1. The document discusses competency-based instruction on caring for a post-operative patient who underwent a below-the-knee amputation due to diabetes. 2. It identifies three competencies - safe nursing care, health education, and sets learning objectives for each competency. 3. The objectives aim to promote safety, identify priorities, and provide health teaching to prevent complications and support psychosocial adjustment to the amputation.

1. Competency - based Instruction (FACILITATING LEARNING) Presented by: Dave Jay Manriquez Rowell Panuncial

2. Subject: Medical-Surgical Nursing Degree: MN-MS UNIT: Nursing Care Management ( Care of client with Physiologic and Psychosocial alterations ) Caring of Post/Op patient who undergone Below the knee Amputation due to Diabetes Mellitus in preventing Post/Op complications and its psychosocial effects of the client.

3. Competencies: 1. Safe and Quality Nursing Care – Setting priority measures in rendering care to the patient by having discussion with the members of the health team. 2. Safe and Quality Nursing Care – Promoting Safety regarding patient condition. (Patient based practice) 3. Health Education – Doing Bedside Health Teaching involving the client and immediate significant others of the client explaining his conditions and some measures to prevent complications for faster healing Elements Objectives

4. Elements: 1.a Identify the first and the less priorities to be done. 1.b Determines appropriate nursing care to be provided. 1.c Analyze the needs of patient. 2.a Identify possible sources of Post/Op complications. 2.b Determine the factors that may lead to Post/Op complications. 2.c Identify some safety measures the patient, significant others, and health care team member may do to prevent Post/Op complications. 2.d Performs age-specific safety measures in all aspects of patient care. 3.a State the importance of having a health teaching in promoting wellness. 3.b Determine the patient ability to learn with his/her carrier education. 3.c Defines relevant information. 3.d Monitors patient and family’s responses to health education. Competencies

5. Learning Objectives: Setting priority measures: 1. Assess patient needs, like changing the limb dressings after every 3 days or whenever the dressings is very soak already with blood. 2. Assess patient diet by giving him the right kind of food like avoiding sugars, promoting fiber rich foods and avoiding alcohol. Promoting Safety: 1. Place the patient in a prone position or the best position the patient is comfortable and remember to always place a side rail on the affected side to prevent falls. 2. Assess patient pain tolerance by preparing always the pain assessment tool so that you will know when to give pharmacologic interventions and remember to treat individual uniquely in regarding pain tolerance. Health Teaching: 1. Orient the patient to reality regarding his condition and inform his significant others that bleeding in the site should be reported and inform also that the patient might experience phantom limb pain and phantom limb sensation which is normal to amputated patient. 2. Assess the patient learning capabilities by letting him ask questions, clarifications regarding the health teaching that you rendered. Competencies Elements

8. Learning Outcomes All Learning Objectives mentioned are Procedural Knowledge on its outcome since it involves concepts and series of action to be done effectively and proficiently. Instructional Activities Total patient care Mastery on Bed positioning recommended for a particular patient Knowledge on the Pain Assessment Tool Knowledge on the Proper Wound Dressings Knowledge on the diet of a Diabetic client Utilizing the proper communication technique in conducting health teachings Doing Bedside clinic Guided practice by the Senior nurses

9. Learning Measures Procedural Knowledge – enough knowledge, skills, abilities and perfect execution on things to be done in caring a Post/Op Below the Knee Amputated patient. All actions to be perform by a nurse must be SMART in nature. There must always a nurse – patient/Significant others interactions during the care treatment.