Cebu Normal University

Osmea Blvd., Cebu City College of Nursing - Graduate Studies

COMPETENCY BASED INSTRUCTIONAL MATRIX

Subject: Medical Surgical Nursing Nursing Topic: Communicable Disease Nursing Care of a Client with Pulmonary Tuberculosis (PTB) A. NURSES BEGINNING ROLE ON CLIENT CARE D Learning Outcomes Motr Dec Stra Pro Att . l. t. c. K . S K K Degree Program: Bachelor of Science in

A Competencies
1. Ensures a working relationship with the client with PTB and/or support system based on trust, respect, and shared decisionmaking.

B Elements
a. Establishing Rapport

C Instructional Objectives
1. Shares pertinent information about oneself as nurse-partner. 2. Explains the nature and purpose of nurse-client working relationship, 3. Directs with respect and trust client partners concern. 1. Obtains a comprehensive and systematic nursing assessment database of a client with PTB through the application of appropriate data gathering techniques. 2. Relates data with each other to determine patterns, recurring themes, or processes that are pertinent based on the clients health history and physical assessment database. 3. Determines which data are

E Instructional Activities
Role Playing Lecture Method Case Incident Method Nursing Care Study

F Outcome Measures
Performance Assessment Pencil-Paper Test (Essay Type) Observation Assessment Product Assessment (Case Study)

2. Assesses with the client with PTB ones health status/competence.

a. Nursing Health History Taking (Biopsychosocial Approach) b. Physical Assessment Techniques (I.P.P.A) c.Nursing Process: Assessment

Nursing Care Study

Product Assessment (Case Study)

Nursing Care Study

Product Assessment (Case Study)

normal and which are not within normal limits that are suggestive of the diagnosis. 4. Identifies subjective and objective cues of the client in order to determine focus of care.

Product Assessment (Nursing Care Plan) Nursing Care Study

3. Specifies clients status / conditions / problems to be addressed identifying reasons (etiology) for the existence of the condition or problem 4. Formulates with the client a plan of care to address the health conditions, needs, problems, or issues based on priorities.

a. Nursing Process: Diagnosis

1. States nursing diagnosis/nursing problem accurately from the list of priority conditions.

Nursing Care Study

Product Assessment (Nursing Care Plan)

a. Nursing Process: Planning

1. Sets priorities among a list of conditions or problems identified from the client. 2. Specifies goals, objectives, and expected outcomes of care maximizing clients competencies. 3. Develops with the client an evaluation plan specifying criteria/indicators, methods, and tools. 1. Define in simplest terms what Pulmonary Tuberculosis is all about. 2. Explain the pathophysiology of the disease leading to the identification of the clinical manifestations. 3. Assesses clients knowledge of the disease. 4. Conducts a health teaching on the definition, etiologic and risk

Nursing Care Study Nursing Care Study

Product Assessment (Nursing Care Plan) Product Assessment (Nursing Care Plan) Product Assessment (Nursing Care Plan)

Nursing Care Study Lecture Method Lecture Method Pencil-Paper Test (Essay Type) Pencil-Paper Test (Essay Type) Observation Assessment

5. Implements safe and quality interventions with the client with PTB to address the health needs, problems, and issues.

a. What is Pulmonary Tuberculosis? b. Etiology and Risk Factors of PTB c.Pathophysiology of PTB. d. Mode of Transmission and Prevention of spread of PTB e. Nursing Process:

Process Record

Nursing Care Study

Portfolio and Direct Observation

Implementation

factors, clinical manifestations, mode of transmission, as well as the prevention of spread of PTB. 5. Implements appropriate evidence-based interventions to address specific concerns, issues, and problems based on the situation. 6. Maintains a positive attitude in caring for the client with PTB amidst the social stigma of having the disease. 1. Demonstrates proper and effective handwashing technique. 2. Demonstrates proper method of wearing and removing personal protective equipments. 3. Explains appropriate transmission-based precaution techniques to maintain infection control and safety. 1. Explains the steps in safe medication preparation and administration. 2. Enumerates the Ten Rights of Drug Administration (10)

Nursing Care Study

Product Assessment (Nursing Care Plan)

Case Incident Method

Self-Evaluation

6. Applies safety principles, evidencebased practice, infection control measures, and appropriate protective devices consistently, when providing nursing care

a. Transmissio n-Based Precaution b. Infection Control

Demonstration Method Demonstration Method Lecture Method

Return Demonstration Return Demonstration

Oral Examination Lecture Method Lecture Method Lecture Method Oral Examination Oral Examination Product Assessment (Drug Study) and Oral Examination Portfolio and Direct Observation

7. Implements strategies related to the safe preparation and administration of medications based on institutional policies and protocols.

a. Administerin g Medications b. Antituberculosis drugs

3. Explains each anti-TB drug according to its classification, mechanism of action, indications, contraindications, and side effects. 4. Conducts health teaching on each drug to the client with emphasis on the importance of compliance to the drug, the time and frequency of taking the medications, and the recommended interventions to alleviate the expected side effects Nursing Care Study

8. Implements safe, adequate, evidencebased care of the client during pre-, intra-, and postdiagnostic and treatment procedures.

a. Chest X-Ray b. Sputum Exam c.Tuberculin Skin Testing (Mantoux Test)

of the medications. 1. Explains to the client the purpose of the diagnostic and treatment procedure. 2. Prepares the client adequately prior to the procedure. 3. Performs evidence-based interventions pre-, intra-, and postdiagnostic and treatment procedure. 4. Demonstrates proper technique in administering Tuberculin Skin Testing (Mantoux Test) as a diagnostic procedure to determine exposure to TB. 5. Explains the steps in obtaining a sputum sample to determine the causative organism. 6. Relays diagnostic procedure results to the physician.

Lecture Method Role Playing

Observation Assessment Observation Assessment

Nursing Care Study Product Assessment (Case Study) Demonstration Return Demonstration Demonstration Return Demonstration Role Playing Observation Assessment Nursing Care Study Nursing Care Study Case Incident Method Product Assessment (Nursing Care Plan) Product Assessment (Nursing Care Plan)

9. Evaluates with the client the health status / competence and for process of nurse-client working relationship.

a. Nursing Process: Evaluation

1. Utilizes participatory approach in evaluating outcomes of care. 2. Specifies nature and magnitude of change in terms of clients health status / competence in the nurse-client relationship. 1. Maintains confidentiality in the safekeeping of records and other information. 2. Releases records and information based on protocol and principle of confidentiality.

10. Adheres to protocol and principles of confidentiality in safekeeping and releasing of records and other information.

a. Patients Bill of Rights: The right to confidentiality.

Self-Evaluation

Self-Evaluation Case Incident Method

11. Models professional behavior.

a. Professionali sm in Nursing

1. Articulates the values roles of nursing to the public.

and

Case Incident Method Case Incident Method Lecture Method

Self-Evaluation Self-Evaluation

2. Demonstrates consistently professional behaviour in words, actions, and in relating with clients, colleagues, and the general public. 12. Adheres to Ethicolegal considerations when providing safe, quality and professional nursing care to clients with Pulmonary Tuberculosis. a. Ethical Principles of Nursing Care 1. Specifies the Ethico-legal bases for providing safe, quality and professional nursing care to patients with Pulmonary Tuberculosis 2. Applies and Ethical principles to advocate for human and Societal well-being and preferences. 3. Makes professional decisions within ethical and legal parameters 13. Adheres to established norms of conduct based on the Philippine nursing law and other legal, regulatory and institutional requirements relevant to the care of patients with Pulmonary Tuberculosis 14. Protects clients rights based on Patients Bill of rights and Obligations. a. Scope and Standards of nursing practice b. Philippine Nursing Law 1. Acts in accordance with the Philippine nursing law and other legal, regulatory and institutional requirements relevant to the care of patients with Pulmonary Tuberculosis 2. Articulates Clearly the Scope and standards of Nursing Practice.

Pencil-Paper Test (Essay Type)

Lecture Method

Pencil-Paper Test (Essay Type) Pencil-Paper Test (Essay Type)

Lecture Method

Lecture Method

Pencil-Paper Test (Essay Type)

Lecture Method

Oral Examination

a. Patients Bill of Rights

3.

Advocates for Clients rights.

Role Playing

Observation Assessment Product Assessment (Nursing Care Plan)

4. Implements Strategies/Interventions to protect clients rights guided by the Patients bill of rights

Lecture Method

B. NURSES ROLE ON MANAGEMENT AND LEADERSHIP D Learning Outcomes Motr Dec Stra Pro Att . l. t. c. K . S K K

A Competencies
1. Maintains a harmonious and collegial relationship among member of the health team for effective, efficient and safe client care.

B Elements
a. Therapeutic Communication Techniques b. Conflict Resolution Strategies

C Instructional Objectives
1. Utilizes various avenues for open communication. 2. Listens to suggestion recommendation. and

E Instructional Activities
Role Playing

F Outcome Measures
Performance Assessment Oral Examination Observation Assessment

Lecture Method Case Incident Method

3. Specifies conflict resolution strategies/ approaches to resolve/ transform conflict situations.

4.

Helps health team resolve differences or areas of conflict by emphasizing concern about a specific situation or action involving safety issue, and suggesting alternatives and stating consequences.

Case Incident Method

Traditional PencilPaper Test (Essay; Extended response)

2. Maintains a positive practice environment.

a. Ethical Principles b. Therapeutic Communication Techniques

1. Specify strategies appropriate for the effective maintenance of positive practice environment. 2. Carries out appropriate strategies to maintain positive practice environment. 3. Determines effectiveness of implemented strategies.

Lecture Method

Traditional PencilPaper Test (Essay; Extended response) Observation Assessment Oral Examination

Case Incident Method Case Incident Method

3. Acknowledges the importance of a safe environment of care through the use of quality assurance, continuous quality improvement, and risk management strategies in patient with PTB.

a. principles of evidenced-based practice in decision making to ensure a safe environment of care

1. Explain the underlying principles of evidenced-based practice in decision making to ensure a safe environment of care. 2. Utilizes critical thinking in solving problems that arise in practice using current information input from patients and colleagues.

Lecture Method

Oral Examination

Lecture Method

Oral Examination

NURSES ROLE ON RESEARCH D Learning Outcomes Motr Dec Stra Pro Att . l. t. c. K . S K K

A Competencies
1. Determines if the research problems/questions, objectives and/or hypotheses are clearly and logically linked to the research purpose, concepts and relationships, and propositions generated from the study framework in the care of patients with PTB. 2. Analyzes the research study for adherence to the ethical principles and guidelines in all phases of the research study.

B Elements

C Instructional Objectives
1. Indicates if the research article has a clear identification of the research problem and its scope and limitations. 2. Recognizes if the research article has a clear, concise and logical statement of purpose, research question or hypothesis of the research article.

E Instructional Activities

F Outcome Measures

a. Patients Bill of Rights b. Research Participants Right c. Ethical Principles

1. Describes how the rights of human subjects are protected. 2. Identifies which ethical principles in nursing research were followed.