Leadership: Enhancing the
OR Nurse Competencies
towards Global Proficiency
41st Annual Convention and Scientific Meeting
July 5, 2015
Maria Linda G . B uhat, R N, Ed.D.
PHC-Asst. Director for Nursing Service
Dis clos ure
References
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 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 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.
Globally
•
Competency certification is the trend to
promote culture of safety
Certification
•
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)
Country
(A)
1
2
Qualifications
(A)
3
4
5
6
AQRF
Country
(B)
1
1
2
2
3
3
4
4
5
5
7
6
6
8
7
9
8
7
8
Qualifications
(B)
LEVEL
6
KNOWLEDGE, SKILLS Graduates at this level will have a broad and
coherent knowledge and skills in their field
AND VALUES
of study for professional work and lifelong
learning
APPLICATION
DEGREE OF
INDEPENDENCE
Application in professional work in a broad
range of discipline and/or for further study
Independent and /or in teams of related field
QUALIFICATION TYPE Baccalaureate Degree
LEVEL
7
KNOWLEDGE, SKILLS Graduates at this level will have advanced
knowledge and skills in a specialized or
AND VALUES
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
DEGREE OF
INDEPENDENCE
QUALIFICATION TYPE
7
Independent and or in teams of
multidisciplinary
Post-Baccalaureate Program
The Philippine Qualifications
Framework
(Approved by the NEDA SDC-Cabinet on May 18, 2012)
L8
BASIC
ED
TESDA
L7
HIGHER
EDUCATION
DOCTORAL AND
POST DOCTORAL
POST BACCALAUREATE
L6
BACCALAUREATE
L5
DIPLOMA
L4
NC IV
L3
NC III
L2
G12
NC II
10
NC I
L1
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 areas
2.Address competency gaps
3.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.
•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
A competency-based
development program that
will address the ‘skills gap’
of nurses
DOH Nurse Certification
Program Theory
CAUSAL
• 'Competency
gaps' of nurses
entering the
workforce
•Lack of standard
competencies as
basis for training
nurses at the
workplace
INTERVENTION
• Competency
based
assessment,
development and
certification of
nurses in
standard
workplace
competencies
OUTCOME
• 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
DOH Nurse Certification Program
Competency Framework
Level 5
Stage 3 of Development, to produce a Nurse with the highest possible level of
Competencies in a Specialty Area and in Management
Level 4 Certified (through an assessment process of Level 4 competencies)
Level 4
Stage 2 of Development, to produce a Nurse with Level 4 Competencies for
chosen Specialty and Sub-Specialty Area
Level 3 Certified (through an assessment process of Level 3 competencies)
Level 3
Stage 1 of Development, to produce a Nurse with the necessary Core (Level 3)
Competencies for a particular Specialty Area
On entry: Pre-Specialty Training and Assessment
Entry-level Competencies (Level 2), with DOH-identified qualifications
DOH Nurse Certification Program
Level 1
Level 2
Ward & OR nursing I
Ward & OR nursing II
Public Health Nursing I
0yrs
Public Health Nursing II
6mos
12mos
Level 3
Level 4
Level 5
Renal I
Renal II
Renal III
Cardio I
Cardio II
Cardio III
Pedia I
Pedia II
Pedia III
PHN III
PHN IV
PHN V
18mos
21mos
• 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
24mos
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
• Safe Quality Nursing Care
• Management of Resources and Environment
• Health Education
• Legal Responsibility
• Ethico-Moral Responsibility
• Personal and Professional Development
Basic Core Competencies
• Research
• Records Management
• Communication
• Collaboration and Teamwork
• Quality Improvement
DOH Additional Basic Core
Competencies
• Professional/Personal Development
• Personal Mastery
Sample Competency Profile
Competency Area
Level 3
(Competent)
Level 4
(Proficient)
Level 5
(Expert)
Level 4 areas +
ER, PICU, CCU, MICU, SICU, ER, PICU, CCU, MICU, SICU,
Telemetry
Unit,
OR,
CV
Lab,
CardioManagement
Telemetry Unit, OR, CV Lab,
Renal
responsibilities
Cardio-Renal
•
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
NCCVNL4A01
Obtains a complete and
accurate patient history to identify
impending
cardiovascular
complications
NC CVN – Nurse Certification Cardiovascular Nursing
NCCVNL5A01
Develops
nurses’ ability in
obtaining
complete and
accurate
cardiovascular
patient history
Self-Assessment Tool
Assessment Plan
Sample Assessment Guide
Checklist for Assessors
Competency-based Assessment and
Certification
1. Application and
self assessment
1.
2.
3.
Choose a specialty area
Go to: www.hhrdb.doh.gov.ph/ncp and
download the self-assessment tool
Do a self-assessment and determine if
you have the competencies or not
2. Validation (by immediate supervisor)
3. 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.
Feedback
“competent”
Certification
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.
Competency - based
learning
“not yet interventions
competent”
Reassessment
DOH Nurse Certification Program Offerings
Level 1 and 2
Level 3 to Level 5
Renal Nursing
Ward &
OR
Nursing
Cardiovascular Nursing
Pediatric Nursing
Mental Health Nursing
Orthopedic and Rehabilitation Nursing
Public
Health
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 4
CVN Level 5
INFECTIOUS DISEAS
NURSING
INF Level 3
INF Level 4
INF Level 5
MATERNAL AND CHILD
NURSING
MCN Level 3
MCN Level 4
MCN Level 5
MENTAL HEALTH NURSING
MHN Level 3
MHN Level 4
MHN Level 5
PEDIATRIC NURSING
PED Level 3
PED Level 4
PED Level 5
PULMONARY NURSING
PUL Level 3
PUL Level 4
PUL Level 5
ORTHOPEDIC AND
REHABILITATION NURSING
ORB Level 3
ORB Level 4
ORB Level 5
RENAL NURSING
TRAUMA NURSING
REN Level 3
TRA Level 3
TRA Level 4
TRA Level 5
REN Level 4
REN Level 5
OPERATING ROOM
NURSING
Levels 1-5
WARD NURSING
Levels 1-2
*each level of specialty area is composed of several modules
PUBLIC HEALTH NURSING
Levels 1-5
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
Level III
Course Title/
Learning Intervention
Modules
Competency Development in
Perioperative Nursing
5
Duration
640 hours
Anesthesia Care Nursing
East Avenue Medical Center
Jose Reyes Memorial Medical Center
Lung Center of the Philppines
Philippine Heart Center
Quirino Memorial Medical Center
Level
Level III
Course Title/
Learning Intervention
Competency Development in
Anesthesia Care Nursing
Modules
5
Duration
640 hours
Implementing Structure
DOH HHRDB


Over-all program mgt and supervision
Formulates policies & guidelines

DOH Nurse Certification
Program Committee
Supervises activities of 3 subcommittees and program
implementation
SUBCOMMITTEES
Assessment and
Certification




Maintains pool of
assessors
Processes applications
for assessment
Supervises assessments
Safeguards integrity of
certifying body
Learning and
Development



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
Accreditation



Sets standards for accreditation of
facilities as providers
Reviews policies and quality
standards for accreditation
Monitors facilities
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%
Note: An increase in the procedural error was contributed by some factors from other
discipline.
PERFORMANCE RATING
Outstanding
Very Satisfactory
Satisfactory
*Unsatisfactory
(*Note: Non certified or probitionary)
2013
2014
%
0
62
38.51%
154
99
61.49%
0
0
0
154
161
Who can apply?
• PRC- licensed nurses
• Foreign nurses with Special Temporary
Permit from PRC
Challenges
•
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