CHAPTER 9

EDVERLY T. MALANA, RN, MSN.

• The nursing industry has established eleven key areas of responsibility
that provide a framework for unifying nursing education, practice and
regulation. This comprehensive list of key areas and core competencies
within each key area furnishes the industry with a standardized measure
that is used in all aspects of the nursing profession.

• LEGAL BASES

Article 3 Sec.9 I of R.A. 9173/ “Philippine Nursing Act 2002”

Board shall monitor & enforce quality standards of nursing practice necessary
to ensure the maintenance of efficient, ethical and technical, moral and
professional standards in the practice of nursing taking into account the
health needs of the nation.
 SIGNIFICANCE OF CORE
COMPETENCY STANDARDS
• - Unifying framework for nursing practice, education, regulation
- Guide in nursing curriculum development
- Framework in developing test 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
- Yardstick for unethical, unprofessional nursing practice
 SAFETY AND QUALITY
• The first key area of nursing responsibility focuses on providing nursing care
that is safe and of high quality. Under this key area, core competencies
include demonstrating knowledge about the health status and illness of a
patient; making appropriate decisions when caring for patients and their
families; and ensuring patient safety, privacy and comfort. Competencies
also include setting appropriate priorities in patient care, working with the
medical team to ensure stability of care, effectively administering
medications and other treatment modalities and performing assessments
and nursing services against a background of established nursing guidelines.
The nurse also works with the medical team and patient’s family to develop a
plan of care. Identifying the goals of care and evaluating progress toward
those goals are also core competencies within this key area.
1. CORE COMPETENCY 1: 2. CORE COMPETENCY 2:
Demonstrate knowledge based on Provides sound decision making in
health/illness status of individual/ care of individual/groups
groups considering their beliefs, values

Indicators : Indicators :
○ Identifies health needs of ○ Problem identification
patients/groups ○ Data gathering related to problem
○ Explains patient/group status ○ Data analysis
○ Selection appropriate action
○ Monitor progress of action taken
3. CORE COMPETENCY 3: 4. CORE COMPETENCY 4:
Promotes patient safety and comfort Priority setting in nursing care based
on patients’ needs
Indicators :
○ Performs age-specific safety Indicators :
measures and comfort measure in ○ Identifies priority needs of
all aspects of patient care patients
○ Analysis of patients’ needs
○ Determine appropriate nursing
care to be provided
5. CORE COMPETENCY 5: 6. CORE COMPETENCY 6:
Ensures continuity of care Administers medications and other
health therapeutics
Indicators :
○ Refers identified problems to Indicators :
appropriate individuals/ agencies ○ Conforms to the 10 golden rules
○ Establish means of providing in medication administration and
continuous patient care health therapeutics
7. CORE COMPETENCY 7: 8. CORE COMPETENCY 8:
Utilizes nursing process as Formulates care plan in
framework for nursing. Performs collaboration with patients, other
comprehensive, systematic nursing health team members
assessment
Indicators :
Indicators : ○ Includes patients, family in care
○ Obtains consent planning
○ Complete appropriate assessment ○ States expected outcomes in
forms nursing interventions
○ Performs effective assessment ○ Develops comprehensive patient
techniques care plan
○ Obtains comprehensive client ○ Accomplishes patient centered
information discharge plan
○ Maintains privacy and
confidentiality
○ Identifies health needs
9. CORE COMPETENCY 9:
Implements NCP to achieve
identified outcomes

Indicators : 10. CORE COMPETENCY 10:

○ Explain interventions to patient, Implements NCP progress toward
family before carrying them out expected outcomes
○ Implement safe, comfortable
nursing interventions Indicators :
○ Acts according to client’s health ○ Monitors effectiveness of nursing
conditions, needs interventions
○ Performs nursing interventions ○ Revises care plan PRN
effectively and in timely manner
11. CORE COMPETENCY 11:
Responds to urgency of patient’s
condition

Indicators :
○ Identifies sudden changes in
patient’s health conditions
○ Implements immediate,
appropriate interventions
 RESOURCES AND
ENVIRONMENT
• The next key area is the management of resources
and environment. Core competencies in this area
include identifying tasks that need to be
completed, developing financially effective
programs, ensuring that equipment performs
adequately and maintaining safety in the
environment.
• CORE COMPETENCY 1: • CORE COMPETENCY 2:
Organizes workload to facilitate Utilizes resources to support
patient care patient care

Indicators: Indicators:
○ Identifies task or activities that ○ Determines the resources
need to be accomplished needed to deliver patient care
○ Plans the performance of task or ○ Control the use of equipment
activities based on priority
○ Finishes work assignment on
time
• CORE COMPETENCY 3: • CORE COMPETENCY 4:
Ensures the functioning of Check the Proper functioning of
resources the Equipment

Indicators: Indicators:
○ Check proper functioning of the ○ Determines the task and
equipment procedures that can be safely
○ Refers Malfunctioning assigned to the other members of
equipment to appropriate unit 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
 HEALTH EDUCATION

• Educational core competencies include

assessing the educational needs of the
patient and family, developing and
implementing health education plans and
learning materials and evaluating the
outcome of education administered.
• CORE COMPETENCY 1: • CORE COMPETENCY 2:
Assesses the learning needs of the Develops Health Education plan
patient and the family based on assessed and anticipated
needs.
Indicators:
○ Obtains learning information Indicators:
through interview, observation and ○ Considers nature of the learner
validation in relation to social, cultural,
○ Defines relevant information political, economic, educational,
○ Completes assessment records and religious factor
appropriately
○ Identify priority needs
• CORE COMPETENCY 3: • CORE COMPETENCY 4:
Develops learning material for health Implements the health Education Plan
education
Indicators:
Indicators: ○ Provides for conducive learning
○ Involves the patient, family and situation in terms of timer and place
significant others and other resources ○ Considers client and family
○ Formulates a comprehensive health preparedness○ Utilize appropriate
educational plan with the following strategies
components , objectives, content and ○ Provides reassuring presence
time allotment through active listening, touch and
○ Teaching-learning resources and facial expression and gestures
evaluation parameters ○ Monitors client and family’s
○ Provides for feedback to finalize responses to health education
plan
• CORE COMPETENCY 5:
Evaluates the outcome of health
Education

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

• Core competencies in the legal key area

include following legally mandated state
and federal processes and procedures, such
as obtaining informed consent from patients
and adequately documenting all procedures
performed for patients.
• 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
• CORE COMPETENCY 2:
Practice Adheres to organizational policies
○ Holds current professional license and procedures, local and national
○ Acts in accordance with the terms of
contract of employment and other Indicators:
rules and regulation ○ Articulates the vision and
○ Complies with the required CPE mission of the institution where
○ Confirms information given by the one belongs
doctor for informed consent ○ Acts in accordance with the
○ Secures waiver of responsibility for
refusal to undergo treatment or established norms and conduct of
procedures the institution/ organization
○ Check the completeness of informed
consent and other legal forms
• 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.
 ETHICAL RESPONSIBILITIES

• In this key area that concerns morals and

ethics, core competencies include
respecting the rights of all individuals and
groups, accepting responsibility for
individual decisions and adhering to the
nurses’ national and international code of
ethics.
• CORE COMPETENCY 1: • CORE COMPETENCY 2
Respects the rights of individual/ Accepts responsibility &
groups accountability for own decisions
and actions
Indicator:
○ Renders nursing care consistent Indicators:
with the patient’s bill of rights (ie. ○ Meets nursing accountability
Confidentiality of information, requirements as embodied in the
privacy, etc.) 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
 PROFESSIONAL
DEVELOPMENT
• The professional development key area
includes core competencies of identifying
personal needs for education and pursuing
those goals, participating in professional
organizations and community activities,
presenting a professional image and
positive attitude as well as performing work
duties in a professional manner.
• CORE COMPETENCY 1 • CORE COMPETENCY 2
Identifies own learning needs Pursues continuing education

Indicators: Indicators:
○ Verbalizes strengths, ○ Participates in formal and non-
weaknesses, limitations. formal education.
○ Determines personal and ○ Applies learned information for
professional goals and the improvement of care.
aspirations.
• CORE COMPETENCY 3 • CORE COMPETENCY 4
Gets involved in professional Projects a professional image of
organizations and civic activities nurse

Indicators: Indicators:
○ Participates actively in ○ Demonstrate good manners and
professional, social, civic and right conduct at all times.
religious activities ○ Dresses appropriately.
○ Maintain membership to ○ Demonstrates congruence of
professional organizations words and actions.
○ Support activities related to ○ Behaves appropriately at all
nursing and health issues times.
• CORE COMPETENCY 5 • CORE COMPETENCY 6
Possesses positive attitude Performs function according to
towards change and criticism professional standards
Indicators:
○ Listens to suggestions and Indicators:
recommendations. ○ Assesses own performance
○ Tries new strategies or against standards of practice.
approaches. ○ Sets attainable objectives to
○ Adapts to changes willingly. enhance nursing knowledge and
skills.
○ Explains current nursing
practices, when situations call for
it.
 QUALITY IMPROVEMENT

• In the quality improvement key area, core

competencies include identifying areas for
improvement, participating in nursing
rounds and audits, staying aware of
variances in treatment and recommending
solutions to improve quality.
 • CORE COMPETENCY 2:
Participates in nursing audits and
rounds

Indicators:
Contributes relevant information about
• CORE COMPETENCY 1: patient condition as well as unit
Gathers data for quality improvement condition and patient current reactions
Shares with the team current
Indicators: information regarding particular
Demonstrates knowledge of method patients condition
appropriate for the clinical problems Encourages the patient to speak about
identified what is relevant to his condition
Documents and records all nursing
Detects variation in the vital signs of
care and actions
the patient from day to day
Performs daily check of patient
Reports necessary elements at the
records/condition
bedside to improve patient stay at
Completes patients records
hospital
Actively contributes relevant
Solicits feedback from patient and information of patients during rounds
significant others regarding care thru readings and sharing with others
rendered
• CORE COMPETENCY 3: • CORE COMPETENCY 4:
Identifies and reports variances Recommends solutions to
identified problems
Indicators:
Documents observed variance Indicators:
regarding patient care and Gives appropriate suggestions on
submits to appropriate group corrective and preventive
within 24 hours measures
Identifies actual and potential Communicates and discusses with
variance to patient care appropriate groups
Reports actual and potential Gives and objective and accurate
variance to patient care reporton what was observed
Submits report to appropriate rather than an interpretation of
groups within 24 hours the event.
 RESEARCH

• Core competencies in the research key area

include gathering and analyzing research
data, sharing results and applying findings
to work functions.
• CORE COMPETENCY 1:
Gathers data using different
methodologies

Indicators: • CORE COMPETENCY 2:

Identifies researchable problems Recommends actions for
regarding patient care and implementation
community health
Identifies appropriate methods of Indicator:
research for a particular Based on the analysis of data
patient/community problem gathered, recommends practical
Combines quantitative and solutions appropriate for the
qualitative nursing design thru problem
simple explanation on the
phenomena observed
Analyzes data gathered
• CORE COMPETENCY 3: • CORE COMPETENCY 4:
Disseminates results of research Applies research findings in
findings nursing practice

Indicators: Indicators:
Communicates results of findings Utilizes and findings in research in
to colleagues/patients/family and the provision of nursing care to
to others individuals/groups/communities
Endeavors to publish research •
Submits research findings to own Makes use of evidence-based
agencies and others as nursing to ameliorate nursing
appropriate practice
 RECORDS MANAGEMENT

• The records management key area includes

core competencies of maintaining
appropriate documentation using the
appropriate system and staying within legal
boundaries in the area of patient privacy.
• CORE COMPETENCY 1: • CORE COMPETENCY 2:
Maintains accurate and updated Records outcome of patient care
documentation of patient care
Indicator:
Indicator: Utilizes a record system
Completes updated
documentation of patient care
• 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
 COMMUNICATION
• In this key area, core competencies include
establishing communication with the patient
and treatment team, learning to read verbal
and nonverbal cues, using visual aids and
other resources when necessary,
responding to patient and group needs and
effectively using technology to facilitate
communication.
• CORE COMPETENCY 1:
Establishes rapport with patients,
significant others and members of
the health team. • CORE COMPETENCY 2:
Identifies verbal and non-verbal
Indicators: cues
○ Creates trust and confidence
○ Listens attentively to client’s Indicator:
queries and requests ○ Interprets and validates client’s
○ Spends time with the client to body language and facial
facilitate conversation that allows expression
client to express concern
• CORE COMPETENCY 3: • CORE COMPETENCY 4:
Utilizes formal and informal Responds to needs of individuals,
channels family, group and community

Indicator: Indicator:
○ Makes use of available visual ○ Provides re- assurance through
aids 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
 TEAMWORK

• The teamwork and collaboration key area

includes core competencies of establishing
beneficial working relationships with peers
and colleagues and communicating care
plans with health team members.
• CORE COMPETENCY 1:
Establishes collaborative
relationship with colleagues and • CORE COMPETENCY 2:
other members of the health team Collaborates plan of care with
Indicators: other members of the health team
○ Contributes to decision making Indicator:
regarding patients” needs and ○ Refers patients to allied health
concerns team partners
○ Participates actively in patients ○ Acts liaison / advocate of the
care management including audit patients
○ Recommends appropriate ○ Prepares accurate
intervention to improve patient documentation of efficient
care communication of services
○ 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
 THANK YOU SO MUCH!!!
SEE YOU IN THE SECOND SEMESTER!!!

EDVERLY T. MALANA, RN., MSN.