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Transcript of 2 Ethico-Legal Issues on IVT
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THE ETHICOLEGAL ASPECTS OF IV
THERAPY
BASIC
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1. Interpret and carry out thephysicians prescriptions for IV
therapy.2. Prepare, initiate and terminate IV
therapy based on physicians
written prescription.3. Perform peripheral venipuncture
(all types of needles and
cannulas) excluding the insertionof subclavian and cut downcatheter.
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4. Determine solution and
medication incompatibilities.5. Administer computed
medications, chemotherapeutic
drugs, flow rates of solutions,compatible blood/bloodcomponents and parenteral
nutrition as prescribed by thephysician.
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6. Assess all adverse reactionsrelated to IV therapy and initiate
appropriate nursing interventions.
7. Establish nursing care plan
related to IV Therapy.
8. Adhere to established infectioncontrol practices.
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LEGAL BASIS
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IV THERAPY AND LEGAL IMPLICATIONS
R.A. 7164The PhilippineNursing Act of 1991 Section 28
states that in administration of IVinjections, special training shall berequired.
IV Nursing Standards of Practicedeveloped by the ANSAP should be
used.
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In giving IV injections, nurses should
follow the policies of their agencies.
Board of Nursing Resolution No.8
Sec.30 (c) Art.VII or administrativelyunder Sec.21 Art.IIIstates that anyregistered nurse without training and
who administers IV injections topatients shall be held liable, eithercriminally, administratively or both.
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R.A. 9173/The Philippine Nursing
Act of 2002, Article VI NursingPractice, SEC.28.Scope of Nursing(a) Provide nursing care through theutilization of the nursing process.Nursing care includes, but not limitedto
administration of written presentationfor treatment, therapies, oral, topicaland parenteral medications
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ETHICAL ISSUES
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CODE OF ETHICS FORNURSES IN THE
PHILIPPINES
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ETHICS according to WebsterDictionary, is the study of thestandards of conduct and moral
judgment.
Therefore..NURSING ETHICS is concerned
with the principles of right conduct
as they apply to the nursingprofession.
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NURSES AND PEOPLE
Values, customs and spiritual beliefs
held by individuals are to be
respected.
Nurses hold in strict confidence
personal information acquired in theprocess of giving nursing care.
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NURSES AND PRACTICES
Nurses are accountable for their
own nursing practice. Nurses maintain or modify
standards of practice within the
reality of any given situation.
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Nurses are the advocates of the
patients.
Nurses are aware that their
actions have professional, ethical,
moral and legal dimensions.
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NURSES AND CO-WORKERS
Nurses maintain collaborative working
relationships with their co-workers and
other members of the health team. They recognize their capabilities and
limitations in accepting responsibilities and
those of their co-workers when delegating
responsibilities to them.
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NURSES AND SOCIETY
Nurses are contributing members
of society. They assume
responsibilities inherent in being
members and citizens of the
community/society in which they
live/work.
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Nurses recognize the need for
change and initiate, participate,
and support activities to meet thehealth and social needs of the
people.
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NURSES AND THE PROFESSION
Nurses are expected to be
members of professional
organizations of nurses. Nurses help to determine and
implement desirable standards of
nursing practice and nursing
education.
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Nurses should initiate and involve
themselves in structured and non-structured research activities within
their existing milieu.
Nurses should assert theimplementation of labor standards
and lobby for favorable legislations to
improve existing socio-economicconditions of nurses.
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CODE OF ETHICS
The Nursing ServiceAdministrators of the
Philippines
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MISSION
Provision of efficient and effective
nursing services.
Promote quality health care for peopleas a basic human right.
Be responsible for planning, organizing,
directing and controlling the programs
and activities of the Nursing Service
towards optimum quality nursing care.
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ARTICLE II
THE ANSAP CREED; CORE VALUES& BELIEFS
1. The nursing profession is acommitment to God and people;
2. The nursing service is responsible
and accountable for quality nursingcare;
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3. The nursing service is a major
function in any health care deliverysystem and deserves a
corresponding importance in the
organizational structure;
4. A high level of self-discipline and
committed leadership are essentialfactors in the effective management
of health care services;
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5. The nursing services is most
important asset, aside from itsclients, are its caring, competent and
productive personnel;
6. Competence enhances the publics
assurance of quality nursing care,
therefore, nursing personnel must beselected and appointed to positions
consistent with their qualifications;
7 The client is the reason for the
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7. The client is the reason for theexistence of the nursing profession;
all efforts should be directed to hiscare and should consider hisuniqueness, personal worth, dignity,
and socio-cultural values;8. The implementation and
maintenance of approved standards
of nursing practice and nursingadministration are bases for effectiveand efficient nursing service;
9 N i i i i t l i th
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9. Nursing service is integral in the
quality of education of students; and
10. A unified stand is vital in achievingtheir objectives through membership
in professional organizations, such
as the Philippine Nurses Association
(PNA), the Association of Nursing
Service Administrators of thePhilippines (ANSAP), and other
specialty groups in nursing.
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ARTICLE III
NORMS OF PROFESSIONALCONDUCT
SECTION 1. Dedication to God andpeople.
SECTION 2. Responsibility and
accountability for quality nursingservice.
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SECTION 3. Leadership and Technical
Competence.SECTION 4. Responsibility and
Accountability for Nursing Practice.SECTION 5. Commitment to the
Nursing Profession.
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ARTICLE IV
GENERAL PROVISIONSSection 1. Creation of Ethics
Committee that shall be responsible
to adjudicate violations against the
NSA Code of Ethics and adopt such
rules and sanctions as the associationis authorized to do.
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SECTION 2. Legal Force.
SECTION 3. Moral Force.
SECTION 4. Dissemination.
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SECTION 5. Sanctions.
SECTION 6. Amendment.
SECTION 7. Effectivity
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CODE OF GOOD
GOVERNANCE FORTHE PROFESSIONS IN
THE PHILIPPINES
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E.O. No. 220 - Directing the
adoption of the Code of Good
Governance for the Professions inthe Philippines on June 23, 2003.
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General Principle of Professional
Conduct
Professionals are required not
only to have an ethicalcommitment, a personal resolve
to act ethically, but also have both
ethical awareness and ethicalcompetency.
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Specific Principles of Professional
Conduct
1. Service to Others
2. Integrity and Objectivity
3. Professional Competence
4. Solidarity and Teamwork
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5. Social and Civic Responsibility
6. Global Competitiveness
7. Equality of All Professions
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PROFESSIONALVALUES
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5 Cs of Caring
Compassionate
Concern
CaringCommitted
Willingness toperform her
responsibilities
Confident
Assertive
SmartConscientious
Honest
Competent
Knowledgeable Effective/
Efficient
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Wholistic
ApproachNurse Practitioner
I.V. Nurse Therapist
Quality
careEthico legal
Responsibility Accountability
In
Varied Health Setting
Industrial
Setting
-Company
Clinics-Occupation
Health
Units
Community
Setting
Health Center
Rural HealthUnits
Periculture
Centers
Hospital and
Institutional
Setting
Lying- inHospice Center
Day Care Center
Educational
Setting
-Colleges
of NursingUniversities
-Other
colleges &
Schools
Home Care
Setting
-Independent
Practitioners-Self
employed
Impact to
Health Care
Delivery sites
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RELATED LAW OFFENSES
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LEGAL ASPECTS AND THE NURSE
The Republic Act 9173 or the
Philippine Nursing Act of 2002 is
the best guide the nurse canutilize as it defines the scope of
nursing practice.
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Negligence
Commission or omission of an
act, pursuant to a duty, that a
reasonably prudent person in thesame or similar circumstance
would or would not do.
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The Doctrine of Res Ipsa Loquitur
Three conditions are required toestablish a defendants negligence
without proving specific conduct:
1. That the injury was of such naturethat it would not normally occur
unless there was a negligent act on
the part of someone;
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2. That the injury was caused by an
agency within control of defendant;
3. That the plaintiff himself did notengage in any manner that would
tend to bring about the injury.
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Example:
A patient came in walking to theout-patient clinic for injection.
Upon administering the injection
to his buttocks, the patient
experienced extreme pain. His leg
felt weak and he wassubsequently paralyzed.
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Incompetence
The lack of ability, legal qualifications
or fitness to discharge the required
duty.Example:
Although a nurse is registered, if shes
not yet an IV therapists, she is notallowed to give IV medications or dothe IV insertion.
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Assault and Battery
Assault is the imminent threat of
harmful or offensive bodily
contact.Battery is an intentional, un
consented touching of another
person.
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It is, therefore, important thatbefore a patient can be touched,
examined, treated or subjected tomedical/surgical procedures, hemust have given a consent to this
effect.Example: If a patient refuses an
injection and the nurse gives itanyway, the latter can be chargedfor battery.
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LEGAL TERMINOLOGIES
THAT ALSO APPLY IN IVTHERAPY
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CIVIL ACTION
a non-criminal action whereby one seeks
to protect, enforce, or declare a right or
address a civil wrong close to him or her.When the harm occurs, the guilty party
may be required to pay damages to the
injured person.
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CRIMINAL ACTION
an action brought about by a state or
federal law enforcement agency or by an
official agency on behalf of an individual,to protect ones person or property or to
protect society in general. Punishment
includes imprisonment, fine or both.
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DEPOSITION
a discovery procedure which is an oral
question and answer proceeding, under
oath and recorded, wherein the attorneysseek to find out what testimony and
evidence will be confronting them in a
lawsuit. It is an informal proceeding withlawyers of all parties present.
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INTERROGATORY
another discovery procedure which is thewritten equivalent of a deposition.
RULE OF PERSONAL LIABILITYevery person is liable for his own
wrongdoing. No one can bypass this rule
with personal assurance.
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STATUTE OF LIMITATIONS
the time limit set by each state
legislature in which civil or criminal action
can be brought.
TORT
a private wrong by act or omission, which
can result in a civil action by the harmedperson.
SUBPOENA
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the process or "paper command" by whichthe person served must appear at a
certain time and give testimony to thecourt. It is an order under the seal of thecourt for which one can be held forcontempt of court for ignoring thesubpoena.
SUMMONS
notification served upon defendant to
appear before the court.
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Points to Observe in Order to Avoid
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Points to Observe in Order to Avoid
Criminal Liability
1. Be very familiar with thePhilippine Nursing Law.
2. Beware of laws that affect
nursing practice.3. At the start of employment, get a
copy of your job description, the
agencys rules, regulations andpolicies.
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4. Upgrade your skills and competence.
5. Accept only such responsibility thatis within the scope of your
employment and your job description.
6. Do not delegate your responsibility toothers.
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7. Develop good interpersonal
relationships with your co-workers,whether they be your supervisors,
peers or subordinates.
8. Consult your superiors for problemsthat may be too big for you to handle.
9. Verify Doctors prescriptions that are
not clear to you or those that seem tobe erroneous.
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10. The doctors should be informedabout the patients conditions.
11. Keep in mind the value and
necessity of keeping complete andaccurate recording.
12. Patients are entitled to an informed
consent.
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STANDARDS OF
NURSING INFUSIONCARE
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Structure Criteria (NOT INCLUDED)
1. Entrance Requirements
Level of academic preparation:
A BSN graduate, RN, with acurrent license from the PRC.
Behavioral characteristics :
Honesty, reliability, initiative,flexibility and judgment.
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Demonstrates communication
and technical skills.
2. Completion Requirements3 days Basic IV Therapy Training
Program must have successfullyparticipated.
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3. Renewal/Revalidation of an IV
Therapy Card
The IV Therapy Card isrenewable every three (3) years.
Attendance to IV related Updatesequivalent to 24 CEU.
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4. Loss of The IV Therapy Nurse
CardPresenting an affidavit of loss.
Submitting Certificate of Training.Photocopy of the official list of
participants of the IV therapytraining attended.
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5. Cancellation of the IV Card
PRC License is not renewed.Any violation of Nursing Law
9173.IV Card is not renewed for more
than 3 years.
Violations in the Standards of IV
Therapy practice.
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Process Criteria(NOT INCLUDED)
The IV Therapy Program consistsof discussions of concepts in IVtherapy and demonstration ofskills in access-related situations.It has a twenty-four (24)-hourdidactic lecture and a practicumwith the following evaluationmethods:
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1. Written examinations: pre and
post tests2. Completion of the required
number of actual cases for each
of the following competencies:
Initiating and maintaining
peripheral IV infusion (3 cases). Administering IV drugs (3 cases)
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Administering and maintaining
blood and blood components(2 cases).
The participants will be rated as
follows: (a) Didactic50%; and
(b) Practicum50%.
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REFERENCES
Association of Nursing Service
Administrators of the Philippines, Inc.
(ANSAP). 2000. Nursing Standards on
Intravenous Practice 7th EDITION.
Atty. Rustico T. De Belen, BA, BSN, LLB,
MNSA, PhD and Donna Vivian V. De
Belen, BSN, RN, CCRN, CRNA, MS
Anesthesia. Nursing Law, Jurisprudence& Professional Ethics 1st EDITION.
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Lesnik,M.J. and Anderson, B. Nursing
Practice and the Law. 2nd EDITION withrevisions. Philadelphia: J.B. Lippincott.
Pallock: Torts, 14th EDITION.
Philippine Nursing Act of 1991, RepublicAct No.7169 Sec.28.
PhilippineNursing Law, Republic Act No.
9173 Section 28 (a), (e).
Prescer: Torts, 3rd EDITION.
PRIMER CODE OF ETHICS THE
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PRIMER CODE OF ETHICS THENURSING SERVICE
ADMINISTRATORS OF THEPHILIPPINES.
Professional Regulation Commission,Board of Nursing Resolution No.8.
ProfessionalRegulation CommissionBoard of Nursing Souvenir Program Oathtaking as Professionals of the Successful
Examinees June 6 & 7, 2004 NurseLicensure Examination.
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Venzon, Lydia M. R.N., M.A., FPCHA.
2003. Professional Nursing in the
Philippines 9th EDITION. Websters New World Dictionary of the
American Language. Cleveland and New
York: World Publishing Co.