Blueprint Regional Examination For Nurse Registration Caricom

BLUEPRINT
REGIONAL EXAMINATION
FOR NURSE REGISTRATION
CARICOM COUNTRIES
Caribbean Community in collaboration with

Canadian Nurses Association
The University of the West Indies
The University of Guyana, The Ministry of Education-Guyana
Pan American Health Organization/World Health Organization
Funds from Canadian International Development Agency (ICDS)
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TABLE OF CONTENT
Page No
LIST OF ILLUSTRATIONS ……………………………………………. iv
ACKNOWLEDGEMENT………………………………………………... v
INTRODUCTION……………………………………………………….. 1
RATIONALE ……………………………………………………………. 2
PHILOSOPHY OF NURSING ………………………………………….. 3
PURPOSE OF THE BLUEPRINT ……………………………………… 5
OBJECTIVES OF THE BLUEPRINT …………………………………. 6
CONCEPTUAL FRAMEWORK ………………………………………. 7
AGREED ON GENERAL COMPETENCIES FOR THE

REGISTERED NURSES IN THE COMMONWEALTH CARIBBEAN… 9
OUTLINE OF THE MAJOR CONCEPTS OF THE BLUEPRINT
1. Growth and Development …………………………………. 12
2. Needs ………………………………………………………. 12
3. Factors Affecting Needs Satisfaction ……………………… 13
4. Common Health Problems of the Caribbean ………………. 13
5. Nursing Process ……………………………………………. 14
MAJOR CONTENT AREAS
A. Man and His Environment ………………………………….. 16
B. Nursing ……………………………………………………… 21
CONTENT OUTLINE ……………………………………………………… 25
Biological and Psychosocial Factors Promoting and
2
Maintaining Needs Satisfaction Throughout the Life
Cycle ………………………………………………………………… 30
APPLICATION OF THE NURSING PROCESS TO INDIVIDUALS
WITH BASIC NEEDS INTERFERENCES
Outline ………………………………………………………………. 40
Example I:
Needs Interferences of the
Pre-School Child (1-4 years) (Gastro-Enteritis) ……………..………… 41
Example II:
Needs Interferences of the School-Child
(5 – 11 years)(Learning Disabilities) ………………………………….. 45
Example III:
Needs Interferences of the Pregnant Adolescent
(12 –19 years)(Pregnancy) ………………………………………..…… 51
Example IV:
Needs Interferences of the Young Adult
(20 – 44 years)(Hysterectomy) (Fibromyoma of
Uterus) ……………………………………………………………….… 57
Example V:
Needs Interferences of the Young Adult
(20 – 44 years)(Hyperactivity) (Anxiety Neuroses) ……………………. 62
Example VI:
Needs Interferences of the Adult (45-64 years)
(Diabetes Mellitus) ………………………………………….………… 68
Example VII:
Needs Interferences of the Older Adults (65 + years)
(Senility) ………………………………………………………………. 73
GUIDELINES FOR DEVELOPING THE TABLE OF

SPECIFICATIONS ……………………………………………………………. 78
TEST ITEMS ………………………………………………………………….. 83
ANNEX I, TABLE I:
COMMON HEALTH PROBLEMS IN THE CARIBBEAN –
ARRANGED BY AGE GROUPS AND CATEGORIES ……………… 84
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ANNEX II, TABLE II:
CORE LIST OF NURSING SKILLS FOR
SCHOOL-BASED ASSESSMENT ……………………………………. 94
ANNEX III:
GUIDELINES FOR THE USE OF CORE LISR OF NURSING
SKILLS FOR ASSESSMENT OF CANDIDATES …………………. 102
ANNEX IV:
CRITERIA FOR CLINICAL ASSESSMENT ……………………….. 106
ANNEX V, FIGURE I:
COMPONENTS OF THE BLUEPRINT ……………………………… 108
ANNEX VI, FIGURE II:

SAMPLE TABLE OF SPECIFICATIONS-
BLUEPRINT COMPONENTS ……………………………………….. 110
ANNEX VII:
GLOSSARY …………………………………………………………… 112
ANNEX VIII:
BIBLIOGRAPHY ……………………………………………………… 115
ANNEX IX:
MAP OF CARICOM MEMBER COUNTRIES ………………. 117
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LIST OF ILLUSTRATIONS
ANNEX I, TABLE I:
COMMON HEALTH PROBLEMS IN THE CARIBBEAN
ARRANGED BY AGE GROUPS AND CATEGORIES ………… 84
ANNEX II, TABLE II:

CORE LIST OF NURSING SKILLS FOR SCHOOL-
BASED ASSESSMENT …………………………………………. 94
ANNEX III:
GUIDELINES FOR THE USE OF CORE LIST OF
NURSING SKILLS FOR ASSESSMENR OF CANDIDATES …. 102
ANNEX V, FIGURE I:
COMPONENTS OF THE BLUEPRINT …………………………. 108
ANNEX VI, FIGURE II

SAMPLE TABLE OF SPECIFICATIONS ……………………….. 110
ANNEX IX:
MAP OF CARICOM MEMBER COUNTRIES …………………… 117
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ACKNOWLEDGEMENT
The Regional Nursing Body acknowledges with gratitude the assistance received from
the following organizations in developing this Blueprint:
 Caribbean Community Secretariat
 Canadian International Development Agency (NGO)
 Ministry of Education, Guyana
 Pan American Health Organization/World Health Organization
 University of Guyana
 University of the West Indies
Contributions made by Ministries of Health, Ministries of Education, General Nursing

Councils and nurses of the participating countries are also acknowledged.
This Blueprint is dedicated to the memory of Miss Evelyn Patterson, Lecturer, Advanced
Nursing Education Unit, University of the West Indies, Mona Campus, for her excellent
contribution and untiring effort in its preparation.
Dr. Una V. Reid

Advisor HMD
PAHO/WHO
January 1992
INTRODUCTION
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In all the CARICOM territories there exist certain conditions that seem to favor the
establishment of a Regional Examination for Professional Nurse Registration. These conditions
include common health problems, similar nursing education programmes, similar nursing
practice and supporting infrastructure and, above all, the need to enhance the effectiveness of the
nursing care available to the peoples of CARICOM territories.
The Regional Nursing Body, therefore, in its objectives developed in 1976, placed the
development of a Regional Examination for Professional Nurse Registration.
A feasibility study was carried during October and November 1976 and established the
fact that 13 Commonwealth Governments in the Region agreed, in principle, to a Regional
Examination for Professional Nurse Registration.
A workshop at Dover, Barbados, in 1978 provided a document, which included common

aspects of nursing considered essential for nurses seeking registration in the Region. The Dover
Document formed the background material for the development of the Blueprint.
There were subsequent activities in the further development of the Project. The General
Nursing Councils met at the Ocean View Hotel, Barbados, in 1990 to develop strategies for the
implementation of the examination. The representatives identified twenty-four(24) competencies
as the scope of practice for all registered nurses awaiting to practice nursing within the
CARICOM Member states.
Under the Canadian Nurses Association (CAN) sponsorship, the Canadian International
Development Agency (CIDA) approved the funding of the Regional Nurse Registration Project
until 1985. Funding for subsequent Project activities were also provided by the Pan American
Health Organization (PAHO) and CARICOM. PAHO continues to support the Project.
The Blueprint, therefore, is the result of the activities of nurses of the Region who
attended a series of workshops between November 1980 and 1991. The philosophy, goals,
objectives, competencies and content outline of nursing and the relevant supporting sciences. It
provides a ready reference on a Regional Professional Nurse Registration Examination.
RATIONALE
The rationale for the Regional Examination for Professional Nurse Registration is to:
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1. Establish a uniform standard of testing and evaluating nursing students for nurse registration
in the Caribbean.
2. Foster the implementation of a uniform testing policy (passing, failing and writing
examinations).
3. Provide adequate security for production and administration of examination
4. Institute continuing research an examinations and examinations policies.
5. Provide data for evaluating curricula for Schools of Nursing.
6. Benefit individual tutors and administrators in developing their competency in testing and
evaluation.
7. Facilitate the emergence of a system for reciprocal registration of nurses in the Region
8. Provide quality examinations in the Region through the cooperation of General Nursing
Councils of the Caribbean Countries.
PHILOSPHY OF NURSING
The nurses of CARICOM Member countries believe that …
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MAN
1. Man is a bio-psycosocial being who has basic needs which are physical, social, spiritual
and emotional.
2. The extent to which man’s needs are satisfied determines the status of his health along
the health-illness continuum.
3. The health status of man is affected by environmental, biological, psycosocial and

lifestyle factors as well as by the health care system.
4. Man has a right to optimum health, health care and social services for himself and his
family.
FAMILY
5. Community is made up of family units, which interact within socio-cultural, political and
economic boundaries, and the community shares common values, beliefs and practices.
HEALTH CARE
6. Health care is a priority for individuals, families and communities.
7. Access to quality health care is a basic human right,
8. Health care should be accessible, acceptable and available to each individual regardless
of his/her ability to pay.
9. Health care should be comprehensive, continuous and coordinated, at primary, secondary

and tertiary levels.
10. Health care should be provided within the resources of the community.
11. The individual shares responsibility with the health care system for the maintenance of
his health, his family’s health and that of his community.
12. Quality health care requires the participation of the community in assessing, planning,
implementing and evaluating health programmes.
NURSING
13. Nursing is a profession
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14. Nursing is a key element in the provision of comprehensive health care in primary,
secondary and tertiary health care settings.
15. Nursing contributes in a unique way to the delivery of health care through its caring role.
16. Nurses function independently, inter-dependently and dependently within the multi-
disciplinary health team.
17. The nurse functions as a clinician, educator, administrator/manager/change agent,

researcher and public/community relations officer in any health care setting.
NURSING EDUCATION
18. Nursing education allows for the acquisition of knowledge, skills, attitude and problem-
solving techniques necessary to assist clients in meeting their health needs.
19. Testing and evaluation skills are important in the method of assessing the competency of
the graduating professional nurse.
PURPOSE OF THE BLUEPRINT
The purpose of the Blueprint is to provide a uniform structure from which a standard
testing instrument can be developed and used among other methods to determine eligibility of
graduates of nursing programmes to practice professional nursing in CARICOM countries.
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OBJECTIVES OF THE BLUEPRINT
The Blueprint for Regional Examination for Nurse Registration:
1. Provides the basis for the development of assessment tools for regional professional nurse
examinations;
2. Outlines the cognitive, affective and psychomotor domains to be tested;
3. Shows the inter-relationships of areas to be tested;
4. Outlines primary, secondary and tertiary levels of nursing and health care;
5. Identifies common health problems in the Caribbean;
6. Categorizes common health problems in the Caribbean;
7. Delineates the critical elements and nursing competencies to be tested;
8. Specifies relevant scientific content essential to the practice of nursing;
9. Establishes the parameters and standards for the professional nurse exam nations.
CONCEPTUAL FRAMEWORK
There are certain biological, psychosocial, environmental and lifestyle factors which have
positive and negative effects on man’s health status and on his needs alleviation of the negative
effects of these factors on man’s health and that of his family and community, fall as a joint
effort between man and the health care system.
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Nursing assists man and his family to promote and maintain health. Nursing also
intervenes when man and his family are unable to cope unaided with the factors affecting health
status and needs satisfaction. The goal of nursing intervention is for man and his family to
achieve self-reliance in health care.
The Blueprint reflects nursing as unified and integrated. Nursing practice, as

portrayed in the Blueprint, brings together concepts from clinical and functional nursing
competencies as well as the biophysical and behavioral sciences. The nursing process is the toll
used as the basis for providing unified, integrated, and comprehensive nursing care to
individuals, families and communities within a multidisciplinary team.
Examples showing the use of the nursing process are included in the Blueprint. Each
example is designed to illustrate how the factors affect needs satisfaction of the individual.
Critical elements of needs interferences and the critical areas of care, using and integrated and
team approach to care, are also identified in the examples.
In developing case studies for examinations, the critical elements of needs interferences
and the critical areas of care must be considered in relation to stages of the life cycle and the
health status of the individual. Example III (page 63-69), illustrates these principles.
The major concepts of the Blueprint are:
1. Growth and development
2. Needs
3. Factors affecting needs satisfaction
4. Common health problems of the Caribbean
5. Nursing process
The major content areas of the Blueprint to be tested are:
A. Man and his Environment
B. Nursing
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1. Clinical nursing
 Nursing process
2. Functional nursing
 Profession of nursing
 Administration of Nursing
 Research
 Teaching, Interviewing and Counselling
For testing purpose, these concepts and content areas may be treated singly, as well as in
an integrated way.
AGREED ON GENERAL COMPETENCIES

FOR THE REGISTERED NURSE IN THE COMMONWEALTH CARIBBEAN
1. Use the problem-solving approach to:
(a) assess the health care needs of individuals of all age groups and families in any health
care setting.
(b) plan health care for individuals and families within the community based
on identified and potential problems and needs;
© implement plan care to assist individuals, families and communities to cope with
actual and/or potential problems;
(d) evaluate the effectiveness of nursing care based on stated objectives.
2. Provide safe and competent nursing care to all age groups at all levels of health in he
wellness/illness continuum in varied settings.
3. Apply knowledge of the bio-psychosocial, spiritual and environmental factors in the

delivery of health care.
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4. Communicate effectively with co-workers, individuals and families on matters related to
health care for the promotion and maintenance of optimum health.
5. Demonstrate interpersonal skills that enhance the functions of the health team
6. Utilize principles and skills of management in administering health care units.
7. Demonstrate leadership ability and skill in the management of health care services.
8. Perform teaching functions in relation to the development of colleagues, students and

auxiliary health workers, and in relation to patient-centered and family-centered care.
9. Provide guidance and counseling in prevention illness and promoting health and
rehabilitation.
10. Function as a member of the interdisciplinary health team in the provision of

comprehensive health care in a variety of health care settings.
11. Demonstrate understanding for national policies and their implications for nursing.
12. Apply research knowledge and skills to study and/or solve nursing and health problems.
13. Maintain competence in nursing practice through continuing education and self-directed
learning.
14. Demonstrate a caring attitude in providing nursing care to individuals, families and
communities.
15. Participate in the formulation, implementation and evaluation of standards of patient care.
16. Motivate the community and its members to participate actively in the health care
delivery system.
17. Coordinate with other sectors in the provision of health care for individuals, families and
communities.
18. Participate in community activities in carrying out his/her responsibilities as a

professional nurse and a citizen.
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19. Demonstrate competence in screening individuals, families and communities with a view
to applying appropriate nursing intervention and/or initiating relevant referral.
20. Exhibit concerns for the rights of the individuals in relation to health care, within the
ethical and legal frameworks, which are congruent with rules governing the practice of
nursing.
21. Initiate change to improve the quality of nursing practice and the delivery of health care.
22. Recognize the value of participating actively in the professional organizing for the
advancement of the Profession.
23. Assume responsibility for his/her own actions within the scope of nursing practice.
24. Recognize the role and contribution of national, regional and international organizations,
and nursing personnel, in the development of nursing.
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OUTLINE OF MAJOR CONCEPTS OF THE BLUEPRINT
1. Growth and Development
For purposes of the Caribbean Blueprint, the following age groupings are identified:
 Infant to Pre-School Child 1 month – 4 years
 School Child 5 – 11 years
 Adolescent 12 – 19 years
 Young adult 20 – 44 years
 Adult 45 – 64 years
 Older Adult 65+ years
2. Needs
Needs are common to individuals at all stages of the life cycle. Satisfaction pf these
needs are essential for physiological and psychosocial well-being. For purposes of the
Blueprint, the needs identified are:
Physiological
 Oxygen
 Nutrition
 Elimination
 Activity, rest, comfort
 Sensory stimulation
 Safety and security
 Sexuality
Psychosocial
 Love and belonging
 Trust
 Self-concept
 Self-esteem
 Self actualization
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3. Factors Affecting Needs Satisfaction
These are conditions that bring about a change in man’s health status. There are four
factors, namely:
 Biological
 Psychosocial
 Environmental
 Lifestyle
4. Common Health Problems of the Caribbean
Health problems are conditions which result from needs interferences. For purposes of
the Blueprint, the health problems are categorized as follows (See Table I):
Congenital
Defects of structure and/or functions existing at, or appearing after birth.
Genetic
Defects of structure and/or functions existing at, or appearing after birth due to
disorders of genes/chromosomes.
Infectious/Inflammatory
The reaction of the body to toxins and invasion by micro-organisms.
Infestations
Invasion of the body by microbes and parasites.
Allergic/Immunological
Abnormal reaction of the body to the entry of foreign substances.
Neoplastic
Benign or malignant proliferation of cells.
Accident/Trauma
Damage to tissues resulting from injuries.
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Metabolic/Nutrition/Endocrine
Changes, which result from absence, decrease/excess of hormones, enzymes and
nutrients.
Degenerative
Disturbances due to deterioration in cellular structures and functions.
Psychosocial/Psychiatric
Disturbances characterized by distorted social, emotional and/or intellectual behaviour.
Environmental
Imbalances in the environment.
Health Infrastructure
Types and availability of health and health-related services and human resources.
5. Nursing Process
The nursing process has the following four phases:
1. Assessing
 Take and record nursing history from individuals and significant others
 Refer to medical data
 Perform physical examination
 Study the data collected
 Interpret the findings of the data
2. Planning
 Formulate nursing diagnoses
 Assign priority to nursing diagnoses
 Establish problem list
 Specify short-term and long-term goals
 Identify appropriate nursing actions
 Establish outcome criteria
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 Develop written plan of care
 Involve the individual, family and significant others
 Review the plan of care
3. Implementing
 Activate nursing care plan – promotive, preventive, restorative/curative,
rehabilitative
 Coordinate care activities
 Record and report responses to nursing actions
 Maintain continuity of care
 Refer to appropriate agency(ies)
4. Evaluating
 Collect data
 Compare to individual, family, community responses with expected
outcome criteria
 Determine extent to which goals are achieved
 Identify alterations that need to be made in nursing diagnoses, goals,
nursing actions and outcome criteria
 Modify the nursing care plan accordingly
 Implement the modifications
MAJOR CONTENT AREA
The goals, objectives, and content included in this Section form the syllabus to be tested
in the examinations.
A. Man and His Environment
Goal
Demonstrate knowledge of relevant concepts of the biophysical and behavioural
sciences in relation to man and his health.
a) Bio-Physical Sciences
Objectives
1) Explain the role of the cell in metabolic activities of the body.

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2) Demonstrate knowledge of homeostasis.
3) Discuss the principles underlying good body mechanics.
4) Demonstrate knowledge of neutral and hormonal regulation of body activities
5) Describe the immunological response of the body and relate the role of immunity in body
defense
6) Demonstrate knowledge of cardiac and circulatory dynamics.
7) Discuss the process of metabolism
8) Explain the process of reproduction.
9) Demonstrate knowledge of mechanisms of inherited characteristics.
10) Explain the conditions, which predispose the individuals to the invasion
and multiplication of microbes and parasites.
11) Discuss measures used in prevention and control of microbes and

parasites.
12) Discuss the concepts and principles of nutrition and related diet therapy.
13) Demonstrate knowledge of the categories and effects of select drugs.
14) Describe the principles and laws, which govern storage and use of drugs.
15) Demonstrate knowledge of ecological factors and their relationships to

health.
Content Outline
I. Human Biology, Biochemistry, Biophysics

II. Microbiology
III. Nutrition
IV. Pharmacology
V. Ecology
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I Broad Concepts
(a) Cell Functions

(h) Process of Reproduction
(b) Concept of homeostasis  Mecha
nisms of heredity
(c) Movement of body and mechanics  Fertiliz
 Muscul ation
o-skeletal  Implan
 Nervou tation
s  Foetal
development
(d) Energy Exchange 
(ix) Metabolic Process

(e) Cardiac and Circulatory Dynamics  Ingesti
 Volum on
e  Digesti
 Output on
 Absorp
(f) Diffusion and Osmosis tion
 Exchan  Secreti
ge of gases on
 Move  Assimi
ment of body water lation
 Fluid  Elimin
and electrolyte balance ation
(g) Immunological Response

 Immun (i) Sensation and Integration
ity  Neural,
 Hypers hormonal and sensory
ensitivity regulations
 Auto-
immunity
II. Microbes and Parasites
 Growth conditions
 Modes of transmission
 Control measures
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III Nutrition
 Types, sources and functions of foods and nutrients

 Nutritional needs and individuals along the life cycle
 Concepts of diet therapy, modifications of normal dietary needs, energy and nutrients.
IV. Pharmaco-Dynamics
 Categories of drugs
 Drug actions
 Indication of drugs
 Adverse responses to drugs
 Variables influencing drug actions
 Storage of drugs
 Drug standards and legislation
VI. Ecology
(a) Effects of Urbanization and Industrialization
 Pollutants and their effects on air, water, land and space

 Monitoring and control of pollutants and pollution
(b) Effects of Natural and Man-Made Disasters
b) Behavioural Sciences
Objectives
1. Demonstrate knowledge of Caribbean family structure and functions.
2. Analyze the effects of social organizations and institutions on family life in the
Caribbean.
3. Demonstrate knowledge of community dynamics and their effects on the health status of
man.
4. Recognize normal patterns of growth and development at all stages of the life cycle.
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5. Demonstrate understanding of the interrelationships of the basic needs of man (e.g.,
Maslow)
6. Describe the developmental tasks of individuals at different stages of the life cycle (e.g.,
Erikson).
7. Explain dynamics of human behaviour.
8. Understand theories of personality development (e.g., Freud, Adler, Sullivan)
9. Discuss principles and theories of learning (e.g. Piaget, Skinner)
10. Demonstrate methods and techniques of behaviour modification.
11. Describe methods and techniques of behaviour modification.
12. Describe the principles of interviewing and counseling.
Content Outline
I. Sociology
II. Psychology
I. Broad Concepts
i. Caribbean Family Structure and Functions

ii. Factors affecting Family Units
1. Cultural beliefs and practices

2. Social organizations and institutions
 Political
 Educational
 Economic
 Religious
3. Socioeconomic
iii. Community dynamics
II. Psychology
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i. Theories of Growth and Development
ii. Developmental Tasks
iii. Needs Theory
iv. Theories of Personality Development
v. Dynamics of Human Behaviour
vi Principles and Techniques of Behaviour Modification
vii. Principles and Theories of learning

viii Principles of Interviewing and Counseling
B. Nursing
Goals
1. Demonstrate technical and professional competence in the provision

of nursing care to individuals, families and communities through integration of
knowledge of the biophysical and psychosocial sciences and the use of the nursing
process.
2. Display behaviour, which reflects the accepted criteria for the

profession, and recognize the practice of nursing as an intellectual discipline,
which requires commitment to service and a positive attitude towards learning as a
life long responsibility.
Objectives
1. Demonstrate knowledge of concepts of health
2. Determine factors that affect health of individuals, families and communities.
3. Assess the health status of the individual, groups and community, using the
epidemiological approach.
4. Describe disease surveillance including sources of surveillance information

and is utilization in the planning and evaluation of health programmes.
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5. Use appropriate community resources in the provision of health care at
primary, secondary and tertiary levels.
6. Apply knowledge of growth and development in the provision of health care
7. Describe the assessment of clients who have interferences of physiological

and psychosocial needs.
8. Discuss factors which alter the capacity of clients to satisfy physiological and
psychosocial needs (e.g., lifestyle, environmental, psychosocial, biological)
9. Discuss effects of alterations in needs satisfaction to client’s health status

(e.g., fluid and electrolyte imbalance, shock, malnutrition, disturbed behavior
patterns)
10. Discuss the most common types of disturbed behaviour patterns evidence
among Caribbean peoples.
11. Discuss measures which will assist clients to cope with alterations meeting
physiological and psychosocial needs.
12. Explain the several treatment modalities used to correct needs interferences
13. Interpret values of selected diagnostic tests in relation to specific health

problems
14. Collaborate with other team members, sectors and agencies in providing care
for individuals, families and communities.
15. Coordinate with other team members, sectors and agencies in establishing
appropriate referrals of clients.
16. Explain the dynamics in a community, which facilitate or hinder community

participation.
17. Establish priorities and plans for intervention with individuals, families and
communities based on analysis, community expectations, accepting standards
of practice and available resources.
18. Determine priority care for high-risk individuals and vulnerable groups.
19. Design health programmes for special groups (e.g., workers, aging and
disabled)
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20. Plan health education programmes, which will assist individuals, families and
communities to assume responsibility for their health.
21. Demonstrate knowledge of causes and effects of disequilibrium between

individuals and their environment.
22. Integrate knowledge of bio-physical and behavioral sciences in the nursing

care of clients with health problems.
23. Demonstrate knowledge of the responsibilities of the nurse in disaster

management
24. Demonstrate ability to prioritize in emergency situations.
25. Assist individuals, families and communities to develop skills to cope with
and to take responsibility for their health care.
26. Execute health and family life education programmes for individuals, families
and communities.
27. Design education programmes which emphasize promotion of health

prevention of illness, restoration and rehabilitation.
28. Demonstrate beginning skills in developing, implementing and evaluating

teaching plans for individuals, families and communities.
29. Describe roles and functions of health, health-related and social organizations
and agencies in the Region.
30. Demonstrate professionalism in the practice of nursing.
31. Adhere to the legal and ethical standards in the practice of nursing
32. Explain implications of health laws in relation to health care individuals,

families and communities.
33. Demonstrate knowledge of manifestations of pregnancy and of assessment

and care of the woman, neonate and family throughout the maternity cycle.
34. Explain physiological and psychosocial changes in individuals and families in

relation to pregnancy.
35. Discuss measures that will foster parental bonding.
36. Discuss the developmental tasks of families in relation to child-bearing and

child-rearing practices.
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37. Identify actual and potential problems that may occur in the pre-natal intra-
natal and post-natal periods and their related management.
38. Discuss the nurses’ role in the management of clients with specific health
problems.
39. Apply basic principles and techniques of administration/management nursing

situations.
40. Use communication skills in recording and reporting client information.
41. Apply basic research methodology in solving health problems
42. Examine results of health care for individuals, families and communities in
terms of achievement of expected outcomes.
43. Demonstrate the ability to perform safe nursing care.
44. Participate actively in community affairs.
Content Outline – Nursing
I Health
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i. Concepts of Health  Primary iv. Levels of Health Care
 Secondary  Primary
ii. Epidemiological Approach  Tertiary  Secondary
 Tertiary
iii. Levels of Prevention
II Growth and Development
i. Stages in the Life Cycle

ii. Developmental Tasks
III. Needs and Their Satisfaction Along the Life Cycle
i. Physiological
ii. Psychosocial
IV. Factors Affecting Needs Satisfaction/Health
i. Biological
 Physiological functions
ii. Psychosocial
 Coping behaviour
 Socio-cultural
 Political
 Economic
 Population dynamics
iii. Environmental
 Ecology
 Housing
 Vectors
 Sanitation
iv. Lifestyle
 Substance abuse
 Health practices
 Dietary habits
 Hobbies
 Religious practices
 Work habits
V. Needs Alterations
 Loss
 Stress
 Changes in body image
 Pain
 Sensory deprivation
 Immobility
 Fluid and electrolyte imbalance
 Disturbed patterns of behaviour
VI. Indicators of Community Health

 Socio-politico-cultural environment
 Economy
 Ecological and environmental conditions
 Disease prevalence
 Groups at risk
 Lifestyle of groups
 Community resources
 Health legislation
 Population dynamics
 Community dynamics
 Availability, accessibility and utilization of health-related services
VII. High Risk Individuals and Groups, Including Emergencies
VIII. Health Programmes for Special Groups

 School health
 Occupational health
 Services for the elderly, the disabled and others
IX. Role of the Nurse in Disaster Preparedness and Management
 Pre-disaster planning
 Mobilization of resources
 Management of mass casualties
o First aid
o Triage
o Crisis prevention
o Post-disaster planning
o Record keeping
o Post-disaster surveillance
X. Group Dynamics
 Group process
XI. Teaching and Learning Process

 Principles of teaching and learning
 Principles of adult education
 Principles of health teaching and counseling
XII. Communication Process

 Principles
 Techniques
 Therapeutic communication
 Interviewing
 Reporting
 Recording
XIII. Health and Families Life Education

 Family relationships
 Preparation for parenthood
 Family spacing
 Sexuality
 Single parent family
 Preparation for the retirement
XIV. The Profession of Nursing

i. Factors influencing the development of nursing:
 Political
 Socio-economic
 Technological
 Scientific
ii. Ethical and legal practice of nursing
iii. Professional organizations
XV. Health and Health-Related Organizations and Agencies at National, Regional

and International Levels
 Governmental
 Non-governmental
 Private voluntary
XVI. Family Unit

 Developmental tasks
XVII. Pregnancy
i. Changes in family unit due to pregnancy
o Psychosocial
o Physiological
ii. Manifestations of pregnancy
iii. Health appraisal and care throughout the maternity cycle
iv. Complications and conditions of pregnancy in the internatal and postnatal

periods
XVIII.Administration/Management
 Principles and techniques of administration and management
 Elements of supervision
 Change process
XIX. Application of Basic Research Methodology in Solving Health Problems

 Steps in research methodology
 Factors affecting quality of research
 Application of research process to nursing practice
XX. Biological and psychosocial Factors Promoting and Maintaining Needs Satisfaction
Throughout the Life Cycle
A. Assessing (to be used for all age group
1. Biographical Data of Family

 Health history
 Hereditary patterns
 Familial tendencies
2. Biographical Data of Individual

 Age
 Address, etc.
 Education
 Occupation
 Hobbies
3. Physiological
i. Oxygen
 Circulatory status:
o Body temperature – range
o Characteristics of apex pulse rates
o Characteristics of blood pressure
 Respiratory status:
o Characteristics of respiration
o Rate of breathing
o Patency of airway
ii. Nutrition
 Eating patterns
 Appetite
 Food fads
 Diet
 Food hygiene and preparation
 Weight
o Normal
o Underweight
o Overweight
 Height
 Oral health
o Dentition
o Condition of mouth, lips, teeth, breath
o Ability to masticate
iii. Elimination
 Skin integrity  Bladder status  Bowel status
iv. Sexuality
 Grooming  Male/female relationships
 Condition of external genitalia  Pattern of menses
 Family planning practices  Menopause – male and female
 Pubertal changes  Condition of breasts
 Psychosexual development  Coordination
v. Activity and Rest

 Sleep pattern  Posture and gait
 Use of supportive aids, e.g., drugs  Range-of-joint movements
 Current mobility status  Coordination
 Type of exercise
vi. Sensory Simulation

 Status of special senses
o Vision o Taste
o Hearing o Smell
o Speech o Touch
 Status of environment (stimulating/non-stimulating)
vii. Safety and Security

 Safety precautions at home, school, with environment, roads, etc.
 Personal hygiene
o Skin
o Hair
o Nails
 Clothing and footwear
 Skin integrity
 Mucous membrane integrity
 Immunizations
 Immunological response
4. Psychosocial
Individual:
i. Love and Belonging
 Family, spouse, peer, other relationships
 Individual and family support system(s)
 Ability to give and accept love
 Capacity for adjustment and adaptations
ii. Trust/Security
 Status of developmental tasks according to stage of life cycle
iii. Self-Concept and Self-Esteem

 Level of cognitive/intellectual development
 Peer and other relationships
 Feelings about self
 Measure of self-esteem and acceptance of body image
 Independent thinking and action
iv. Self-Actualization
 Career (and other) goals and ability to achieve these
 Problem-solving ability and coping with stress
v. Socio-Economic
 Occupation  Financial status
vi. Socio-Cultural
 Beliefs and customs influencing health
Family:
i. Family Membership (include all persons/relatives household)
 Name
 Age
 Religion
 Position, role in the family
 Scholl or work of each member
ii. Extended Kinship Network
 Father  Children  Aunts/uncles
 Mother  Grandparents  Other
iii. Living Conditions
 Amount of physical space in house
 Income and socio-economic level
 Neighborhood life (i.e. safety, housing conditions, availability of resources)
iv. Work
 Employment stability of breadwinner
 Job satisfaction
o Father o Mother o Other
 Work schedule (to permit family interactions)
 Family budget
v. School
 Educational background of parents
 Academic achievement of school-age children
 Behavioural conduct of school-age children
 School (teacher/family relations)
vi. Recreation
Time spent in family activities together (including meals), hobbies, individual’s
outside interests of family members
 Father  Mother  Children
vii. Social Welfare Agencies

 Involvement with legal system (police, court, jail)
 Dependence on income supplement, welfare
 Medical care of family members
 Mental health care
o Father
o Mother
o Children
5. Environmental
i. Home
 Environment
o Cleanliness
 Ventilation
o Adequacy
 Water
o Source of supply
o Adequacy
o Safety
 Electricity
o Presence
 Lighting
o Adequacy
 Privacy
o Number of rooms in house

o Number of people in home
o Sharing of facilities/space in home
Solid wastes
o Dry
 Method of disposal
 Adequacy
 Wet
o Method of disposal
 Sewage disposal
 Vectors
o Presence
o Control
 Drainage (around home)
o Effectiveness
 Sanitation
o General sanitation
 Telephone, radio, television
o Presence
o Programmes on radio and television and possible side effects
 Newspapers
o Availability of newspapers in the home and work
 Postal services
o Home delivery
o Postal collection
 Roads
o Adequacy and/or accessibility
o Availability
 Safety
o Floors
o Electrical outlets, plugs
o Rugs
o Handrails
o Locking devices
o Adequacy of storage, use and disposal of:
 Toys
 Drugs
 Detergents
 Insecticides
 Other chemicals
 Food
o Storage
o Food and milk hygiene
ii. Community
 Cleanliness of streets, public facilities, etc.,
 Presence of recreational facilities
 Presence of parks
Air
 Pollution from traffic, factories, other
Water
 Type of supply
 Adequacy
 Safety
Housing
 Types
 Adequacy
Electricity
 Presence of supply
Solid wastes
 Dry
o Method of disposal
 Wet
o Types of disposal
o Adequacy
Sewage disposal
Drainage (streets)
 Effectiveness
Telephone, television, radio
 Presence of radio, television, public telephones
Safety
 Community
o Supervision in swimming pools
o Presence of safety railings on roads, bridges, etc.,
o Cleanliness of public conveniences, roads, pedestrian crossings, sidewalks
 Industry
o Use of protective devices
o
 Ecology
o Pollutants and types
6. Lifestyle
i. Cultural beliefs about health, child rearing practices etc.,
ii. Hobbies
iii. Use of leisure time
iv. Use of substances
- Alco - Tobacco - Others

hol - Drugs
v. Methods of coping with stress and use of support system(s)
vi. Religious beliefs
B. Planning
Planning nursing interventions to support individual’s and family’s ability to promote and
maintain health.
C. Implementing
Interventions to promote and maintain health/basic needs achievement.
D. Evaluation
Evidence of change in health behaviour necessary to promote and maintain health.
XXI Health Teaching/Counseling
1. Genetic Counseling
2. Physiological
i. Oxygen
 Maintain body temperature
 Erect posture for better chest expansion
 Prevent respiratory infections
ii. Nutrition
Nutrition education and counseling to include:
 Oral health practices
 Appropriate nutritional requirements and food for age
 Family budgeting for food
 Food hygiene and preparation
 Growing backyard gardens
 Norms for height and weight
 Maintain appropriate weight for age
iii. Elimination
 Appropriate fluid, food and exercise to develop and maintain bowel
and bladder activity
iv. Exercise and Rest
 Planned physical activity

 Period of time for rest
 Recommended number of hours of sleep per age group
 Sleep pattern
 Aids to sleep
v. Sensory stimulation
 Stimulating environment (home, school, work)

 Play opportunities
 Visual and tactile stimulation
vi. Sexuality
 Satisfactory male/female relationships

 Peer group relationships
 Opposite sex relationships
 Grooming and sexuality
 Sexual behaviour
 Sex and family-life education
vii. Safety and security
 Immunizations according to age
 Methods of accident prevention on roads, in home, school,
workplace
 Personal hygiene
3. Psychosocial
i. Love and belonging
 Supportive family, spouse, peer and other relationships
 Developing capacity to love and accept love
ii. Trust and Security
 Achieving developmental tasks
iii. Self-Concept and Self-Esteem

Factors influencing self concept:
 Cognitive development
 Peer relationships
 Physique according to age
 Degree of attractiveness
 Career (and other) goals and ability to achieve these
 Problem solving ability
 Achievement of career goals
 Development of problems-solving ability
v. Socio-Economic
 The effects of beliefs and customs on health
4. Environmental
i. Home
Appropriate housing and living conditions
 Noise  Sanitation
 Lighting  Vector control
 Ventilation  Food and milk
 Temperature  Hygiene
 Safety  Water availability and safety
Methods of communication
 Newspaper  Radio  Other
 Telephone  Television
ii. Community
 General sanitary measures or community
 Cleanliness of streets
 Disposal of sewage and solid wastes
 Management of pollution
 Cleanliness of public places, e.g., restaurants, etc.
5. Lifestyle
 Developing appropriate health habits
 Work habits
 Leisure time activities
 Use of substances, e.g. alcohol, drugs, tobacco etc.
 Developing hobbies
6. Community Resources
 Availability of resources to promote and maintain health
XXII. Application of the Nursing Process to Individuals with Needs Interferences

Along the Life Cycle caused by Bio-Pyschsocial Factors as Follows:
Example I Gastro-enteritis
Age 1 ½ years
Example II Learning Disabilities

Age 10 years
Example III Pregnancy

Age 13 years
Example IV Hysterectomy (Fibromyoma of Uterus)

Age 39 years
Example V Diabetes Mellitus

Age 55 years
Example VII Senility
Age 80+ years
EXAMPLE I
FACTOR: GASTRO ENTERITIS (1 ½ YEARS)
A. Assessing
1. Physiological
i. Oxygen
 Color
 Breathing patterns
 Vital signs
 Cough
ii. Nutrition
 Nutritional status (growth chart)
 Hydration
 Diet
iii. Elimination
 Frequency, consistency, quantity, color of:
 Vomitus
 Stools
 Urine
iv. Sexuality
 Psychosexual development
v. Activity, Rest and Comfort

 Degree of restlessness or lethargy
vi. Sensory Stimulation

 Integrity of skin
 Mucous membranes
2. Psychosocial
ii. Trust
iii. Self-Esteem
 Effects of illness and hospitalization on child and family
 Parent/child relationships
 Position of child in the family
v. Socio-Economics
 Family’s belief about illness
vi. Economics
 Family finances
3. Environmental
 Ecology
 Housing and living conditions
 Sanitation
 Vectors
 Water
 Food and milk hygiene
4. Lifestyle
 Family life patterns and effects on child
B. Planning
1. Nursing diagnoses
2. Problem list – actual and potential problems
3. Critical areas of care and expected outcomes
4. Required resources
5. Team approach
C. Implementing
1. Physiological
i. Oxygen
- Check color
- Monitor vital signs
- Ensure clear airway
- Administer oxygen
ii. Nutrition
- Analyze results of growth chart
- Rehydrate
- Provide adequate diet
- Monitor weight for age
iii. Elimination
- Monitor and record intake and output
iv. Activity and Rest

- Ensure bed rest
v. Sensory Stimulation
- Provide play opportunities
- Provide visual and tactile stimulation
vi. Sexuality
- Observe level of psychosocial development
vi Safety and Security

- Interpret diagnostic tests
- Administer prescribes medications
- Give personal hygiene care
- Prevent cross infection
- Protest from accidents and trauma
2. Psychosocial
Foster relationships between:
 Parent/child
 Nurses/child and family
 Child/child
 Significant others
3. Environmental
 Foster environmental hygiene
4. Lifestyle
 Advise on changes/modifications in family’s lifestyle if necessary
5. Health Teaching/Counselling to Family on:
 Teach/counsel family about gastro-enteritis in relation to:
o Condition of gastro-enteritis
o Causes
o Prevention
o Management
o Coping skills
o Availability of resources
o Follow-up
o Family budgeting
 Referrals
 Coordination and continuity of care
 Follow-up
D. Evaluating
1. Achievement of expected outcomes

2. Alleviation of problems
EXAMPLE II
FACTOR: LEARNING DISABILITIES (10 YEARS)
A. Assessing
1. Physiological
i. Oxygen
 Color
 Vital signs
ii. Nutrition
 Nutritional status (growth chart)
 Diet
 Weight
 Height
 Types of foods eaten and their additives
iii. Elimination
 Bowel patterns
 Bed wetting
iv. Sexuality
 Peer group relationships
 Sibling relationships
v. Activity and Rest and comfort

 Attention span
 Degree of activity
o Restlessness
o Listlessness
 Sleep patterns and disturbances
 Involvement in sports
 Physical deportment and motor coordination
 Aggression

 Visual acuity
 Hearing ability
 Language development
 Speech pattern
 Sensorium

 Self-care ability
 Immunization record
 Skin integrity
 Diagnostic tests
2. Psychosocial

 Family unit
o Dynamics
ii. Trust
Relationships of child to:
 Parents
 Siblings
 Teachers
 Peers
 Significant others
iii. Self-Concept
iv. Self-Esteem
v. Self-Actualization
 Achievement of developmental tasks
 Industry
 Ambivalence
 Independence
vi. Soci-Cultural
 Child-rearing practices
 Education/school system
 Parental expectations
 Expectations of the school; system
 Family’s cultural beliefs and customs
vii. Economics
 Family budget
3. Environmental
 Housing
 Living conditions
 Overcrowding
 Basic sanitation
 Vectors
 Stimulation in the home
 Supervision in the home
 Water and food hygiene
4. Lifestyle
 Family’s lifestyle:
 Religious practices
 Eating, drinking patterns
 Ability to cop with problems
 Dress patterns of family and child
 Family spacing
 Recreational activities
B. Planning
5. Team approach
C. Implementing
1. Physiological
i. Oxygen
ii. Nutrition
 Advise on diet for age
 Advise on preparation and eating of nutritious meals
 Monitor weight and height
iii. Elimination
- Encourage child to develop good bowel and urinary habits
iv. Sexuality
- Monitor levels of psychosexual development

- Establish prescribed daily routine for child if necessary
- Promote involvement in school activities
- Implement prescribed therapy

 Encourage use of protheses for visual and/or hearing defects
 Ensure speech therapy
 Develop with teachers family, child and others, programmes for
specific learning disabilities

 Administer prescribed medications
 Teach accident prevention
 Teach personal hygiene
 Teach potential dangers of drugs, alcohol, tobacco and other
substances
2. Psychosocial

- help family to accept child’s disability
- encourage sharing relationships in family if necessary
- encourage family involvement in child’s school achievement
ii. Trust
foster positive relationships between:
- parents/child
- siblings/child
- teachers/child
- peers/child
- significant others
iii. Self-Concept
- assist child to recognize and accept his strengths and weakness
iv. Self-Esteem
- assist child to understand and accept his disability
- establish goals achievable by child
- facilitate goal achievement
- reinforce successes
- encourage family’s recognition and acceptance of child’s level of
achievement
- implement behaviour modification programmes if necessary
vi. Family Economics

- assist family with budget preparation, refer to social agencies if
necessary
3. Environmental
- counsel family
- sanitation of home including vector control
- basic living and housing conditions
- problems of overcrowding
- structured and stimulating home environment
- refer if necessary to social agencies regarding housing and living
conditions
4. Lifestyle
- encourage family spacing if necessary
- counsel on family’s lifestyle
- encourage hobbies within child’s capabilities, family’s preferences and
resources
5. Health Teaching/Counselling
- child’s relationships with others
- expected level of achievement within child’s capabilities
- nutrition
- immunization
- importance of family support and involvement in child’s education
- measures to reinforce child’s achievements
- methods of establishing achievable goals with child, teachers and
others
- importance of continuity of prescribed programmes
- techniques of developing parent-support groups in the community
- genetic counseling
- assist family to develop appropriate coping skills
- provide information on community resources
- referral to school psychologist, social worker, etc., if necessary follow-
up
D. Evaluating
2. Alleviation of problems.
EXAMPLE III
FACTOR: PREGNANCY (13 YEARS)
A. Assessing
1. Physiological
i. Oxygen
- respiration
- vital signs
ii. Nutrition
- dietary habits
- types of food
- idiosyncrasies
- weight, height
- morning sickness, nausea, vomiting
iii. Elimination
- diaphoresis
- frequency, dysuria, output
- bowel habits
iv. Sexuality
- menstrual history
- breast changes
- sexual intercourse
- vaginal discharge
- enlarged uterus
- knowledge of health and family life education
- male/female relationships

- exercise patterns and tolerance
- rest periods
- sleep patterns

- visual acuity
- hearing ability
- speech pattern
3. Environmental
- adequate housing and living conditions
- need for privacy
4. Lifestyle
- smoking
- substances abuse
- family life patterns and effects
- hobbies
B. Planning
5. Team Approach
Actual Problems
Psychosocial Physical
Family conflicts Low haemoglobin

Emotional problems inadequate diet
Economic needs constipation
Housing/shelter frequency of micturition
Potential Problems
Psychosocial Physical
Withdrawal elevated blood pressure
Tearfulness proteinuria
Aggressiveness headache
Anxiety hemorrhage
Rejection abortion
Insomnia
Oedema
Weight gain: excessive
None
C. Implementing
1. Physiological
i. Oxygen
- monitor rate and depth of respiration
- monitor degree of dyspnoea on exertion and at rest
- monitor vital signs including foetal heart rate
- teach breathing exercises for labor
ii. Nutrition
- advise dietary measures t correct iron deficiency anemia
- monitor weight gain
- monitor dental health, refer to dentist
iii. Elimination
- test urine
- advise on dietary management of constipation
- check for odema/fluid retention
iv. Sexuality
- counsel regarding sexual practices
- assist, under supervision of midwife, with monitoring foetal growth
- physical assessment of client
v. Activity, rest and Comfort

- encourage physical activity, exercise and rest periods
- suggest activities to promote sleep
-

- encourage diversional activities (e.g. games. Films, music)

- advise on personal hygiene
- interpret diagnostic tests
- explain prescribed medications
- advise regarding vulval hygiene
2. Psychosocial
ii. Trust
- encourage family acceptance of pregnancy
- encourage other social relationships
iii. Self-Concept
iv. Self-Esteem
- encourage adolescent to accept pregnancy
- encourage adolescent to participate in, and accept responsibility for,
care during and after pregnancy
- provide for privacy
3. Environmental
- foster environmental sanitation
- control environmental hazards
4. Lifestyle
- modify as necessary
- develop and foster hobbies
- encourage plans to continue education
- pregnancy and birth process
- family life education
- family budget
- resolution of conflicts
- family communication
- sexuality
- care of baby
- preparation for parenthood
- nutrition
- exercise
- care of breasts
- refer to social agencies
- provide for financial assistance
- refer to maternity clinic
- coordination and continuity of care
- follow-up
D. Evaluating

EXAMPLE IV
FACTOR: HYSTERECTOMY (FIBROMYOMA OF UTERUS) (39 YEARS)
A. Assessing
1. Physiological
i. Oxygen
- vital signs
- pallor
ii. Nutrition
- nutritional status
- weight
- dental health
- appetite
- hydration
iii. Elimination
- urinary output
- dysuria
- frequency of micturition
- bowel habits
iv. Sexuality
- abnormal vaginal bleeding
- obstetrical history
- sexual history
- family planning practices
- abdominal enlargement
- loss of fertility

- exercise pattern
- sleep pattern and disturbances

- visual acuity and prosthesis
- hearing ability and prosthesis

- personal hygiene
- skin integrity
- pre-anesthetic and pre-operative readiness
2. Psychosocial
ii. Trust
- wife/husband relationship
- family relationships
iii. Self-Concept
- knowledge of condition, required surgery and implications
iv. Self-Esteem
- body image
- job satisfaction
- community involvement
vi. Socio-Cultural
- husband and family knowledge of the condition and implications of
the intervention
vii. Economic
- family finances
- health and hospitalization insurances
3. Environmental
- housing and living conditions
- basic sanitation
4. Lifestyle
- substances abuse
- occupation
- hobbies
B. Planning
5. Team approach
C. Implementing
1. Physiological
i. Oxygen
- monitor vital signs
- ensure clear airway
- assist with breathing exercises
- administer blood transfusion as ordered
ii. Nutrition
- maintain adequate nutrition: diet
intravenous infusion
iii. Elimination
- maintain and record intake and output
- monitor urinary drainage
- give catheter care
- ensure bowel activity
iv. Activity, Rest and Comfort

- positioning
- ensure bed rest as prescribed
- provide exercise
- ambulate early
- promote self-care activities
- Create stimulating environment
- Reduce painful stimuli
vi. Sexuality
- counsel wife and husband on implication of loss of uterus
- observe for changing moods and needs

- maintain personal hygiene
- administer prescribed medications
- give routine or special pre- and post-operative care
- interpret laboratory values
- observe for allergic reactions
- observe for, and prevent complications
- prepare for discharge
2. Psychosocial
ii. Trust
- encourage acceptance of condition
- encourage family participation in care
iii. Self-Concept
iv. Self-Esteem
- provide for occupational therapy
- encourage self-care
vi. Socio-Cultural
vii. Family Economics

- provide for completion of insurance forms
3. Environmental
- modify living conditions
4. Lifestyle
- modify as necessary
- give instructions for discharge
- do anticipatory teaching: menopause
sexual function
activities
- arrange for referrals
- follow-up
D. Evaluating

EXAMPLE V
FACTOR: HYPERACTIVE BEHAVIOUR (ANXIETY NEUROSES) (35 YEARS)
A. Assessing
1. Physiological
i. Oxygen
- vital signs
- breathing pattern
- pulse rate
ii. Nutrition
- appetite
- food fads
- idiosyncrasies
- pica
- weight
iii. Elimination
- bowel patter – frequency
- voiding pattern – frequency
- diaphoresis
iv. Sexuality
- sexual pattern and practice
- body image
- role identity

- rest patterns
- degree of activity and agitation
- gait and posture
- hand movements, facial expressions
- sleep patterns and disturbances

- environmental stimuli
- irritability/hostility
- sensorium
- visual, auditory, memory distortions
- speech patterns
- phobia
- decision-making ability, reasoning and comprehension

- personal hygiene practices
- mode of dress
- nail biting
2. Psychosocial
ii. Trust
- family history
- recent changes, loss/grief, separation
- family dynamics/relationships
- spousal relationships
- child/parent relationships
- in-law relationships
- sibling relationships
- significant others relationships
- peer group/work relationships
- acceptance of others (e.g., minority groups)
iii. Self-Concept
iv. Self-Esteem
- self-acceptance
- ambivalence – self and others
- mood swings
- self-reliance, self sufficiency
- guilt, doubts, fears, obsessions
- acceptance by others
- usual coping patterns
- problems with law enforcement officers
- social and community development
- life’s goals/philosophy
- religious and political concerns
3. Environmental
- ecology
- residence facilities
o housing
o lighting
o water
o sanitation
o companionship
4. Lifestyle
- relation with social/ethnic groups
- customs
- values
- beliefs
- income/income source
- s[ending pattern
- use of patent medicines
- substance abuse
- occupation and job changes
- leisure/recreational activities
B. Planning
5. Team approach
C. Implementing
1. Physiological
i. Oxygen
ii. Nutrition
- encourage food intake
- offer small, attractive meals
- monitor weight gain
iii. Elimination
- encourage regular bowel activity
- monitor urinary output
iv. Sexuality
- monitor interest in appearance

- establish controlled activity programme
- promote suitable and safe sleep environment
- give prescribed medications
- note effects of drug therapy
-

- control environmental stimuli
- maintain calm attitude and manner
- give firm, clear instructions

- ensure good personal hygiene
- establish a team approach to care
2. Psychosocial
- establish helping nurse/patient relationships
- therapeutic communication; process recording
- observe response to therapy
ii. Trust
- encourage development of trust
- encourage acceptance of behaviour
- adopt non-judgmental attitude
- document and report all observations
iii. Self-Concept
iv. Self-Esteem
- assist client to face realities
- support improvement in self-confidence
- develop therapeutic milieu
- encourage occupational and group therapy
- encourage diversional therapy – games, music, etc.,
- provide behaviour therapy
- provide psychotherapy
- support employment efforts
vi. Family Therapy

- establish positive relationships
- allow for verbalization of feelings
- encourage
- participation:
- understanding of problem
- use of coping mechanisms
- cooperation with therapists
3. Environmental
- modify environment where necessary
- refer to social services
4. Lifestyle associations
- modify to ensure meaningful
-
educate patient and family in relation to:
- acceptance of patient’s behaviour

- use of discharge medications
- recreational activities
- work activities
- signs of relapse
- personal hygiene
- nutrition
- setting limits on patient’s behaviour
- creating a therapeutic environment
- follow-up and continuity of care through use of team approach
- referral services
- follow-up
D. Evaluating

EXAMPLE VI
FACTOR: DIABETES MELLITUS (55 YEARS)
A. Assessing
1. Biographic Data
- family history
2. Physiological
i. Oxygen
- peripheral circulation
- vital signs
ii. Nutrition
- weight
- fluid intake
- appetite
- dietary practices
- hydration
- dental health
iii. Elimination
- glycosuria
- voiding pattern
- urine volume
- bowel habits
- attraction of ants to urine

- gait
- exercise tolerance
- sleep patterns
- sensorium
- visual acuity
- tactile sensation
vi. Sexuality
- pruritis
- sexual activities
- body image

- blood sugar levels
- condition of skin
3. Psychosocial
i. Self-Concept
ii. Self-Esteem
- body image
iii. Love and Belonging

- family relationships
v. Family Income
4. Environmental
- occupational hazards
- hazards in the environment
5. Lifestyle
- smoking habits
- substance abuse
- sporting and recreational activities
- occupation
B. Planning
5. Team approach
C. Implementing
1. Physiological
i. Oxygen
- monitor peripheral circulation
ii. Nutrition
- advise on:
- dietary management
- food exchanges
- required calories
- meal distribution
iii. Elimination
- urinalysis
- monitor urine volume

- advise on activity programmes
- manipulate environment
vi. Sexuality
- advise on genital hygiene

- Interpret diagnostic tests
- Counsel on: drug therapy
General hygiene
Special care to feet, eyes, skin and nails
Special care if surgery is warranted
2. Psychosocial
ii. Trust
iii. Self-Concept
iv. Self-Esteem
- encourage family participation in care
- encourage involvement in community affairs
- suggest types of diversional therapies
- suggest sources for financial assistance if necessary
3. Environmental
- control environmental hazards
4. Lifestyle
- modify lifestyle as necessary
- develop new recreational interests
- limit drug, alcohol and tobacco consumption
- condition and complications
- management to foster self-care and self-reliance
- urine testing
- dietary therapy
- drug therapy
- care of feet, eyes, nails and skin
- exercise
- sexuality
- prevention of infection
- importance of follow-up
- travel
- eating out
- blood sugar monitoring
(e.g., Diabetic Clinics and Associations)
- referral services
- follow-up
D. Evaluating

EXAMPLE VII
FACTOR: SENILITY (80+ YEARS)
A. Assessing
1. Physiological
i. Oxygen
- breathing patters
- vital sogns
- history of cardiovascular and respiratory problems
- cough
- sputum
- peripheral
ii. Nutrition
- condition of teeth
- dental health
- diet
- food preferences
- fluid intake and preferences
- weight
- swallowing
iii. Elimination
- bowel pattern
- voiding pattern
- continence
- perspiration
iv. Sexuality
- sexual need

- posture
- sleep pattern
- exercise
- recreation
- mobility
- mental status
- visual acuity and prosthesis
- hearing ability and prosthesis
- speech pattern
- sensorium
- use of prosthesis and their conditions
- personal hygiene
- prescribed medications
- hazards in environment
2. Psychosocial
ii. Trust
- family support
- significant others’ support
- interaction with family and others
iii. Self-Concept
iv. Self-Esteem
- ability for self-care
- acceptance of readiness for death
vi. Cultural Belief About Aging
vii. Economic Situation

- finances
3. Environmental
- environmental hazards
- basic sanitation
4. Lifestyle
- concept of disengagement
- recreation
- hobbies
- occupational activities
- participation in community activities
B. Planning
5. Team approach
C. Implementing
1. Physiological
i. Oxygen
- monitor effects of activity on cardiovascular and pulmonary systems
ii. Nutrition
- advise on good dental health
- ensure provision and eating of nutritious foods
- stimulate appetite by various measures
iii. Elimination
- ensure bowel regularity
- measures to cope with incontinence
iv. Sexuality
- encourage peer association
- encourage hair and nail care and attractive dressing

- encourage exercise – daily walks
- provide for recreational activities
- ensure adequate rest
vi Sensory Stimulation
- reality reorientation
- assist with provision of prosthesis
- assist with development of stimulating environment

- protect from environmental hazards
- counsel on personal hygiene
- administer and/or advise on medications
- check prostheses for safety
- advise on appropriate uses and care of respective prostheses
- ensure appropriate management of diagnosed ailments
2. Psychosocial
ii. Trust
iii. Self-Concept
iv. Self-Esteem
- involve client in planning activities
- counsel on preparation for death
vi. Socio-Cultural
- monitor effects of cultural beliefs about aging on clients welfare
vii. Economics
- ensure financial assistance and legal aid
3. Environmental
- ensure safe environment
- create a home-like environment
4. Lifestyle
- develop new hobbies/activities
- nutrition
- hygiene
- dental health
- activity/exercise
- accident prevention
- leisure time
- maintenance of independence
- sexuality
- economic situation
6. Community Resource
- referral services
- follow-up
D. Evaluating

GUIDELINES FOE DEVELOPING THE TABLE OF SPECIFICATIONS

While it is recognized that the candidate may utilize all levels of the cognitive taxonomy
in solving nursing problems, the objective-type items will focus on testing the knowledge,
comprehension and application skills of the candidate.
On the other hand, the essay-type items will test all levels of the cognitive and affective
taxonomies, but in these terms emphasis will be placed on application, analysis, synthesis and
evaluation skills of the candidate.
Weighting of Papers
The four papers composing the examination will be weighted as follows:
Clinical Nursing - 60-70 percent

Functional Nursing - 30-40 percent
The above weightings define the parameters and standards for the professional nurse
examination at the beginning level of practice.
Weighting of the Total Examination
Final weighting of each section of the Regional Examination will be at the dissection of
the RGNCs, to be decided on at each annual meeting. However, the suggested weightings are:
 Objective-type items – 60%

 Essay-type items – 40%
It is further suggested that the essay-type items be weighted no higher than 50% of the total
examination.
Scoring
The pass mark for each paper will be set at 60 percent.
The Regional Examination will define, for each examination paper, a minimum score below
a nurse’s practice is at risk. Each Member Country, however, will reserve the right to decide
on the registration criteria based on its GNC Regulations.
The examinations will also produce for each candidate a set of scores to describe hi/her
performance.
Weighting of Components of the Blueprint
The following weightings for various components of the Blueprint document will be used:
1. Types and Levels of Nursing Skills
Cognitive
Objective Items Essay Items
Knowledge 25 )
Comprehension 35 ) 100%
Application 40 ) 25)
Analysis 35)
Synthesis 20) 100%
Evaluation 20)
Affective and Psychomotor
Both the affective and psychomotor domains will be reflected in the written
examination. Essay-type questions will test at all levels of the affective
domain. Only the cognitive component of the psychomotor domain will be
tested in the written examination.
Guidelines for clinical assessment relative to the psychomotor domain are

provided in the Blueprint.
2. Major Concepts of the Blueprint
Nursing Competencies
Clinical Nursing
The Nursing Process:
 Assessing 30%
 Planning 25%
 Implementing 25%
 Evaluating 20%
Functional Nursing:
 The Profession of Nursing 30%
 Administration/management 30%
 Research 10%
 Teaching, Interviewing and
Counselling 30%
2.2 Categories of Health Problems

All categories of health problems will be tested in each examination. The emphasis
placed on a category will related to the prevalence of health problems for that category in
the Caribbean.
Major emphasis will be placed on the following categories:
 Infectious/inflammatory
 Neoplastic
 Accident/trauma
 Degenerative
 Psychosocial/psychiatric
 Environmental
Less emphasis will be placed on these categories:
 Congenital
 Genetic
 Infestations
 Allergic/immunological
A minimum number of items will test the candidates’ knowledge and understanding of
the health infrastructure of the Region
In preparing essay-type items, the writer will include aspects of primary, secondary and
tertiary levels of health. As well as primary, secondary and tertiary levels of health care.
2.3 Growth and Development
Each age group will receive equal weighting since it is necessary for a professional nurse
to be acknowledgeable in all areas.
Needs
The examination will deal with all the needs, since they are common to individuals at all
stages of the life cycle.
3. The examination will deal with all areas of Nursing as outlined below:
3.1 Clinical Nursing Content
 Health
 Growth and Development
 Needs and their Satisfaction
 Factors Affecting Needs Satisfaction
 Needs Alterations
 Indicators of Community Health
 High-risk Individuals and Groups, including Emergencies
 High Programmes for Special Groups
 Health and Family Life Education
 Family Unit
 Pregnancy
3.2 Functional Nursing Content
 Role of the Nurse in Disaster Preparedness and Management

 Group Dynamics
 Teaching and Learning Process
 Communication Process
 Profession of Nursing
 Health and Health-Related Organizations and Agencies at National, Regional and
international Levels
 Administration/management
 Application of Basic Research Methodology in Solving health Problems
Under Functional Nursing, the most emphasis will be placed on the Profession of Nursing
and Administration/Management.
Man and His Environment
The content related to Man and His Environment will be integrated into the
nursing content. However, no more than 30 percent of all the items will reflect the
content of man and His Environment.
TEST ITEMS
Pre-Testing of Items
All items to be used for Regional Examination will be pre-tested.
Lifespan of Objectives and Test Items
1. Specific objectives will be retained for five (5) years, reviewed and updated as
necessary.
2. Test Items will be used for one examination, stored, review and made available for
reuse after two years.
3. Examination papers (scripts) will be retained by each GNC for five (5) years and then
destroyed.
TABLE 1
COMMON HEALTH PROBLEMS IN THE CARIBBEAN
ARRANGED
BY AGE GROUPS AND CATEGORIES
CATEGORIES AGE GROUPS AGE GROUPS

Birth - 4 years 5 - 11 years 12 - 19 years 20 - 44 years 45 -64 years 65+ years
Congenital/Genetic Intussucpeption scolosis     
haemophilia
Syphilis
neonatal jaundice
cleft lip
Oesophageal malformatos of   
atresia reproductive organs
and related
structures
pyloric stenosis
Hurschsprungs
imperforate anus
Talipes
hydrocephalus
spina bilula
heart conditions
CATEGORIES AGE GROUPS
Birth - 4 years 5 - 11 years 12 - 19 years 20 - 44 years 45 - 64 years 65+ years
Congenital /Genetic Meningoceole     
(cont=d)
Cataract
Down’s syndrome
Sickle cell anemia
genito-urinary malformations  
physical disabilities 
Infectious/ umblical infections eye infections     
Inflammatory upper respiratory
tract infections
broncho pneumonia
bronchiolitis
diarrheal diseases
tetanus
HIV+
skin disorders
communicable diseases
dental health
rheumatic fever 
Meningitis 
Osteomyelitis    
acute
glomerulonephritis
AGE GROUPS
CATEGORIES
Accidents/Trauma cot deaths

child abuse 
burns     
fracture
poisoning
head injuries
foreign bodies
internal injuries
dismemberment
wounds
asphyxiation
abortion 
ectopic
gestation
industrial  
accidents
prelapsed
intravertebral disc
multiple injuries   
due to motor
vehicles
Infestations helminal tests     
scabies
schistos masis
filariasis
malaria
pediculosis
dengue
AGE GROUP
CATEGORIES
Allergic/ eczema 
Immunological
(cont=d)
Nephritic syndrome
hay fever    
Anaphylactic shock   
serum
sickness
Systemic lupus
erythematous
Rheumatoid
arthritis
polyarthritis
polyarteritus
nodosa
sexually transmitted   
diseases
urinary tract
infections
pelvic inflammatory
disease  
appendicitis   
pulmonary
tuberculosis
AGE GROUP
CATEGORIES
Birth - 4 years 5 - 11 years 12 - 19 years 20 - 44 years 45 -64 years 65+ years
Infectious/ prostatitis Periodontal senile vaginitis

Inflamattory viral hepatitis disease
(cont=d) cholecystitis
leptospirosis
bacterial endocarditis
Hansen’s disease
pancreatitis
bronchitis
urethral
stricture
Neoplastic Wilm’s tumour leukemia    

neuroblastomia brain
smooth muscle tumrours
tumours bone tumours
fibroadenoma   
ovarian cysts
ovarian
tumours
uterine cancer  
breast cancer
fibroids
cancer of the
stomach
AGE GROUP
CATEGORIES
Neoplastic polycythemia 
(cont=d) vera
benign prostatic
hyprotrophy
cancer of:
penis
tongue
lungs
colon
larynx and
oesophagus
prostate
Degenerative hernias     
visual defects
hearing defects
transient  
ischaemia
hypertension
peptic ulcer
myocardial
infraction
renal
calculi
varicosities
aneurysms
emphysema
urinary 
incontience
osteo-arthritis
parkinson’s disease
CATEGORIES AGE GROUP
Degenerative cirrhosis of the liver 
(cont=d) arteriosclerosis
glaucoma
cataract
cerebrovascular disease
congestive cardiac
failure
osteoporosis
Metabolic/ protein calorie     
Nutritional/ malnutrition
Endocrine
failure to thrive
inborn error of  
metabolism
anaemias     
vitamin
deficiencies
malabsorption
syndrome
non toxic goitre  

gout, obesity
thyrotoxicosis
myxoedema
diabetes mellitus
CATEGORIES AGE GROUP

Environmental ecological     
imbalance
vectors
unsafe housing
overcrowing
poor sewage and
solid waste
disposal
poor water management
improper food and
milk hygiene
disaster:
manmade and
natural
deficient
educational
opportunities breakdown in
social order
Health types and availability of services and     
infrastructure human resources
ANNEX II
TABLE II
CORE LIST OF NURSING SKILLS FOR

SCHOOL-BASED ASSESSMENT
CLINICAL NURSING COGNITIVE PSYCHO AFFECTIVE

MOTOR
Oxygen
1. Take, record and interpret vital signs   
2. Administer oxygen by mask, nasal canula or tent   
3. Administer steam inhalation   
4. Suction patient   
5. Perform coughing and deep breathing exercises   
6. Collect specimens
$ sputum   
$ nasal swab   
$ throat swab   
7. Perform cardiopulmonary resuscitation   
8. Prepare patient for and manage during and after:
$ thoracentesis   
$ bone marrow aspiration   
$ tracheostomony   
$ underwater seal drainage   
$ nebulization
  
Nutrition
9. Prepare and administer oral and parenteral fluids 

 
10. Serve meals
$ regular
$ special diets   
11. Feed helpless patients
  

12. Feed infants and preschoolers  
13. Administer artificial feeding:   

$ intravenous
$ nasogastric
$ gastrostomy   
$ hyperalimentation   
  
  
14. Measure height and weight
15. Measure and record intake and output

  
  
Elimination
16. Prepare for urethral catherization (male)

  
17. Prepare for urethral catherization (female)
  
18. Collect urine specimens from patient to include
24-hour specimen   
19. Perform urinalysis
  
20. Give and remove bed pans/urinals
21. Care for and remove indwelling catheters

  
22. Manage urinary bladder drainage
$ supra-pubic catheter   
$ indwelling uretheral catheter   
$ condom drainage   
$ other   
23. Irrigate urinary bladder   
24. Give cleansing enema

  
25. Insert rectal suppositories
  
26. Care for stoma
  
Activity, Rest and Comfort

27. Observe neurological signs
  
28. Care for patient in splints, casts and tractions

 
29. Perform range-of-motion exercises

30. Assist patient to move in and out of bed  

31. Lift, turn and position patient  

32. Perform last offices  

 
Sensory Stimulation
33. Instill drops - eye, ear and nose


34. Assess ocular and auditory senses
  
35. Cleanse eyelids
  
36. Collect conjunctival swabs
  
37. Apply eye-pads

38. Irrigate eye  

39. Irrigate ear  

 
Safety and Security
40. Administer medications:
$ oral   
$ intradermal
  
$ hypodermic
$ intramuscular   

41. Store drugs
 
42. Care for wound:
$ surgical dressing

$ removal of sutures and clips
$ removal of drain packs
$ wound irrigation  
  
43. Give bed bath
  
44. Give mouth care   

45. Give skin and pressure care  

46. Apply bandages, splints, restraints, tourniquets, other
 
47. Use and maintain prostheses: 
 
$ wheelchair 
$ walkers
 
$ canes
$ crutches 
$ artificial limbs
$ other
 



Safety and Security 
(cont=d)   
  
48. Apply electric and electronic patient devices 
49. Conduct a screening programme  


50. Make beds and use bed accessories
51. Arrange equipment/instruments for minor operations

 
52. Perform barrier nursing and infection control   
  
53. Do case finding and contact tracing   

54. Counsel patient and family  

55. Prepare patient/client and equipment for delivery  
56. Observe ante, intra and post partum patients

 
57. Give sitz bath, vulval swab, episiotomy care 
 
58. Prepare patient for: 
$ surgery
$ bone marrow aspiration  
$ paracentesis abdominis   
$ lumbar puncture
  
$ endoscopy

  
Sexuality   
59. Prepare for examination of genital areas for (male and

female)
Nursing Process
60. Utilize the nursing process in giving care:
 assessing – to include history taking and   
completephysical assessment   
  
 planning – to include written care plan   
 implementing – to include report and recording
 evaluating – to assess outcomes of care
FUNCTIONAL NURSING
61. Use interview techniques   
62. Counsel and teach patient/client   
63. Perform management skills
$ planning   
$ organizing   
$ directing  

64. Apply:
$ epidemiological approach   
$ research methodology   
ANNEX III
GUIDELINES FOR THE USE OF CORE LIST OF NURSING SKILLS

FOR ASSESSMENT OF CANDIDATES
Guidelines
1. Continuous clinical assessment of students should be done by nursing schools throughout the educational programme, using
the approved core list of nursing skills.
2. All skills outlined in the core list must be taught.
3. All items included in the core list must be completed successfully before entry to the final programme examination.
4. Close supervision and teaching of students in the clinical areas must be provided.
5. Students must be made aware of their strengths and weaknesses through the use of anecdotal records.
6. Before the final programme examination, students must complete a specified number of hours of practical instructions as
determined by the General Nursing Council.
7. A standardized checklist will be used to determine the students’ proficiency in each area of skill.
8. The students’ performance of each skill must be assessed and recorded on the checklist by the person supervising the student.
9. Activities should be grouped according to patients’ needs.
10. The critical skills indicated by asterisks as outlined in the checklist denote that some steps of the nursing procedures are critical
and can endanger the life of a patient if performed inaccurately.
11. Any student who fails in performing accurately a skill(s) which is/are indicated as critical will, at the discretion of the
examiners, be asked to discontinue the assessment.
12. Students should be given further instruction for a specified period before reassessment of those skills, which were not
performed accurately.
N.B. Examples I and II provide an assessment checklist for surgical aseptic technique and an observation checklist, respectively.
ANNEX III
EXAMPLE I
ASSESSMENT CHECKLIST FOR SURGICAL ASEPTIC TECHNIQUE
Candidate No:
Candidates are expected to perform in all areas list and MUST pass in areas with as asterisk (*)
Examiners: ____________________________________
____________________________________
____________________________________
AREAS OF ASSESSMENT PASS FAIL REMARKS SIGNATURE

*1. Preparation and care of equipment
and environment
2. Communication with the patient
*3. Maintenance of patients privacy
*4. Maintenance of sterile field
*5. Manual dexterity in use of equipment
6. Comfort of patient
*7. Knowledge of underlying principles
8. Disposal of infected dressing
9. Recording and reporting of relevant

Information
ANNEX III
EXAMPLE II
OBSERVATION CHECKLIST
PROCEDURE:
CANIDATE NO.: COUNTRY:
OBSERVER:
PROCEDURAL STEPS COMPLETED PARTIALLY NOT CREDIT REMARKS

COMPLETED COMPLETED
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
TOTAL
ANNEX IV
CRITERIA FOR CLINICAL ASSESSMENT
1. Nursing theory and clinical practice must be integrated.
2. Students must be taught nursing courses relevant to procedures.
3. Clinical objectives related to nursing courses must be developed to guide students

practice; must be discussed with students and their supervisors; and must be used by
the school, nursing service and students.
4. Tools for clinical evaluation, derived from the clinical objectives, must be developed
and used to assess students’ performance in the clinical areas.
5. Tools for clinical evaluation include checklists, anecdotal records, profiles, other.
6. Checklists of nursing procedures must be developed in a sequential format.
7. Appropriate supervision, continuous assessment and feedback to the students in the

clinical areas are required to improve clinical performance.
8. In order to complete the clinical component of the nursing programme, the students
must be assigned to all designated areas for the specified time.
9. Students must be allowed to practice in the Demonstration Room/Practical Room to

gain mastery of skills.
10. Clinical assignment and evaluation tools must form part of the students’ permanent
records.
11. Clinical assessment must focus on the overall care provided to one or more patients,
using the nursing process and will include the related procedures performed.
12. Clinical assessment will include assessment of the overall organization and
management ability of students, to include such areas as management of time and
resources, communication skills, etc.
ANNEX VII
GLOSSARY
For the purpose of this Blueprint, the following terms are operationally defined:
1. Comprehensive nursing care
Promotive, preventitive, restorative/curative, habilitative/rehabilitative care.
2. Critical elements of needs interferences
The actual and/or potential responses to need interferences that threaten the
physiological and psychosocial well-being of the individual, family and community.
3. Critical areas of care
Comprehensive nursing care provided in response to the critical elements of

needs interferences.
4. Disabled
A person with structural and/or functional defects who is able to carry out
activities of daily living within his capacity.
5. Elderly
The term elderly in the Blueprint refers to individuals age 65 and over, and is
used synonymously with the term aging.
6. Factor
Conditions that maintain or change the health status of man. For the purpose
of the Blueprint, the following four factors are identified:
o Biological - innate physiological factors

o Psychosocial - mental and interpersonal factors
o Environmental - physical factors external to man
o Lifestyle - typical patterns of living
Maternity Cycle
That period from conception to six weeks post-natal. Any reference to the maternity
cycle includes care of the mother, neonate and other members of the family.
Optimum health
The highest level of health achievable by the individual.

ANNEX VIII
BIBLIOGRAPHY
1. Bloom, Benjamin, S. (1965). Taxonomy of educational objectives:

cognitive domain. New York: David McKay Co. Inc.
2. Canadian Nurses Association. (1977). A Blueprint for a Comprehensive

Examination for nurses registration/licensure. Ottawa: CNATS
3. Caribbean Community Secretariat. (1979). Report of workshop on phase II of

feasibility study on regional examination for nurse registration. (Unpublished)
Guyana: CARICOM Secretariat
4. Caribbean Examinations Council. (1977) Secondary Education certificate:

Mathematics syllabus. Barbados: CXC.
5. Caribbean Schools of Nursing. (1976). Curricula, Ministries of Health and

PAHO/WHO. (Unpublished)
6. Krathwohl, David, r., bloom, Benjamin, Masta, S., and Bertran, B. (1964).
Taxonomy of educational objectives: affective domain. New York: David McKay Co.,
Inc.
7. Lukmann, Joan and Sorensen, Karen. (1980). Medical-Surgical nursing: a

Psycho-physiological approach. Philadelphia: W.B.Saunders Co.
8. Reillky, Dorothy E. (1975). Behavioral Objectives in nursing: evaluation of

Learner attainment. New York: Appleton Century-Crofts.

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Blueprint Regional Examination For Nurse Registration Caricom

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BLUEPRINT

Caribbean Community in collaboration with

LIST OF ILLUSTRATIONS ……………………………………………. iv

PHILOSOPHY OF NURSING ………………………………………….. 3

PURPOSE OF THE BLUEPRINT ……………………………………… 5

OBJECTIVES OF THE BLUEPRINT …………………………………. 6

CONCEPTUAL FRAMEWORK ………………………………………. 7

AGREED ON GENERAL COMPETENCIES FOR THE

OUTLINE OF THE MAJOR CONCEPTS OF THE BLUEPRINT

1. Growth and Development …………………………………. 12

3. Factors Affecting Needs Satisfaction ……………………… 13

4. Common Health Problems of the Caribbean ………………. 13

5. Nursing Process ……………………………………………. 14

MAJOR CONTENT AREAS

A. Man and His Environment ………………………………….. 16

CONTENT OUTLINE ……………………………………………………… 25

Biological and Psychosocial Factors Promoting and

GUIDELINES FOR DEVELOPING THE TABLE OF

TEST ITEMS ………………………………………………………………….. 83

ANNEX VI, FIGURE II:

ANNEX II, TABLE II:

ANNEX VI, FIGURE II

 Caribbean Community Secretariat

 Canadian International Development Agency (NGO)

 Ministry of Education, Guyana

 Pan American Health Organization/World Health Organization

 University of the West Indies

Contributions made by Ministries of Health, Ministries of Education, General Nursing

Dr. Una V. Reid

A workshop at Dover, Barbados, in 1978 provided a document, which included common

3. Provide adequate security for production and administration of examination

4. Institute continuing research an examinations and examinations policies.

5. Provide data for evaluating curricula for Schools of Nursing.

The nurses of CARICOM Member countries believe that …

3. The health status of man is affected by environmental, biological, psycosocial and

7. Access to quality health care is a basic human right,

9. Health care should be comprehensive, continuous and coordinated, at primary, secondary

13. Nursing is a profession

17. The nurse functions as a clinician, educator, administrator/manager/change agent,

PURPOSE OF THE BLUEPRINT

The Blueprint for Regional Examination for Nurse Registration:

2. Outlines the cognitive, affective and psychomotor domains to be tested;

3. Shows the inter-relationships of areas to be tested;

5. Identifies common health problems in the Caribbean;

6. Categorizes common health problems in the Caribbean;

7. Delineates the critical elements and nursing competencies to be tested;

8. Specifies relevant scientific content essential to the practice of nursing;

The Blueprint reflects nursing as unified and integrated. Nursing practice, as

The major concepts of the Blueprint are:

1. Growth and development

3. Factors affecting needs satisfaction

4. Common health problems of the Caribbean

The major content areas of the Blueprint to be tested are:

A. Man and his Environment

AGREED ON GENERAL COMPETENCIES

1. Use the problem-solving approach to:

(d) evaluate the effectiveness of nursing care based on stated objectives.

3. Apply knowledge of the bio-psychosocial, spiritual and environmental factors in the

6. Utilize principles and skills of management in administering health care units.

8. Perform teaching functions in relation to the development of colleagues, students and

10. Function as a member of the interdisciplinary health team in the provision of

18. Participate in community activities in carrying out his/her responsibilities as a

1. Growth and Development