COLLEGE OF NURSING

Competency Appraisal
Name of Student: Mary Crystel V.Banocnoc and Graciella V. Borja
Clinical Scenario: Undifferentiated Schizophrenia
Summary
NCM 105 Clinical rotation at Cavite Center for Mental Health (CCMH) January 12, 2014 to January 15, 2014. 2-10 pm shift. This is
an assessment of the core competencies achieved from handling the case of a 24 y/o male, brought to the mental health center due to
talking to oneself and insomnia
Demographic Profile
Personal Data:
Patients name: EG
Age: 34 y/o
Sex: Male
Birthday: January 1, 1979
Birthplace: Brgy. Iba, Silang, Cavite
Address: #59 Brgy. Iba, Silang, Cavite
Civil status: Single
Nationality: Filipino
Religion: Iglesia ni Cristo
Educational Attainment: 3rd year high school undergraduate
Occupation: none
Number of Brothers: 3 Number of Sisters: 1
Mother: EMG
Age: 54
Educational Attainment: High School Graduate
Occupation: Maid
Father: EGG
Age: 54

Educational Attainment: High School

Occupation: Welder
Clinical Data:
Ward/Service: Yellow ward
Admitting Physician: Dr. Escao
Admitting Diagnosis: Schizophrenia Undifferentiated
Principal Diagnosis: Schizophrenia Undifferentiated
Date of Admission: January 20, 2012
Institution: Cavite Center for Mental Health

Key Area of
Responsibility
A. Safe and Quality
Nursing Care

Core Competencies
1. Demonstrates knowledge based on
the health/illness status of
individual/groups

Indicators

Trust built in our nurse-patient interaction.

Alleviated anxiety of the patient.

Able to obtain a brief history and relevant information regarding

patients condition.

Congruency has been made.

Communicate with the patient with empathy.

Positive regard established.

Established acceptance of the client.

Observed for extra pyramidal side effects of psychotropic drugs.

Read the patient chart to know the past and present management

of the patient.

Consent from the relatives and hospital administrator received.

Home visit was done.

Able to answer the question of the relative regarding the patients

condition, the nature of the disease as well as the management.

Establish clear, consistent, and open communication.

2. Provides sound decision making in

the care of individuals/families/groups
considering their beliefs and values

Disturbed thought processes (hallucination) was identified as health

problem of the patient.
Able to gather data related to the problem.
Established therapeutic communication.
Observed patient for sign of hallucination.
Decreased environmental stimuli by placing the patient in front of the
wall.
Eye to eye contact maintained while having NPI.
Able to identify nursing management based on the patient condition.
Reinforced and focused patient in reality.
Asked the cooperation of the mother in the care of the patient in
providing emotional support (home visit)
Observed for extra pyramidal side effects of psychotropic drugs.
Educate relatives regarding patients illness and etiology.

3. Promotes safety and comfort and

privacy of clients

Instructed the patient that if theres information that would help their
condition will be reported to the nurse on duty or clinical instructor.
Instructed patient to feel free to approach us every time he feels
anxious.
Placed patient in a comfortable place for nurse-patient interaction.

Placed patient in a place of free sharp objects.

Set boundaries
Established confidentiality of information.
Assisted patient in going to the comfort room.
Assisted patient in doing the exercise.
Assisted patient in doing their hygiene.
Slippers was provided to the patient.
Observed for extra pyramidal side effects of psychotropic drugs.
Vital signs checked and recorded before the nurse-patient interaction.

4. Sets priorities in nursing care based

on clients needs

Safety was the priority for patient EG because he get easily distracted
on the environmental stimuli and it may cause agitation.
Identified nursing care for preventing distraction to the client.
Remove all sharp objects around the area.
Positioned patient in front of the wall to prevent environmental stimuli.
Therapeutic relationship established.
Disturbed Thought Processes (Hallucination) is another concern.
Identified nursing care for Disturbed Thought Processes.

5. Ensures continuity of care

6. Administers medications and other

health therapeutics

Endorsed patient to staff nurses before leaving the patient after hours
of duty.
Recommend to provide good quality of bed.
Report if disobedient observed.
Recommend to isolate aggressive patient from kind patient.
Listened to the endorsement of the staff nurses.
Recommend to provide slippers in every patient.
Recommend to avoid favoritism inside the ward.
Recommend to provide a socialization day every week.

Encouraged patient to take his medication everyday.

7. Utilizes the nursing process as

a framework of nursing

Educates patient regarding the importance of taking his medication.

Encouraged patient not to skip his medication.
Review all the side effects of the psychotropic drugs.
Observed for extra pyramidal side effects of psychotropic drugs.
Obtains informed consent
Complete assessment done.
Performs appropriate assessment techniques
Obtains comprehensive client information
Maintains privacy and confidentiality
Identifies health needs

Result/Outcomes of Indicators Used:

- Regarding patients safety and quality care, I believe that we have done our very best to provide it to my
patient. And he was very satisfied to our service and care. Necessary measures to provide comfort to the
patient was done and rendered.
- Needs/problems were prioritized and were addressed properly.
Peer Feedback:
Key Area of
Responsibility
B. Management of
Resources and
Environment

Core Competencies

Organizes work load to facilitate

client care

Indicators
Activities and occupational therapy was made and organized to be done
everyday.
Occupational therapy
Grahams ball making
Pastillas making
Activities of the day
Thursday : hygiene, exercise, NPI , pinoy henyo, break, post conference
Friday: hygiene, exercise, NPI, salawikain interpretation, break, post
conference
Saturday: hygiene, exercise, NPI, art work interpretation, break, post

Utilizes financial resources to support

client care

conference
Each group member was assigned each day to take in charge of the
activities to be done every session.
Before handling the patient information that was given by the staff/C.I
was verified.
Organizing the venue was safely assigned to other members of the
team.
Finishes work assignment on time (5pm).
We listed all the things needed by our patient.
Compute for the cost.
Each member of the group contributed for the amount to be used
every week.
Each member of the group provided patient a pair of slippers.
Each member of the group contributed for patients snack.
During the socialization day each member of the group contributes for
the preparation of the party.

Establishes mechanism to ensure

proper functioning of equipment

Maintains a safe environment

Made sure that

Made sure that
Made sure that
comfort room.
Made sure that

Checked
Checked
Checked
Checked
Checked
Checked
effects.

if the thermometer is functioning.

patient vital signs before the NPI.
if the cassette is functioning.
if all the chairs and table are safe to use.
if the extension wire is functioning.
if there are no signs and symptoms of extra pyramidal side

sharp objects are away from the side of the patients.

all the exit way are secured.
the group did not leave their patient when going to
the patient are free extra pyramidal side effect.

 Made sure that the patient will not be agitated by preventing

environmental stimuli.
Made sure that the patient will not harm others by doing the proper
therapeutic communication.
Assisted patient in doing the exercise and other activities.
Advised patient to verbalize if they feel anxious.
Result/Outcomes of Indicators Used:
- I appreciate most was the core competency number 2 in this key area. We believed weve been a big help to my
patient when it comes to his emotional aspect. In a simple way of teaching and accompanying him when he is
feeling alone. Talking to him in a right way and giving the best support we can provide.
- Monitoring the proper functioning of the equipment and maintaining the safety of the room were done.
- Regarding to my work load, since it was just a one on one interaction it is easier for me to identify his needs. We
did not only focus in this patient, we also interact and rendered care to our other patient.
Peer Feedback:
Key Area of
Responsibility
C. Health Education

Core Competencies
1. Assesses the learning needs of the
clients/partner/s

Indicators
Obtained and analysed learning information through interview,
observation and validation.
Performed comprehensive and systematic nursing assessment.
Therapeutic use of self-done.
Trust built in our nurse-patient interaction.
Alleviated anxiety of the patient.
Able to obtain a brief history and relevant information regarding
patients condition.
Congruency has been made.
Communicate with the patient with empathy.
Positive regard established.
Established acceptance of the client.
Observed for extra pyramidal side effects of psychotropic drugs.

 Therapeutic relationship established.

Identified knowledge deficit as a priority needs. (ncp)
Home visit done to gather complete assessment data.
2. Develops health education plan
based on assessed and anticipated
needs

Considered patient as having mental problem in planning management

of health needs.
Interviewed relatives regarding patients past and present condition for
management of patients health needs.
Formulates a comprehensive health education plan with the following
components: objectives, content, time allotment, teaching-learning
resources and evaluation parameters.
EGs mother states kaya ho nagkaganyan si EG dahil sa pag kagaling
sa trabaho e maliligo na, napapasma ho lagi, diba ho? Tama po ba?.
(feedback to finalize the plan)

3. Develops learning materials for

health education

Used visual aids (White cartolina) in explaining about the nature of the
illness and clinical manifestations.
We used all the techniques that was learned from our psychiatric
subject (therapeutic relationship, components of therapeutic
relationship, proper way of questioning the patient) in the development
of information education materials.

4. Implements the health education plan

Determined appropriate time to conduct health education: the relatives

are at home not doing anything, sitting at their small rest house.
Consent from the relatives and hospital administrator received before
the home visit.
Client and familys preparedness considered.
Therapeutic relationship and self-awareness established before the
management of health needs as the strategies used.
Reassured presence through active listening, touch, facial expression
and gestures.
Monitored client and familys responses to health education by asking

them what has been said by our team member.

5. Evaluates the outcome of health
education

Relatives health perception regarding EGs condition changed.

ah ganon pala yon, kapag pala ang mga problemang yon ay nagsama
sama yun ang kalalabasan kaya pala minsan nakikita naming siyang
hindi nagsasalita yun pala dahil sa gamot na sinisinghot nila ng tiyuhin
niya, tapos meron pa kaming kamag-anak na nagkaroon din ng ganong
kalagayan as verbalized by EGs mother.

Result/Outcomes of Indicators Used:

- The health educations that we implemented regarding the three major health problems that we identified were
very successful. Patient performed well on every activities we implemented for him. He was enthusiastic every
time we are with him.
- Patient was really satisfied that he learned a lot of things from us.
- It is indeed a very fulfilling results and response from our patient.
Peer Feedback:
Key Area of
Responsibility
LEGAL
RESPONSIBILI
TY

Core Competencies

Adheres to practices in
accordance with the nursing law
and other relevant legislation
including contracts, informed
consent

Adheres to organizational policies

Indicators

Consent from the relatives and hospital administrator received

before the home visit.

Explained to the patients relative that he/she had the right to refuse
any treatment or diagnostic procedures for the patient.

Observed patient bill of rights.

Come into the orientation on time and in a complete white uniform.

and procedures, local and national

Documents care rendered to

clients

Followed the protocols of the institution when doing nursing care or

NPI.

Avoided taking pictures with the patient.

Avoided giving money to the patient.

Each member of the group have their institution shirt.

Always come on time.

Provided a socialization party.

Equipment and facilities

Deleted all the data of the patient after the case presentation.

All records of the patient kept organized and private.

All data gathered from the patient was discussed within the
students and the clinical instructor.

Vital signs every session was documented with the appropriate

time.

Submitted a diary to the clinical instructor.

Result/Outcomes of Indicators Used:

-

Confidentiality of the records of the patient are implemented, documenting the necessary care for the patient is
done.

Following the procedure with an utmost responsible way a nurse should do.

Peer Feedback:

Key Area of
Responsibility
ETHICO
MORAL
RESPONSIBILI
TY

Core Competencies
Respects the rights of individual /
groups

Indicators

Observed patients rights, privacy, and confidentiality of documents

or any information

Always asked for permission before rendering any interventions/care

Explained the procedures to the patient and relatives

Explained to the patients relative that information they give will

remain confidential and will only be released to the medical staff
thats responsible for the patients case.

Explained to the patients relative the purpose of patients

medications

Encouraged the patients relative to express feelings, opinions and

views on patient condition

Accepts responsibility and

accountability for own decision
and actions

Came to duty knowing the components of therapeutic relationship.

Explained to the patient that we are nursing students and we will

take care of him from 8am to 5pm (phases of NPI)

Informed and explained to the patient the reasons/rationale

regarding the nursing care as well as to the patient.

Came to duty on time in a proper uniform and complete

paraphernalia and materials needed in the activity.

-

Came to duty with the knowledge of the illness and medication as

well as the possible occurrence of EPS.

Came to duty with self-awareness.

Result/Outcomes of Indicators Used:

-

The respect from the patient and between the nurses are formally rendered with each other.

Every care we give to the patient is well thought and given to them in a responsible way.

Peer Feedback:

Key Area of
Responsibility
QUALITY
IMPROVEMENT

Core Competencies

Gathers data for quality

improvement

Indicators

Interviewed the client and identified health problems.

-disturbed thought processes

Observed patients verbal and nonverbal cues.

Observed for the symptoms that patient may manifests.

Requested for the chart and reviewed all important data.

Made a home visit and assessed the living environment and also
interviewed the parents on the history of the patient.

Assessed thought processes and content

Assessed vital signs of the patient before interviewing.

Participate in nursing audits and

rounds

Identifies and reports variances

Shared to the clinical instructor all data collected to the patient.

Encouraged patient to verbalized his feelings.

Read and reviewed chart of the patient. Updated self on the

doctors order.

Documented any changes to the behavior of the patient as well as

the actions and interventions rendered.

Reported and documented any changes to vital signs, behavior or

physical actions.

Observed patient while interviewing.

Reports for delusional activity while talking to the patient.

Always prepared self in handling patient.

Peer Feedback:

Key Area of
Responsibility
PERSONAL AND
PROFESSIONAL
DEVELOPMENT

Core Competencies

Identifies own learning needs

Pursues continuing education

Indicators

Practicing more therapeutic communication especially in a

psychiatric client serves as the weakness.

Researching and applying nursing interventions based on the

diagnosis of the client is the strength.

Assessing psychiatric patient is limited only on some areas.

Updated ourselves by searching journals or research about

undifferentiated schizophrenia.

Gets involved in professional

organizations and civic activities

Projects a professional image of a

nurse

Possesses positive attitude

towards change and criticisms

Performs function according to

Watched educational movie related to schizophrenia.

Support activities related to nursing and health issues like seminars,

training or be a member of a professional organizations

Enroll or renew BLS

Showed respect to every person talking with.

Demonstrated good manners and right conduct at all times.

Dresses appropriately and used CCMH shirt so that it would be easy

for the patient to recognize us.

Demonstrated congruence of words and actions and maintained

proper addressed to the patient or which he preferred.

Behaves appropriately at all times

Listened and made notes on suggestions and recommendations of

the clinical instructor.

Tried another strategies and recommendations that is effective to the

patient.

Time for bathing should not be as early as 3 am.

Patient should not be given anything that he may be used as

payment for cigarettes or any drugs.

Always showed sincerity and honesty when communicating with the

client.

Evaluate own performance based on the standards of practice

professional standards

Sets attainable objectives to enhance nursing knowledge and skills

Result/Outcomes of Indicators Used:

-

Having the patient around us and knowing that our care is given to them with our most positive attitude and
the functional way to them are fulfilling. Seeing that our goals are being met to our best effort.

Peer Feedback: