o R.A. 9173 or THE

PHILIPPINE NURSING ACT OF2002

REPUBLIC ACT NO. 9173

o An Act Providing For A More

Responsive Nursing Profession,Repealing For The Purpose RepublicAct No. 7164, Otherwise Known As"The Philippine Nursing Act Of 1991"And For Other Purposes

o This Act shall be known as the

"Philippine Nursing Act of 2002."

CREATION AND

COMPOSITION OF THE BOARD

o There shall be created a

Professional Regulatory Board ofNursing, hereinafter referred to asthe Board, to be composed of aChairperson and six (6) members.

o They shall be appointed by the

president of the Republic of thePhilippines from among two (2)recommendees, per vacancy, of theProfessional Regulation Commission,hereinafter referred to as theCommission, chosen and rankedfrom a list of three (3) nominees, pervacancy, of the accreditedprofessional organization of nurses inthe Philippines who possess thequalifications prescribed in Section 4of this Act.

QUALIFICATIONS OF THE

CHAIRPERSON AND MEMBERS OFTHE BOARD

o (a) Be a natural born citizen

and resident of the Philippines;

o (b) Be a member of good

standing of the accreditedprofessional organization of nurses;

o (c) Be a registered nurse and

holder of a master's degree innursing, education or other alliedmedical profession conferred by acollege or university duly recognizedby the Government: Provided, Thatthe majority of the members of theBoard shall be holders of a master'sdegree in nursing: Provided, further,That the Chairperson shall be aholder of a master's degree innursing;

o (d) Have at least ten (10) years

of continuous practice of theprofession prior to appointment:Provided, however, That the last five(5) years of which shall be in thePhilippines; and

o (e) Not have been convicted of

any offense involving moralturpitude; Provided, That themembership to the Board shallrepresent the three (3) areas ofnursing, namely: nursing education,nursing service and communityhealth nursing.

REQUIREMENTS UPON

QUALIFICATION AS MEMBER OFTHE BOARD OF NURSING

o Any person appointed as

Chairperson or Member of the Boardshall immediately resign from anyteaching position in any school,college, university or institutionoffering Bachelor of Science inNursing and/or review program forthe local nursing board examinationsor in any office or employment in thegovernment or any subdivision,agency or instrumentality thereof,including government-owned orcontrolled corporations or theirsubsidiaries as well as theseemployed in the private sector.

o He/she shall not have any

pecuniary interest in oradministrative supervision over anyinstitution offering Bachelor ofScience in Nursing including reviewclasses.

TERM OF OFFICE

o The Chairperson and Members

of the Board shall hold office for aterm of three (3) years and until theirsuccessors shall have beenappointed and qualified: Provided,That the Chairperson and membersof the Board may be re-appointed foranother term.

o Any vacancy in the Board

occurring within the term of aMember shall be filled for theunexpired portion of the term only.Each Member of the Board shall takethe proper oath of office prior to theperformance of his/her duties.

o The incumbent Chairperson

and Members of the Board shallcontinue to serve for the remainderof their term under Republic Act No.7164 until their replacements havebeen appointed by the President andshall have been duly qualified.

COMPENSATION OF THE

BOARD MEMBERS

o The Chairperson and Members

of the Board shall receivecompensation and allowancescomparable to the compensation andallowances received by theChairperson and members of otherprofessional regulatory boards.

Administrative Supervision of

the Board, Custodian of its Records,Secretariat and Support Services

o The Board shall be under the

administrative supervision of theCommission.

o All records of the Board,

including applications forexaminations, administrative andother investigative cases conductedby the Board shall be under thecustody of the Commission.

o The Commission shall

designate the Secretary of the Boardand shall provide the secretariat andother support services to implementthe provisions of this Act.

o THE BOARD SHALL

SUPERVISE AND REGULATE THEPRACTICE OF THE NURSINGPROFESSION AND SHALL HAVETHE FOLLOWING POWERS,DUTIES AND FUNCTIONS:

o (a) Conduct the licensure

examination for nurses;

o (b) Issue, suspend or revoke

certificates of registration for thepractice of nursing;

Powers and Duties of the Board

o (c) Monitor and enforce quality

standards of nursing practice in thePhilippines and exercise the powersnecessary to ensure themaintenance of efficient, ethical andtechnical, moral and professionalstandards in the practice of nursingtaking into account the health needsof the nation;

o (d) Ensure quality nursing

education by examining theprescribed facilities of universities orcolleges of nursing or departments ofnursing education and those seekingpermission to open nursing coursesto ensure that standards of nursingeducation are properly complied withand maintained at all times. Theauthority to open and close collegesof nursing and/or nursing educationprograms shall be vested on theCommission on Higher Educationupon the written recommendation ofthe Board;

o (e) Conduct hearings and

investigations to resolve complaintsagainst nurse practitioners forunethical and unprofessional conductand violations of this Act, or its rulesand regulations and in connectiontherewith, issue subpoena adtestificandum and subpoena ducestecum to secure the appearance ofrespondents and witnesses and theproduction of documents and punishwith contempt persons obstructing,impeding and/or otherwiseinterfeming with the conduct of suchproceedings, upon application withthe court;

o (f) Promulgate a Code of Ethics

in coordination and consultation withthe accredited professionalorganization of nurses within one (1)year from the effectivity of this Act;

o (g) Recognize nursing specialty

organizations in coordination withthe accredited professionalorganization; and

o (h) Prescribe, adopt issue and

promulgate guidelines, regulations,measures and decisions as may benecessary for the improvements ofthe nursing practice, advancement ofthe profession and for the proper andfull enforcement of this Act subject tothe review and approval by theCommission.

ANNUAL REPORT

o The Board shall at the close of

its calendar year submit an annualreport to the President of thePhilippines through the Commissiongiving a detailed account of itsproceedings and theaccomplishments during the yearand making recommendations forthe adoption of measures that willupgrade and improve the conditionsaffecting the practice of the nursingprofession.

REMOVAL OR SUSPENSION

OF BOARD MEMBERS

o The president may remove or

suspend any member of the Boardafter having been given theopportunity to defend himself/herselfin a proper administrativeinvestigation, on the followinggrounds;

o (a) Continued neglect of duty

or incompetence;

o (b) Commission or toleration of

irregularities in the licensureexamination; and

o (c) Unprofessional immoral or

dishonorable conduct.

LICENSURE EXAMINATION

o All applicants for license to

practice nursing shall be required topass a written examination, whichshall be given by the Board in suchplaces and dates as may bedesignated by the Commission:Provided, That it shall be inaccordance with Republic Act No.8981, otherwise known as the "PRCModernization Act of 2000."

QUALIFICATIONS FOR

ADMISSION TO THE LICENSUREEXAMINATION

o (a) He/she is a citizen of the

Philippines, or a citizen or subject ofa country which permits Filipinonurses to practice within its territoriallimits on the same basis as thesubject or citizen of such country:Provided, That the requirements forthe registration or licensing of nursesin said country are substantially thesame as those prescribed in this Act;

o (b) He/she is of good moral

character; and

o (c) He/she is a holder of a

Bachelor's Degree in Nursing from acollege or university that complieswith the standards of nursingeducation duly recognized by theproper government agency.

SCOPE OF EXAMINATION

o The scope of the examination

for the practice of nursing in thePhilippines shall be determined bythe Board. The Board shall take intoconsideration the objectives of thenursing curriculum, the broad areasof nursing, and other relateddisciplines and competencies indetermining the subjects ofexaminations.

RATINGS

o In order to pass the

examination, an examinee mustobtain a general average of at leastseventy-five percent (75%) with arating of not below sixty percent(60%) in any subject.

o An examinee who obtains an

average rating of seventy-fivepercent (75%) or higher but gets arating below sixty percent (60%) inany subject must take theexamination again but only in thesubject or subjects where he/she israted below sixty percent (60%).

o In order to pass the succeeding

examination, an examinee mustobtain a rating of at least seventy-five percent (75%) in the subject orsubjects repeated.

OATH

o All successful candidates in the

examination shall be required to takean oath of profession before theBoard or any government officialauthorized to administer oaths priorto entering upon the nursingpractice.

ISSUANCE OF CERTIFICATE

OFREGISTRATION/PROFESSIONALLICENSE AND PROFESSIONALIDENTIFICATION CARD

o A certificate of

registration/professional license as anurse shall be issued to an applicantwho passes the examination uponpayment of the prescribed fees.

o Every certificate of

registration/professional license shallshow the full name of the registrant,the serial number, the signature ofthe Chairperson of the Commissionand of the Members of the Board,and the official seal of theCommission.

o Fees for Examination and

Registration. - Applicants forlicensure and for registration shallpay the prescribed fees set byCommission.

o Automatic Registration of

Nurses. - All nurses whose namesappear at the roster of nurses shallbe automatically or ipso factoregistered as nurses under this Actupon its effectivity.

REGISTRATION BY

RECIPROCITY

o A certificate of

registration/professional license maybe issued without examination tonurses registered under the laws of aforeign state or country: Provided,That the requirements forregistration or licensing of nurses insaid country are substantially thesame as those prescribed under thisAct: Provided, further, That the lawsof such state or country grant thesame privileges to registered nursesof the Philippines on the same basisas the subjects or citizens of suchforeign state or country.

PRACTICE THROUGH

SPECIAL/TEMPORARY PERMIT

o A special/temporary permit

may be issued by the Board to thefollowing persons subject to theapproval of the Commission andupon payment of the prescribed fees:

o (a) Licensed nurses from

foreign countries/states whoseservice are either for a fee or free ifthey are internationally well-knownspecialists or outstanding experts inany branch or specialty of nursing;

o (b) Licensed nurses from

foreign countries/states on medicalmission whose services shall be freein a particular hospital, center orclinic; and

o (c) Licensed nurses from

foreign countries/states employed byschools/colleges of nursing asexchange professors in a branch orspecialty of nursing;

NURSING EDUCATION

PROGRAM.

o - The nursing education

program shall provide sound generaland professional foundation for thepractice of nursing.

o The learning experiences shall

adhere strictly to specificrequirements embodied in theprescribed curriculum aspromulgated by the Commission onHigher Education's policies andstandards of nursing education.

REQUIREMENT FOR

INACTIVE NURSES RETURNINGTO PRACTICE

o Nurses who have not actively

practiced the profession for five (5)consecutive years are required toundergo one (1) month of didactictraining and three (3) months ofpracticum. The Board shall accredithospitals to conduct the said trainingprogram.

QUALIFICATIONS OF THE

FACULTY

o (a) Be a registered nurse in the

Philippines;

o (b) Have at least one (1) year

of clinical practice in a field ofspecialization;

o (c) Be a member of good

standing in the accreditedprofessional organization of nurses;and

o (d) Be a holder of a master's

degree in nursing, education, orother allied medical and healthsciences conferred by a college oruniversity duly recognized by theGovernment of the Republic of thePhilippines.

SCOPE OF NURSING

o A person shall be deemed to

be practicing nursing within themeaning of this Act when he/shesingly or in collaboration withanother, initiates and performsnursing services to individuals,families and communities in anyhealth care setting.

o It includes, but not limited to,

nursing care during conception,labor, delivery, infancy, childhood,toddler, preschool, school age,adolescence, adulthood, and old age.

o As independent practitioners,

nurses are primarily responsible forthe promotion of health andprevention of illness.

o A members of the health team,

nurses shall collaborate with otherhealth care providers for thecurative, preventive, andrehabilitative aspects of care,restoration of health, alleviation ofsuffering, and when recovery is notpossible, towards a peaceful death.

It shall be the duty of the

nurse to:

o (a) Provide nursing care

through the utilization of the nursingprocess.

o (b) establish linkages with

community resources andcoordination with the health team;

o (c) Provide health education to

individuals, families andcommunities;

o (d) Teach, guide and supervise

students in nursing educationprograms including theadministration of nursing services invaried settings

o (e) Undertake nursing and

health human resource developmenttraining and research, which shallinclude, but not limited to, thedevelopment of advance nursingpractice;

QUALIFICATION OF

NURSING SERVICEADMINISTRATORS

o (a) Be a registered nurse in the

Philippines;

o (b) Have at least two (2) years

experience in general nursing serviceadministration;

o (c) Possess a degree of

Bachelors of Science in Nursing, withat least nine (9) units inmanagement and administrationcourses at the graduate level; and

o (d) Be a member of good

standing of the accreditedprofessional organization of nurses;

STUDIES FOR NURSING

MANPOWER NEEDS,PRODUCTION, UTILIZATION ANDDEVELOPMENT

o The Board, in coordination with

the accredited professionalorganization and appropriategovernment or private agencies shallinitiate undertake and conductstudies on health human resourcesproduction, utilization anddevelopment.

COMPREHENSIVE NURSING

SPECIALTY PROGRAM

o Within ninety (90) days from

the effectivity of this Act, the Boardin coordination with the accreditedprofessional organization recognizedspecialty organizations and theDepartment of Health is herebymandated to formulate and developa comprehensive nursing specialtyprogram that would upgrade thelevel of skill and competence ofspecialty nurse clinicians in thecountry, such as but not limited tothe areas of critical care, oncology,renal and such other areas as maybe determined by the Board.

SALARY

o In order to enhance the

general welfare, commitment toservice and professionalism of nursesthe minimum base pay of nursesworking in the public healthinstitutions shall not be lower thansalary grade 15 prescribes underRepublic Act No. 6758, otherwiseknown as the "Compensation andClassification Act of 1989": Provided,That for nurses working in localgovernment units, adjustments totheir salaries shall be in accordancewith Section 10 of the said law.

FUNDING FOR THE

COMPREHENSIVE NURSINGSPECIALTY PROGRAM

o The annual financial

requirement needed to train at leastten percent (10%) of the nursingstaff of the participating governmenthospital shall be chargeable againstthe income of the Philippine CharitySweepstakes Office and thePhilippine Amusement and GamingCorporation, which shall equallyshare in the costs and shall bereleased to the Department of Healthsubject to accounting and auditingprocedures: Provided, That thedepartment of Health shall set thecriteria for the availment of thisprogram.

INCENTIVES AND BENEFITS

o The Board of Nursing, in

coordination with the Department ofHealth and other concernedgovernment agencies, association ofhospitals and the accreditedprofessional organization shallestablish an incentive and benefitsystem in the form of free hospitalcare for nurses and theirdependents, scholarship grants andother non-cash benefits.

o The government and private

hospitals are hereby mandated tomaintain the standard nurse-patientratio set by the Department ofHealth.

PENAL AND

MISCELLANEOUS PROVISIONS

o Prohibitions in the Practice

of Nursing. - A fine of not less thanFifty thousand pesos (P50,000.00)nor more than One hundredthousand pesos (P100,000.00) orimprisonment of not less than one(1) year nor more than six (6) years,or both, upon the discretion of thecourt, shall be imposed upon:

o (a) any person practicing

nursing in the Philippines within themeaning of this Act:

o (1) without a certificate of

registration/professional license andprofessional identification card orspecial temporary permit or withouthaving been declared exempt fromexamination in accordance with theprovision of this Act; or

o (2) who uses as his/her own

certificate of registration/professionallicense and professionalidentification card or specialtemporary permit of another; or

o (3) who uses an invalid

certificate of registration/professionallicense, a suspended or revokedcertificate of registration/professionallicense, or an expired or cancelledspecial/temporary permits; or

o (4) who gives any false

evidence to the Board in order toobtain a certificate ofregistration/professional license, aprofessional identification card orspecial permit; or

o (5) who falsely poses or

advertises as a registered andlicensed nurse or uses any othermeans that tend to convey theimpression that he/she is aregistered and licensed nurse; or

o (6) who appends B.S.N./R.N.

(Bachelor of Science inNursing/Registered Nurse) or anysimilar appendage to his/her namewithout having been coferred saiddegree or registration;

o (7) who, as a registered and

licensed nurse, abets or assists theillegal practice of a person who is notlawfully qualified to practice nursing.

o (b) any person or the chief

executive officer of a judicial entitywho undertakes in-serviceeducational programs or whoconducts review classes for bothlocal and foreign examinationwithout permit/clearance from theBoard and the Commission; or

o (c) any person or employer of

nurses who violate the minimumbase pay of nurses and theincentives and benefits that shouldbe accorded them as specified inSections 32 and 34; or

o (d) any person or the chief

executive officer of a juridical entityviolating any provision of this Act andits rules and regulations.

o LEGAL RESPONSIBILITIES

OF NURSES

LAW

o It is defined as the Principles &

regulations established by the govt.or other authority & applicable to apeople, whether by legislation or bycustom enforced by judicial decision.

FUNCTIONS OF LAW IN

NURSING

o Provides a framework for

establishing which nursing actions inthe care of client are legal.

o It differentiates the nurse’s

responsibilities from those of otherhealth professional.

o It helps establish the

boundaries of independent nursingaction.

o It assists in maintaining a

standard of nursing practice bymaking nurse’s accountable underthe law.

Nurse Practice Acts &

Licensure

o laws established by the

legislature in each state to regulatethe practice of nursing:

designed to protect public

create a state board (regulatory body

to enforce rules and regulations ofnursing practice)

define legal requirements & titles for

RNs, LPNs, CNAs (in NC)

Establish criteria for education

licensure

Licensure

o Legal tire that attests to basic

degree of competency

o Legal credential conferred by a

state that gives an individual theright to practice a profession

Purposes of Nursing

Licensure

o Protection of the public

o Make practitioners accountable

for their actions (autonomy)

TYPES OF LAW

o Public Law

oConstitutional Law

oAdministrative Law

oCriminal Law

o Civil Law

Contract law

Tort Law

PUBLIC LAW

o deals with an individual’s

relationship to the state.

o Constitutional Law

o set of basic laws that defines and

limits the powers of government.

oNurse maintains rights as an

individual.

o Ex: Constitutional Rights, Civil Rights

State Constitution

o Administrative Law

oDeveloped by groups who are

appointed to governmentaladministrative agencies.

o Ex: Food, Drug and Cosmetic Act;

Social Security Act; Nurse PracticeAct

o Criminal Law

oActs or offenses against the welfare

or safety of the public.

o Ex: Controlled Substance Act;

Criminal Codes

CIVIL LAW

o deals with crimes against a

person or persons (between thenurse and patient)

o Contract law

o Enforcement of agreements among

private individuals

o Ex: Elements of Promise, Mutual

Understanding and CompensationEmployment Contracts

o Tort Law

o Enforcement of duties and rights

among independent of contractualagreements.

o It is a civil wrong committed on a

person or property stemming fromeither a direct invasion of some legalright of the person, infraction ofsome public duty, or the violation ofsome private obligation by whichdamages accrue to the person.

o Intentional and Unintentional

Tort law

o Intentional Torts

o They are deliberate or willful actions

in which the intent is to cause injuryto a person (or) property

o Examples:

oAssault and Battery

o False Imprisonment

o Trespass

o Fraud

Assault

It is an attempt (or) intentional threat

to make harmful or offensive contactwith another individual.

Ex: threat to give injection when the

client has refused consent.

Battery

Battery is any intentional touching

without consent.

A battery always include an assault

Ex: Touching the clients private part

for a procedure without takingconsent.

False imprisonment

If a person is made to stay in a place

against his/her. The person isdetained confined(or) restrainedagainst his will.

Trespass

It is an unauthorized handling of

another person’s personal property.

Fraud

lying about data/facts

o Unintentional Torts

Negligence (breach of duty) –

failure of an individual to providecare that a reasonable person wouldordinarily use in a similarcircumstance.

Common sources of negligence:

Medications errors that results in

injury to the client.

IV therapy errors resulting in

infiltration of phlebitis.

Burns caused by equipment.

Falls resulting in injury..

Malpractice

It includes professional

misconduct,breach of a duty orstandard of care,illegal or immoralconduct or failure to exercisereasonable skill,all of which lead toharm.

It is more serious than negligence

because it indicates professionalmisconduct in performing duties.

Examples:-

Leaving foreign objects inside the

clients body during surgery.

Failure to observe and report a

change in the client’s condition.

Abandonment

It is a type of negligence in which a

duty to give care exists but isignored and results in harm to apatient.

6 COMMON CATEGORIES OF

NEGLIGENCE RESULTING INMALPRACTICE SUITS

Failure To:

follow standard of care

use equipment in a responsible

manner

communicate

document (if you didn't document it,

you didn't do it)

assess & monitor

act as patient advocate

o SPECIFIC TORTS

It involves situations of

communications & often violates aperson’s reputation,personal privacyof civil rights.

Example:

Defamation & Invasion of

privacy.

CONSENT

Nurses must know their legal

responsibilities concerning a signedletter from the client for all routinetreatment,hazardous proceduressuch as surgery,chemotherapy

INFORMED CONSENT

An agreement by a client to accept a

course of treatment or a procedureafter being fully informed of it.

Information to be given to a client to

make an informed consent:

Diagnosis or condition that requires

treatment

Purpose of treatment

What the client can expect to feel or

experience

The intended benefits of the

procedure

Possible risks

Advantages and disadvantages of

alternatives to treatment

Informed Consent

Validity of informed consent:

Voluntary

Patient is capable and competent to

understand

Client must be given enough

information

Language used is understandable to

the client

Nurse’s role in obtaining a client’s

informed consent:

The nurse is not responsible for

explaining the medical or surgicalprocedure but for witnessing theclient’s signature on the consentform.

Nurse’s signature means:

Client gave voluntary consent after

receiving enough information

Client’s signature is authentic

Client appears competent to give

consent

In general the consent may be

taken from the following persons:

o Any individual above 18 years.

o Any parent for his/her minor

child.

REGULATION OF NURSING

PRACTICE

o Nursing practice falls under

both public law and civil law.

o If public law is violated, the

nurse can be punished by paying afine, losing her license, or beingincarcerated.

o If civil law is violated, the client

may receive compensation forinjuries but the nurse receives no jailtime.

CONTRACTUAL

ARRANGEMENTS IN NURSING

o Contract – an agreement

between two parties as to what willtranspire and the rules andregulations governing the servicethat will be provided.

o The legal agreement is

enforceable by law and those whosign the agreement must be able tolegally enter into a contract.

REPORTING CRIMES, TORTS

AND UNSAFE PRACTICES

o Nurses may report colleagues

or other professionals if for practicesthat endanger the health and safetyof clients.

o This may include alcoholism,

drug use, theft and unsafe nursingpractice.

LEGAL RESPONSIBILITIES IN

NURSING

o Safeguards for the nurse and

student

o Common sense precautions

o Be competent in practice

o Ask for assistance

o Document well

o Do not give legal advice to

clients

o Do not accept gifts

LEGAL RESPONSIBILITIES

OF NURSING STUDENTS

o As a nursing student your only

legal responsibilities are to not doany intentional harm to the patients.

o The clinical instructor will be

responsible for the student.

o When doing a procedure, the

student must be supervised andassisted (never by yourself)

Legal protection in nursing

practice

o According to Medismart:

Nursing Educational Resources,nursing practitioners can protectthemselves from most legalproblems by following 5 basicguidelines:

o Obtain an informed consent

signature before treatment begins

o Document all actions regarding

a patient’s care

o Report any allegations of abuse

toward a vulnerable population

o Protect the patient’s right to

privacy

o Pay strict attention to avoid

medication dosing errors

RESPONSIBILITIES OF

NURSES IN PREVENTION OFLEGAL PROBLEMS:

o Nurses must have complete

knowledge regarding the rules &regulations, procedures and policiesof the hospital.

o They must have their job

descriptions (duties &responsibilities).

o The nurse must perform only

those functions for which she or hehas been prepared by the education& experience.

o Accurate & comprehensive

records and must be maintainedproperly in all wards.

o Six R’s :-right patient, right

drug, right time, right dose, rightroute, & right technique must befollowed.