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    Chapter 5

    SUMMARY, CONCLUSION AND RECOMMENDATIONS

    In this chapter, the summary with its implications, conclusions of the findings as

    well as recommendations were developed in relation to the entire research study.

    Summary

    This study was conducted to find out the performance of Registered Nurses

    Health Enhancement And Local Services (RN HEALS) Program at Dr. Paulino Garcia

    Memorial Research and Medical Center deployed from January to December 2013.

    Performances before and during the training, and at the present employment were

    considered all in staff nurse and RN HEALS employees' perspectives.

    One hundred three (103) nurses at Dr. Paulino J. Garcia Memorial Research and

    Medical Center were utilized as the client-respondents. Fifty three (53) of which were

    staff nurses and the remaining number were RN HEALS employees. The researcher used

    the descriptive type of research in accomplishing this manuscript with the use of

    questionnaire as instrument in data gathering.

    In data gathering, the researcher used a four-segment questionnaire. Segment A

    had been used in gathering information about the socio-demographic profile of the

    respondents. Segment B provided descriptions for performance before the training;

    segment C for the performance during the training; segment D for the performance at

    present employment. For segments B, C, and D the researcher provided the respondents

    with a Likert scale of 1-4. 1 corresponds for never, 2 for seldom, 3 for often, and 4 for

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    always. Two sets of questionnaires were prepared, one for RN HEALS employees and

    one for the staff nurses.

    Findings

    1. The Socio-Demographic Profile of Employees under the RN HEALS ProgramMajority of the employees of the RN HEALS program belonged to the 22-

    25 years old group with 46 or 86.79% respondents. Further, 40 or 75.47%

    belonged to the female group. Additionally, a vast number of RN HEALS

    employees belonged to the single category with a number of 48 or 90.57%, 47 or

    88.68% had provided nursing services for 1-3 years, and 49 or 92.45%, were

    Bachelor's Degree Graduates.

    2.1. Performance of the Employees under RN HEALS Program as Described by

    Themselves Before Their Training

    The responses on all the items pertaining to the performance of RN

    HEALS employees before their training got an overall weighted mean of 3.21

    indicating that these items are Oftendone by RN HEALS employees. Among

    the identified items before their training, it was very remarkable that item number

    12 Clarify doctors order before carrying them out got the highest weighted

    mean of 3.47 and was verbally interpreted as always. The least among the list,

    however, was item number 37 Identify own learning and training needswhich

    had a weighted mean of 2.72and was verbally interpreted as "Often".

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    2.2. Performance of the Employees under RN HEALS Program as Described by

    Themselves During Their Training

    The responses on all the items pertaining to the performance of RN HEALS

    employees during their training got an overall weighted mean of 3.28 indicating that

    these items are Alwaysdone by RN HEALS employees. Among the identified items

    during their training, it was very remarkable that item number 10 Formulate nursing

    care plans according to patients needs and item number 12 "Clarify doctors order

    before carrying them out"both got the highest weighted mean of 3.55 and were verbally

    interpreted as "Always".The least among the list, however, was item number 37 Identify

    own learning and training needswhich had a weighted mean of 2.75and was verbally

    interpreted as "Often".

    2.3. Performance of the Employees under RN HEALS Program as Described by

    Themselves at their Present Employment

    The responses on all the items pertaining to the performance of RN HEALS

    employees at their present employment got an overall weighted mean of 3.37indicating

    that these items are Always done by RN HEALS employees. Among the identified

    items at their present employment, it was very remarkable that item number 12 Clarify

    doctors order before carrying them outand item number 17 "Disseminate information

    that will promotes health and healthy environment, preventive measures to illnesses and

    healthy lifestyle" both got the highest weighted mean of 3.60 and were verbally

    interpreted as "Always".The least among the list, however, was item number 37 Identify

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    own learning and training needswhich had a weighted mean of 2.79and was verbally

    interpreted as "Often".

    3.1. Performance of the Employees under RN HEALS Program as Described by

    Staff Nurses Before the Former's Training

    The responses on all the items pertaining to the performance of RN HEALS

    employees as perceived by staff nurses before the former's training got an overall

    weighted mean of 3.13 indicating that these items are Often done by RN HEALS

    employees. Among the identified items before the training of RN HEALS employees,

    staff nurses perceived that it was very remarkable that item number 5 Clarify doctors

    order before carrying them outgot the highest weighted mean of 3.51 and was verbally

    interpreted as "Always".The least among the list, however, was item number 37 Identify

    own learning and training needswhich had a weighted mean of 2.68and was verbally

    interpreted as "Often".

    3.2. Performance of the Employees under RN HEALS Program as Described by

    Staff Nurses During the Former's Training

    The responses on all the items pertaining to the performance of RN HEALS

    employees as perceived by staff nurses during the former's training got an overall

    weighted mean of 3.19 indicating that these items are Often done by RN HEALS

    employees. Among the identified items during the training of RN HEALS employees,

    staff nurses perceived that it was very remarkable that item number 12 Clarify doctors

    order before carrying them outgot the highest weighted mean of 3.49 and was verbally

    interpreted as "Always".The least among the list, however, was item number 37 Identify

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    own learning and training needswhich had a weighted mean of 2.79 and was verbally

    interpreted as "Often".

    3.3. Performance of the Employees under RN HEALS Program as Described by

    Staff Nurses in the Former's Present Employment

    The responses on all the items pertaining to the performance of RN HEALS

    employees as perceived by staff nurses at the former's present employment got an

    overall weighted mean of 3.29 indicating that these items are Always done by RN

    HEALS employees. Among the identified items during the training of RN HEALS

    employees, staff nurses perceived that it was very remarkable that item number 21

    Collaborate patient care with other members of the health care teamgot the highest

    weighted mean of 3.53 and was verbally interpreted as "Always".The least among the

    list, however, was item number 37 Identify own learning and training needswhich had

    a weighted mean of 2.87 and was verbally interpreted as "Often".

    Conclusions

    Based on the results and findings of the study, the following conclusions were

    drawn:

    1. Majority of the employees of the RN HEALS program belonged to the 22-25years old group, female, single, had provided nursing services for 1-3 years,

    and were Bachelor's Degree Graduates.

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    2. RN HEALS employees before their training often done the identifiedparameters. However, during their training and at their present employment,

    they were able to always perform the items identified.

    3. RN HEALS employees before and during their training often done theidentified parameters as perceived by staff nurses. However, at their present

    employment, they were able to always perform the items identified.

    Recommendations:

    The following recommendations were made based on the findings of the study:

    1. That hospital administrators should always find time to do the training needsassessment of the RN HEALS employees to make it certain that they were

    adequately and correctly exposed to areas that will stimulate them to grow

    professionally. This could be done prior to employees' training period, during

    the training period, and even after the training period.

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    Appendix 1

    Permission Letter

    July 14, 2013

    DR. HUBERTO F. LAPUZ (Sgd.)Chief of Hospital

    Dr. Paulino J. Garcia Memorial Research and Medical Center

    Cabanatuan City

    Thru: PINKY MIRIAM D. CANLAS, RN, MAN (Sgd.)Chief Nurse

    Sir:

    Christian Greetings in the name of our Lord, Jesus!

    I am a graduate student of Wesleyan University-Philippines taking up Master of Arts in

    Nursing. Currently, I am conducting my study on Performance Appraisal of

    Registered Nurses Health Enhancement and Local Services (RN HEALS) Program

    of Dr. Paulino J. Garcia Memorial Research and Medical Center" In line with this,

    may I request permission from your honourable office to please allow me to conduct the

    abovementioned study in your hospital. Rest assured that the information that would be

    collected will be treated with utmost confidentiality.

    Thank you very much and I am looking forward for your positive response. God bless

    you more.

    Respectfully yours,

    RAMIL V. GARCIA, RN (Sgd.)Researcher

    Noted by:

    ERLINDA C. DOMINGO, RN, MPH (Sgd.)Thesis Adviser

    DR. GENER S. SUBIA (Sgd.)Statistician

    DR. MA. VICTORIA PAZ B. PASCUAL (Sgd.)Dean, Graduate School

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    Appendix 2

    Cover Letter

    July 14, 2013

    Dear Colleague

    Greetings!

    I am presently conducting a study on Performance Appraisal of Registered

    Nurses Health Enhancement and Local Services (RN HEALS) Program of Dr.Paulino J. Garcia Memorial Research and Medical Center" in partial fulfillment of

    the requirement for the degree Master of Arts in Nursing at Wesleyan University

    Philippines.

    In this connection, may I request your assistance by filling out the attached

    questionnaires, honestly and accurately. Please do not leave any item unanswered. Restassured that all your answers will be treated with strict confidentiality.

    Thank you very much for your support and anticipated response.

    Respectfully yours,

    Ramil V. Garcia RN (Sgd.)

    Thesis Statistician:

    Prof. Gener Subia (Sgd.)

    Thesis Adviser:Prof. Erlinda Domingo (Sgd.)

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    Appendix 3

    Sample Questionnaire (For RN HEALS Employees)

    PART I. SOCIO-DEMOGRAPHIC PROFILE OF THE REPONDENTS

    Directions: please read and supply the needed information on the blank provided

    by placing a check. Rest assured that your responses will be treated with utmost

    confidentiality

    1. Name: ________________________ (optional)2. Age: _______3. Sex:

    ( ) Male

    ( ) Female

    4. Civil Status( ) Single ( ) Widowed

    ( ) Married ( ) Separated

    5. Educational Attainment( ) B.S. Nursing( ) Masters DegreeGraduate ( )Masters degree Student

    ( ) Doctorate Degree Graduate ( )Doctorate Degree Student

    6. Length of experience( ) less than a year ( ) 1-less than 3 years

    ( ) 3-less than 5 years ( ) more than 5years

    Part II. Self Assessment on performance before the RN HEALS Program

    Directions: Place a check mark ( / ) on the space provided that corresponds toyour answer

    4 Always All the time3 Often Most of the time2 Sometimes Not all the Time1 Never Not at all

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    BEFORE THE TRAINING 4 3 2 1

    1. Obtain a detailed patient history2. Perform case prioritization upon patient arrival3. Perform systematic head to toe assessment4. Formulate appropriate nursing diagnosis from the data

    obtained

    5. Documents assessment for networking and referral6. Explain to patients diagnostic procedures to be performed

    and the necessary preparation

    7. Prepare the patient for diagnostic procedure after securinginformed consent

    8. Identify abnormal laboratory and other diagnostic finding9. Identify expected outcomes of a holistic nursing intervention10.Formulate nursing care plans according to patients needs11.Implement the nursing care plan with the participation of the

    patients significant others

    12.Clarify doctors order before carrying them out13.Utilize infection control measure14.Prioritize patient needs and provide them accordingly15.Monitor patients progress16.Gather feedback from the patient and the his/her significant

    others

    17.Disseminate information that will promotes health andhealthy environment, preventive measures to illnesses and

    healthy lifestyle18. Establish a trusting relationship to the patient including their

    significant others

    19. Advocate patients rights

    20. Secure patients informed consent after a thorough

    explanation of the procedure or treatment to be performed

    21. Collaborate patient care with other members of the health

    care team

    22. Regularly update the healthcare team with the patients

    progress

    23. Participate in meetings and discussions on the patients

    condition and plan of care with other members of the healthcare team

    24. Prioritize workload and utilizes time efficiently

    25. Check the availability of medical supplies and medication

    26. Monitor functionality of medical and non-medical

    equipment

    27. Utilize medical and non medical supply appropriately

    28. Address and reports potential risks observed in the work

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    place

    29. Document care rendered accurately following the rules

    implemented by the nursing division

    30. Maintain confidentiality of patients records31. Maintain strict compliance to hospital policies and

    regulations

    32. Provide patient care in accordance with national laws on

    health

    33. Identify topics appropriate for research

    34. Participate in preparing a research proposal complying with

    the ethical principles in nursing research

    35. Gather data using different methodologies

    36. Able to performs and act as senior nurse whenever delegated

    37. Identify own learning and training needs

    38. Pursues continuing education

    39. Participate in professional organizations

    40. Provide nursing care that reflects values and respect forpeople regardless of their place of origin, race, politics,

    status, role, gender, culture, belief system and behavior

    41. Accept accountability for own decisions

    DURING THE TRAINING 4 3 2 1

    1. Obtain a detailed patient history2.

    Perform case prioritization upon patient arrival3. Perform systematic head to toe assessment

    4. Formulate appropriate nursing diagnosis from the dataobtained

    5. Documents assessment for networking and referral6. Explain to patients diagnostic procedures to be performed

    and the necessary preparation

    7. Prepare the patient for diagnostic procedure after securinginformed consent

    8. Identify abnormal laboratory and other diagnostic finding9. Identify expected outcomes of a holistic nursing intervention10.Formulate nursing care plans according to patients needs11.Implement the nursing care plan with the participation of the

    patients significant others

    12.Clarify doctors order before carrying them out13.Utilize infection control measure14.Prioritize patient needs and provide them accordingly15.Monitor patients progress16.Gather feedback from the patient and the his/her significant

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    others

    17.Disseminate information that will promotes health andhealthy environment, preventive measures to illnesses and

    healthy lifestyle18. Establish a trusting relationship to the patient including their

    significant others

    19. Advocate patients rights

    20. Secure patients informed consent after a thorough

    explanation of the procedure or treatment to be performed

    21. Collaborate patient care with other members of the health

    care team

    22. Regularly update the healthcare team with the patients

    progress

    23. Participate in meetings and discussions on the patients

    condition and plan of care with other members of the healthcare team

    24. Prioritize workload and utilizes time efficiently

    25. Check the availability of medical supplies and medication

    26. Monitor functionality of medical and non-medical

    equipment

    27. Utilize medical and non medical supply appropriately

    28. Address and reports potential risks observed in the work

    place

    29. Document care rendered accurately following the rules

    implemented by the nursing division

    30. Maintain confidentiality of patients records

    31. Maintain strict compliance to hospital policies and

    regulations

    32. Provide patient care in accordance with national laws on

    health

    33. Identify topics appropriate for research

    34. Participate in preparing a research proposal complying with

    the ethical principles in nursing research

    35. Gather data using different methodologies

    36. Able to performs and act as senior nurse whenever delegated

    37. Identify own learning and training needs38. Pursues continuing education

    39. Participate in professional organizations

    40. Provide nursing care that reflects values and respect forpeople regardless of their place of origin, race, politics,

    status, role, gender, culture, belief system and behavior

    41. Accept accountability for own decisions

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    PRESENT EMPLOYMENT 4 3 2 1

    1. Obtain a detailed patient history2. Perform case prioritization upon patient arrival3. Perform systematic head to toe assessment4. Formulate appropriate nursing diagnosis from the data

    obtained

    5. Documents assessment for networking and referral6. Explain to patients diagnostic procedures to be performed

    and the necessary preparation

    7. Prepare the patient for diagnostic procedure after securinginformed consent

    8. Identify abnormal laboratory and other diagnostic finding9. Identify expected outcomes of a holistic nursing intervention10.Formulate nursing care plans according to patients needs11.Implement the nursing care plan with the participation of the

    patients significant others

    12.Clarify doctors order before carrying them out13.Utilize infection control measure14.Prioritize patient needs and provide them accordingly15.Monitor patients progress16.Gather feedback from the patient and the his/her significant

    others

    17.Disseminate information that will promotes health andhealthy environment, preventive measures to illnesses and

    healthy lifestyle18. Establish a trusting relationship to the patient including their

    significant others

    19. Advocate patients rights

    20. Secure patients informed consent after a thorough

    explanation of the procedure or treatment to be performed

    21. Collaborate patient care with other members of the health

    care team

    22. Regularly update the healthcare team with the patients

    progress

    23. Participate in meetings and discussions on the patients

    condition and plan of care with other members of the healthcare team

    24. Prioritize workload and utilizes time efficiently

    25. Check the availability of medical supplies and medication

    26. Monitor functionality of medical and non-medical

    equipment

    27. Utilize medical and non medical supply appropriately

    28. Address and reports potential risks observed in the work

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    place

    29. Document care rendered accurately following the rules

    implemented by the nursing division

    30. Maintain confidentiality of patients records31. Maintain strict compliance to hospital policies and

    regulations

    32. Provide patient care in accordance with national laws on

    health

    33. Identify topics appropriate for research

    34. Participate in preparing a research proposal complying with

    the ethical principles in nursing research

    35. Gather data using different methodologies

    36. Able to performs and act as senior nurse whenever delegated

    37. Identify own learning and training needs

    38. Pursues continuing education

    39. Participate in professional organizations

    40. Provide nursing care that reflects values and respect forpeople regardless of their place of origin, race, politics,

    status, role, gender, culture, belief system and behavior

    41. Accept accountability for own decisions

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    Appendix 4

    Sample Questionnaire (For Staff Nurses)

    Directions: Place a check mark ( / ) on the space provided that corresponds to

    your answer

    5 Always All the time4 Often Most of the time3 Sometimes Not all the Time2 Never Not at all

    BEFORE THE TRAINING 4 3 2 1

    1. Obtain a detailed patient history2. Perform case prioritization upon patient arrival3. Perform systematic head to toe assessment4. Formulate appropriate nursing diagnosis from the data

    obtained

    5. Documents assessment for networking and referral6. Explain to patients diagnostic procedures to be performed

    and the necessary preparation

    7. Prepare the patient for diagnostic procedure after securinginformed consent

    8. Identify abnormal laboratory and other diagnostic finding9. Identify expected outcomes of a holistic nursing intervention10.Formulate nursing care plans according to patients needs11.Implement the nursing care plan with the participation of the

    patients significant others

    12.Clarify doctors order before carrying them out13.Utilize infection control measure14.Prioritize patient needs and provide them accordingly15.Monitor patients progress16.Gather feedback from the patient and the his/her significant

    others

    17.Disseminate information that will promotes health andhealthy environment, preventive measures to illnesses and

    healthy lifestyle

    18. Establish a trusting relationship to the patient including their

    significant others

    19. Advocate patients rights

    20. Secure patients informed consent after a thoroughexplanation of the procedure or treatment to be performed

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    21. Collaborate patient care with other members of the health

    care team

    22. Regularly update the healthcare team with the patients

    progress23. Participate in meetings and discussions on the patients

    condition and plan of care with other members of the healthcare team

    24. Prioritize workload and utilizes time efficiently

    25. Check the availability of medical supplies and medication

    26. Monitor functionality of medical and non-medical

    equipment

    27. Utilize medical and non medical supply appropriately

    28. Address and reports potential risks observed in the work

    place

    29. Document care rendered accurately following the rules

    implemented by the nursing division

    30. Maintain confidentiality of patients records

    31. Maintain strict compliance to hospital policies and

    regulations

    32. Provide patient care in accordance with national laws on

    health

    33. Identify topics appropriate for research

    34. Participate in preparing a research proposal complying with

    the ethical principles in nursing research

    35. Gather data using different methodologies

    36. Able to performs and act as senior nurse whenever delegated

    37. Identify own learning and training needs

    38. Pursues continuing education

    39. Participate in professional organizations

    40. Provide nursing care that reflects values and respect for

    people regardless of their place of origin, race, politics,

    status, role, gender, culture, belief system and behavior

    41. Accept accountability for own decisions

    DURING THE TRAINING 4 3 2 11. Obtain a detailed patient history2. Perform case prioritization upon patient arrival3. Perform systematic head to toe assessment4. Formulate appropriate nursing diagnosis from the data

    obtained

    5. Documents assessment for networking and referral6. Explain to patients diagnostic procedures to be performed

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    and the necessary preparation

    7. Prepare the patient for diagnostic procedure after securinginformed consent

    8. Identify abnormal laboratory and other diagnostic finding9. Identify expected outcomes of a holistic nursing intervention10.Formulate nursing care plans according to patients needs11.Implement the nursing care plan with the participation of the

    patients significant others

    12.Clarify doctors order before carrying them out13.Utilize infection control measure14.Prioritize patient needs and provide them accordingly15.Monitor patients progress16.Gather feedback from the patient and the his/her significant

    others

    17.Disseminate information that will promotes health andhealthy environment, preventive measures to illnesses and

    healthy lifestyle

    18. Establish a trusting relationship to the patient including their

    significant others

    19. Advocate patients rights

    20. Secure patients informed consent after a thoroughexplanation of the procedure or treatment to be performed

    21. Collaborate patient care with other members of the healthcare team

    22. Regularly update the healthcare team with the patientsprogress

    23. Participate in meetings and discussions on the patients

    condition and plan of care with other members of the health

    care team

    24. Prioritize workload and utilizes time efficiently

    25. Check the availability of medical supplies and medication

    26. Monitor functionality of medical and non-medical

    equipment

    27. Utilize medical and non medical supply appropriately

    28. Address and reports potential risks observed in the work

    place29. Document care rendered accurately following the rules

    implemented by the nursing division

    30. Maintain confidentiality of patients records

    31. Maintain strict compliance to hospital policies andregulations

    32. Provide patient care in accordance with national laws onhealth

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    33. Identify topics appropriate for research

    34. Participate in preparing a research proposal complying with

    the ethical principles in nursing research

    35. Gather data using different methodologies36. Able to performs and act as senior nurse whenever delegated

    37. Identify own learning and training needs

    38. Pursues continuing education

    39. Participate in professional organizations

    40. Provide nursing care that reflects values and respect for

    people regardless of their place of origin, race, politics,

    status, role, gender, culture, belief system and behavior

    41. Accept accountability for own decisions

    PRESENT EMPLOYMENT 4 3 2 1

    1. Obtain a detailed patient history2. Perform case prioritization upon patient arrival3. Perform systematic head to toe assessment4. Formulate appropriate nursing diagnosis from the data

    obtained

    5. Documents assessment for networking and referral6. Explain to patients diagnostic procedures to be performed

    and the necessary preparation

    7. Prepare the patient for diagnostic procedure after securinginformed consent

    8.

    Identify abnormal laboratory and other diagnostic finding9. Identify expected outcomes of a holistic nursing intervention10.Formulate nursing care plans according to patients needs11.Implement the nursing care plan with the participation of the

    patients significant others

    12.Clarify doctors order before carrying them out13.Utilize infection control measure14.Prioritize patient needs and provide them accordingly15.Monitor patients progress16.Gather feedback from the patient and the his/her significant

    others

    17.Disseminate information that will promotes health andhealthy environment, preventive measures to illnesses andhealthy lifestyle

    18. Establish a trusting relationship to the patient including theirsignificant others

    19. Advocate patients rights

    20. Secure patients informed consent after a thoroughexplanation of the procedure or treatment to be performed

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    21. Collaborate patient care with other members of the health

    care team

    22. Regularly update the healthcare team with the patients

    progress23. Participate in meetings and discussions on the patients

    condition and plan of care with other members of the healthcare team

    24. Prioritize workload and utilizes time efficiently

    25. Check the availability of medical supplies and medication

    26. Monitor functionality of medical and non-medical

    equipment

    27. Utilize medical and non medical supply appropriately

    28. Address and reports potential risks observed in the work

    place

    29. Document care rendered accurately following the rules

    implemented by the nursing division

    30. Maintain confidentiality of patients records

    31. Maintain strict compliance to hospital policies and

    regulations

    32. Provide patient care in accordance with national laws on

    health

    33. Identify topics appropriate for research

    34. Participate in preparing a research proposal complying with

    the ethical principles in nursing research

    35. Gather data using different methodologies

    36. Able to performs and act as senior nurse whenever delegated

    37. Identify own learning and training needs

    38. Pursues continuing education

    39. Participate in professional organizations

    40. Provide nursing care that reflects values and respect for

    people regardless of their place of origin, race, politics,

    status, role, gender, culture, belief system and behavior

    41. Accept accountability for own decisions