RA 9173 & Legal Responsibilities of Nurses
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Transcript of RA 9173 & Legal Responsibilities of Nurses
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 ®ulations, 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.