Course Title: HEALTH ASSESSMENT

Course No.: NCM 101

Course Description: This course deals with concepts, principles and techniques of history taking, head to toe physical examination and psychosocial assessment
using various tools and interpretation of laboratory findings to arrive at a nursing diagnosis. The learners are expected to perform holistic
nursing assessment of an individual adult client

Course Credit: Theory: 3 units (54 hours); RLE: Skills lab - 2 units (102 hours)

Placement: First Year, Second Semester

Prerequisite: Anatomy and Physiology

Program Outcomes:
1. Apply knowledge of physical, social, natural and health sciences, and humanities in the practice of nursing.
2. Provide safe, appropriate, and holistic care to individuals, families, population group, and community utilizing nursing process.
3. Apply guidelines and principles of evidence-based practice in the delivery care.
4. Practice nursing in accordance with existing laws, legal, ethical and moral principles.
5. Communicate effectively in speaking, writing, and presenting using culturally appropriate language.
6. Document to include reporting up-to-date client care accurately and comprehensively.
7. Work effectively in collaboration with inter-, intra- and multi-disciplinary and multi-cultural teams.
8. Practice beginning management and leadership skills in the delivery of client using a systems approach
9. Engage in lifelong learning with a passion to keep current with national and global developments in general, and nursing and health
developments in particular..
10. Demonstrate responsible citizenship and pride of being a Filipino.
11. Apply techno-intelligent care systems and processes in health care delivery.
12. Adopt the nursing core values in the practice of the profession.

Level Outcomes: At the end of the first year, given simulated situations in selected settings, the learners demonstrate basic nursing skills in rendering safe and
appropriate care utilizing the nursing process.
Course Outcomes:
1. Utilize knowledge of principles and concepts of relevant sciences and humanities in the practice of nursing.
2. Practice beginning skills in performing health assessment to individuals.
3. Apply guidelines and principles of evidence-based practice in health assessment.
4. Observe ethico-legal principles in conducting health assessment.
5. Communicate effectively in conducting health assessment.
6. Document assessment data accurately and comprehensively.
7. Value the significance of collaborative relationship of the members of the health team in conducting health assessment.
8. Practice beginning management and leadership skills in conducting health assessment
9. Engage in lifelong learning in developing competence in health assessment.
10. Demonstrate responsible citizenship and pride of being a Filipino when conducting health assessment.
11. Apply techno-intelligent care systems and processes in health assessment.

Learning Plan

PROGRAM OUTCOMES COURSE OUTCOMES LEARNING OUTCOMES CONTENT

Apply knowledge of physical, social, Utilize knowledge of principles and Integrate relevant concepts and principles Introduction to Health Assessment
natural and health sciences, and concepts of relevant sciences and of Anatomy and Physiology in health
humanities in the practice of nursing. humanities in the practice of nursing. assessment A. Overview of Nursing Process
(ADPIE)

Discuss the concepts, principles and B. Health assessment in Nursing

techniques of health assessment. Practice

1. Types:
 Initial Comprehensive
Assessment
 On-going or Partial
Assessment
  Focused or Problem-
oriented Assessment
 Emergency Assessment

C. Nurse's Role in Health Assessment

Provide safe, appropriate, and holistic care Practice beginning skills in performing
to individuals, families, population group, health assessment to individuals.
and community utilizing nursing process.
Apply guidelines and principles of
evidence-based practice in the delivery if
care
Practice beginning management and
leadership skills in the delivery care using
a systems approach
Document to include reporting up-to-date
client care accurately and
comprehensively
Apply guidelines and principles of
evidence-based practice in health
assessment.
Practice beginning management and
leadership skills in conducting health
assessment.
Document assessment data accurately and
comprehensively.
Assess one's / peer health Steps of Health Assessment
status/competence utilizing correct A. Collection of Subjective Data
assessment techniques through Interview and Health
history
Integrate evidence-based practice in 1. Biographic Data
conducting health assessment. 2. Reasons for Seeking Health
Care
3. Chief Complaint
Manage resources (human, physical and 4. History of:
time) efficiently and effectively in health  Present Illness
assessment.  Past Health History
 Family Health History
Maintain a safe environment in  Current Medication
conducting health assessment.  Lifestyle
 Developmental Level
Document health assessment data  Psychosocial History
properly.
B. Collection of Objective Data
Ensure accuracy, completeness and 1. Physical Examination
integrity of health assessment data.
 Preparation
 Positioning
Adhere to guidelines in documentation
related to confidentiality of health  Techniques
assessment data. 2. Diagnostic Test and Procedures
3. Other Sources e.g. client chart

C. Validation of Data

PROGRAM OUTCOMES COURSE OUTCOMES LEARNING OUTCOMES CONTENT

Apply techno-intelligent care systems and
processes in health care delivery
Demonstrate responsible citizenship and
pride of being a Filipino.
Apply techno-intelligent care systems and
processes in health assessment.
Demonstrate responsible citizenship and
pride of being a Filipino when conducting
Health assessment
Use appropriate technology in performing
health assessment.
Apply systems of informatics in health
assessment.
Holistic Nursing Assessment
Customize health assessment process
based on the culture and values of the
client / family.
Physical Assessment
D. Documentation of Data
1. Guidelines for Documentation
 Written Notes
 Electronic Documentation
1. General Status and Vital Signs
2. Mental Status
 Children and Adolescent
 Adults
3. Psychosocial, Cognitive and Moral
Development
4. Pain
5. Violence
6. Culture and Ethnicity
7. Spirituality and Religious Practices
8. Nutritional Status
1. Skin , Hair and Nails
2. Head and Neck
3. Eyes
4. Ears
5. Mouth, Throat, Nose and Sinuses
6. Thorax and Lungs
7. Breast and Lymphatic System
8. Heart and Neck Vessels
9. Peripheral Vascular System
10. Assessing the Abdomen
11. Musculo-skeletal System
12. Neurologic System
13. Male Genitalia and Rectum
14. Female Genitalia and Rectum
Practice nursing in accordance with
existing laws, legal, ethical and moral
principles.
Communicate effectively in speaking,
writing, and presenting using culturally
appropriate language.
Work effectively in collaboration with
inter-, intra- and multi-disciplinary and
multi-cultural teams.
Engage in lifelong learning with a passion
to keep current with national and global
developments in general, and nursing and
health developments in particular.
Adopt the nursing core values in the
practice of the profession.
Observe the ethico-legal principles in
conducting health assessment.
Communicate effectively in conducting
health assessment.
Value the significance of collaborative
relationship with the members of the
health team in conducting health
assessment.
Engage in lifelong learning in developing
competence in health assessment.
Adopt nursing core values in performing
health assessment.
Adhere to relevant ethico-legal principles
in conducting health assessment.
Protect clients rights based on "Patient's
Bill of Rights and Obligations"
Implement strategies / policies related to
informed consent as it applies in health
assessment
Utilize appropriate communication /
interpersonal techniques in conducting
health assessment.
Describe the harmonious among members
of the health team in conducting health
assessment.
Engage in self-directed learning to
enhance competence in health assessment
Demonstrate caring as the core of nursing,
love of God, love of country and love of
people when performing health
assessment.
Relevant Ethico-Legal Guidelines in
Conducting Health Assessment
1. Ethico-Legal Consideration
 Informed Consent
2. Patient's Bill of Rights
3. Data Privacy Act
Guidelines of an Effective Interview and
Health History
1. Phases
2. Types of Communication
3. Special Considerations Related to
Age, Cultural and Emotional
Variations.
Health Care Team in Health
Assessment
1. Team-based Approach
2. Roles of the Nurse and Other
Members of the Health Team
Program Instructions in Health
Assessment
Core Values of Nursing in Conducting
Health Assessment

LEARNING OUTCOMES
Integrate relevant concepts
and principles of Anatomy
and Physiology in health
assessment
Discuss the concepts,
principles and techniques
of health assessment.
Assess one's / peer health
status/competence utilizing
correct assessment
techniques
Integrate evidence-based
practice in conducting
health assessment.
Manage resources (human,
physical and time)
efficiently and effectively
in health assessment.
Maintain a safe
environment in conducting
health assessment.
LEARNING STRATEGIES
RELATED LEARNING
CONTENT ASSESSMENT
CLASSROOM TA EXPERIENCE (SKILLS TA
LABORATORY)
Introduction to Health Assessment
Advance assignment : Simulation in: Rubrics: Case Analysis on
A. Overview of Nursing Process - defenition of  Obtaining informed a given scenario
(ADPIE) terms consent
- nursing process Individual / Group
- roles of the nurse Feedback
in health
assessment
B. Health assessment in Nursing lecture Quiz
Practice
Interactive - Discussion Rubrics: Case Analysis
2. Types:
 Initial Comprehensive
Assessment
 On-going or Partial
Assessment Focused or
Problem-oriented
Assessment
 Emergency Assessment
C. Nurse's Role in Health Assessment
Steps of Health Assessment
A. Collection of Subjective Data
through Interview and Health
history
1. Biographic Data
2. Reasons for Seeking
Document health
assessment data properly.
Ensure accuracy,
completeness and integrity
of health assessment data.
Adhere to guidelines in
documentation related to
confidentiality of health
assessment data.
Use appropriate
technology in performing
health assessment.
Apply systems of
informatics in health
assessment.
Customize health
assessment process based
on the culture and values
of the client / family.
Adhere to relevant ethico-
legal principles in
conducting health
assessment.
Protect clients rights based
on "Patient's Bill of Rights
and Obligations"
Implement strategies /
policies related to
Health Care
3. Chief Complaint
4. History of:
 Present Illness
 Past Health History
 Family Health History
 Current Medication
 Lifestyle
 Developmental Level
 Psychosocial History
B. Collection of Objective Data
1. Physical Examination
 Preparation
 Positioning
 Techniques
2. Diagnostic Test and
Procedures
3. Other Sources e.g. client
chart
C. Validation of Data
D. Documentation of Data
1. Guidelines for Documentation
 Written Notes
 Electronic Documentation
Holistic Nursing Assessment
1. General Status and Vital Signs
2. Mental Status
 Children and Adolescent
 Adults
3. Psychosocial, Cognitive and
informed consent as it
applies in health
assessment
Utilize appropriate
communication /
interpersonal techniques in
conducting health
assessment.
Describe the harmonious
among members of the
health team in conducting
health assessment.
Engage in self-directed
learning to enhance
competence in health
assessment
Demonstrate caring as the
core of nursing, love of
God, love of country and
love of people when
performing health
assessment.
Moral Development
4. Pain
5. Violence
6. Culture and Ethnicity
7. Spirituality and Religious
Practices
8. Nutritional Status
Physical Assessment
1. Skin , Hair and Nails
2. Head and Neck
3. Eyes
4. Ears
5. Mouth, Throat, Nose and Sinuses
6. Thorax and Lungs
7. Breast and Lymphatic System
8. Heart and Neck Vessels
9. Peripheral Vascular System
10. Assessing the Abdomen
11. Musculo-skeletal System
12. Neurologic System
13. Male Genitalia and Rectum
Female Genitalia and Rectum
Learning Environment: Classroom and Skills Laboratory

Independent Study: Use of learner's time spent outside of the laboratory for self-directed learning using available resources (Actual and online),
equivalent to 20-30% of the total RLE hours.

Resources: Print, Non-print materials, and Electronic Materials, Equipment and supplies, Clinical Scenarios, Vignettes Videos, CDs, Audio on Physical
Assessment

Course Requirement: These are major student outputs (whether individual or group outputs) reflective of the integrated attainment of course outcomes.

Learning Environment: Classroom, Library, Multimedia / Audiovisual room

Resources: Print, Non-print materials, and Electronic Materials

Course Requirements: I. I. Term Examination - 40%

II. Quizzes/exercises - 30%

III. Class Standing - 20%

IV. Attendance - 10%

100%

Grading Systems: Student performance will be rated based on the following:

Assessment Tasks Weight Minimum Average

for Satisfactory
Performance

Class Requirements (Design Portfolio, 40%

 quizzes, Participation, etc.)

Preliminary Examination

Mid-term Examination 30%

30%

100% 30%

Previous (Midterm) Grade = 100% x 40%

Class Requirements (Design 40%

Portfolio,quizzes , Participation, etc.)

Final Examination
30%

45%

100% 75%

Present (Final) Grade = 100% x 60%

40% Previous Grade + 60% Present Grade = Final Grade

Rubrics will be used for other types of assessment such as return demonstration, simulation, etc.

Aside from academic deficiency, other grounds for a failing grade are:

1. Failing academic standing and failure to take the final examination

2. Grave misconduct other than cheating

 3. Excessive absences (in excess of 20% of the total class hours)

Course Policy:

a. Attendance - Attendance shall be monitored in accordance with CHED policy and the provisions of the Student Handbook.

b. Submission of Assessment Tasks - Late submission of learning activities is not allowed

c. Written Examination - There will be three major examinations – Preliminary. Mid-Term, and Final Examinations. The final examination is the summative assessment of
the periods and will have to demonstrate understanding of the course. Test booklet will be used as answer sheet in all written examinations.

d. Issuance of Mid-Term Grade - The mid-term grade is issued to students so that formal consultation where students are apprised of their class standing is done to afford
them the opportunity to make up and to cope with the rigors of the course.

e. Course Portfolio - Selected assessment tools are to be compiled and collected before the end of the semester. The selection is based on statistical data gathering (lowest,
median, and highest). Learning tasks and examinations with marks lowest, median and highest must be photocopied and returned to the Instructor/professor for course
portfolio keeping.

f. Language of Instruction - Lectures, discussions and documentation will be in English. Written and spoken work may receive a lower mark, if the student is deficient in
English.

g. Classroom Discipline - Students are not allowed to use electronic gadgets such as cell phones, I-pads and head/ear sets/pads inside the classroom to avoid disruption of
the lesson.

h. Honor, Dress and Grooming Codes -Students must observe the College Dress and Grooming Code as provided in the Student Decorum of the Collegiate Student
Handbook. For this course, the Honor Code is that there will be no plagiarizing on written work and no cheating on examinations. Proper citation must be given to authors
whose works were used in the preparation of any material for this course. If a student is caught cheating on an examination, they will be given zero mark for the
examination. If a student is caught cheating twice, they will be referred to the Prefect of Discipline and be given a failing grade.

i. Consultation Schedule - Consultation schedules are announced by the Instructor/professor at the beginning of the semester. For this course, students may consult with
the Instructor/Professor at a given date at the Consultation Room. It is recommended that the student set an appointment first to confirm the Instructor/Professor’s
availability.

j. Resit/Re-examination - After the instructor/professor has computed the final grade of the student, and he obtains a failing grade, the student has one chance for a resit/re-
examination on the schedule set by the instructor/professor. Failure to take the resit/re-examination on the announced schedule forfeits the student’s chance.
References: Bibliography and Webliography (Include several appropriate and relevant references)