NURSING CORE COMPETENCY REVISITING PROJECT

CURRENT NURSING CORE COMPETENCIES REVISED NURSING CORE COMPETENCIES

Among the mandated functions of the Board of Nursing is to ensure that the Nursing Core Competencies needed for nursing standard development for both nursing education and practice/service are in place and are implemented well through a monitoring and evaluation scheme. Legal Basis of Core Competency Standards Development: Legal Basis of Core Competency Standards Development: Cognizant of the important role of the 2 million professionals all over the country, Republic Cognizant of the important role of Filipino professionals all over the country, Republic 8981 Republic Act 8981 was created. Section 2 of the said law states: No. 8981 (The PRC Modernization Act of 2000). was created. Section 2 Statement of Policy of the said The state recognizes the important role of professionals in nation building and towards this end law states: promotes the sustained development of a reservoir of professionals whose competence has been The state recognizes the important role of professionals in nation building and towards this end determined by honest and credible licensure examinations and whose standards of professional promotes the sustained development of a reservoir of professionals whose competence has been service and practice are internationally recognized and considered world-class brought about by determined by honest and credible licensure examinations and whose standards of professional service regulatory measures, programs and activities that foster professional growth and advancement. and practice are internationally recognized and considered world-class brought about by regulatory Likewise, Art. 3 Sec. 9 of R.A. 9173 known as the Philippine Nursing Act of 2002 states, measures, programs and activities that foster professional growth and advancement. The Board shall monitor and enforce quality standards of nursing practice necessary to Art. 3 Sec. 9 (c) of R.A. 9173 known as the Philippine Nursing Act of 2002 states, ensure the maintenance of efficient, ethical and technical, moral and professional standards in The Board shall monitor and enforce quality standards of nursing practice necessary to ensure the the practice of nursing taking into account the health needs of the nation maintenance of efficient, ethical and technical, moral and professional standards in the practice of nursing taking into account the health needs of the nation On the regional and international arena, competency standards are already in place for more than Developments (Local & International) In The Nursing Profession That Contributed To The a decade. The Regulatory Authorities of the Western Pacific and Southeast Asian regions for Decision To Revisit The Core Competencies which the Philippine Board of Nursing is a member has well-defined regional competency 1. During the development of the revised BSN Curriculum the following were noted: standards that were promulgated in 2004. Moreover, the International Council of Nurses has There was a need to incorporate competencies focusing in Health Promotion competency standards for the generalist nurse. These local, regional and international standards For CHN competencies on the care of the family, population group and community as a client, and prompted the development of the core competency standards for nursing practice in the PHC were not included Philippines. There was also a need to emphasize care of the older person, disaster preparedness etc. Some indicators had broader scope compared to the competencies 2. Regarding the NLE RESULTS decrease in national passing percentage has been noted. The e various contributory factors needed to be explored. 3.For Nursing Educators there was a need to strengthen implementation of curriculum and improve knowledge of the core competencies and teaching methodology used in the competency based approach 4. Many Nursing Practitioner - not aware of the expected core competencies 5. International Developments in Nursing Emphasis in the development of nursing competencies was noted. To name a few: ASEAN Nursing Core Competencies WHO Nursing of Curriculum Guidelines , Public Safety Guidelines and Patient Safety Guidelines WP/SEAR Core Competency Standards ICN Core Competency Standards 6. Another significant milestone in Philippine Nursing was the development of the Nursing Profession Roadmap towards Good Governance. The vision, mission, core values, objectives and the various

initiatives to be undertaken to achieve the objectives were spelled out. The following are the initiatives: I. Professionalism and Self-regulation Core Values Program Positive Practice Environment Program Nurse Watch Nursing Image State of Philippine Nursing II. Nursing Human Resource Management Program Competency Enhancement for Education and Service Functional Integration between Education and Service National Career Progression Plan Nursing Management Information System (NMIS) Deployment Program of Nurses III. Nurse-led Centers Primary Health Care Independent Nursing Practice IV. Regulation of Nursing Practice Standard Practice Guidelines Review of the Nursing Law & other related Laws V. A Center for Nursing Governance Set up the Office of Strategy Management (OSM) Nursing Organizations Roadmap & Scorecard Alignment Resource Generation for Philippine Nursing Development

The Conceptual Framework of the Core Competency Standards Development:

Design Core Competency Standards Policy Formulation by the BON Document Analysis/Survey

The Competency-based Framework utilized in the Nursing Core Competency Standards Revisiting Project:
The Competency-based Approach to Curriculum Design* Scenario-Setting: Analysis of the Work Setting (Current and Projections)
National/Regional and Local Professional Roles Required in the Scenarios Workforce Demographic Profile Professional Responsibilities to Health Picture Implement each Role Socio-PoliticalCultural Context Professional Tasks to carry out each Responsibility

Benchmarking with Regional Core Competency Standards

Practitioner
Researcher
Manager/Leader

Pilot Test the Core Competencies Regional and National Consultation

Verification of Core Competencies

Immersion into the World of Nursing

Focus Group Discussions

Identify Core Competencies Phases

DACUM WORKSHOP Activities

Figure 1. Conceptual Paradigm in Developing Core Competency Standards for Nursing Practice in the Philippines. (Adopted from Decker Walkers Naturalistic Model in Curriculum Development)

SKA Analysis Skills, Knowledge, and Attitudes/Values per Task/Responsibility Bases for Selecting Learning Experiences (e.g. Professional Competencies Practicum/R.L.E.) (reflecting the SKA required to function in the Position Role) Student Competencies

Professional Competencies (reflecting the SKA required to function in the Position Role)
Student Competencies

Entry Competencies Terminal competencies of previous/earlier course/year level Determined through Pre-requisite test

Intermediate Competencies Within course work (e.g. unit/lesson)

Terminal Competencies Should be congruent with requisites of work setting/professional competencies

Determined through Determined through Progress Test (e.g. performance unit exam or quiz) evaluation/post test or achievement exam

The National Task Force on Core Competency Standards Development: Chairperson: MDelia M. Llanes, Member, Board of Nursing Members: Carmelita D. Divinagracia, President, ADPCN Amelia B. Rosales, Governor, PNA Ma. Linda G. Buhat, Preident, ANSAP Lydia Cabigao, Member, IRNUP Annabelle R. Borromeo, (Administrator) Consumer group Various institutions, both government and non-government, professional organizations, professionals as well as consumers in nursing practice specifically physicians, administrators, patients and senior nursing

Composition of the Initial Task Force on Nursing Core Competencies Revisiting Project: Carmencita M. Abaquin Project lead BON Members: Mila Dellia M. Llanes Chair Core Comp. Com. 01-05 Yolanda C. Arugay Araceli S. Maglaya UPM-CN Leonila A. Faire Leonora Reyes - ADPCN Betty F. Merritt Nancy Lacerna ANSAP Pearl G. Po Teresita I. Barcelo - PNA Amelia B. Rosales Marilyn D. Yap CHED-TCNE Marco Antonio C. Sto. Tomas Weny .Udtujan MHD

students were involved in the development of the core competency standards.

EXPANDED CORE TEAM MEMBERS: Carmelita C. Divinagracia Lydia Palaypay Elizabeth Roxas Larry Tagalog HOSPITAL BASED RESEARCH TEAM Annabelle Borromeo Mila Delia M. Llanes Eden E. Cacanindin Deogracia M. Valderrama Amelia B. Rosales Araceli O. Balabagno Merline S.Pocesion Remedios L. Fernandez COMMUNITY BASED RESEARCH TEAM Araceli S. Maglaya Erlinda C. Palaganas Luz Barbara P.Dones Milabel Ho Weny Udtujan Cynthia Ybarola COORDINATORS FOR LUZON, VISAYAS, MINDANAO Merline S. Pocesion Milabel Ho Erlinda C. Palaganas
CONSENSUAL VALIDATION TEAM: ZAMBOANGGA (Region XII, ILOILO (Region VI and VII) XIII, ARRM) Merline S.Pocesion- Coord. Milabel Ho Coord Araceli S. Maglaya Aracelli S.Maglaya Luz Barbara P.Dones Luz Barbara P.Dones Remedios L. Fdernandez Mila Delia M. Llanes Leonila A. FRaire Pearl G. Po Amelia B. Rosales Carmencita M.Abaquin Marco Antonio C. Sto. Tomas Carmencita M. Abaquin In Coord. with University of Western Mindanao State In Coord with West Visayas State University and Regional University and Regional PNA and PNA and ADPCN ADPCN Participated by nurses in Participated in by nurses in academe academe and those in hospital and community nursing services BAGUIO(Region 1, 2, 3 & CAR) Erlinda C. Palaganas Coord. Betty F. Merritt Amelia B. Rosales Yolanda C. Arugay Carmencita M. Abaquin In Coord with the Philippine Nursing Research Society, and Regional PNA and ADPCN Participated in by nurses in academe and those in hospital and community nursing services

RESEARCH /STATISTICS TEAM Rita C. Ramos Sheila Bonito Annabelle R. Borromeo FORMATTING TEAM Araceli S. Maglaya Annabelle R. Borromeo Eden E. Cacanindin Luz Barbara P.Dones

Araceli O. Balabagno Mila Delia M. Llanes Pearl G. Po Yolanda C. Arugay Marco Antonio C. Santo Tomas

Carmencita M. Abaquin Amelia B. Rosales Betty F Merritt Leonila A. Faire

The Process of Core Competency Standards Development The development of the core competency standards was a joint effort between the Professional Regulation Commission- Board of Nursing and the Commission on Higher Education-Technical Committee on Nursing Education (TCNE). The project started in June 2001 with a DACUM workshop and was completed in February 18, 2005. Board of Nursing Resolution # 112 series of 2005 adopted and promulgated the core competency standards for implementation by nurses in the country. The process involved five phases of development: (1) identifying the competencies; (2) validating the competencies; (3) pilot testing the competencies; (4) benchmarking; and (5) designing the competencies Methods Used: The Developing a Curriculum (DACUM) approach, which is a small group consensus building was used to identify the core competencies that must be demonstrated by a beginning nurse. This was augmented by a series of focus group discussions (FGD) that were conducted among consumers of nursing services like doctors, administrators and physicians. Verifying the competencies was done through survey questionnaires specifically the Nursing Core Competency Inventory (NCCI). Pilot testing tool was the Senior Nursing Students Core Competency Inventory (SNSCCI), and the tool used for benchmarking was Core Competency Development Process Tool (CCDPT) for the Chief Nurse Executives of New Zealand Nursing Council, Australian Nursing

The Processes Undertaken in the Nursing Core Competency Revisiting Project

Part I of Revisiting of the Core Competencies Phase I Work-setting Scenario Analysis (Feb. 2010). Guide Questions: o Based on the current worksetting scenario analysis, specify the health and health care scenarios that the nursing profession can help create in 5 to 7 years? In 8 to 10 Years? o What precise contributions of graduates f the BSN program can help create the health and health care scenarios of specific time targets? o Given these contributions, specify the major professional nursing roles that graduates of the BSN program should perform to help create the health and health care scenarios at specific time targets o Work setting scenario inputs and analysis. The expected output: creation of health and health care scenarios affecting the nursing profession; identification of their roles and the responsibilities needed to perform each role

Phase II A-C Validation studies of roles and responsibilities, tasks for each role. (June , Nov. 2010 and Jan. 2011)
Validation strategies of the identified nurses roles. Methodology focus-group discussion, Participant Observation, Modified Delphi. Clinical Exemplar Wider coverage Luzon, Visayas, Mindanao Hospital Setting Tertiary, Secondary Community Setting Public Health, Clinics/ Centers Occupational Nursing Settings Capsule Project Proposal Coordinators For Visayas And Mindanao DR. MERLINE S. POSECION VISAYAS DR. MILABEL E. HO MINDANAO Phase II A Presentation of Validation Studies were undertaken by: Tertiary Hospital Prof. M.D. Llanes, Dr. T.I.Barcelo, Mrs. M.R.V. Tamse Community Urban Prof. L.B. P. Dones and Ms. W. Udtuhan 6

Council and HongKong Nursing Council.

Tertiary Hospital Dean D. M. Valderrama Hospitals (varied levels) - ANSAP PHASE II B: Presentation of Validation Studies were done by Community Rural Dr. Erlinda C. Palaganas Community Rural Dr. Milabel E. Ho Tertiary Hospital Dr. Eden Cacanindin Tertiary Hospital Dr. Annabelle R. Borromeo Phase II C: Presentation of Validation Studies were done by: Hospital Secondary and Tertiary Dr. Merline S, Posecion Community Rural Prof. Luz Barbara P. Dones Occupational Health Nursing Settings OHNAP Ms. Cynthia Ybarola Tertiary Hospital Prof. Mila Delia M. Llanes Phase II D: Benchmarking of competencies with other countries, comparing finalization of design, development of training modules Phase IIIA Integrative review of outputs from the validation strategies. 1. Workshops to do the following for each task: Specify the skills needed to perform each task, identify the knowledge needed to perform each skill, list the values and attributes needed to perform the skills. Specify the condition/s under which the skills, knowledge and attitudes are to be demonstrated as competencies 2. Presentation of Field Validation Analysis on Nurse Competencies by Roles & Work Setting 3. Presentation of outputs by the Research Teams: Community based Research Team Hospital based Research Team Phase III B - These includes: Consolidation of Parts I and II and Phase III A Outputs and Content Validity Determination Identification of Roles : Beginning Practitioner Role Beginning Manager-Leader Role Beginning Researcher Roles Phase III C Initial Presentation of Core Competency List (August 24, 2011) Phase IV A Core Competency Consensual Validation (Mindanao, Iloilo,and Baguio ) Sept.Oct. 2011 Phase IV B Presentation of Consolidated Outputs of the Consensual Validation and the Statistical Implications (Oct- Nov. 2011) 7

Eleven Key Areas of Responsibility There were eleven key areas of responsibility that were identified by the group of experts and consumers of nursing services. These include the following: Safe and quality nursing care Management of environment and resources Health education Legal responsibility Ethico-moral responsibility Quality improvement Research Personal and professional growth and development Record management Communication Collaboration and team work

Phase IV C - Finalization of Outputs by the Formatting Team ( Nov. Dec. 2011) Phase V A Public Hearing Mindanao, Iloilo, Baguio, NCR) (Jan.- Feb. 2012) Phase V B - Promulgation of Nursing Competency Standards by the BON (Feb. 2012) Phase V C - Printing and Dissemination of Revised Nursing Core CompetencyStandards (Feb.2012) Phase VI A - Training workshop Harmonization of Competency Standards by Nursing Professional Organizations. (2nd 3rd Quarter of 2012) Phase VI B - Implementation of Nursing Core Competencies (4th Quarter 2012 2013) Phase VI C - Summative Evaluation of Nursing Competency Standards by 2014-2015. ROLES AND RESPONSIBILITIES OF THE BEGINNING RN/FIRST LEVEL POSITION ROLES RESPONSIBILITIES KEY AREAS OF RESPONSIBILITY 1. Practices in accordance with the Code of Ethics Legal Responsibility Legal Resp.: Beginning in making personal and professional judgment. Ethico-Moral Resp. Communication Practitioner
2. Utilizes the nursing process in the interdisciplinary care of clients reflecting ethicolegal-moral and spiritual dimensions that empower the client and promote safe, and highquality care. Maintains complete, accurate and up-to-date recording and reporting system Safe Quality Care Ethico-Moral Resp Legal Resp. Communication Health Education Collaboration & teamwork

3. 4. 5. Beginning Manager/ Leader Role 1.

Establishes collaborative relationship with colleagues and other members of the team to enhance nursing and other health care services. Promotes professional and personal growth and development. Demonstrates management and leadership skills to provide safe and quality care. Demonstrates accountability for practice.

Record Management Communication Legal Responsibilities Teamwork and Collaboration Communication Personal and Professional Development Communication Management of Quality Improvement Resources & Collaboration and Environment Teamwork Communication Management of Legal Resp. Resources & Communication Environment Quality Improvement Ethico-Moral Resp.

2.

ROLES Beginning ManagerLeader Role Cont.

RESPONSIBILITIES
3. Demonstrates management and leadership skills to deliver health programs and services effectively to specific client groups in the community setting Manages a community / village-based health facility/component of a health program or a nursing service Demonstrates ability to lead and supervise nursing support staff. Utilizes appropriate mechanisms for networking, linkage building and referrals

KEY AREAS OF RESPONSIBILITY

Management of Resources & Environment Communication Management of Resources & Environment Quality Improvement Management of Resources & Environment Communication Management of Resources & Environment Quality Improvement Research Collaboration and Teamwork Quality Improvement Research Collaboration and Teamwork Research Quality Improvement Communicatio n Quality Improvement Ethico-Moal Resp. Legal Resp. Collaboration & Teamwork Communication Collaboration and teamwork Quality Improvement Collaboration and Teamwork Communication Ethico-Moral Resp. Legal Resp. Communication Communication Ethico-Moral Resp. Legal Resp. Collaboration and Teamwork Ethico-Moral Resp. Legal Resp.

4.

5.

6.

Beginning Researcher Role

1.

Engages in nursing or health related research with or under the supervision of an experienced researcher.

2.

Critiques a research study/report

3.

Applies the research process in improving patient care

CMA DEC. 21, 2011