Leadership: Enhancing the Leadership: Enhancing the OR Nurse Competencies OR Nurse Competencies
towards Global Proficiencytowards Global Proficiency
Maria Linda G. Buhat, RN, Ed.D.PHC-Asst. Director for Nursing Service
4141stst Annual Convention and Scientific Meeting Annual Convention and Scientific MeetingJuly 5, 2015July 5, 2015
Disclosure
ReferencesReferences
Department of Health, Philippines (DOH) Patricia Benner. Retrieved from http://www. currentnursing.com/nursing_theory/Patricia • http://www.brainyquote.com/quotes/keywords/
competence.html#ubGCOLcIlDsKUceI.99
Definition of CompetenciesDefinition of Competencies
• The specification of knowledge and skills, and the application of such knowledge and skills, within an occupation or industry level, to the standard of performance required in employment
Definition of CompetenciesDefinition of Competencies
• The combination of skills, knowledge attitudes and attributes needed to carry out a task or job to a defined performance standard
• The critical characteristics that cause or predict outstanding job performance
• Include personal characteristics, motives, self-concept, knowledge, and behavioral skills
The competency-based approach to defining performance and development is
premised on the use of critical characteristics that predict outstanding job
performance – behaviors that are consistently demonstrated at the
workplace so that success is assured.
GloballyGlobally
• Competency certification is the trend to promote culture of safety
CertificationCertification
• Gain credibility and recognition from colleague, patient and physician
• Personally gain confidence in their skill
• Knowledgeable of the current standard
Asean Qualifications Reference Framework (AQRF)
8
1
2
34
5
6
7
123456
78
9
12
34
5
6
7
Qualifications(A)
Qualifications(B)
Country(A)
Country(B)
AQRF
8
LEVEL 6
KNOWLEDGE, SKILLS AND VALUES
Graduates at this level will have a broad and coherent knowledge and skills in their field of study for professional work and lifelong learning
APPLICATION Application in professional work in a broad range of discipline and/or for further study
DEGREE OF INDEPENDENCE
Independent and /or in teams of related field
QUALIFICATION TYPE Baccalaureate Degree
LEVEL 7
KNOWLEDGE, SKILLS AND VALUES
Graduates at this level will have advanced knowledge and skills in a specialized or multi-disciplinary field of study for professional practice, self-directed research and/or lifelong learning
APPLICATION Applied in professional work that requires leadership and management in a specialized or multi-disciplinary professional work and/or research and/or for further study
LEVEL 7
DEGREE OF INDEPENDENCE
Independent and or in teams of multidisciplinary
QUALIFICATION TYPE Post-Baccalaureate Program
TESDATESDA
HIGHER HIGHER EDUCATIONEDUCATION
POST BACCALAUREATE
DOCTORAL AND POST DOCTORAL
BACCALAUREATE
NC I
G12
10
The Philippine Qualifications The Philippine Qualifications FrameworkFramework
BASIC BASIC EDEDL 8
L 7
L 6
L 5
L 4
L 3
L 2
L 1
DIPLOMA
NC III
NC II
NC IV
(Approved by the NEDA SDC-Cabinet on May 18, 2012)(Approved by the NEDA SDC-Cabinet on May 18, 2012)
Legal Basis: DOH Mandate
EO No. 102 s. 1999: “Redirecting the Functions and Operations
of the Department of Health”
Section 3. Powers and Functions k) Ensure quality of training and health human resource development at all levels of the health care system
Rationale
•Improve the quality of delivery of health services through an upgrading of competencies of nurses in health facilities
•Standardize training programs in clinical and public health nursing areas through a system of competency-based development
•Increase employability and opportunities of certified nurses
The DOH Nurse Certification Program (DOH-NCP)
• Program was launched last November 23, 2012
Objectives:1.Standardize clinical competencies in various
specialty areas2.Address competency gaps3.Improve delivery of nursing care
Issuances
• Department Order No. 2012-0181 “Guidelines on the Department of Health Nurse Certification Program”, dated October 15, 2012
• Department Order No. 2013-0100 “Operational Guidelines on the Implementation of Department of Health Nurse Certification Program (DOH NCP) in Designated Hospitals”, dated July 23, 2013
What DOH-NCP is What DOH-NCP is NOT
A DOH- initiated and supervised system of developing and certifying nurses based on a set of standard competencies in specific specialty areas.
A competency-based development program that will address the ‘skills gap’ of nurses
•Employment •A solution to unemployment
•A training program•A Volunteer program•A program for nurse specialist training
•A guarantee for local or international employment
•An ICN equivalent to nurse specialization
DOH Nurse Certification DOH Nurse Certification Program TheoryProgram Theory
CAUSAL INTERVENTION OUTCOME
• 'Competency gaps' of nurses entering the workforce
•Lack of standard competencies as basis for training nurses at the workplace
• Competency based assessment, development and certification of nurses in standard workplace competencies
• Improve competencies of nurses in the health facilities
•Improve quality of health services delivery
•Increase employment opportunities for certified nurses
DOH Nurse Certification Program Competency Framework
Level 5
Level 4
Level 3Level 3 Certified (through an assessment process of Level 3 competencies)
Level 4 Certified (through an assessment process of Level 4 competencies)
Entry-level Competencies (Level 2), with DOH-identified qualifications
Stage 1 of Development, to produce a Nurse with the necessary Core (Level 3) Competencies for a particular Specialty AreaOn entry: Pre-Specialty Training and Assessment
Stage 2 of Development, to produce a Nurse with Level 4 Competencies for chosen Specialty and Sub-Specialty Area
Stage 3 of Development, to produce a Nurse with the highest possible level of Competencies in a Specialty Area and in Management
DOH Nurse Certification Program Competency Framework
12mos 21mos18mos6mos 24mos0yrs
• Competency-based development that will be standardized across all DOH hospitals • With level progression: Levels 1-2 – General Nursing; Levels 3-5 – Specialty Nursing • Assessment of competencies is a major part of the implementation • Certification will be based on the competencies demonstrated and applied in the workplace • Creates a pool of DOH-certified nurses
• Provides nurses options for different career paths
Ward & OR nursing I Ward & OR nursing II
Renal I Renal II Renal III
Cardio I Cardio II Cardio III
Pedia I Pedia II Pedia III
Level 1 Level 2 Level 3 Level 4 Level 5
PHN III PHN IV PHN VPublic Health Nursing I Public Health Nursing II
DOH Nurse Certification Program
Competencies are both cumulative and incremental. A higher level of proficiency assumes an individual has gone through
and been declared competent in the lower level competencies.
“With higher levels of competence, a nurse is expected to be able to synthesize theory with
practice, and apply past experiences to actual nursing situations in a holistic
manner.”
- Benner, Patricia
Basic Core Competencies Basic Core Competencies
• Safe Quality Nursing Care
• Management of Resources and Environment
• Health Education
• Legal Responsibility
• Ethico-Moral Responsibility
• Personal and Professional Development
Basic Core Competencies Basic Core Competencies
• Research
• Records Management
• Communication
• Collaboration and Teamwork
• Quality Improvement
DOH Additional Basic Core DOH Additional Basic Core Competencies Competencies
• Professional/Personal Development
• Personal Mastery
Sample Competency Profile Competency Area Level 3
(Competent)Level 4
(Proficient)Level 5(Expert)
ER, PICU, CCU, MICU, SICU, Telemetry Unit, OR, CV Lab, Cardio-Renal
ER, PICU, CCU, MICU, SICU, Telemetry Unit, OR, CV Lab, Cardio-Renal
Level 4 areas + Management responsibilities
• Safe and Quality Nursing Care
• Assessment: History-taking NCCVNL3A01
Obtains a complete and accurate patient history to identify risks, predisposition to and/or actual cardiovascular problems
Underpinning NCCVNL3A01 Obtains a complete and accurate patient history to identify risks, predisposition to and/or actual cardiovascular problems
NCCVNL5A01 Develops nurses’ ability in obtaining complete and accurate cardiovascular patient history
NCCVNL4A01 Obtains a complete and accurate patient history to identify impending cardiovascular complications
NC CVN – Nurse Certification Cardiovascular Nursing
Self-Assessment Tool
Assessment Plan
Sample Assessment Guide
Checklist for Assessors
Competency-based Assessment and Certification
1. Application and self assessment
2. Validation (by immediate supervisor)
3. Assessment
Certification
FeedbackCompetency - based learning interventions
Reassessment
“not yet competent” “competent”
1. Choose a specialty area 2. Go to: www.hhrdb.doh.gov.ph/ncp and
download the self-assessment tool 3. Do a self-assessment and determine if
you have the competencies or not
If you are confident that you have all the competencies on a particular Level, prepare the following: 1) accomplished Application Form- downloaded from the website, 2) Portfolio of evidence of your competencies. Then contact the designated hospital to get a schedule for Assessment.
If you feel that you still have “gaps” in your competencies, contact the designated hospital and get advise on the available modules that you can take and the schedule of enrolment.
DOH Nurse Certification Program Offerings
Ward & OR
Nursing
Renal Nursing
Cardiovascular Nursing
Pediatric Nursing
Level 1 and 2Level 1 and 2 Level 3 to Level 5Level 3 to Level 5
Mental Health Nursing
Public Health
Nursing
Orthopedic and Rehabilitation Nursing
Infectious Disease Nursing
Maternal and Child Nursing
Emergency and Trauma Nursing
Operating Room Nursing
Public Health Nursing
Standard Learning Modules under DOH-NCP CARDIOVASCULAR
NURSING CVN Level 3 CVN Level 4CVN Level 5
INFECTIOUS DISEAS NURSING INF Level 3INF Level 4INF Level 5
MATERNAL AND CHILD NURSING
MCN Level 3
MCN Level 4
MCN Level 5
MENTAL HEALTH NURSING MHN Level 3MHN Level 4MHN Level 5
PEDIATRIC NURSINGPED Level 3 PED Level 4PED Level 5
PULMONARY NURSING PUL Level 3PUL Level 4PUL Level 5
ORTHOPEDIC AND REHABILITATION NURSING
ORB Level 3ORB Level 4ORB Level 5
RENAL NURSING
REN Level 3
REN Level 4
REN Level 5
TRAUMA NURSING
TRA Level 3TRA Level 4TRA Level 5
OPERATING ROOM NURSINGLevels 1-5
WARD NURSINGLevels 1-2
PUBLIC HEALTH NURSINGLevels 1-5
*each level of specialty area is composed of several modules
DOH-NCP Providers (as of Nov 2012)
HOSPITAL LEARNING INTERVENTIONS
1. Philippine Heart Center Cardiovascular Nursing Level III-V, all modules
2. National Kidney and Transplant Institute Renal Nursing Level III-V, all modules
3. Lung Center of the Philippines Pulmonary Nursing Level III-V, all modules
4. National Children’s Hospital Pediatric Nursing Level III-V, all modules
5. Philippine Children’s Medical Center Pediatric Nursing Level III-V, all modules
6. National Center for Mental Health Mental Health Nursing Level III-V, all modules
7. Philippine Orthopedic Center Orthopedic and Rehabilitation Nursing Level III-V, all modules
8. Dr. Jose Fabella Memorial Hospital Maternal and Child Nursing Level III-V, all modules
9. San Lazaro Hospital Infectious Disease Nursing Level III-V, all modules
10. East Avenue Medical Center ER/Trauma Nursing Level III-V, all modules
Operating Room Nursing
National Kidney and Transplant Institute Philippine Heart Center
Level Course Title/Learning Intervention
Modules Duration
Level III Competency Development in Perioperative Nursing
5 640 hours
Anesthesia Care Nursing
East Avenue Medical CenterJose Reyes Memorial Medical Center
Lung Center of the PhilppinesPhilippine Heart Center
Quirino Memorial Medical Center
Level Course Title/Learning Intervention
Modules Duration
Level III Competency Development in Anesthesia Care Nursing
5 640 hours
DOH HHRDB
DOH Nurse Certification Program Committee
Assessment and Certification
Learning and Development
Accreditation
Over-all program mgt and supervision Formulates policies & guidelines
Supervises activities of 3 sub-committees and program implementation
Maintains pool of assessors
Processes applications for assessment
Supervises assessments Safeguards integrity of
certifying body
Sets standards for LD interventions in accredited facilities
Develops, implements and regularly reviews modules per level
Monitors conduct of LD interventions by level and specialty
Sets standards for accreditation of facilities as providers
Reviews policies and quality standards for accreditation
Monitors facilities
SUBCOMMITTEES
Implementing Structure
SAFETY INDEX 2013 2014 PERCENTAGE DIFFERENCE
Medication Error 6 2 -66.67%Fall 3 0 -100.00%Procedural Error 6 10 66.67%Communication 8 4 50.00%
PERFORMANCE RATING 2013 2014 %Outstanding 0 62 38.51%Very Satisfactory 154 99 61.49%Satisfactory 0 0 0*Unsatisfactory 154 161
Note: An increase in the procedural error was contributed by some factors from other discipline.
(*Note: Non certified or probitionary)
Who can apply?
• PRC- licensed nurses
• Foreign nurses with Special Temporary Permit from PRC
ChallengesChallenges
• Global proficiency – Leadership
• Transformational Leadership
• Create a comprehensive and effective plan
“No human being will work hard at anything unless they believe that they are working for
competence.”
-William Glasser