneys don’t
receive proper perfusion)
 Eyes: visual changes (damages blood vessels to the retina…blurred vision..can’t focus images)

Causes of Hypertension
Primary/Essential Hypertension:
Unknown causes….look at the “risk factors”…know the risk factors for HTN (test questions come from
this section)

 Race (black males)  Cholesterol high

 Increased consumption of salt/alcohol  Too much caffeine intake
 Smoking/stress  Obese
 K+ level and vitamin d level low  Restricting activity
 Family health  Sleep apnea
 Advanced aged

Secondary Hypertension:
Caused by a pre-existing issue….there is something causing the person to have high blood pressure:

 Pregnancy, Cushing Syndrome, adrenaline/noradrenaline to be

 Chronic Renal Failure secreted increase BP)
 Diabetes  Coarctation of the aorta (congenital
 Hypo/hyperthyroidism defect main artery of the body is
 Pheochromocytoma (tumor on super narrow and this leads to high
adrenal gland which cause blood pressure)

Prevention
Prevention of hypertension mainly relies on a healthy lifestyle and self-discipline.
 Weight reduction. Maintenance of normal body weight can help prevent hypertension.
  Adopt DASH. DASH or the Dietary Approaches to Stop Hypertension includes consummation of
a diet rich in fruits, vegetable, and low-fat dairy.
 Dietary sodium retention. Sodium contributes to an elevated blood pressure, so reducing the
dietary intake to no more than 2.4 g sodium per day can be really helpful.
 Physical activity. Engage in regular aerobic physical activity for 30 minutes thrice every week.
 Moderation of alcohol consumption. Limit alcohol consumption to no more than 2 drinks per
day in men and one drink for women and people who are lighter in weight.
Complications
If hypertension is left untreated, it could progress to complications of the different body organs.
 Heart failure. With increased blood pressure, the heart pumps blood faster than normal until
the heart muscle goes weak from too much exertion.
 Myocardial infarction. Decreased oxygen due to constriction of blood vessels may lead to MI.
 Impaired vision. Ineffective peripheral perfusion affects the eye, causing problems in vision
because of decreased oxygen.
 Renal failure. Blood carrying oxygen and nutrients could not reach the renal system because of
the constricted blood vessels.
Nursing Assessment of Hypertension

Remember silent killer…probably be without symptoms

 Headache*  Nose bleeds

 Blurry vision*  Ringing in the ears
 Chest Pain*  Dizzy
*Most common symptoms

Nursing Interventions for Hypertension

Assess: measure blood pressure (obtain in both arms…make sure patient has been in a resting position
for 5 minutes, no smoking…causes vasoconstriction), ask about family history, and if they have any
sensory changes
Evaluate: blood pressure reading, dietary intake, body mass index (overweight)
****Educate: limiting sodium, alcohol and caffeine in diet, quit smoking (vasoconstriction), start an
exercise program (cardiovascular) for weight loss, importance of medication compliance (some patients
think if their blood pressure reading are good they don’t need to take their medication anymore),
measuring blood pressure regularly and keeping a record of it and bringing it to the doctor’s office.
****Pay attention to education part…asked on exams

Pharmacology for Hypertension

Typically, non-pharmacological techniques are implemented for about 1 to 3 months while monitoring
the patient’s blood pressure, and then if not controlled, medications are started.
Thiazide Diuretics: End in “iazide” HCTZ (hydrochlorothiazide), Diuril (Chlorothiazide)

 Work by removing water and sodium through the kidneys WATCH BUN and CREATININE
Levels.
  Not for patients in renal failure
 Watch patients who are taking Lithium (increases chances of Lithium toxicity)
 WASTE POTASSIUM…educate about potassium supplement compliance, and photosensitivity
ACE Inhibitors (Angiotension -Converting Enzyme Inhibitors): End in “PRIL” Lisinopril

 Prevent vasoconstriction by blocking Angiotension 1 and 2

 Educate pt about a dry cough/taste changes
 Avoid potassium substitutes or supplement…this drug causes potassium retention
 Compliance very important due to rebound hypertension
 Captopril (increased risk of bleeding) and Moexipril…take 1 hour BEFORE a meal
ARBS (Angiotension Receptor Blockers): drugs that end in “sartan” ex: Losartan (may be prescribed in
place of ACE inhibitors if patient can’t tolerate ACE Inhibitor)

 Works by causing vasodilation by blocking aldosterone and Angiotension

 Same side effects as ACEI (except dry cough)
 Increase k+ level
CCB (Calcium Channel Blockers): end in “dipine” Amlodipine, and Cardizem, Verapamil

 Slow the heart rate to decrease the work load on the heart and cause vasodilation which
lowers blood pressure
 Watch HR: bradycardia
 Watch pts who have CHF or AV blocks
BB: Beta blockers: end in “olol” ex: Labetalol, Metoprolol

 Affects epinephrine and norepinephrine which blocks the sympathetic nervous system of the
heart and this keeps the heart rate nice and low which helps dilates vessel which lowers
blood pressure
 Not for patients with asthma and COPD because this medication blocks the receptors in the
lungs and causes bronchoconstriction
 Monitor Glucose levels in diabetics because it conceals the signs of hypoglycemia
 Monitor heart rate and for orthostatic hypotension

Stage 1 Hypertension
Thiazide diuretic is recommended for most and angiotensin-converting enzyme-1, aldosterone receptor
blocker, beta blocker, or calcium channel blocker is considered.
Stage 2 Hypertension
Two-drug combination is followed, usually including thiazide diuretic and angiotensin-converting
enzyme-1, or beta-blocker, or calcium channel blocker.
Diagnosis
 Deficient knowledge regarding the relation between the treatment regimen and control of the
disease process.
 Noncompliance with the therapeutic regimen related to side effects of the prescribed therapy.
 Risk for activity intolerance related to imbalance between oxygen supply and demand.
 Risk-prone health behavior related to condition requiring change in lifestyle.
Nursing Priorities
 Maintain/enhance cardiovascular functioning.
 Prevent complications.
 Provide information about disease process/prognosis and treatment regimen.
 Support active patient control of condition.

BURNS
 Burn injury is the result of heat transfer from one site to another.
 Burns disrupt the skin, which leads to increased fluid loss; infection; hypothermia; scarring;
compromised immunity; and changes in function, appearance, and body image.
 Young children and the elderly continue to have increased morbidity and mortality when
compared to other age groups with similar injuries. Inhalation injuries in addition to cutaneous
burns worsen the prognosis.
 The severity of each burn is determined by multiple factors that when assessed help the burn
team estimate the likelihood that a patient will survive and plan for the care for each patient.
Burns are classified according to the depth of tissue destruction as superficial partial-thickness injuries,
deep partial thickness injuries, or full thickness injuries.
 Superficial partial-thickness. The epidermis is destroyed or injured and a portion of the dermis
may be injured.
 Deep partial thickness. A deep partial thickness burn involves the destruction of the epidermis
and upper layers of the dermis and injury to the deeper portions of the dermis.
 Full thickness. A full thickness burn involves total destruction of the epidermis and dermis and,
in some cases, the destruction of the underlying tissue, muscle, and bone.

Pathophysiology
Tissue destruction results from coagulation, protein denaturation, or ionization of cellular components.
 Local response. Burns that do not exceed 20% of TBSA according to the Rule of Nines produces
a local response.
 Systemic response. Burns that exceeds 20% of TBSA according to the Rule of Nines produces a
systemic response.
 The systemic response is caused by the release of cytokines and other mediators into the
systemic circulation.
 The release of local mediators and changes in blood flow, tissue edema, and infection, can cause
progression of the burn injury.
Clinical Manifestations
The changes that occur in burns include the following:
 Hypovolemia. This is the immediate consequence of fluid loss and results in decreased
perfusion and oxygen delivery.
 Decreased cardiac output. Cardiac output decreases before any significant change in blood
volume is evident.
 Edema. Edema forms rapidly after burn injury.
  Decreased circulating blood volume. Circulating blood volume decreases dramatically during
burn shock.
 Hyponatremia. Hyponatremia is common during the first week of the acute phase, as water
shifts from the interstitial space to the vascular space.
 Hyperkalemia. Immediately after burn injury hyperkalemia results from massive cell
destruction.
 Hypothermia. Loss of skin results in an inability to regulate body temperature.
Complications
There are a lot of consequences involved in burn injuries that may progress without treatment.

 Ischemia. As edema increases, pressure on small blood vessels and nerves in the distal
extremities causes an obstruction of blood flow.
 Tissue hypoxia. Tissue hypoxia is the result of carbon monoxide inhalation.
 Respiratory failure. Pulmonary complications are secondary to inhalational injuries.
Assessment and Diagnostic Findings

 Rule of Nines. A common method, the rule of nines is a quick way to estimate the extent of
burns in adults through dividing the body into multiples of nine and the sum total of these parts
is equal to the total body surface area injured.
 Lund and Browder Method. This method recognizes the percentage of surface area of various
anatomic parts, especially the head and the legs, as it relates to the age of the patient.
 Palmer Method. The size of the patient’s palm, not including the surface area of the digits, is
approximately 1% of the TBSA, and the patient’s palm without the fingers is equivalent to 0.5%
TBSA and serves as a general measurement for all age groups.
Medical Management
Burn care is a delicate task any nurse can have and being knowledgeable in the proper sequencing of the
interventions is very essential.
  Transport. The hospital and the physician are alerted that the patient is en route so that life-
saving measures can be initiated immediately.
 Priorities. Initial priorities in the ED remain airway, breathing, and circulation.
 Airway. 100% humidified oxygen is administered and the patient is encouraged to cough so that
secretions can be removed by coughing.
 Chemical burns. All clothing and jewelry are removed and chemical burns should be flushed.
 Intravenous access. A large bore (16 or 18 gauge) IV catheter is inserted in the non-burned area.
 Gastrointestinal access. If the burn exceeds 20% to 25% TBSA, a nasogastric tube is inserted and
connected to low intermittent suction because there are patients with large burns that become
nauseated.
 Clean beddings. Clean sheets are placed over and under the patient to protect the burn wound
from contamination, maintain body temperature, and reduce pain caused by air currents
passing over exposed nerve endings.
 Fluid replacement therapy. The total volume and rate of IV fluid replacement is gauged by the
patient’s response and guided by the resuscitation formula.
Nursing Management
Nursing management in burn care requires specific knowledge on burns so that there could be a
provision of appropriate and effective interventions.
Nursing Assessment
The nursing assessment focuses on the major priorities for any trauma patient; the burn wound is a
secondary consideration.
 Focus on the major priorities of any trauma patient. the burn wound is a secondary
consideration, although aseptic management of the burn wounds and invasive lines continues.
 Assess circumstances surrounding the injury. Time of injury, mechanism of burn, whether the
burn occurred in a closed space, the possibility of inhalation of noxious chemicals, and any
related trauma.
 Monitor vital signs frequently. Monitor respiratory status closely; and evaluate apical, carotid,
and femoral pulses particularly in areas of circumferential burn injury to an extremity.
 Start cardiac monitoring if indicated. If patient has history of cardiac or respiratory problems,
electrical injury.
 Check peripheral pulses on burned extremities hourly; use Doppler as needed.
 Monitor fluid intake (IV fluids) and output (urinary catheter) and measure hourly. Note
amount of urine obtained when catheter is inserted (indicates preburn renal function and fluid
status).
 Obtain history. Assess body temperature, body weight, history of preburn weight, allergies,
tetanus immunization, past medical surgical problems, current illnesses, and use of medications.
 Arrange for patients with facial burns to be assessed for corneal injury.
 Continue to assess the extent of the burn; assess depth of wound, and identify areas of full and
partial thickness injury.
 Assess neurologic status: consciousness, psychological status, pain and anxiety levels, and
behavior.
 Assess patient’s and family’s understanding of injury and treatment. Assess patient’s support
system and coping skills.
Acute Phase
The acute or intermediate phase begins 48 to 72 hours after the burn injury. Burn wound care and pain
control are priorities at this stage.
 Focus on hemodynamic alterations, wound healing, pain and psychosocial responses, and early
detection of complications.
 Measure vital signs frequently. Respiratory and fluid status remains highest priority.
 Assess peripheral pulses frequently for first few days after the burn for restricted blood flow.
 Closely observe hourly fluid intake and urinary output, as well as blood pressure and cardiac
rhythm; changes should be reported to the burn surgeon promptly.
 For patient with inhalation injury, regularly monitor level of consciousness, pulmonary
function, and ability to ventilate; if patient is intubated and placed on a ventilator, frequent
suctioning and assessment of the airway are priorities.
Rehabilitation Phase
Rehabilitation should begin immediately after the burn has occurred. Wound healing, psychosocial
support, and restoring maximum functional activity remain priorities. Maintaining fluid and electrolyte
balance and improving nutrition status continue to be important.
 In early assessment, obtain information about patient’s educational level, occupation, leisure
activities, cultural background, religion, and family interactions.
 Assess self concept, mental status, emotional response to the injury and hospitalization, level of
intellectual functioning, previous hospitalizations, response to pain and pain relief measures,
and sleep pattern.
 Perform ongoing assessments relative to rehabilitation goals, including range of motion of
affected joints, functional abilities in ADLs, early signs of skin breakdown from splints or
positioning devices, evidence of neuropathies (neurologic damage), activity tolerance, and
quality or condition of healing skin.
 Document participation and self care abilities in ambulation, eating, wound cleaning, and
applying pressure wraps.
 Maintain comprehensive and continuous assessment for early detection of complications, with
specific assessments as needed for specific treatments, such as postoperative assessment of
patient undergoing primary excision.
Diagnosis
Nursing diagnoses for burn injuries include:

 Impaired gas exchange related to carbon monoxide poisoning, smoke inhalation, and upper
airway obstruction.
 Ineffective airway clearance related to edema and effects of smoke inhalation.
 Fluid volume deficit related to increased capillary permeability and evaporative losses from burn
wound.
 Hypothermia related to loss of skin microcirculation and open wounds.
 Pain related to tissue and nerve injury.
 Anxiety related to fear and the emotional impact of burn injury.
Nursing Priorities  Restore hemodynamic
stability/circulating volume.
 Maintain patent airway/respiratory
 Alleviate pain.
function.
 Prevent complications.
  Provide emotional support for  Provide information about condition,
patient/significant other (SO). prognosis, and treatment.

11 KEY AREAS OF RESPONSIBILITY

 Safe & quality nursing practice
 Management of resources & environment
 Health education
 Legal responsibility
 Ethico – moral responsibility
 Personal & professional development
 Quality improvement
 Research
 Record management
 Communication
 Collaboration & teamwork
I. SAFE AND QUALITY NURSING CARE
Core competency 1:
Demonstrate knowledge based on health/illness status of individual/ groups
Indicators :
○ Identifies health needs of patients/groups
○ Explains patient/group status
Core competency 2:
Provides sound decision making in care of individual/groups considering their beliefs, values
Indicators :
○ Problem identification
○ Data gathering related to problem
○ Data analysis
○ Selection appropriate action
○ Monitor progress of action take
Core competency 3:
Promotes patient safety and comfort
Indicators :
○ Performs age-specific safety measures and comfort measure in all aspects of patient care
Core competency 4:
Priority setting in nursing care based on patients’ needs
Indicators :
○ Identifies priority needs of patients
○ Analysis of patients’ needs
○ Determine appropriate nursing care to be provided
Core competency 5:
Ensures continuity of care
Indicators :
○ Refers identified problems to appropriate individuals/ agencies
○ Establish means of providing continuous patient care
Core competency 6:
Administers medications and other health therapeutics
Indicators :
○ Conforms to the 10 golden rules in medication administration and health therapeutics
Core competency 7:
Utilizes nursing process as framework for nursing. Performs comprehensive, systematic nursing
assessment
Indicators :
○ Obtains consent
○ Complete appropriate assessment forms
○ Performs effective assessment techniques
○ Obtains comprehensive client information
○ Maintains privacy and confidentiality
○ Identifies health needs
Core competency 8:
Formulates care plan in collaboration with patients, other health team members
Indicators :
○ Includes patients, family in care planning
○ States expected outcomes in nursing interventions
○ Develops comprehensive patient care plan
○ Accomplishes patient centered discharge plan
Core competency 9:
Implements NCP to achieve identified outcomes
Indicators :
○ Explain interventions to patient, family before carrying them out
○ Implement safe, comfortable nursing interventions
○ Acts according to client’s health conditions, needs
○ Performs nursing interventions effectively and in timely manner
Core competency 10:
Implements NCP progress toward expected outcomes
Indicators :
○ Monitors effectiveness of nursing interventions
○ Revises care plan PRN
Core competency 11:
Responds to urgency of patient’s condition
Indicators :
○ Identifies sudden changes in patient’s health conditions
○ Implements immediate, appropriate interventions

II. MANAGEMENT OF RESOURCES AND ENVIRONMENT

Core competency 1:
Organizes workload to facilitate patient care
Indicators:
○ Identifies task or activities that need to be accomplished
○ Plans the performance of task or activities based on priority
○ Finishes work assignment on time
Core competency 2:
Utilizes resources to support patient care
Indicators:
○ Determines the resources needed to deliver patient care
○ Control the use of equipment
Core competency 3:
Ensures the functioning of resources
Indicators:
○ Check proper functioning of the equipment
○ Refers Malfunctioning equipment to appropriate unit
Core competency 4:
Check the Proper functioning of the Equipment
Indicators:
○ Determines the task and procedures that can be safely assigned to the other members of the team
○ Verifies the competence of the staff prior to delegating tasks
Core competency 5:
Maintains safe Environment
Indicators:
○ Observe proper disposal of waste
○ Adheres to policies, procedures and protocols on prevention and control of infection
○ Defines steps to follow incase of fire , earthquake and other emergency situation

III. HEALTH EDUCATION

Core competency 1:
Assesses the learning needs of the patient and the family
Indicators:
○ Obtains learning information through interview, observation and validation
○ Defines relevant information
○ Completes assessment records appropriately
○ Identify priority needs

Core competency 2:
Develops Health Education plan based on assessed and anticipated needs.
Indicators:
○ Considers nature of the learner in relation to social, cultural, political, economic, educational, and
religious factor
Core competency 3:
Develops learning material for health education
Indicators:
○ Involves the patient, family and significant others and other resources
○ Formulates a comprehensive health educational plan with the following components , objectives,
content and time allotment
○ Teaching-learning resources and evaluation parameters
○ Provides for feedback to finalize plan
Core competency 4:
Implements the health Education Plan
Indicators:
○ Provides for conducive learning situation in terms of timer and place
○ Considers client and family preparedness○ Utilize appropriate strategies
○ Provides reassuring presence through active listening, touch and facial expression and gestures
○ Monitors client and family’s responses to health education
Core competency 5:
Evaluates the outcome of health Education
Indicators:
○ Utilizes evaluation parameters
○ Documents outcome of care
○ Revises health education plan when necessary

V. LEGAL RESPONSIBILITY
Core competency 1:
Adheres to practices in accordance with the nursing law and other relevant legislation including contract
and informed consent.
Indicators:
○ Fulfill legal requirements in Nursing Practice
○ Holds current professional license
○ Acts in accordance with the terms of contract of employment and other rules and regulation
○ Complies with the required CPE
○ Confirms information given by the doctor for informed consent
○ Secures waiver of responsibility for refusal to undergo treatment or procedures
○ Check the completeness of informed consent and other legal forms
Core competency 2:
Adheres to organizational policies and procedures, local and national
Indicators:
○ Articulates the vision and mission of the institution where one belongs
○ Acts in accordance with the established norms and conduct of the institution/ organization
Core competency 3:
Document care rendered to patients.
Indicators:
○ Utilizes appropriate patient care records and reports
○ Accomplish accurate documentation in all matters concerning patient care in accordance with the
standard of nursing practice.

IV. ETHICO-MORAL RESPONSIBILITY

Core competency 1:
Respects the rights of individual/ groups
Indicator:
○ Renders nursing care consistent with the patient’s bill of rights (ie. confidentiality of information,
privacy, etc.)
Core competency 2
Accepts responsibility & accountability for own decisions and actions
Indicators:
○ Meets nursing accountability requirements as embodied in the job description
○ Justifies basis for nursing actions and judgment
○ Protects a positive image of the profession
Core competency 3
Adheres to the national and international code of ethics for nurses
Indicators:
○ Adheres to the Code of Ethics for Nurses and abides by its provisions
○ Reports unethical and immoral incidents to proper authorities

VI. PERSONAL & PROFESSIONAL DEVELOPMENT

Core competency 1
Identifies own learning needs
Indicators:
○ Verbalizes strengths, weaknesses, limitations.
○ Determines personal and professional goals and aspirations.
Core competency 2
Pursues continuing education
Indicators:
○ Participates in formal and non-formal education.
○ Applies learned information for the improvement of care.
Core competency 3
Gets involved in professional organizations and civic activities
Indicators:
○ Participates actively in professional, social, civic and religious activities
○ Maintain membership to professional organizations
○ Support activities related to nursing and health issues
Core competency 4
Projects a professional image of nurse
Indicators:
○ Demonstrate good manners and right conduct at all times.
○ Dresses appropriately.
○ Demonstrates congruence of words and actions.
○ Behaves appropriately at all times.
Core competency 5
Possesses positive attitude towards change and criticism
Indicators:
○ Listens to suggestions and recommendations.
○ Tries new strategies or approaches.
○ Adapts to changes willingly.
Core competency 6
Performs function according to professional standards
Indicators:
○ Assesses own performance against standards of practice.
○ Sets attainable objectives to enhance nursing knowledge and skills.
○ Explains current nursing practices, when situations call for it.

XI. QUALITY IMPROVEMENT

CORE COMPETENCY 1:
Gathers data for quality improvement
Indicators:
 Demonstrates knowledge of method appropriate for the clinical problems identified
 Detects variation in the vital signs of the patient from day to day
  Reports necessary elements at the bedside to improve patient stay at hospital
 Solicits feedback from patient and significant others regarding care rendered
CORE COMPETENCY 2:
Participates in nursing audits and rounds
Indicators:

 Contributes relevant information about patient condition as well as unit condition and patient
current reactions
 Shares with the team current information regarding particular patients condition
 Encourages the patient to speak about what is relevant to his condition
 Documents and records all nursing care and actions
 Performs daily check of patient records/condition
 Completes patients records
 Actively contributes relevant information of patients during rounds thru readings and sharing
with others
CORE COMPETENCY 3:
Identifies and reports variances
Indicators:

 Documents observed variance regarding patient care and submits to appropriate group within
24 hours
 Identifies actual and potential variance to patient care
 Reports actual and potential variance to patient care
 Submits report to appropriate groups within 24 hours
CORE COMPETENCY 4:
Recommends solutions to identified problems
Indicators:
 Gives appropriate suggestions on corrective and preventive measures
 Communicates and discusses with appropriate groups
 Gives and objective and accurate reporton what was observed rather than an interpretation of
the event.

VII. RESEARCH
CORE COMPETENCY 1:
Gathers data using different methodologies
Indicators:

 Identifies researchable problems regarding patient care and community health

 Identifies appropriate methods of research for a particular patient/community problem
 Combines quantitative and qualitative nursing design thru simple explanation on the
phenomena observed
 Analyzes data gathered
CORE COMPETENCY 2:
Recommends actions for implementation
Indicator:
  Based on the analysis of data gathered, recommends practical solutions appropriate for the
problem
CORE COMPETENCY 3:
Disseminates results of research findings
Indicators:

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

 Endeavors to publish research
 Submits research findings to own agencies and others as appropriate
CORE COMPETENCY 4:
Applies research findings in nursing practice
Indicators:

 Utilizes and findings in research in the provision of nursing care to

individuals/groups/communities
 Makes use of evidence-based nursing to ameliorate nursing practice
VIII. RECORDS MANAGEMENT
CORE COMPETENCY 1:
Maintains accurate and updated documentation of patient care
Indicator:
 Completes updated documentation of patient care
CORE COMPETENCY 2:
Records outcome of patient care
Indicator:
 Utilizes a record system
CORE COMPETENCY 3:
Observes legal imperatives in recording keeping
Indicators:
 Observes confidentially and privacy of patient’s records
 Maintains an organized system of filing and keeping patient’s records in a designated area
 Refrains from releasing records and other information without proper authority
IX. COMMUNICATION
CORE COMPETENCY 1:
Establishes rapport with patients, significant others and members of the health team.
Indicators:
○ Creates trust and confidence
○ Listens attentively to client’s queries and requests
○ Spends time with the client to facilitate conversation that allows client to express concern.

CORE COMPETENCY 2:
Identifies verbal and non-verbal cues
Indicator:
○ Interprets and validates client’s body language and facial expression
CORE COMPETENCY 3:
Utilizes formal and informal channels
Indicator:
○ Makes use of available visual aids
CORE COMPETENCY 4:
Responds to needs of individuals, family, group and community
Indicator:
○ Provides re- assurance through therapeutic, touch, warmth and comforting words of encouragement
○ Readily smiles
CORE COMPETENCY 5:
Uses appropriate information technology to facilitate communication
Indicator:
○ Utilizes telephone, mobile phone, email and internet, and informatics
○ Identifies a significant other so that follow up care can be obtained
○ Provides “holding” or emergency numbers of services

X. COLLABORATION and TEAMWORK

CORE COMPETENCY 1:
Establishes collaborative relationship with colleagues and other members of the health team
Indicators:
○ Contributes to decision making regarding patients” needs and concerns
○ Participates actively in patients care management including audit
○ Recommends appropriate intervention to improve patient care
○ Respects the role of the other members of the health team
○ Maintains good interpersonal relationships with patients, colleagues and other members of the health
team
CORE COMPETENCY 2:
Collaborates plan of care with other members of the health team
Indicator:
○ Refers patients to allied health team partners
○ Acts liaison / advocate of the patients
○ Prepares accurate documentation of efficient communication of services