ARELLANO UNIVERSITY

College of Nursing
Pag-asa St, Caniogan, Pasig City

SURVEY QUESTIONNAIRE
(For Staff Nurse, Senior nurse and Supervisor)

This Study aims to determine the level of competencies of an Arellano University

graduate nurse who are currently employed and or part of a private or public hospital
institution. Your participation will help the researcher to improve the quality their health care
service.

Directions: Please provide the information listed by checking the appropriate space.

Part I: Demographic Profile

Age: ___18 20 Sex : ___ Male

___ 21 25 ___ Female
___ 26 30
___ 31 35 Civil Status: ___ Single
___ 35 40 ___ Married
___ 41 and above

Educational Attainment: Occupation ___________

___ Elementary
___ High school level
___ High school
___ College level
___ College

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Part II: Competency Evaluation

This questionnaire will serve as an instrument to assess the Correlation of the Nursing
Competency of an AU graduate nurse in the clinical area. The researchers is sincerely
requesting for your cooperation in answering the following question. Put a (√) on the box that
correspond to your best answer. Each of the box contains numbers that indicate the following

5 – Strongly agree
4 – Agree
3 – Uncertain
2 – Disagree
1- Strongly disagree

Strongly Agree Uncertain Disagree Strongly

agree disagree

5 4 3 2 1
Level of Knowledge

 Demonstrates knowledge base

on the health /illness status of
individual / groups.
Nagpapakita ng kaalaman
base sa estado ng kalusugan
o karamdaman ng isang
indibidwal.
 Sets priorities in nursing care
based on clients’ needs.
Nagbibigay ng karampatang
pag aalaga base sa
pangangailangan ng pasyente.
 Assesses the learning needs
of the client-partner/s.
Sinisigurado na maipahatid
ang tamang pangangailangan
sa kasama ng pasyente.
Level of Skills
 Promotes safety and comfort
and privacy of clients.
Nagtataguyod ng tamang
kaligtasan at pananatiling
pribado ng bawat pasyente.

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

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 informed consent. Umaayon
sa kasunduan ng pagsasanay

 Documents care rendered to

clients. Ibinibigay sa pasyente
ang dokumento tungkol sa
kanilang kalusugan.

 Identifies own learning needs.

Inaalam ang sariling
pangangailangan.

 Maintains accurate and

updated documentation of
client care. Pinapanatiling
tama at bago ang dokumento
ng pasyente.
 Organizes work load to
facilitate client care. Inaayos
ang trabaho para makatulong
sa pangangailangan ng
pasyente.

 Gathers data for quality

improvement. Lumilikom ng
mga data para mas mapabuti
ang kalidad ng serbisyo.
 Participates in nursing audits
and rounds. Tumutulong sa
mga katrabaho.

 Gather data using different

methodologies. Lumilikom ng
data gamit ang iba’t ibang
teknik.

Level of Attitude
 Provides sound decision
making in the care of
individuals / families/groups
considering their beliefs and
values. Iginagalang ang mga
kaugalian at paniniwala ng
pasyente at ng kanyang
pamilya.

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  Ensures continuity of care.
Sinisigurado ang tulong
pangangailangan.
 Establishes collaborative
relationship with colleagues
and other members of the
health team. Nagtatatag ng
relasyon sa mga katrabaho at
sa ibang miyembro ng health
team.
 Respects the rights of
individual / groups.
Nirerespeto ang karapatan ng
bawat indibidwal o grupo.

Safe and Quality Nursing Care u    

 Identifies the health needs of     
the clients (individuals,
families, population groups
and/or communities). Inaalam
ang pangangailangan
pangkalusugan ng pasyente.
 Explains the health status of     
the clients/ groups.
Ipinapaliwanag ang estado ng
kalusugan ng pasyente.

 Identifies clients’ wellness     

potential and/or health
problem. Inaalam
 Gathers data related to the     
health condition. Lumilikom
ng data tungkol sa kundisyon
pangkalusugan.
 Analyzes the data gathered.     
Sinusuri ang mga nalikom na
data.

 Performs age-specific safety     

measures in all aspects of
client care. Nagsasagawa ng
 Performs age-specific comfort     
measures in all aspects of
client care. Nagsasagawa ng
tamang pag aalaga sa
pasyente sa lahat ng aspeto
 Performs age-specific     
measures to ensure privacy in

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 all aspects of client care.
Nagsasagawa ng tamang
method para masigurado ang
pribadong pag aalaga ng
pasyente
 Identifies the priority needs of     
clients. Inaalam ang mga
pangangailangan ng
pasyente.
 Analyzes the needs of     
clients. Sinusuri ang mga
pangangailangan ng
pasyente.
 Determines appropriate     
nursing care to address
priority needs/problems.
Nagpapasya ng ukol sa pag
aalaga upang matukoy ang
mga pangangailangan at
problema.
 Refers     
identified problem to
appropriate individuals /
agencies. Nagrerekomenda
ng kilalang problema sa
mga tamang tao at ahensya.
 Establishe
s means of providing
continuous client
care.Nagtatatag ng patuloy
na pag aalaga sa pasyente.
Collaboration and Teamwork     

 Contributes to decision     
making regarding clients’
needs and concerns.
Nagbibigay kontribusyon sa
mga desisyon tungkol sa mga
pangangailangan ng
pasyente.
 Participates actively in client     
care management including
audit. Sumasali sa tamang
pangangasiwa ng pag aalaga
sa pasyente.
 Recommends appropriate     
intervention to improve client
care. Nagrerekomenda ng
tamang paraan o teknik para

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 mas mapaganda ang
kalagayan ng pasyente.
.    
 Respect the role of other
members of the health team.
Nirerespeto ang papel ng
bawat miyembro ng health
team.
 Maintains good interpersonal     
relationship with clients ,
colleagues and other
members of the health team.
Umaalalay sa magandang
relasyon ng pasyente,
katrabaho at ibang miyembro
ng health team

 Refers clients to allied health     

team partners.
Nirerekomenda ang pasyente
sa ibang hanay ng health
team.
 Acts as liaison / advocate of     
the client. Gumaganap bilang
koneksyon ng pasyente.

Health Education     
 Obtains     
learning information through
interview, observation and
validation. Kumukuha ng sapat
ng kaalaman sa pamamagitan ng
interview, obserbasyon at
pagpapatunay.
 Analyzes     
relevant information. Sinusuri ang
tamang impormasyon.
 Complete     
s assessment records
appropriately. Maayos at
kumpletong pag aasista.

Legal Responsibility     

 Fulfills     
legal requirements in nursing

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 practice. Pagtupad sa mga legal
na pangangailangan ng isang
nurse.
 Holds     
current professional license.
Pagpigil sa lisensya ng isang
professional.
 Acts in     
accordance with the terms of
contract of employment and
other rules and regulations.
Pagkilos sa kasunduan ng
kontrata at iba pang patakaran
ng isang empleyado.
 Articulate     
s the vision, mission of the
institution where one belongs.
Pagpapaliwanag ng maayos ang
tungkulin
 Acts in     
accordance with the established
norms of conduct of the
institution / organization/legal
and regulatory requirements
 Utilizes     
appropriate client care records
and reports.
 Accompli     
shes accurate documentation
in all matters concerning client
care in accordance to the
standards of nursing practice.
Pagtatapos ng tamang
dokumento ukol sa tamang pag
aalaga ng pasyente base sa
tungkulin ng isang nurse.

Ethico-moral Responsibility     
 Renders nursing care     
consistent with the client’s bill
of rights: (i.e. confidentiality of
information, privacy, etc.)
 Adheres     
to the Code of Ethics for Nurses
and abides by its provision
 Reports     
unethical and immoral incidents
to proper authorities

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Personal and Professional     
Development
Identifies one’s strengths,     
weaknesses/ limitations.
Inaalam ang isang kalakasan
at kahinaan.
 Determines personal and     
professional goals and
aspirations. Inaalam ang
personal at propesyonal na
ambisyon at inspirasyon.
 Participat
es in formal and non-formal
education. Nakikilahok sa
pormal at di-pormal na
edukasyon.

Records Management     
 Utilizes a records system ex.     
Kardex or Hospital Information
System (HIS)

 Uses data in their decision     
and policy making activities

Management of Resource and
Environment
 Identifies
tasks or activities that need to be
accomplished
 Plans the
performance of tasks or activities
based on priorities
 Verifies
the competency of the staff prior to
delegating tasks

Quality Improvement
 Identifies
appropriate quality improvement
methodologies for the clinical
problems
 Detects
variation in specific parameters i.e
vital signs of the client from day to
day
 Reports
significant changes in clients’
condition/environment to improve

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stay in the hospital

 Encourag     
es the client to verbalize
relevant changes in his/her
condition
 Performs daily check of clients’     
records / condition.
Nagsasagawa araw-araw ng
mga rekords at kondisyon ng
pasyente
 Documents and records all     
nursing care and actions
implemented

Research     
 Specifies     
researchable problems regarding
client care and community health
 Identifies appropriate methods of     
research for a particular client /
community problem
 Combines quantitative and     
qualitative nursing design through
simple explanation on the
phenomena observed