Related Learning Experiences

Cebu Institute of TechnologyUniversity

College Of Nursing

__________________________________________________________________________________

RELATED LEARING EXPERIENCE

(YOUR NAME HERE!)

C E B U I N S T IT U T E O F T E C H N O L O G Y - U N I V E R S I T Y

__________________________________________________________________________________________

VISION

A world-class academic institution continuously developing highly-skilled, values-driven and competitive Technologians.

MISSION

To provide quality education for the total development of Technologians committed in practicing professionalism and in meeting the demands of local and global communities.

GOALS

As a private, non-sectarian academic institution, Cebu Institute of Technology aims to:

1. Provide early childhood, basic and higher education for the total development of individual students in an academic environment conducive to teaching and learning;

2. Develop instructional, research and community extension programs attuned to the Filipino culture, national goals and global competitiveness with optimum utilization of existing resources, harnessing community involvement and goodwill in its implementation;

3. Provide opportunities for CIT’s academic community, school staff, and students to join hands and help improve the institution as well as its local and global networks;

4. Develop and strengthen the values of leadership, cooperation, collegiality, and respect for human dignity in a culture of peace.

AIMS- College of Nursing

The College of Nursing offers a community oriented competency-based nursing program that applies relevant, responsive and interdisciplinary approaches. It aims to provide quality education to prepare students to become active participants of society’s welfare and advancement in harmony with human values, right and dignity. The College envisions producing globally competitive Technologians nurses who can demonstrate entry-level professional competencies, utilize findings in the practice of the profession and shall continue to assume responsibility for professional development.

CORE VALUES

PASSION FOR EXCELLENCE is total quality in any endeavour by striving to work in the best way that one could.

TEAMWORK AND TENACITY foster cooperation and collegiality in the pursuit of the institution’s mission.

INTERDEPENDENCE is acknowledging the vital role of all sectors in the institution and recognizing the efforts and expertise of colleagues and students.

SPIRIT OF ALTRUISM AND COMMITMENT enhances capacity of persons to give witness to God’s love for mankind.

FOCUSED VALUES

June Passion for Excellence

July Interdependence

August Teamwork and Tenacity

September Spirit of Altruism and Commitment

October Peace and Unity

November Nationalism

December Generosity

January Global Competitiveness

February Love

March Honesty

April Patience and Perseverance

May Care for Mother Earth

NURSE’S PRAYER

Bless me, Lord for I am to begin the day’s work. Teach me to receive the sick in thy name. Give to my efforts success, Sweet Jesus, for the glory of Thy Holy Name. It is thy work, without thee I cannot succeed. Grant that the sick thou have placed in my care be abundantly blessed and not one of them be lost because of anything that is lacking in me. Help me to overcome every temporal weakness and strength in me, whatever that may enable me to bring the sunshine of joy to the lives that are gathered around me day by day. Make me beautiful within for the sake of the sick ones and those whose lives will be influenced by me. Amen.

CEBU INSTITUTE OF TECHNOLOGY UNIVERSITYCollege of Nursing

Related Learning ExperienceReplacement Form

___ Semester SY 201__ - 201__

Name: ____________________________________ Year & Section: ___________________________

SUMMARY OF DUTY

Area Inclusive Dates Remarks No. of Days for Replacement

CI’sSignature

REPLACEMENT SCHEDULE

Date Area Staff Nurse’sSignature

CI’sSignature Remarks

PAYMENT DETAILS

Date : _____________ Total No. of days to be replaced : ____________ Receipt No. : _____________ Total No. of Service Credits : ____________ Amount : _____________ Total No. of pending Extensions : ____________

CEBU INSTITUTE OF TECHNOLOGY-UNIVERSITYCollege of Nursing

L A B O R W A T C H

NAME OF INSTITUTION : ____________________________ GTPAL : ____________________________CASE/HOSPITAL NUMBER : ____________________________ LMP : ____________________________NAME OF MOTHER : ____________________________ EDC : ____________________________AGE : ____________________________ AOG : ____________________________PHYSICIAN (OB) : ____________________________

Time contraction

starts

Time Contraction

EndsDuration Interval Frequency Intensity Dilatation Effacement Fetal Heart

Tone (FHT)

_________________________________ ___________________________________ Name & Signature of Student Name & Signature of Supervising C. I.

CEBU INSTITUTE OF TECHNOLOGY- UNIVERSITYCollege of Nursing

A C T U A L D E L I V E R Y

NAME OF INSTITUTION : ______________________________________________________________________________CASE/HOSPITAL NUMBER : ______________________________________________________________________________NAME OF MOTHER : ______________________________________________________________________________AGE : ______________________________________________________________________________SEX : ______________________________________________________________________________GTPAL : ______________________________________________________________________________LMP : ______________________________________________________________________________EDC : ______________________________________________________________________________AOG : ______________________________________________________________________________DATE OF DELIVERY : ______________________________________________________________________________TIME OF DELIVERY : ______________________________________________________________________________MODE OF DELIVERY : ______________________________________________________________________________DIAGNOSIS : ______________________________________________________________________________

DATE & TIME OF PLACENTAL EXPLUSION : _________________________ T = __________________________TYPE OF PLACENTA : ________________________ P = __________________________

R = __________________________ BP = __________________________

NAME OF BABY : ______________________________________________________________________________CASE/HOSPITAL NUMBER : ______________________________________________________________________________ SEX : ________________________________ HT : ________________________________ T = __________________________ WT : ________________________________ P = __________________________ HC : ________________________________ R = __________________________ CC : ________________________________ MID-ARM : ________________________________

APGAR SCORE : _________________________ BALLARD’S SCORE : _________________________ CREDE’S PROPHYLAXIS : _________________________

PHYSICIAN (OB) : _________________________PHYSICIAN (Pedia) : _________________________Handled by : _________________________Cord Dressed by : _________________________

_____________________________________ _____________________________________ Name & Signature of Student Name & Signature of D. R. Nurse

_____________________________________ ____________________________________ Name & Signature of Supervising C. I. Name & Signature of D. R. Supervisor

CEBU INSTITUTE OF TECHNOLOGY- UNIVERSITYCollege of Nursing

I M M E D I A T E N E W B O R N C A R E

NAME OF INSTITUTION : ___________________________________________________________________________________NAME OF BABY : ___________________________________________________________________________________CASE/HOSPITAL NUMBER : ___________________________________________________________________________________

SEX : ___________________________________HT : ___________________________________ T = ___________________WT : ___________________________________ P = ___________________HC : ___________________________________ R = ___________________CC : ___________________________________MID-AIR : ___________________________________

APGAR SCORE : ___________________________BALLARD’S SCORE : ___________________________CREDE’S PROPHYLAXIS : ___________________________COMPLICATIONS : ___________________________

CASE/HOSPITAL NUMBER : ___________________________________________________________________________________NAME OF MOTHER : ___________________________________________________________________________________AGE : ___________________________________________________________________________________SEX : ___________________________________________________________________________________GTPAL : ___________________________________________________________________________________LMP : ___________________________________________________________________________________EDC : ___________________________________________________________________________________AOG : ___________________________________________________________________________________DATE OF DELIVERY : ___________________________________________________________________________________TIME OF DELIVERY : ___________________________________________________________________________________MODE OF DELIVERY : ___________________________________________________________________________________DIAGNOSIS : ___________________________________________________________________________________

DATE & TIME OF PLACENTAL EXPULSION : ___________________ T = ____________________TYPE OF PLACENTA : ___________________ P = ____________________EPISIOTOMY (specify) : ___________________ R = ____________________

BP = ____________________

PHYSICIAN (OB) : ___________________________PHYSICIAN (Pedia) : ___________________________Handled by : ___________________________Assisted by : ___________________________Cord Dressed by : ___________________________

_________________________________________ ____________________________________ Name & Signature of Student Name & Signature of D. R. Nurse

_________________________________________ ____________________________________ Name & Signature of Supervising C. I. Name & Signature of D. R. Supervisor


M A J O R S C R U B

NAME OF INSTITUTION : ______________________________________________________________________________

NAME OF PATIENT : ______________________________________________________________________________CASE/HOSPITAL NUMBER : ______________________________________________________________________________AGE : ______________________________________________________________________________SEX : ______________________________________________________________________________DATE OF ADMISSION : ______________________________________________________________________________ADMITTING DIAGNOSIS : ______________________________________________________________________________

HISTORY OF PRESENT ILLNESS : ______________________________________________________________ ______________________________________________________________

PERTINENT PHYSICAL EXAM FINDINGS : _____________________________________________________________ _____________________________________________________________

SIGNIFICANT LABORATORY FINDINGS : _____________________________________________________________ _____________________________________________________________

SIGNIFICANT DIAGNOSTIC EXAMS : ____________________________________________________________ _____________________________________________________________

SURGICAL RECORD

DATE OF OPERATION : ____________________ T = _____________________Time started : ____________________ P = _____________________Time ended : _______________________ R = ________________________

BP = ________________________

PRE-OP MEDICATIONS : _______________________________________________________________________TYPE OF ANESTHESIA : _______________________________________________________________________ANESTHETIC AGENT USED : _______________________________________________________________________

OPERATION PERFORMED: ______________________________________________________________________________________________ ________________________________________________________________________________________________

POST-OP DIAGNOSIS : _____________________________________________________________________________________________ ________________________________________________________________________________________________

SURGEON : ____________________SCRUB NURSE : ____________________ STUDENT SCRUB NURSE : _______________________________CIRCULATING NURSE : ____________________ STUDENT CIRCULATING NURSE : _______________________________

__________________________________________ ________________________________________ Name & Signature of Student Name & Signature of O. R. Nurse

__________________________________________ _______________________________________ Name & Signature of Supervising C. I. Name & Signature of O. R. Supervisor


M A J O R C I R C U L A T I N G

NAME OF INSTITUTION : ______________________________________________________________________________

NAME OF PATIENT : ______________________________________________________________________________CASE/HOSPITAL NUMBER : ______________________________________________________________________________AGE : ______________________________________________________________________________SEX : ______________________________________________________________________________DATE OF ADMISSION : ______________________________________________________________________________ADMITTING DIAGNOSIS : ______________________________________________________________________________

HISTORY OF PRESENT ILLNESS : ______________________________________________________________ ______________________________________________________________

PERTINENT PHYSICAL EXAM FINDINGS : _____________________________________________________________ _____________________________________________________________

SIGNIFICANT LABORATORY FINDINGS : _____________________________________________________________ _____________________________________________________________

SIGNIFICANT DIAGNOSTIC EXAMS : ____________________________________________________________ _____________________________________________________________

SURGICAL RECORD

DATE OF OPERATION : ____________________ T = _____________________Time started : ____________________ P = _____________________Time ended : _______________________ R = ________________________

BP = ________________________

PRE-OP MEDICATIONS : _______________________________________________________________________TYPE OF ANESTHESIA : _______________________________________________________________________ANESTHETIC AGENT USED : _______________________________________________________________________

OPERATION PERFORMED: ______________________________________________________________________________________________ ________________________________________________________________________________________________

POST-OP DIAGNOSIS : _____________________________________________________________________________________________ ________________________________________________________________________________________________

SURGEON : ____________________SCRUB NURSE : ____________________ STUDENT SCRUB NURSE : _______________________________CIRCULATING NURSE : ____________________ STUDENT CIRCULATING NURSE : _______________________________

__________________________________________ ________________________________________ Name & Signature of Student Name & Signature of O. R. Nurse

__________________________________________ _______________________________________ Name & Signature of Supervising C. I. Name & Signature of O. R. Supervisor


SUMMARY OF DR-OR CASES PERFORMED

Name of Student : __________________________________ Class : ____________________________ID No. : __________________________________

I. ACTUAL DELIVERIES

Name of Patient Date of Delivery Diagnosis Hospital

1. _____________________ __________________ _____________________________ ___________________________

2. _____________________ __________________ _____________________________ ___________________________

3. _____________________ __________________ _____________________________ ___________________________

4. _____________________ __________________ _____________________________ ___________________________

5. _____________________ __________________ _____________________________ ___________________________

II. IMMEDIATE NEWBORN CARE


1. _____________________ __________________ _____________________________ ___________________________

2. _____________________ __________________ _____________________________ ___________________________

3. _____________________ __________________ _____________________________ ___________________________

4. _____________________ __________________ _____________________________ ___________________________

5. _____________________ __________________ _____________________________ ___________________________

III. MAJOR SURGERIES (SCRUB)


1. _____________________ __________________ _____________________________ ___________________________

2. _____________________ __________________ _____________________________ ___________________________

3. _____________________ __________________ _____________________________ ___________________________

4. _____________________ __________________ _____________________________ ___________________________

5. _____________________ __________________ _____________________________ ___________________________

IV. MAJOR SURGERIES (CIRCULATING)


1. _____________________ __________________ _____________________________ ___________________________

2. _____________________ __________________ _____________________________ ___________________________

3. _____________________ __________________ _____________________________ ___________________________

4. _____________________ __________________ _____________________________ ___________________________

5. _____________________ __________________ _____________________________ ___________________________

I affirm that the above information given by me is true and correct

________________________ ________________________ ___________________________ Printed Name of Student Signature Date

CEBU INSTITUTE OF TECHNOLOGY-UNIVERSITYCOLLEGE OF NURSING

N. Bacalso Avenue, Cebu CityTel # 261-7741 local 134

Website: http://www.cit.edu

http://www.cit.edu/

SUMMARY OF PERFORMANCE EVALUATION ACHIEVINGINTRA-PARTAL CARE COMPETENCY

In according with PRC Board of Nursing Memorandum No. 01, Series 2009

________________________ __________________________ ___________________________ Name of Student Signature Date

INTRA-PARTAL COMPETENCIESDESIREDRATING

1ST

RLE2ND

RLE3RD

RLEAVERAGERATING

I. SAFE AND QUALITY NURSING CARE (SQC)

1. Obtain obstetrical history including parity, gravid score, LMP, EDC, AOG, BOW, onset of true labor. 4

2. Check Vital Signs 13. Conducts Physical Examination. 24. Performs Leopold’s maneuver. 25. Check Fetal Heart Rate and Fundic Height 26. Monitor progress of labor/uterine contractions as to:

Frequency Duration Intensity Interval

1111

7. Observes for the timely rupture of membrane. 18. Coaches mother on process of labor. 2

PERFORMS FUNCTIONS DURING ACTUAL LABOR

1. Transports clients safety while providing privacy. 12. Places mother in lithotomy position. 13. Performs perineal care using sterile technique correctly. 14. Performs proper hand scrub. 15. Wears gown and gloves according 16. Performs Ritgen’s Maneuver safely. 27. Coaches mother on breathing pushing techniques. 18. Deliver baby and placenta carefully.

Checks and manages cord recoil correctly. Clamps and cuts the cord accordingly. Identify signs of placental separation. Checks the characteristic/ completeness of the placenta.

1111

9. Assesses amount of blood loss (Normal <500 cc) 210. Employs interventions to achieve and maintain a well contracted uterus to prevent/ control hemorrhage.

Uterine massage. Correct administration of Oxytocin Cold compress.

111

11. Assesses presence and degree of laceration. 112. Assists in episiorrhaphy. 113. Checks, size, consistency and location of uterus. 114. Performs perineal care and applies pad correctly. 115. Provides emotional support to the mother throughout labor and delivery. 116. Evaluates patient’s condition and records pertinent data accordingly. 217. Prepares patient for transfer to recover room/ ward. 1

INTRAPARTAL COMPETENCIESDESIRE

DRATING

1ST

RLE2ND

RLE3RD

RLEAVERAGERATING

II. MANAGEMENT OF RESOURCES, ENVIRONMENT AND EQUIPMENT (MRE)1. Prepares room, instruments, and equipment needed.

Sterile drape Sterile instruments and equipment [forceps, scissors, bulb, syringe, gauge,

suture, needle holder, catheter (optional)]. Kelly pad Disinfectant

11

11

2. Performs sterilization procedure. 13. Maintains adequacy of supplies as the delivery progresses. 14. Maintain orderliness of the sterile table. 15. Observe precautionary measures related to use of electrical equipment. 16. Ensure a quiet environment. 17. Uses supplies diligently. 18. Performs after care of the materials and equipments used. 19. Ensure proper disposal of hospital waste including blood and other fluids. 1

III. HEALTH EDUCATION (HE)

1. Teaching clients on basic preparations during labor and delivery. (Can be done in the labor room). 1

2. Coaches client on breathing/ bearing down technique. 23. Demonstrate proper “latch-on” breast-feeding technique. (done post-partum period) 14. Gives instructions to parents regarding infant care before discharge. (done post-partum period) 1

5. Provides discharge instructions as to feeding, bathing, administration of ordered medications, appointment dates for past natal and well baby check-up. (done post-partum period)

1

6. Responds to questions of clients and relatives regarding expectations. 1

IV. LEGAL RESPONSIBILITIES (LR)

1. Secure informed consent in all procedures related to labor and delivery. 12. Report accurately and honestly the gender,thime of delivery of the baby and placenta. 2

3. Ensure proper identification of the mother and newborn. 24. Documents all pertinent data correctly and completely. 1

V. ETHICO-MORAL RESPONSIBILITIES (EMR)

1.Respect the religious, cultural and ethnical practices of the family of the woman in labor and delivery. 1

2. Promotes emotional security by supporting needs. 13. Ensure privacy and confidentiality. 1

VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)

1. Updates oneself with the latest trends and development in labor and delivery. 12. Projects a professional image of a delivery room nurse. 13. Accepts criticisms according to standards. 14. Performs functions according to standards. 1

VII. QUALITY IMPROVEMENT (QI) (preferably done during post conferences.)

1. Identifies deviation of practice from the standards. 12. Participates in audit practices in the delivery room/ lying- in. 13. Recommends corrective and preventive measures for the identified deviations. 1

VIII. RESEARCH (R) (preferably done during post conferences.)

1. Identifies researchable problems related to labor and delivery. 22. Utilize findings of research studies in intra-partal care. 2

IX. RECORDS MANAGEMENT (RM)

1. Documents accurately relevant data about client. 12. Maintains an organized system of filling and keeping records of the client. 1

INTRAPARTAL COMPETENCIESDESIRE

D RATING

1ST

RLE2ND

RLE3RD

RLEAVERAGERATING

X. COMMUNICATION (Comm)

1. Utilizes appropriately all forms of communication; verbal, non-verbal electronic. 12. Inform client’s significant others of the progress of labor and delivery. 13. Listen attentively to clients and families queries and requests. 1

XI. COLLABORATION AND TEAMWORK (CTW) 1

1. Functions effectively as a team player in the delivery room/ lying-in. 12. Communicate the progress of labor/ delivery to significant others. 13. Establishes collaborative relationship with members of the health team and family members. 1

TOTAL SCORE: 90

When graded RLE performed (specify Academic Year and Semester):

First Graded RLE : Academic Year _________ 1st Semester ( ) 2nd Semester ( ) Summer ( )Clinical Instructor : Name ____________________________ Signature ________________

License Number ____________________________ Validity ________________

Second Graded RLE: Academic Year _________ 1st Semester ( ) 2nd Semester ( ) Summer ( )Clinical Instructor : Name ____________________________ Signature ________________


Third Graded RLE: Academic Year _________ 1st Semester ( ) 2nd Semester ( ) Summer ( )Clinical Instructor : Name ____________________________ Signature ________________


Fourth Graded RLE:Academic Year _________ 1st Semester ( ) 2nd Semester ( ) Summer ( )Clinical Instructor : Name ____________________________ Signature ________________


Academic Year Graduated : ________________

Verified True and Correct:

________________________________________ _________________________________Signature over printed name of Clinical Instructor Signature over printed name of the Dean

License Number : ____________________ License Number : ________________Validity : ____________________ Validity : ________________




SUMMARY PERFORMANCE EVALUATION ACHIEVING IMMEDIATE CARE OF THE NEWBORN COMPETENCY

In accordance with PRC Board of Nursing Memorandum No. 01, Series 2009

___________________________ _______________________________ ________________________ Name of Student Signature Date

NEWBORN COMPETENCIES DESIRED RATING

1ST

RLE2ND

RLE3RD

RLEAVERAGE RATING

I. SAFE AND QUALITY CARE (SQC)

1. Puts on double gloves aseptically. 12. Provides warmth by during the newborn immediately and thoroughly

Stimulates the baby to cry by massaging the baby’s back. Checks quickly newborn’s breathing.

3

3. Facilities bonding through skin to skin contact. Places newborn on mother’s abdomen on prone position to facilitate

drainage. Covers the baby with blanket Observe skin to skin contact for a minimum of 30 minutes.

2

11

4. Ensure proper identification of newborn (name tag: name of mother, gender of baby, date and time of delivery, name of attending physician; foot printing).

Places ID band to left ankle.2

5. Removes 1st set of gloves aseptically. 16. Assists the physician in clamping and cutting the cord

Cord cutting and clamping should be done when the cord pulsations stop or between 1 to 3 minutes from birth.

3

7. Initiates breastfeeding and maintains mother-baby’s skin to skin contact 38. Performs and interprets APGAR scoring correctly immediately after delivery and after 5 minutes. 3

9. Applies CREDE’s prophylaxis on the eye. 110. Takes vital signs (temperature is taken from rectum to check patency). 111. Perform physical assessment. 212. Takes anthropometric measurements including weight, height, head, chest and abdominal circumference. 1

13. Administers vitamin K (1mg) IM into the lateral anterior thigh or vastus lateralis. 114. Records pertinent observations and nursing care done. 215. Reports any signs of deviations/ abnormalities to the paediatrician 1

II. MANAGEMENT OF RESOURCES, ENVIRONMENT AND EQUIPMENT (MRE)

1. Prepares the instrument and equipment needed Cord clamp, blanket, Vitamin K, ophthalmic ointment. 4

2. Ensures use of sterile equipment during immediate care of newborn 13. Maintains adequacy of supplies as newborn care is rendered. 14. Maintains orderliness of the working area. 15. Observes precautionary measures related to use of electrical equipment. 16. Ensures a warm and quiet environment. 17 Uses supplies diligently. 18. Ensures proper disposal of hospital waste. 1

http://www.cit.edu/

NEWBORN COMPETENCIES DESIRED RATING

1ST

RLE2ND

RLE3RD

RLEAVERAGE RATING


1. Provides instruction to the mother on daily cord care and prevention of the cord infection. 2

2. Provides discharge instructions to the mother to report signs of cord infection. 13. Provides information regarding newborn screening, immunization, proper, breastfeeding, etc. 2

4. Responds to questions of mother and relatives regarding expectations. 1

IV. LEGAL RESPONSIBILITES (LR)

1. Identifies newborn by comparing ID band with data in the chart. 22. Document all pertinent data correctly and completely. 13. Reports accurately any deviations/ abnormal findings and nursing intervention rendered. 1

4. Ensure that birth certificate and other civil registration forms are accomplish/ filled out according to institutional policy. 2

5. Performs foot printing according to hospital policy. 1

V. ETHICO- MORAL RESPONSIBILITIES (EMR)

1. Respect the religious, cultural and ethnical practices of the family of the newborn. 12. Maintains privacy and confidentiality of findings of assessment. 1

VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)

1. Updates oneself with the latest trends and development in newborn care. 12. Projects a professional image of a pediatric nurse. 13. Accepts constructive criticisms and recommendations. 14. Performs functions according to standards. 1

VII. QUALITY IMPROVEMENT (QI)

1. Identifies deviation of practice from the standards. 12. Participates in audit practices in the nursery. 13. Recommends corrective and preventive measures for the identified deviations. 1

VIII. RESEARCH (R)

1. Identifies researchable problems related to immediate care of newborn. 12. Initiates a study on an identified researchable problem. 13. Participates as a member of a research team in the conducted of a research study. 14. Utilizes findings of research studies in the immediate care of the newborn. 1

IX. RECORDS MANAGEMENT (RM)

1. Documents accurately relevant data about newborn. 12. Maintains an organized system of filling and record keeping 1

X. COMMUNICATIONS (Comm)

1. Utilizes appropriately all forms of communication; verbal, non-verbal electronic. 12. Maintains an open line of communications with the mother and other family members. 1

3. Informs mother of relevant information about the newborn. 14. Listen attentively to queries and requests of the mother and family members. 1

XI. COLLABORATION AND TEAMWORK (CTM)

1. Function effectively as a team member in the nursery. 12. Communicates findings of assessment to all concerned. 13. Establishes a collaborative relationship with members of the health team and family of the newborn. 1

TOTAL SCORE: 75

















SUMMARY PERFORMANCE EVALUATION ACHIEVINGINTRA-OPERATIVE CARE COMPETENCY

In accordance with PRC Board of Nursing Memorandum No. 01, Series 2009

___________________________ _______________________________ ________________________ Name of Student Signature Date

INTRA- OPERATIVE CARE COMETENCIES DESIRED RATING

1ST RLE

2ND RLE

3RD RLE

AVERAGE RATING

I. SAFE AND QUALITY NURSING CARE (SQC)

1. Utilizes the nursing process in the care of OR client:a) Obtains comprehensive client’s information by checking complete

accomplishment of the preoperative checklist. Client’s chart.b) Identifies priority needs of the client at the Operating Room.c) Provides needed nursing interventions based on identified needs.d) Monitors client’s responses to surgery.

4

442

2. Promotes safety and comfort of patients inside the OR. 23. Performs the functions of the scrub nurse:

a) Performs surgical scrub correctly.b) Wears sterile gown and gloves aseptically.c) Prepares surgical instruments, sponges, sutures, and other supplies in the

functional arrangement.d) Hands instruments, sponges, sutures, and other needed materials

according to surgeon’s preference.e) Performs surgical count accurately.

422

2

24. Performs the functions of the circulating nurse:

a) Anticipates the needs of the surgical team.b) Sets up the OR room needed equipment.c) Receives client for surgery/ endorses client post- operatively.d) Assists in skin preparation and draping of client.

2222

5. Administers medications and other health therapeutics safety. 2

II. MANAGEMENT OF RESOURCES AND ENVIRONMENT (MRE)

1. Organizes work load to facilitate timely patient care. 42. Utilizes adequate and appropriate resources to support the OR team. 23. Ensures functionality of the OR resources. 24. Maintain a safe environment at the OR by observing the principles of asepsis. 2


1. Implements appropriate health education activities to client based on needs assessment. 2

IV. LEGAL RESPONSIBILTIES (LR)

1. Adheres to legal and institutional protocols regarding informed consent. 2

V. ETHICO-MORAL RESPONSIBILITIES (EMR)

1. Respect the right of the OR client. 22. Accept responsibility and accountability for own decisions and actions as an OR nurse. 2

http://www.cit.edu/

INTRA-OPERATIVE CARE COMPETENCIES DESIRED RATING

1ST

RLE2ND

RLE3RD

RLEAVERAGE RATING

VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)1. Performs OR functions according to professional standards. 42. Possesses positive attitude towards learning surgical and OR- related knowledge and skills. 2

VII. QUALITY IMPROVEMENT (QI)

1. Participates in quality improvement activities related to infection control and successful OR operations. 2

2. Identifies and reports variances in sterility and other OR activities. 2

VIII. RESEARCH (R)

1. Disseminates results of OR-related research findings to clinical group and other members of the OR team as appropriate 2

IX. RECORDS AND MANAGEMENT (RM)

1. Maintain accurate and updated documentation of patient care. 1

X. COMMUNICATIONS (Comm)

1. Establishes rapport with patients, significant others and members of the health team. 1

2. Uses appropriate information mechanisms to facilitate communication inside the OR and with other departments in the hospital 2

XI. COLLABORATION AND TEAMWORK (CTM)

1. Collaborates plan of care with other members of the health team. 2

TOTAL SCORE 75












