VOLUME  1 | ISSUE 8 | MAY 2025

Post-Operative Pain Management in the PACU

by John Mike A. Nifras, RN

Efficient postoperative pain management is a critical component of great surgical treatment, particularly in the Post Anaesthesia treatment Unit (PACU). Prompt and sufficient pain management has a significant impact on healing, satisfaction, and overall outcomes as patients transition from the perioperative phase to recovery. In order to preserve patient comfort and safety, PACU nurses, who are typically the first point of contact after surgery, are critical in evaluating, managing, and reassessing pain.

Surgical incisions, tissue manipulation, endotracheal intubation, and surgical placement can all induce pain in the early postoperative period. Improper care can lead to complications such as high blood pressure, delayed wound healing, breathing difficulties, and even psychological distress. As a result, individualized pain management plans based on the patient's medical history, kind of surgery, and continuous evaluations are critical.

Periañez et al. (2025) found that patients' perception of pain increased after entering the PACU. 5.8% of patients experienced moderate to severe pain upon arrival at the unit, which increased to more than 34% two hours after admission to the recovery section. Recent research has yielded similar results. The increase in pain perception may be due to the lingering impact of anesthetics, which fades over time. However, it is possible that efficient treatments for controlling acute postoperative pain, such as the use of preventative analgesia, have yet to be developed. 

In the PACU, multimodal analgesia is typically the gold standard. This therapy addresses several pain pathways by combining various kinds of drugs and procedures, including opioids (such as morphine and fentanyl), non-opioid analgesics (such as acetaminophen and NSAIDs), and localized anaesthetics.

Opioids are still used to treat severe pain, but they must be used with caution due to the danger of adverse effects such as respiratory depression, nausea, and oversedation. Patient education that outlines what type of pain to expect and how it will be managed empowers patients and reduces anxiety, which can lead to lower levels of perceived pain. Non-pharmacological therapy, such as epidural or nerve blocks administered intraoperatively, are critical in delivering targeted pain management while lowering opioid consumption. Their effectiveness can extend into the PACU, therefore nurses must maintain a close eye on these patients for motor block, hypotension, or catheter issues. Repositioning, utilizing color or heat, relaxing techniques, and providing emotional support can all help to increase medication effectiveness. 

Continuous reassessment is a vital part of pain management in the PACU. Pain is a dynamic condition that requires constant evaluation of the patient's reaction to treatment. Nurses must monitor pain scores, medication efficacy, and side effects, as well as work with the anaesthesia and surgical teams to change treatment regimens as needed.

References 

Periañez, C. A. H., Castillo-Diaz, M. A., & Garcia, M. A. M. (2025). Postoperative pain 

control in patients in the post-anesthesia care unit: a prospective observational study. Perioperative Care and Operating Room Management, 100490.

The Function of a Nurse Administrator: Connecting Leadership and Healthcare

Nurse administrators are essential to ensuring that patient care is provided effectively, morally, and efficiently in the quickly changing healthcare landscape of today. They are the backbone of healthcare facilities, managing teams, resources, and policies by combining clinical knowledge with administrative savvy.

What Is a Nurse Administrator?

A nurse administrator is a registered nurse (RN) who has progressed into a leadership or managerial position within a healthcare organization. Unlike bedside nurses, they are more focused on strategic planning, budgeting, staffing, operations management, and compliance. They typically work for hospitals, clinics, long-term care facilities, or public health organizations.

Responsibilities of Nurse Administrator

Nurse administrators wear many hats. Often, their responsibilities include:

• Recruiting, training, and evaluating nurses and other medical professionals are all part of nursing staff supervision.

• Managing budgets: Distributing money wisely to meet departmental needs.

• The process of creating and enforcing rules that improve care quality while abiding by the law is known as policy development.

• Coordination between departments: Promoting communication between the clinical and administrative teams.

• The process of monitoring patient care standards and implementing plans to enhance outcomes is known as quality improvement.

• Leadership and Strategic Management Create and carry out nursing departmental strategies that are in line with hospital objectives. Oversee the nursing staff in providing excellent, patient-focused care. Encourage a culture of responsibility, professionalism, and ongoing development. Be a nurse representative. Represent nursing interests in executive-level decision-making and policy development. 

• Human Resource Management Recruit, hire, orient, and retain qualified nursing staff. Develop staffing plans and oversee staff scheduling to ensure adequate coverage. Conduct performance appraisals, staff evaluations, and professional development planning. Address employee relations issues, including conflict resolution and disciplinary actions. 

• Financial and Resource Management Prepare and manage the nursing department's operating budget. Monitor expenditures and allocate resources efficiently. Ensure cost-effective use of supplies, equipment, and human resources. Justify financial requests for staffing, equipment, and training needs. 

• Policy Implementation and Compliance

Create, revise, and implement nursing rules and procedures in accordance with.

Ensure that all nursing standards and legal criteria are met at the local, national, and international levels. Oversee the accreditation and licensing processes for nursing services.

Education and Qualifications

The following is the usual path to becoming a nurse administrator:

• A Bachelor of Science in Nursing (BSN) is required to pursue a career in nursing.

• A registered nurse (RN) license is required in order to practice nursing.

• Master of Science in Nursing (MSN) or Healthcare Administration: Specialization in management, leadership, or administration is usually essential.

Skills and Qualities:

• A successful nurse administrator must possess:

• Capabilities in leadership and communication

• Organizational and analytical thinking

• Empathy and emotional intelligence

• Knowledge of healthcare regulations and ethics

• Proficiency in budgeting and financial management

Obstacles and Benefits:

Staff shortages, regulatory demands, and budgetary balance are some of the difficulties that come with being a nurse administrator, just like any other leadership position. But the benefits—like influencing legislation, enhancing patient outcomes, and coaching aspiring nurses—make it a fulfilling career.

In conclusion

Nurse administrators are the unsung heroes behind the scenes in healthcare. Their ability to successfully combine business acumen and compassion guarantees the success of both employees and patients. Becoming a nurse administrator offers a dynamic and fulfilling career path for nurses who are passionate about leadership and wish to have a bigger impact. As a nurse administrator, the integration of clinical expertise with strategic leadership is essential to ensure high-quality patient care, effective team management, and efficient healthcare operations. By fostering collaboration, implementing evidence-based practices, and prioritizing both patient outcomes and staff well-being, nurse administrators play a vital role in shaping the future of healthcare. Their ability to lead with compassion, integrity, and innovation continues to drive improvements across the healthcare system.

From Farm to Operating Room: A Journey of Passion and Resilience

Life often takes unexpected turns, leading us to places we never imagined. For one determined individual, the journey began in the vast fields of a farm and eventually led to the bright lights of an operating room. A proud graduate of Silliman University, Holy Trinity University, and Palawan State University, this inspiring figure transitioned from a dedicated farmer to a registered nurse, proving that passion and perseverance can open doors to new and fulfilling paths.

A Farmer at Heart

Growing up with a deep connection to the land, farming was more than just a livelihood—it was a source of peace and fulfillment. The discipline and resilience required to cultivate crops and manage a commercial farm instilled a strong work ethic and problem-solving skills that would later prove invaluable in another demanding profession. Farming became a way to de-stress, a therapeutic escape from the rigors of daily responsibilities.

The Call to Nursing

Despite a love for agriculture, the call to serve in the medical field grew stronger. Choosing to pursue a Bachelor of Science in Nursing at Holy Trinity University was a pivotal decision. The rigorous training and compassionate philosophy of care at the university laid a strong foundation for a career in healthcare. Not stopping at a bachelor's degree, further studies led to a Master of Science in Nursing (MSN) majoring in Nursing Service Administration at Palawan State University, further enhancing leadership and administrative capabilities in the nursing profession. The transition from farm work to nursing studies was not easy, but dedication and adaptability ensured success.

Operating Room Nurse: Precision and Care

After earning a nursing degree and obtaining licensure, the journey into the medical field officially began. Specializing as an operating room (OR) nurse, the role demanded meticulous attention to detail, quick decision-making, and unwavering commitment to patient care. The fast-paced environment of the OR mirrored the unpredictability of farming—both required adaptability, endurance, and a keen ability to handle pressure.

Farming as a Stress Reliever

Even as a full-time nurse, the love for farming never faded. Engaging in commercial farming alongside a nursing career became a perfect balance—one profession healing people, the other nurturing the land. Tending to crops and livestock provided a much-needed escape from the high-stress environment of surgery. The farm remained a sanctuary, a place to reconnect with nature and recharge the spirit.

A New Chapter in the United States

Seeking broader opportunities and greater professional growth, the decision to immigrate to the United States marked another milestone. The transition was challenging, requiring adaptability to a new healthcare system, cultural shifts, and professional licensing requirements. However, the strong foundation built through years of experience, coupled with a relentless drive, ensured a smooth integration into the U.S. healthcare workforce.

Today, as a registered nurse in the United States, this journey continues to inspire many. From the fields of a farm to the sterile precision of an operating room, it is a testament to the power of resilience, lifelong learning, and unwavering dedication. Whether healing patients or nurturing crops, the passion remains the same—making a difference, one life at a time.

Reality Check: The Life of Middle-Ages Female with Genecological Disorder

Lea M. Cerdena RN, MM, CPFA, CSFA

Introduction

Trends, Issues and Gaps

Gynaecological care is primarily associated with reproductive health, encompassing topics such as family planning, pregnancy, and childbirth. As women approach the end of their reproductive years, they may seek consultation and treatment from outpatient gynaecological service providers for various reasons, including hormonal changes during menopause. 

Age-related increases in breast and endometrial cancer incidence rates, as well as conditions like urinary incontinence, osteoporosis, and uterine prolapse, become more common after menopause (Charité – Universitätsmedizin Berlin (Ed) (2020)  Some of these conditions may require surgical intervention followed by outpatient medical aftercare. In terms of prevention, early detection of cancer holds significant importance in gynaecological practice (Kolip P, Hurrelmann K. (2016) 

 Within specific age groups, cancer screening tests are offered as a standard benefit under statutory health insurance. As of January 2020, the early detection of cervical cancer transitioned from opportunistic screening to an organized screening program, which includes an annual cervical cell smear for women aged 20 to 34, and a cervical cell smear and human papillomavirus (HPV) test every three years for women aged 35 and older. Breast cancer early detection involves annual breast palpation examinations for women aged 30 and older, and biennial mammography screening for women aged 50 to 69. Some patients may seek additional consultation on mammography screening from their gynaecologists (Gemeinsamer Bundesausschuss (G-BA) (2020)

In the recent study in the US by Krause L, Dini L, Prütz F (2020), it was found that when women enter the non-reproductive phase of life, other reasons for seeking gynecological care become more important. Cancer screening and menopausal complaints are highlighted as significant reasons for seeking gynecological services in this age group.The DEGS1 data reveals that a considerable percentage of women between 50 and 79 years old underwent breast palpation examinations (65.0%) and cervical cell smear tests (pap smears) (58.0%) within the last twelve months. These figures suggest that cancer screening is an important motive for gynecological consultations among women in this age range.Additionally, the claims data from the KVen shows that menopausal symptoms (coded as N95 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision, ICD-10) and screening for malignant neoplasms (coded as Z12 in ICD-10) were the most frequently billed services. This indicates that menopausal symptoms and cancer screening are the primary reasons for seeking gynecological care among women aged 50 years and older.

In the Philippines, the 2020 data collected through the POGS nationwide statistics system (PNSS), which gathers statistical information on obstetric and gynecologic health indicators revealed that out of the total reported cases, 92% were obstetric cases. The live birth rate was highest in the National Capital Region, with the highest age-specific birth rate in the 25-29 age group. Cesarean section rate, stillbirth rate, neonatal mortality rate, and perinatal mortality rate were higher than in 2019. The maternal mortality ratio was 121.6 per 100,000 live births. There were 2,858 confirmed cases of COVID-19 infection. Gynecologic admissions totaled 26,164, with abnormal uterine bleeding being the most common diagnosis. The most frequent gynecologic procedures performed were hysterectomy, salpingo-oophorectomy, medical management, and blood transfusion. Gynecologic malignancies were associated with the majority of deaths, with cervical cancer having the highest number of fatalities (19%). The report concludes that obstetric and gynecologic admissions were lower compared to the previous year, and further exploration is needed to understand the deterioration in obstetrical indications. Timely and accurate statistics are crucial for identifying areas of improvement and addressing the unmet needs of patients. (Macayaon AM et al., 2020)

Objectives

With the above premises, the objective of this study is to delve into the lived experiences of middle-aged women who had gynecological disorders during the Middle Ages. By examining this specific historical period, the study aims to understand the societal and cultural factors that influenced the perceptions and treatment of gynecological disorders at that time. It also seeks to identify the challenges faced by middle-aged women in managing their gynecological disorders and the coping mechanisms they employed. Ultimately, the study intends to propose recommendations that can enhance the understanding and care of women with gynecological disorders in both historical and contemporary contexts. By shedding light on the experiences of these women and the broader social context in which they lived, this research has the potential to contribute to improvements in healthcare practices and support systems for women with gynecological disorders today.

Contributions

The proposed study on the lived experiences of middle-aged women with gynecological disorders during the Middle Ages holds significant implications across multiple domains, including policy, research, theory, and the practice of nursing. 

From a policy perspective, the study's findings can inform the development of policies that address historical inequities and prioritize women's health, thereby promoting access to comprehensive care for gynecological disorders.

 In terms of research, the study fills a critical gap in historical research by focusing on this specific population and time period, expanding our understanding of women's experiences in the context of gender, age, and health.

 Additionally, the study contributes to theoretical frameworks within gender studies, medical anthropology, and women's health by examining the societal and cultural factors that influenced perceptions and treatment of gynecological disorders in the Middle Ages. Such insights enrich theoretical discussions and frameworks related to gender and health. 

Lastly, the study directly impacts the practice of nursing, as the findings can inform the development of patient-centered care approaches, tailored interventions, and improved support systems for women with gynecological disorders. 

By bridging historical and contemporary contexts, the study has the potential to bring about positive changes in the understanding and care of women with gynecological disorders, ultimately improving patient outcomes and enhancing the quality of care provided by nurses in this field.

References:

Berufsverband der Frauenärzte e.V. (no date) Krebsfrüherkennung in der Krankenversicherung. https://www.frauenaerzte-im-netz.de/frauengesundheit/krebs-frueherkennung-kfu/kfu-in-der-krankenversicherung/

Charité – Universitätsmedizin Berlin (Ed) (2020) Frauen 5.0 – Executive Summary: Regionale Versorgung von Frauen 50+ durch Fachärztinnen und Fachärzte für Allgemeinmedizin und Gynäkologie. https://allgemeinmedizin.charite.de/fileadmin/user_upload/microsites/m_cc01/allgmed/DOCS/Executive_Summary_Frauen50_Printed.pdf 

Gemeinsamer Bundesausschuss (G-BA) (2020) Richtlinie des Gemeinsamen Bundesausschusses über die Früherkennung von Krebserkrankungen, (Krebsfrüherkennungs-Richtlinie/KFE-RL). https://www.g-ba.de/downloads/62-492-2002/KFE-RL_2019-12-05_iK-2020-01-01.pdf 

Gemeinsamer Bundesausschuss (G-BA) (2020) Richtlinie des Gemeinsamen Bundesausschusses über die Früherkennung von Krebserkrankungen, (Krebsfrüherkennungs-Richtlinie/KFE-RL). https://www.g-ba.de/downloads/62-492-2002/KFE-RL_2019-12-05_iK-2020-01-01.pdf 

Kolip P, Hurrelmann K. (2016) Handbuch Geschlecht und Gesundheit. Männer und Frauen im Vergleich. 2., vollständig überarbeitete und erweiterte Auflage. Hogrefe Verlag, Bern

Krause, L., Dini, L., & Prütz, F. (2020). Reasons for women aged 50 years and older to seek gynaecological advice and treatment. Journal of health monitoring, 5(2), 3–14. https://doi.org/10.25646/6065

Macayaon AM, Habana MA, Amorin HR, Añonuevo AU, del Prado JC, Irabon IS, Magno AD, Mangubat ML. (2020) POGS report on obstetrical and gynecological indicators of health care. Philipp J Obstet Gynecol [serial online] 2022 [cited 2023 Jun 13];46:29-37. Available from: https://www.pogsjournal.org/text.asp?2022/46/1/29/343232

Illuminating Compassion: The Nurse’s Role in Honoring the Dying Patient’s Aura

Jovan S. Parreño RN, MSN

End-of-life care is not merely a clinical process but a profound journey requiring exceptional empathy, deep understanding, and unwavering respect for the patient's holistic well-being, extending far beyond the management of physical symptoms. Within this sensitive domain, recognizing and honoring the subtle, intangible essence or "aura" that surrounds a dying individual constitutes a vital aspect of holistic care, significantly impacting their comfort and dignity in their final moments.

An aura is often described as an energetic field thought to envelop each person, reflecting their emotional, spiritual, and physical states. While this concept has historical roots in spiritual traditions and complementary healing modalities, its relevance resonates deeply with many healthcare professionals. They observe that patients frequently exhibit non-verbal cues – subtle shifts in breathing patterns, facial expressions, or overall demeanor – that suggest a deeper, unspoken presence. These nuanced indicators can serve as crucial markers of a patient's inner condition, guiding caregivers to respond with heightened sensitivity and profound empathy.

Nurses, positioned at the forefront of patient interaction, possess a unique opportunity to perceive and nurture this ethereal energy. Through the practice of mindful presence, compassionate communication, and gentle, intentional touch, nurses can cultivate an environment that fosters healing and profoundly respects the patient's inner world. Simple yet powerful actions, such as maintaining a calm and reassuring tone, cultivating a tranquil environment, or engaging in active, heartfelt listening, can illuminate and honor a patient's aura, fostering a profound sense of security and serenity.

Equally critical is the acknowledgment and integration of diverse cultural and spiritual beliefs. For many patients, rituals, prayers, or spiritual practices rooted in their traditions provide immense comfort, validating their identity and offering a vital sense of connection that transcends the physical realm. Nurses who respectfully support these practices demonstrate a profound reverence for the patient's individual journey, upholding their dignity and value in their final days.

Research in palliative and holistic care consistently highlights that addressing the spiritual and emotional dimensions of death significantly enhances a patient's quality of life. When nurses recognize and honor the invisible energy that envelops each individual, they facilitate an end-of-life experience that is more compassionate, deeply meaningful, and truly respectful.

Fundamentally, illuminating compassion necessitates a genuine acknowledgment of the patient's inner nature, extending beyond the mere provision of physical care. By recognizing and honoring the subtle yet potent presence of the aura, nurses transform the dying process into a spiritual passage imbued with dignity, compassion, and peace. This all-encompassing approach not only benefits patients but also enriches the experience of providing care, reinforcing the powerful human connection that lies at the heart of healthcare.

DIGITAL WRITING AND EDITING OF SCHOOL PAPER ADVISERS (SPAs)

JEFF BENEDICT V. NONES

1Ilocos Sur Polytechnic State College – Tagudin Campus, Tagudin, 2714 Ilocos Sur

2Department of Education - Luna Central School, Luna, La Union

Corresponding Author: Jeff Benedict V. Nones, E-mail: jeffbenedict.nones@deped.gov.ph

ABSTRACT

This study examines the demographic profile, perceived competencies, and seminar effectiveness of School Paper Advisers (SPAs) in Luna, La Union, with the aim of identifying competency gaps and proposing measures to enhance digital writing and editing skills. Using a descriptive-correlational research design, data were collected from 40 SPAs across 20 schools through structured questionnaires, validated with a reliability coefficient of 0.995. Statistical methods such as descriptive analysis and Kendall’s Tau correlation were employed to analyze relationships between demographic factors, competency levels, and training effectiveness.

Findings reveal that mid-career educators dominate SPA roles, while younger advisers are underrepresented. A strong female presence aligns with national trends in education. All SPAs attended at least one seminar, yet seminar frequency and task engagement exhibit weak correlations with perceived competency. Technical skill gaps in SEO, layout design, and digital writing tools remain, with younger SPAs perceiving themselves as more proficient. Seminar effectiveness is significantly influenced by age, as older SPAs rate sessions as less impactful.

These findings imply the need for structured interventions, including expanding seminar frequency, refining mentorship programs, improving access to digital tools, and promoting interdisciplinary collaboration. Targeted training strategies should accommodate varying experience levels and focus on practical applications, expert engagement, and continuous learning. Implementing these recommendations will enhance SPAs’ ability to mentor student journalists, strengthen student publication quality, and ensure journalism education remains aligned with evolving industry standards.

KEYWORDS

Competency, Digital Journalism, Mentorship, Professional Development, Training Programs

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IMPACT OF NURSE-INITIATED PREOPERATIVE HEALTH

EDUCATION IN SELECTED HOSPITALS

IN SOUTHERN PALAWAN

By: Donann Xaris H. Navarro, RN

MSN Candidate, Graduate School, Palawan State University

Abstract

Effective nurse-initiated preoperative education is essential for a positive surgical experience, yet Level I Philippine data are scarce. This descriptive-comparative study surveyed 90 elective postoperative adults (18–60y) in three Southern Palawan public hospitals using a validated 35-item questionnaire (Cronbach α = .88). Descriptive and inferential statistics examined perceptions across four teaching focuses and three barrier focuses. Respondents (38.9% aged 26–35 y; 50 % married; 35.6 % college-educated) rated teaching very highly (domain means = 4.47–4.49/5; grand mean = 4.48, “strongly agree”). Perceptions did not differ by sex, age, education, or surgical complexity; only operation type mattered (orthopedics M= 4.11; F = 2.84, p = .029). Major barriers were an unfavorable nurse-patient ratio (rM=4.76) and insufficient teaching resources (rM=4.60). While communication proved clear and comprehensive, staffing and material deficits threaten sustainability; a three-phase plan comprised of protected teaching windows, resource-efficient multimedia aids, and staffing advocacy is therefore recommended.

Introduction

Nurse-initiated preoperative teaching is a vital nursing practice that helps reduce patient anxiety, clarify understanding of the procedure, and enhance recovery. Numerous international studies have documented these benefits, however evidence from Level I public hospitals in the Philippines remains scarce. To address this, the researcher conducted a study in three hospitals in Southern Palawan to determine the socio-demographic data of their patients, measure their perceptions of nurse-initiated preoperative education and identify variations, determine teaching barrier perception, and develop an augmentation plan to enhance teaching practices. The results of this study shall serve as basis for improvements in the healthcare systems, benefiting humanity as a whole.

Methodology

Research Design

The study utilized a descriptive-comparative design, capturing respondents’ socio-demographics and perceptions towards nurse-initiated preoperative teaching and its barriers, at a single postoperative time point, allowing group comparisons without longitudinal follow-up.

Participants

Purposive sampling selected 90 elective adult (18–60y) patients from Aborlan Medicare, Narra Municipal and Southern Palawan Provincial Hospitals. All could converse in Filipino/English; emergency cases and unstable patients were excluded.

Instrument

A researcher-made three-part 35-item validated questionnaire (Cronbach α = 0.88) determined respondent socio-demographics and perceptions to nurse-initiated preoperative teaching and its barriers.

Procedure

After securing informed consent, the questionnaire was distributed to be answered by the respondent in the presence of their guardian, without interference from the researcher/assistant and hospital staff. Filled-out questionnaires were collected and secured. The data obtained were treated with descriptive statistics, Welch t-tests, one-way ANOVA, and Fisher exact tests to describe the socio-demographics and examine the perceptions across four teaching focuses and three barriers to teaching, including the differences in perception.

Results and Discussion

Respondents were mainly 26- 35 years old (38.9%), married (50%), college-educated (35.6%), and mostly undergone major and general surgeries. They rated nurse-initiated preoperative teaching very highly across all four focuses (Surgical Overview, Diet and Nutrition, Addressing Fears and Anxiety, and Postoperative Expectations), with weighted means ranging from 4.47 to 4.49 on a five-point Likert scale (grand mean = 4.48 “strongly agree”).

No statistically significant differences in teaching perceptions were detected by sex, age group, educational level, or surgical complexity. The only subgroup variation emerged by operation type where orthopedic patients rated teaching slightly lower (M = 4.11; F = 2.84, p = .029). Among the three barrier focuses—nurse-patient ratio, teaching resources, and communication—the first two reversed-scored scales were identified major barriers (reverse mean = 4.76 and 4.60, respectively), while communication scored as a negligible barrier. These indicate that nurses were able to overcome communication-related barriers and delivered clear and comprehensive preoperative teaching, but the staffing and teaching resource deficits threaten its sustainability.

Using the empirical evidence of this study, rooted in the theoretical foundations of Orem’s Self-care Deficit Nursing Theory, Watson’s Theory of Human Caring, and Deming’s System of Profound Knowledge, the researcher proposes the following augmentation plan to support preoperative education, advance patient self-care, foster caring relationships, and continually push the quality improvement of level I hospitals in Southern Palawan. It is divided into three sequential phases with corresponding timeframes:

1. First Phase: Quick Wins (0-3 months) involving a protected teaching window per shift and use of bilingual teach-back cards for standardized explanations.

2. Second Phase: System Build-up (4-12 months) involving the use of simple high-reach multimedia and training of teaching champions who will focus on effective preoperative teaching.

3. Third Phase: Consolidation & Policy (12-24 months) embedding of teaching checklists in patient records, advocating for evidence-based staffing ratios, and conducting annual audits of teaching performance.

Following the proposed augmentation plan aims to fortify existing strengths and ensure enduring, high-quality patient education.

Conclusion

This study concludes that nurse-initiated preoperative education in Southern Palawan’s Level 1 public hospitals is highly effective and equitably delivered. Patients of all identified ages, sex, education levels, and most surgical types consistently rated teaching very positively. Two major barriers were identified: unfavorable nurse-to-patient ratio and limited teaching resources that pose significant threats to the sustainability and quality of the program. The results call for action to promote the program’s current strengths and close identified gaps.

Recommendations

The researcher recommends the Department of Health to review national guidelines for optimal nurse-patient ratios across Level 1 hospitals and provide adequate funding for standardized multimedia teaching materials. Hospital management should adopt the proposed augmentation plan. Ensure protected teaching windows, allocate budget for simple high-reach multimedia, and provision of new staff. The Nursing Department is urged to certify at least two “teaching champions” per unit through accredited micro-courses, pilot a “surgical buddy” peer-educator scheme, and maintain routine barrier audits. Finally, future researchers are encouraged to use mixed methods designs to assess the augmentation plan’s impact on patient anxiety, length of stay, and readmissions; to compare low-tech versus high-tech media effectiveness; and to replicate the study in other Philippine regions to establish broader best practices.

References

Navarro, D.X. (2025). Impact of nurse-initiated preoperative teaching in selected hospitals in Southern Palawan. Palawan State University, Graduate School. Retrieved from https://drive.google.com/file/d/1_o2MJtwFTwXCbBxpep-2BjrzKBRMSOUZ/view?usp=sharing