A Lecturette Teaching Guide on

Endorsement

In Partial Fulfillment of the

Requirements in NCM 219-RLE

PRACTICING CLINICAL INSTRUCTOR ROTATION

Submitted to:
Aprilaine Capuno, RN
CLINICAL INSTRUCTOR

Submitted by:
Audrey Nica Therese C. Junsay, St. N.

BSN 4D

September 11, 2023

TITLE OF THE LECTURETTE
The practicing clinical instructor (PCI) would present a thirty (30) minute lecturette on the topic of the endorsement. The said
topic shall cover the definition, goal and importance, types, and flow of an endorsement in a clinical area. The lecturette shall also
cover topics such as what to bring to an endorsement and when an endorsement shall commence.

LEVEL OF STUDENTS
The intended students are college students from BSN 2F Groups 1 and 2 who are currently on their pre-clinical rotation. The
practicing clinical instructor will be using English and Filipino; languages to deliver the topics effectively to the student nurses.

GENERAL OBJECTIVES
At the end of the thirty (30) minute lecturette, the BSN 2F Group 1 and 2 students of San Pedro College would be able to
grasp the idea and nature of a clinical endorsement and gain the necessary nursing skill of being able to receive an endorsement.

Specific Objective Content Strategy/ Time allotment Evaluation

Methodology

1. Define the What is an endorsement? Interactive 3 MINUTES

meaning of ● refers to the transfer of discussion and
endorsement professional responsibility PowerPoint
Presentation
and accountability for some
or all aspects of care for a
patient, or group patients, to
another person or
professional group on a
 temporary or permanent
basis
● the communication process
that occurs between two
10-ITEM QUIZ
shifts of nurses whereby the
specific purpose is to
communicate information
about patients under the care
of nurses for CONTINUITY
OF CARE
● AKA HANDOVER

2. Recall the goals Goals of an Endorsement Interactive 2 MINUTES

and importance of ● to achieve the efficient discussion and
endorsement in PowerPoint
communication of high quality
the clinical area Presentation
clinical info at any time when
the responsibility for patient
care is transferred
● for accurate, reliable
communication of task-
relevant info across shift
changes or between teams
thereby ensuring continuity of
safe and effective working
3. Enumerate the ● Group Handover 5 MINUTES
four (4) types of ○ facilitated as a large
endorsement group with all nurses
commencing the shift
and/or within smaller
groups of nurses
working together
● Bedside Handover
○ direct patient handover
that occurs at the
patient's bedside and
includes patients and
parents/carer
○ PROS: Presence of
the patient
○ CONS: Lack of privacy
(due to presence of
guests); anxiety on the
patient’s part
● Break Handover
○ occurs between the
nurses that holds
responsibility for care
and the nurse who will
be assuming
responsibility for the
care of the patient
○ often short and
informal
● Transfer of Patient
○ all patients transferred
 from one clinical area
to another clinical area
require handover to be
documented. This
includes details of
transfer time indicating
transfer of professional
responsibility and
accountability
○ transfer time becomes
basis for accountability

4. Recognize ● What should I prepare? Interactive 2 MINUTES

when an ○ Ward Notebook discussion and
endorsement ○ Ballpen PowerPoint
should begin ○ Parakit Presentation
○ Attention
○ Ability to stand for 10
or more minutes
● When does an endorsement
start?
○ Usually 15-30 mins
before the start of the
shift, the endorsement
may begin.
○ Endorsement starts
when the receiving
Charge nurse (1) and
medicating/bedside
nurse (1) is already
present.
○ The number of staff
 nurses who will
receive the
endorsement depends
from one ward to
another. Some may
have 2 charge nurses,
1 bedside and 1
medicating nurse

5. Familiarize the ● Flow of an Endorsement Interactive 8 MINUTES

flow of an ○ Assembly discussion and
endorsement and ○ Prayer PowerPoint
the information Presentation
○ Announcements
endorsed
○ Endorsement
● Assembly
○ During morning shifts
(7-3) the head nurse
may or may not be
present during
endorsement.
○ The outgoing charge
nurse prepares the
endorsement table
with the Kardex;
Charge nurse's
endorsement logbook;
and medicating
 nurse's endorsement
sheet
○ Outgoing nurse - nurse
who will
endorse/hand-over the
patient to the next shift
○ Incoming nurse -
nurses who sill receive
the endorsement
○ Kardex - a desktop file
that has slots for
multiple pages. Thick
cardstock pages (NCP
sheets) are inserted
into the slots, one for
each patient. This is
updated every shift.
● Prayer
○ Present SPH Ward
Prayer
● Announcements
○ Reminders or
announcements are
usually announced first
○ Helps keep nurses up
to date and aware of
events, equipment
 malfunctions, and
doctors who are not
present.
○ eg CT Scan out of
order; medical
residents' and
consultants' general
meeting; scheduled
monthly ward
meetings.
● Endorsement
○ Good morning,
endorsement! - start of
endorsement
○ The outgoing charge
nurse begins with the
summary of the total
census with their shift
from the last total
census, admissions,
discharge, trans-out,
trans-in, deaths, and
even those who have
escaped.
■ Last total -
Census prior to
the
 commencement
of the previous
shift
■ Admission -
number of
patients
admitted to the
ward
■ Discharge -
number of
patients who
went home
■ Trans in -
number of
patients
transferred
INTO the ward
■ Trans out -
number of
patients
transferred OUT
of the ward
■ Death - number
of patients who
lost their lives
■ Present total -
census NOW
○ Nurse then starts to
read from the Kardex:
■ Patient’s Room
#
■ Patient’s
COMPLETE
NAME
■ Age and Sex
■ Religion
■ Chief Complaint
■ Impression
■ Diet
■ Medical orders -
freq. of VS and
I&O
■ Signs to watch
out for
■ Pending labs
■ Medications
■ Special
procedures to
be done (Blood
transfusion,
CBG
monitoring)
■ Clearances
(Accounting, CP
 [Cardiopulmona
ry])
■ Any significant
events during
the shift
■ Special
considerations
(AV fistula @
arm, isolation
precautions)
■ IVF - Type,
intake, level,
due time, vein
○ After which, the
outgoing nurse ends
the endorsement by
saying: “end of
endorsement”
○ Prepare to do rounds
and take vital signs.

6. Execute writing ● PCI will read a sample Live 10 MINUTES

down a live endorsement while student demonstration
endorsement. nurses shall write down the and activity
endorsement.
 A Lecturette on

VITAL SIGNS
by: Keah Gertrude V. Bernil, St. N BSN 4D
 Objectives

01 02 03
Define Vital Identify the 4 Understand
Signs primary vital signs normal vital
signs ranges

04 05 06
Explain the Discuss Conclusion/
purpose of methods of Activity
measuring the measuring vital
vital signs signs
 DEFINITION:

Clinical measurements specifically:

Temperature
Pulse
Respiration
Blood Pressure

____ is considered to be the 5th VS

 DEFINITION:

Clinical measurements specifically:

Temperature
Pulse
Respiration
Blood Pressure

PAIN is considered to be the 5th VS

WHEN do we take Vital Signs?

Upon Admission
2

Change in client’s
health status
3

Client reports symptoms

such as chest pain, feeling
hot, or faint
WHEN do we take Vital Signs?
4

Pre and post surgery/invasive

procedures
5
Pre and post medication
administration that could
affect CV system
6
Pre and post nursing
intervention that could affect
vital signs
 TEMPERATURE
It is the difference between the
Definition: heat produced and heat lost by
the body and is measured with
the use of a thermometer.

ROUTES LAOR
ACLRET
INPACMYT
LILAYRXI
 TYPES

Core Temperature Surface Temperature

Temperature of Temperature of
the deep tissues the skin,
in the body subcutaneous
e.g. abdominal tissue, and fats
cavity, pelvic
cavity
 TEMPERATURE

AGE Normal Values PYREXIA

Abnormally high body
temperature
A.K.A (hyperthermia & fever)
Newborn 35.5-37.5°C

Children to Adult 36.4-37.6°C

HYPOTHERMIA
Reflects bpdy temperature
that is lower than normal

Adults >65 y/o 35.8-36.9°C

 STEPS:

1. Greet the patient

2. Identify the patient
3. Inform that you will be taking the VS
4. Disinfect the thermometer
5. Ask consent that you will put the
thermometer
6. Place the thermometer on the
deepest part of the axilla
 STEPS:

7. Wait for a one full minute/ until the

thermometer beeps
8. Disinfect the thermometer
9. Record on the jotdown notebook
 PULSE RATE
It is a rhythmical throbbing that
Definition: results from a wave of blood
passing through an artery as the
heart contracts

Apical
SITES Popliteal Artery
Radial Artery
Carotid Artery
Temporal Artery
Brachial Artery
Dorsalis Pedis
Posterior Tibialis
Femoral Artery
 PULSE RATE
AGE Normal Values

Newborn (0-1mos.) 120-160bpm (Ave. 140)

Infant (11-12mos.) 100-140bpm (Ave. 120)

Toddler (1-3y/o) 80-120bpm (Ave. 100)

Pre-Schooler (3-6y/o) 75-120bpm (Age. 100)

Adult (Male) 70-80bpm

Adult (Female) 80-90bpm
 STEPS:

1. Greet the patient

2. Identify the patient
3. Inform that you will be taking the VS
4. Locate the radial pulse
5. Place 2 fingers on the radial pulse
6. Place arms of the patient on the chest
7. Count pulse rate for a one full minute
8. Record on the jotdown notebook
 CARDIAC RATE
If a peripheral pulse is irregular, weak, or
Definition: extremely rapid, causing it difficult to
assess accurately, the apical rate may be
assessed.

Apical
Pulse Left Midclavicular
Line, 5th Intercostal
Space

Take Note!: An Apical Pulse will NEVER be lower than Radial Pulse
 CARDIAC RATE
Rate:
AGE Normal Values
Tachycardia:
Infant (1-12mos.) 100-160bpm excessively fast
heart rate; above
Toddler (1-3y/o) 90-150bpm the normal rate

Pre-Schooler (3-6y/o) 80-140bpm Bradycardia:

decreased rate
School-Aged (6-12y/o) 70-120bpm
than normal
Adolescent/ Adult 60-100bpm
 STEPS:
1. Greet the patient
2. Identify the patient
3. Inform that you will be taking the VS
4. Ask for consent/ give privacy
5. Warm the diaphragm of stethoscope
6. Locate the apical pulse
7. Place diaphragm of the stethoscope
over the apical pulse
8. Count for a one full minute
9. Record on the jotdown notebook
 RESPIRATORY RATE
It is the exchange of oxygen and
Definition: carbon dioxide between the
atmosphere and body cells and
is initiated by the act of breathing

Purpose
To obtain the respiratory rate
per minute and an estimatate
of the patient’s respiratory
status
RESPIRATORY RATE Rate:
Tachypnea:
AGE Normal Values
a respiratory rate
that exceeds the
Infants 30-40cpm
normal breathing
pace.
Children 20-25cpm

Bradypnea:
Adult 12-20cpm
abnormal slow
respiratory rate
 STEPS:

1. Greet the patient

2. Identify the patient
3. While the arm still on the chest of
the patient count the respiratory
rate
4. 1 cycle= 1inspiration, 1expiration
5. Count for a one full minute
6. Record on the jotdown notebook
 BLOOD PRESSURE

It is the lateral force exerted by

Definition:
the blood on the arterial walls.

Purpose
To aid in diagnosis
To observe changes in a
patient’s condition
 Contraindication for Brachial Artery
Blood Pressure Measurement

Surgery Venous Access Injury or disease to

including the Device such as AV the shoulder, arm,
shunt (in patient on or hands such as
breasts, axilla,
hemodialysis) or IVF trauma, burn or
shoulder, arm or in the arm application of cast
hands or bandage
 Sites for BP taking

Either arm on the Either leg on the

dorsalis pedis
antecubital popliteal space
space
 BLOOD PRESSURE Terms:
Hypertension:
AGE Normal Values
high blood
pressure; higher
Infant 50/40-80/50mmHg
than the normal
range
Children 87/48-117/64mmHg

Hypotension:
Adult 110/70-130/90mmHg
low blood
pressure; lower
than the normal
range
 STEPS:
1. Greet the patient
2. Identify the patient
3. Ask the patient if client smoked, took
caffeine
4. Place cuff on the arm (not too tight,
not too loose)
5. Locate the brachial artery and place
the diaphragm of the stethoscope on
top
6. Locate the radial pulse using 2 fingers
 STEPS:
7. Inflate the cuff until you will no
longer feel the radial pulse; add
30mmHg
8. Gradually deflate the cuff
9. 1st sound= systolic; last
sound=diastolic
10. Remove the cuff
11. Deflate the cuff
12. Record on the jotdown notebook
 September 11, 2023 Sta. Rita

203-1 Doe, John q4 8:00AM110/80 75 80

 Sta. Rita

203-1 Doe, John 36.9 75 16

THANK YOU FOR
LISTENING!
Any Questions?
 Phase 01 Phase 03 Phase 05 Phase 07
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Phase 02 Phase 04 Phase 06

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TAKE CARE OF THE HUMAN BODY FINAL CONCLUSION

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Conclusions
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placerat. Cras suscipit est at mauris. placerat. Cras suscipit est at mauris.

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placerat. Cras suscipit est at mauris. placerat. Cras suscipit est at mauris.
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