PA and Research

University of Santo Tomas
College of Nursing
MICHAEL JOHN VALLARIT
Professional Adjustment and Research Teresita I Barcelo, RN PhD
Nursing Law and Code of Ethics for Nursing
Elements of a TRUE Profession

1. Special body of knowledge and skill which can be obtained through formal education
2. More or less permanent membership
Nurses- biggest group of health professionals
3. Acceptance of service motive/ orientation
Justly compensated it is okay for nurses to charge patients for their service
4. Autonomy self governance
Code of Ethics
Nursing Law
RA 9173
o
Sections 3 Composition of the Board
7 member of the board
Section 4 Qualifications of the Board
Natural born citizen or resident of Philippines no foreigner can

be a board; not even a naturalized citizen
Member of good standing of accredited profession PNA
Registered nurse in the Philippines
Holder of masters degree in nursing, education or allied medical

profession; majority holders of MAN
Chairperson shall have a MAN
At least 10 years of continuous practice prior to application; 5

years of which shall be in the Philippines
Not convicted of any offense involving moral turpitude
Membership to the board shall represent the 3 areas of nursing:

Education, Service and Community health
Section 5 no conflict of interest
PNA agency that is tasked to nominate member of the board
For every vacancy 5 nominees
Immediately resign from any teaching position in any school or

university offering BSN and or review program for local boards
NOYNOY FOR PRESIDENT
NOYNOY, Ikaw ang aming Pag-asa.

College of Nursing
Resign from any office or employment in the government
No pecuniary interest in or administrative supervision over any

institution offering BSN ---
Section 6
Term of office 3 years
More than 3 years allowed to be re-appointed once
Section 9 Powers of the board
Conduct the licensure exams
Issue, suspend or revoke the certificate of registration
Monitor and enforce quality standards of nursing practice to

ensure the maintenance of efficient ethical, moral, technical and
profession standards in the practice of nursing
Ensure the quality of nursing educational authority to open or

close nursing schools is vested with CHED upon recommendation
of BON
Investigate case of unethical or unprofessional conduct and

violation of this act
Promulgate the code of ethics
Recognize specialty organization
Not simple just generalist
-NAP
16 specialty organization
MCNAP, ORNAP, GNAP
Prescribe, adopt, issue and promulgate resolution, regulations,

measures and decision as maybe necessary for the improvement
of nursing practice and full enforcement of this Act.
3 Broad Powers of the Board
Quasi Legislative make laws; board resolution = law
Quasi Judicial investigate violation to issue and revoke

license
Executive implement the nursing law
Sec 11 causes for removal or suspension of BON
Continue neglect of duty or incompetence

College of Nursing
Commission or tolerance of irregularities in the licensure of the

exam
Sec 28 Scope of Nursing
Definition of practice of nursing a person, singly or in

collaboration with another, initiates and performs nursing services
to AFC in any health care setting. It includes but not limited to
nursing care during conception, labor, delivery, infancy, childhood,
toddler, preschool, school age, adolescence, adulthood and old
age.
RA 7164
- all stages of development; labor and delivery not
included
As an independent nurse practitioner, a nurse is primary

responsible for the promotion of health and prevention of illness.
Own private birthing clinic possible.
As member of health team, nurse shall collaborate with other

health
care
providers
for
the
curative,
preventive
and
rehabilitative aspects of care, restoration of health, alleviation of

suffering and when recovery is not possible, towards peaceful
death.
Hospice care for the dying
Duties of the nurse
Provide nursing care using the nursing process.

o
We are allowed to do IV by law
Establish
linkages
with
community
resources
and
coordination with the health team
Provide health education to IFC
Teach
guide
and
supervise
nursing
students;
administration of nursing services in varied settings such

as hospitals and clinics; undertake consultation services;
engage in such activities that require the utilization of
knowledge and decision making skills of a registered
nurse.
Unprofessional, immoral and dishonorable conduct

College of Nursing
o
If nursing functions supervised by other nurse,

not any other professional.
Undertake
nursing
and
health
human
resource
development training and research
This section does not apply to students who perform

nursing functions under the supervision of a qualified
In the practice of nursing, the nurse must observe the

Code of Ethics and uphold the standards of safe nursing
practice
o
COE Boards Resolution
The nurse is required to obtain competence

through continuing professional education provided
by recognized professional org; -----
RA 877 created the first board of nursing -2 nurses, 1 MD (chairperson)
RA 6704 amended RA 877 about the composition of the board 1966 5

members of the board (all nurses)
Code of Ethics
Guide to professional behavior of the nurse
Norms of conduct
BON Resolution 220 Series of 2004

o
Previous COE:
1984 simple adaption of the International Council of Nurses COE
1989 developed by PNA
Original version developed by BON
BON resolution 425 series 2003 Implementing rules and regulations (IRR) Rule V
the nurse while in practice of nursing in all settings is duty bound to observe
COE
Any violation revoke or suspension of license
4 basic ethical principles applied to nursing

o
The fundamental responsibility of the nurse is four-fold ; all are of equal

performance
To promote health
faculty.

College of Nursing
To prevent illness
To restore health a
To alleviate suffering
1st three = HEALTH is the primary goal of nursing
The nurse renders service regardless of race, creed, nationality or political

belief
We observe medical neutrality
The nurse protects life and respects the dignity of man
The nurse works in collaboration with the members of the team
Basic RIGHTS of the Patient

o
The right to information or to know about his or her condition
The right to make decisions about his or her own care or autonomy
Informed consent
The right to privacy and confidentiality
Privacy body
Confidentiality information
Privileged Communication all information personal to the patient

which must be kept secretly
Illness, diagnosis, prognosis
Not absolute;
o
Communicable disease it involves public welfare

and safety; inform only the proper authority DOH
Welfare and safety of the patient abuse
Domestic and child abuse
There is a court order in a criminal case with

written order with the court
o
-
With patients consent
The basis of a trusting relationship with the client
The right to quality care
Trends in Nursing Service

1. Automation
Nursing informatics
2. Independent/ Private Practice

College of Nursing
Entreprenurse
3. Specialization RA 9173 ***
Section 31 Comprehensive Nursing Specialty Program
The BON in coordination with the PNA, recognized specialty organization and the
DOH shall formulate and develop a comprehensive nursing specialty program
The purpose of the comprehensive specialty programs to upgrade the level of

areas of critical care ----
Beneficiaries of the program are obliged to serve in any Philippine Hospital for a
period of at least 2 years of continuous service
Section 33 Funding for the Nursing Specialty Program
DOH shall set the criteria for the availment of this program
Train at least 10% of the nursing staff annually of the participating government
hospital
Funds shall be given by the PCSO and PAGCOR to be released by DOH
4. Primary Nurse
PDN
The nurse is responsible and accountable for total nursing care of the patient from
admission to discharge, 24 hours a day
Attending nurse of the patient
First, assessment >> then NCP
Kardex contains the NCP
5. Holistic Nursing
6. Hospice care care of the terminally ill clients
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Trends in Nursing Education

1. Ladder- Type Curriculum every step in the ladder is a terminal course you get a degree
each step
Step is the foundation to the next step
2. Post graduate education

3. Team teaching
4. Distance Education
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National Nurses Organization

1. Only registered nurses can be members of PNA
skill and competence of specialty nurse clinicians such as but not limited to the

College of Nursing
2. PRC accredited professional organization for nursing PNA
That organization is the official representative of the profession accreditation
3. Code of Ethics Article VI section 17 states that registered nurses must be members of the
accredited professional organization
Accreditation lasts for only 3 years
4. To be part is not a legal obligation; ethical obligation, as stated in the COE

official function
6. May get benefits from PNA
Member of ICN Indirectly
Complimentary copy of the Philippine Journals for Nursing two times per year
Upon death, family will get a fund
Fields of Practice
1. Hospital Nursing
2. CHN
3. Nursing Education
4. Private Practice
5. Nursing Research
Qualifications in various fields

1. Hospital Nursing
Staff nurse > RN
Head Nurse
Educational no requirement
Experience of at least 1 year experience
Supervisor / Nursing Service Administrators
Section 29
o
Nurse Supervisor
RN
At least 23 years experience in general nursing service

administration at least 2 years head nurse
BSN with at least 9 units in management and administration

courses at the graduate level
5. LOI 1000 gives priority to members of PNA when they are going to hire or select delegates to

College of Nursing
Member of good standing of accredited professional organization

of nurses
Chief nurses
o
Must posses
At least 5 years of being a supervisor or managerial position in nursing
MA in nursing
For primary hospitals, the maximum academic qualifications and

experiences for a chief nurse is the same as that of nursing supervisor
PH less than 50 beds
For chief nurse in public health agency, priority is given to one a masters
degree in public health or CHN
For chief nurse in military hospital, priority shall be given to those with
MAN and have completed the General Staff course
2. CHN
PHN RN only; apply at the local health department of own place
Chief Nurse
Categories
PHN in DOH
Military nurse RN; board rating not more than 80%; single for women only
for three years
Occupational Health Nursing
3. Nursing Education
Qualifications
Faculty members
o
RN
At least 1 year clinical practice in a field of specialization
Member of PNA
MA in Nursing, education or allied medical health sciences; including MD
Dean Section 27
o
MA in Nursing
5 years experience in teaching and supervising a nursing education

program
Member of PNA

College of Nursing
4. Private Practice
Various areas hospital PDN, home care, private practice
PDN > RN with affiliation with the hospitals
Private practice breathing center, day care center for children or elderly,
hospice care, ostomy care nurse, diabetes education center
How to obtain a license to practice

1. By examination
RA 9173 Sec 13 qualifications for admission to licensure exam
Graduate RLE and TOR
Filipino citizen and resident in the Philippines birth certificate; resident

certificate - cedula
Good moral character no document to check
Sec 15 GA of 75 with nor rating below 60 in any subject
If GWA is 75 or higher but gets a rating below 60 in any subject must take exam
again in the subjects rated below 60; to pass examinee must obtain at least 75
in the repeated subjects
Removal exam shall be taken within 2 years after the last failed exam (BON Res.
425 s 2003 IRR)
2. By reciprocity for foreigners
Section 20 of RA 9173
Conditions:
o
Requirements for registration or licensing nurses in said country is

substantially the same.
The laws of said country grants the same privileges to Filipino nurses as
their own citizens.
3. By special permit
Section 21 Special or temporary permit
Granted to:
o
Licensed foreign nurses whose service is either for a fee or fee if

internationally known specialist or outstanding experts
Licensed foreign nurses on FREE medical mission
Licensed foreign nurses employed by school or colleges of nursing as

exchange professors

College of Nursing
Very specific and temporary time, place or mission; no renewal if expired
4. Mutual Recognition Agreement agreement among ASEAN
Indonesia, HK, Thailand, Brunei, Vietnam, Myanmar
RA 9173 Section 16 OATH

1. Successful examinee must take oath of the profession before the Board or authorized
Only if the mass oath taking is done
To register and get license where you took the Board Examination
RA 9173 Section 17 Issuance of certificate of registration/ professional license and ID

1. Certificate of registration or professional license shall be issued to a successful examinee upon
payment of prescribed fee (permanent)
Renewal of ID every 3 years at birth month; PRC office
Revocation and suspension of certificate of registration Section 23

1. Causes
Unprofessional and unethical conduct
Gross incompetence or serious ignorance
Malpractice or negligence in the practice of nursing
Use of fraud, deceit or false statement in obtaining license
Violation of provisions of this act
Negligence within your scope
Malpractice beyond the scope
RA 9173 Section 24 Re-issuance of revoked certificate

1. The BON may re-issue with the following conditions:
After at least 4 years from date of revocation
When the cause of revocation has been removed or corrected
Sec 26- Requirements for inactive nurses returning to practice

1. Nurses who have not actively practiced the profession for 5 consecutive years are required to
undergo 1 month of didactic training and 3 months practicum
2. BON shall accredit hospitals to conduct said training
ONLY PGH is accredited.
Obtaining Filipino Citizenship

1. Ways
By birth natural born Jus sanguinis based on the citizenship of parents
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government official prior to entering the practice

College of Nursing
By naturalization foreigners
Legal process >> court >> apply >> 10 years of residence
RA 9225 Citizenship Retention and Re-acquisition Act of 2003 natural born Filipinos
doo not lose citizenship when they become naturalized in another country provided they
make the oath of allegiance so they can vote, run for office, or practice profession with
proper authority.
Duties of a Filipino Citizen

1. Pay Taxes
Income tax
Professional Tax 50 pesos every year, not later than January 31.
PTR, Privilege Tax, Occupational Tax
Where to pay: BIR
Government officials are
free from paying PT Magna Carta for Health
Professionals
2. Show love of country or Allegiance to the country
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Working Contract
1. Contract is an agreement between at least 2 parties which creates an obligation recognized by
law.
2. Elements of a VALID working contract
TRUE Consent
COMPETENT PARTIES
Sound mind
Major age 18 years old
LAWFUL object
True means it is voluntary, freely given, no coercion, no pressure
Object or subject must be something within the bounds of law
VALID consideration something of value
Compensation
Service with no compensation cannot be sued for liability that have occurred
3. At least 2 witnesses NOT AN ELEMENT

4. Written > Verbal; with witness; better but not essential
If with breech of contract there is a proof
5. TYPES
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College of Nursing
According to form
Formal written and signed; follows the legal format
Informal either verbal or format; does not follow the legal format
According to terms of contract
Expressed either verbal or written the terms of the contract period of validity,
salary and benefits
Implied terms are not specified but the actions will tell the terms of contract
Last Will and Testament

1. Is the will an action or document? Action
2. Document testament
3. The will is an act allowed by law whereby a person makes a decision about the distribution of
ones estate and the decision will be carried out upon his death.
4. Not compelled
5. Qualifications of a testator who makes the testament
Major age
Competent or sound mind
6. Qualifications of a witness
Sound mind
Legal age
Can read and write
Acceptable form of last will and testament WRITTEN
Not under the influence of alcohol
Not convicted of perjury
Not deaf or dumb
Not a beneficiary prevent of conflict of interests
7. Types
Holographic will hand written entirely by the testator
From the date to the content to the signature
No need for witnesses
Authenticated Will dictated by the testator but written by somebody else.
With witnesses at least 2 witnesses
It is not the duty of the nurse to act as a witness in the making of the will. Only out of
willingness or voluntariness of the nurse
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College of Nursing
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Lawsuit
1. It is a proceeding in court for a purpose
2. Possible purposes
To redress a wrong done to a person
To enforce a right
Complainant or plaintiff the one who files the case
Defendant or the respondent object of the lawsuit
4. Summons respondent
Written court order asking the defendant to appear in court
5. Subpoena witness
Written court order
Subpoena duces tecum = witness + documents
CRIMES
1. Violation of law
2. An act or an omission punishable by law which may be committed with deceit or by fault
3. Commission or omission
4. Deceit is present if the person committed the crime with full knowledge and understanding of
the gravity of the act and with full consent.
5. Fault ignorance of the law
6. Conspiracy when a crime is committed by a group of people who agree to commit a crime
together
Roles in conspiracy
Principal
o
Mastermind
Actually performing the act
Assisted in the commission of the crime>> act is essential to the

commission of the crime
Accessory or accessory after the act

o
Ways:
Destroying the evidence of a crime
Planting evidence in a crime
Assisting principal to escape or hiding the principal
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3. The 2 parties involved in a lawsuit

College of Nursing
Assisting the principal to benefit or you yourself benefits from the

effects of the crime
Accomplice or accessory before the act

o
Accomplice the person refers someone so that a crime can be done
7. Types
According to punishment
Grave minimum imprisonment is 6 years and 1 day; Php 6,001 and above
Less grave maximum is 6 years; 1 month and 1 day minimum; Php 201 to
6000
Light 30 days maximum ; Php 200 or less
According to degree of execution
Consummated objective of the crime is achieved
Frustrated completed all actions but objectives are not achieved
Attempted did not achieve object because you did not finish all actions
8. Forms of punishment
Imprisonment
Fine
9. Circumstances affecting liability in a crime
Justifying no liability
Exempting the law excuses the person who commits the crime; the action carries a
liability but the person who commits the act is exempted
Mitigating reduces liability
Aggravating increases liability
Alternating may decease or increase liability depending on the situation
10. Examples of justifying circumstances
In defense of ones self
In defense of ones property
Conditions for self- defense to be justified:
The unlawful aggression was started by the offended party
No provocation on part of the offender
Reasonable means employed to repel or prevent the aggression
11. Examples of Exempting circumstance
Offender is below 9 years old no full capacity on the gravity of his actions
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College of Nursing
Offender is between 9-15 years old but acted without discernment (full understanding)
Mentally retarded or insane
Doing the act under the compulsion of an irresistible force or force majeure
When the person is doing the lawful act, with due care, causes injury by mere accident,
there was neither fault nor intention to commit the crime.
12. Examples of Mitigating Circumstance

Offender is a minor or above 70 years old minor(below 18 not fully accountable with
the action)
There was no intention to commit such a grave offence.
Voluntary surrender so that measures can be done to counteract the problem
Offender committed the act under the compulsion of a very strong emotion or passion.
When the offender is deaf, dumb or blind- seen in Penal Code; with limitations
13. Examples of aggravating circumstance
Offender committed the crime in abuse of power or confidence: incest
Offender committed the crime during a calamity or conflagration
Offender fire or sabotage- big destruction of property which is uncontrolled
Offender uses fraud or deceit in the commission of the crime
Offender gets paid or reward to do the crime
Crimes done with pre-meditation planning and intention
14. Examples of alternating circumstance
Intoxication of alcohol
Level of education
Definition of Crimes
1. Infanticides killing of infant less than 3 days old, regardless of relationship
2. Parricide- killing an immediate member of family spouse, child, parent
3. Murder with pre-meditation
4. Homicide- no intention
5. Assault- attempting to harm others VS. Battery with physical contact
Always get informed consent- invasive procedure and admission
6. Illegal distention or false imprisonment
Sign a waiver
Some crimes
1. Substitution of a child with another
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College of Nursing
2. Simulation of a birth
3. Child abuse
First to do: Report to medico-legal MD if diagnosis is confirmed, report to DSWD

(Child Welfare) and Police (crime)
4. Abandonment of a child left alone but not harmed

5. Slander defamation false statement given in public intended to destroy reputation of a
6. Libel written
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Neligence
1. It is doing an act which a prudent nurse would not do; or not doing an act which a prudent
nurse would have done in the same situation
2. Imprudence does not know when or when not to do things
3. Voluntary, causes harm RECKLESS IMPRUDENCE doing an act voluntarily and causing
injury without the intention to cause such
4. Doctrine affecting liability; even no doctrine applies there is still a liability
Res ipsa loquitor
Injury that was caused is the proof the there was a negligent act
Example: patient got burned in application of hot water bath; left sponge in the
abdomen circulating nurse
3 conditions for the doctrine to apply: - all three must be present

o
Injury would have not occurred in the absence of someones negligence
There is voluntary control on the part of the nurse of the instrumentality

that caused the injury
There is lack of voluntary participation on the part of the patient to the

occurrence of the injury
Respondeat superior
Superior is ALSO accountable for the action of the subordinates
When does it apply?

o
When the subordinate committed the error while on duty because there is
an active employer- employee relationship
When do you consider that the order is legal? written and signed by a licensed
MD
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person - verbal

College of Nursing
Telephone orders to be countersigned by the MD within 24 hours to make it

legal
o
When ACCEPTABLE? If there is an emergency; what exempts to the

liability: the emergency
Strategies to protect superior from being accountable for subordinates error

o
Hire only qualified nurses
Orient the staff nurses properly and adequately
Issue memoranda, policies, bulletins, circulars to remind the staff nurses

of their duty
Force majeure
Irresistible force or an act of God
Key element: it cant be predicted or it cant be controlled
5. Analysis to determine liability in a negligent act
First Question: Is there a duty to protect the injured party from the injury received?
IF yes, proceed to second question
Good Samaritan Act: Nurse does not have the obligation to help the person,
thus, if client got more injured
o
Second question: was there a failure to do the duty?
Third: Did an injury result from the failure?
All 3 questions must be answered with a yes to have a criminal liability.
Some situations where negligence will likely to occur:
Admission: consent on admission (covers routine procedure); orientation
Surgery OR consent
RN makes sure that the patient signs the consent
Should come from a legitimate person
Invasive procedure needs written consent every time

o
In NY- does not recognize the GSA
Key element in IC: explain at the level of the patients understanding
Discharge instructions
Charting - What is not written was not done; erasures in charting
Laws affecting the Practice of Nursing
RA 9173 Nursing Act (other provisions)
Section 32 salary: salary of the beginning nurse must be salary grade 15 Php15000
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College of Nursing
Section 34- Incentives and Benefits depend on the hospital ; free hospitalization,
scholarships, fellowship
Section 35- Prohibitions in the practice of nursing
In 7164 less penalty
PD 651 Compulsory Birth Registration register the birth within 30 days from the date of
birth the one who assisted the delivery office of the local civil registrar
RA 9255 An act allowing illegitimate children to use the surname of the father amending
Article 176 of E0 209 Family Code- provide that father acknowledge the child signs the back
of the birth certificate
PD 825 Garbage Disposal
RA 8749 Clean Air Act of 2000
RA 9003- Solid Waste Management Act of 2000
Zero Waste Management
Reuse, Reduce, Recycle
RA 6675 Generics Act
If there is an impending epidemic, parents cannot refuse for their child to be immunized
Needs parental consent EPI no impending epidemic
RA 6972 Establishment of Barangay Day Care Center

Your services should go beyond what the barangay can give
RA 7600 Rooming In and Breastfeeding Act
Baby Friendly hospital practices rooming in and BF
Promotion of these services
EO 51 Milk Code
We should only promote generic drugs
PD 996 Compulsory immunization Law
Incinerations of hospital waste is prohibited
Health professionals are inhibited in endorsing commercially prepared formula
RA 9231 Special Protection of Children against child abuse, exploitation and discrimination
Previously, RA 603
RA 7170 Organ Donation Act
RA 9211 Tobacco Regulation Act
Prohibited to smoke in close public places, hospitals and schools
RA 9251- Expanded Senior Citizen acct
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College of Nursing
20% discount on diagnostic procedure, PF, hospitalizations, transportations, domestic

and basic requirements
RA 8423 Creation of the Institution of Traditional and alternative Health Care
Alternative modes of treatment have been legitimized
Herbs, massage
RA 8172 Salt Iodization Law
Hyperthyroidism is endemic; due to iodine deficiency
Requiring that all processed foods use iodized salts
RA 8344 Prohibitions of hospitals to refuse care in emergencies
Health is a right of a citizen
RA 8505 Establishment of rape crisis center in hospitals and other suitable agencies
RA 3573 Requirement to report all communicable diseases
RA 9262 An act defining violence against women and their children providing for protective
measures for victims
RA 9288 National system for ensuring NB screening
Health practitioners are obliged to inform parents of availability or newborn screening

test
RA 1054 requires owner or lessee of any industrial, commercial or agricultural establishments to

provide free emergency medical and dental services to his employers or laborers
At least 100 employees- regularly employed RN
RA 9165- Comprehensive Danger Drugs Act of 2002 possession of 5 grams of prohibited drugs
is punishable by 12-20 years of imprisonment and 500,000 1M fine
Kinds of Dangerous Drugs
Prohibited
Regulated medical purposes

o
Morphine pain
Demerol
Codeine
Specifies who can handle them
Where to keep: cabinet with lock; key hang a key on the chain, where
it on your neck (principle: key should only be accessible to authorized
people)
RA 8976 Food Fortification Act of 2000
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College of Nursing
Foods should have Vit A,D, B
RA 9502 Universally Accessible Cheaper and Quality Medicine Act of 2008
RA 1080 Civil Service Eligibility Law
RA 7875 Amended National Health Insurance Law Philhealth
Once employed, automatically a member of Philhealth
Hospital benefits for 45 days per year
Covers outpatient cases cataract, breast cyst, sterilization
With benefits Normal delivery
First delivery with episiotomy (surgical procedure)
At least 60 years old and not employed and single dependent - single
Married: spouse (not employed) , children below 21 (unemployed)
RA 6713 Code and Conduct and Ethical Standards for Public Officials and Employees
RA 6809 major age lowered to 18 years old
RA 7160 Local Government Code (devolution of DOH)
Health services is no longer the responsibility of DOH, not a responsibility of Local

Health Department
RA 7305 Magna Carta for Public Health Workers
Benefites and incentives:
Exempted from paying professional tax
RA 7877 Anti Sexual Harassment at work and Education
PD 442 Labor Code private employers
Permanent status if you work continuously for 6 months - regular
Cannot be removed unless there is a valid cause
Contractual or regular no benefits
Overtime pay more than regular
Regular: +25% of hourly rate
Holiday:
o
Special: +30% of hourly rate
Legal: according to law: +100% of hourly rate or double pay
Night differential pay:
10PM -6AM
10% night DFP
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Exemptions from CS Exam can work in government as a permanent employee

College of Nursing
Regular day : Any eight hour work
Regular week: any 40 hours
Sick Leave: 15 days paid leave
Maternity leave
PD 626 Employee Compensation and State Insurance Fund
Injury, illness or death work related compensable
Private sector: SSS
Public: GSIS
RA 8981- PRC modernization Act
Computerization of Board Exam
LOI 1000 Government agencies to give preference to members of accredited professional

organization when hiring or when selecting official delegates to official functions
RA 8187 Paternity Leave
7 days 4 pregnancies also
Only for legal spouse
RA 9225
BON Res 112 Series 2005- Core Competencies standard for nursing practice
Presidential Proclamation 539 proclamation declaring nurses week every last week of October
(promulgated October 1958)
RA 1612 Payment of privilege tax/ professional tax for professionals
BON Res 4595 series 2002 MCN standard of practice
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60 days 4 pregnancies

College of Nursing
NURSING RESEARCH
-
Definition: scientific process that validates and refines existing knowledge and generates new
knowledge that directly and indirectly influences nursing care.
Primary Goal:
To develop scientific knowledge base for nursing practice. The knowledge generated through
research is essential for description, explanation, prediction and control of nursing phenomena
Specific Purposes
Generate new knowledge
Develop new gadgets and techniques
Evaluate a program or technique
Generate or validate theory (tentative explanation of a phenomenon event that is not fully
understood)
Scientific Law - explanation is universally accepted as correct
Types of Quantitative Research
According to Purpose:
Basic or Pure
Knowledge for knowledge sake
Applied
Purpose is to solve problems, to make decisions, to predict or control outcomes

in the real world
First researcher- Florence Nightingale
Limitations of Nursing Research
Ethico-legal considerations
Measurement Problems
Validity measures what you intend to measure.
Reliability yield the same result even repeatedly used
Control Problem
Ethics of research
Nuremberg Code of Ethics informed consent
Germany
Made Jews human guinea pigs
Belmont Report
Articulated 3 primary ethical principles
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College of Nursing
Beneficence significance of the study
Respect for human dignity
Justice
Vulnerable groups for research unable to protect themselves
Children
Mentally or emotionally disabled persons
Physically disabled
Prisoners
Hospitalized persons (may feel pressured to participate)
Pregnant women (fetus)
Steps in Quantitative Research
The Conceptual Phase
Formulating and Delimiting the Problem
Reviewing the Literature
Developing a Theoretical Framework
Design and Planning Phase (RESEARCH PROPOSAL)
Selecting an appropriate research design
Specifying the Population
Specifying the Methods
Designing the plan for selecting the sample
Finalizing and reviewing all aspects of the research plan
Conducting a Pilot Study and making revisions mini research / whole research
Objective: run a study and look for possible areas of problems and gaps to be
revised
Empirical Phase
Collecting the Research Data
Preparing the Data for Analysis
Analytic Phase
Analyzing through appropriate quantitative or qualitative methods the research data
Interpreting the results of the analyses
Dissemination Phase
Communicating the findings through written or oral presentations
Undertaking steps to utilize the findings or to promote their utilization
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College of Nursing
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First Step in the research Process: To find a topic for Research
Where do you search for research topics:
Own thoughts, observations and experiences
Review of literature
Theories concepts e.g. Role theory, sick role, the nurses role, the interaction between the
patients role and the nurses role
Testing assessment and intervention strategies
Criteria for Selecting a Research Topic
Relevance and Significance
Avoidance of duplication
Feasibility personnel time, equipment, money, availability of student participants
Political acceptability getting the permission of authorities involved
Ethical acceptability
Capability of researcher
3 levels of Research questions
Level I Exploratory in nature
Answers provide a complete description of the topic
Level II Descriptive level
Focus on relationships between 2 or more variable previously studied but never studied
together before
Level III Experimental level require considerable knowledge of the topic
Tests predictive hypothesis about the variables
Causal relationship
Hypothesis
Formal statement of the expected relationship between 2 or more variables in a specified

population
Translates the research problem and objectives into clear explanation or prediction of the
expected results of outcomes of the study
Hypothesis differs from objectives and research questions by predicting the outcomes of a study
and the researcher indicates the rejection or non rejection or support or nonsupport of each
hypothesis.
Uses:
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College of Nursing
Indicates the variable (trait, property or characteristic of the population being studied)
to be manipulated and the variable to be measured
Identifies the population to be studied
Directs the conduct of the study by indicating the type of research
It influences the study design, sampling technique, data collection and analysis methods
and the interpretation of the results.
Types of variables
Research variables main focus of the study
Independent variables variable that is manipulated by researcher
Dependent variables- variable that you observe and measure; shows the result of
the manipulation
Extraneous Variables / Confounding variables
Variables present in the population but is not the main interest can affect the
result
May not be recognized or uncontrolled
Maybe recognized but cant be controlled
As control decreases, the potential influence of recognized and unrecognized

confounding variables increase
Characteristics of a Hypothesis
Statement of anticipated relationship causal or non causal
Testability
There is a predicted relationship
Variables are observable or quantifiable definition of variables (operational

definitions)
Hypothesis that involves moral, ethical, or value laden issues are not testable
Justifiability Theoretical Framework
Maybe deduced from theory if there is
If new area being investigated, maybe based on logical reasoning or personal

experience
Consistent with existing body of research findings
Types of Hypothesis according to complexity
Simple one independent and one dependent variable
Complex or multivariable 2 or more IV and or 2 or more DV
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Types
Research or alternate hypothesis
Statistical. null hypothesis
Statement of expected relationship

Statement of no relationship
Predicted relationship of alternate hypothesis
Directional direction is specified
Non Directional
Example:
There is no difference in the nutritional status of children given nutribun with those given a liter
of milk daily.
IV type of food
DV nutritional
Null, simple, non directional
The incidence of nosocomial infection can be reduced by 50% when using the new technique of
HW than when using the traditional HW technique
Research Framework
Brief explanation of a theory or those portions of a theory to be tested
Every study has a framework
Must identify and define the concepts and the relational statements being studied
Design and Planning Phase
Elements of a good quantitative research
Appropriate to the purpose of the study
Cause and effect- experimental design; quasi-experimental design
Feasible given realistic constraints
Effective in reducing threats to validity
Concepts important in choosing design
Causality
Bias
Means to slant away from the true or expected result/ situation
The sources of bias need to be eliminated to arrive at valid and reliable results
If present unreliable results
Sources:
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College of Nursing
Researcher
Measurement Tools
Individual study subjects
Sample
Data sources- definitions maybe different
Possible sources of bias during data collection

o
Defective instruments
Questionnaires with:
Fixed or closed question on topics about which little is

known yes/no ; with choices
Open ended questions without guidelines on how to

ask/answer them
Vaguely phrased questions
Questions placed in an illogical manner
Mechanical devices that are not standardized
The source of bias in the instrument can be prevented by:
Carefully planning the data collection process
Pre-testing the data collection tools groups of experts

sample population
Observer bias
Halo effect with pre conceived idea about the sample
Hawthorne effect- knowing that the samples are being observed,

they will act artificially
This can be prevented by:
Having training of the observers
Supervising them during the data collection
Effect of observer on the subjects (hawthorne effect)
Prevented by:
Prolong the observation time HE is usually observed in

the early stage of data collection and diminishes over time
Observer must try to maintain the naturalness of the

situation and be as unobtrusive as possible
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College of Nursing
How the observer should behave and relate with the

subject during the observation must be included in the
Manipulation
Control
Having the power to direct or manipulate factor to achieve a desired outcome
In uncontrolled confounding variables increases effect
The greater amount of control the research has of the study situation, the more
credible the findings
The purpose of a research design is to maximize control factors in the study

situation
Controlling of treatment strategies:

o
Make a detailed description of the treatment.
Be consistent in implementing the treatment. Variation in the treatment

reduces effect size.
Controlling of measurement
o
Measures must have documented validity and reliability test
Data collectors must be observed for consistency of measurement
Strategies of control
o
Controlling the environment- consistent for all subjects
Controlling equivalence of subjects and groups
Equal number in E and C group to say that they are the same
in the beginning
Define selection criteria
Random sampling (how you choose the sample) followed by

random assignment (control and experimental)
Examine the extent of equivalence by measuring and comparing

characteristics for which the groups must be equivalent. This
comparison is usually reported in the description of the sample.
Controlling extraneous variables
Design strategies used to control extraneous variables:
Random sampling
Random assignment
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College of Nursing
Homogeneity
Heterogeneity obtain subject with a wide variety

(heterogenous) to reduce the risk of biases. This is
designed to increase generalizability.
Stratification involves even distribution of the subjects

throughout the sample
Matching
Validity - Study validity is the measure of the truth or accuracy of the claim.
Internal the extent to which the effects detected in the study are a true
reflection of reality rather than the result of extraneous variables
External extent to which study findings can be generalized beyond the study
group
Factor that can affect internal validity:

o
History an event that is not related to the planned study but occurs
during the time of the study.
Maturation described as growing older, wiser, hungrier, more tired,

stronger, or more experienced during the study
Testing effect- effect being measured can be due to the number of times
the subjects responses have been tested.
Instrumentation effects can be due to changes in the measurement

instruments between pretest and posttest; when observer or data
collectors become more experienced between pre-test and post test, thus
altering in some way the data to collect
Selection a selection threat is more likely to occur when randomization

is not employed
Volunteer group least acceptable; with acknowledge biased
Mortality due to the subjects who drop out before the completion of the
study
Problem: if more loss on one group over the other unequal

number of participants per group
Diffusion or imitation of treatments the control group may gain access

to the treatment intended for the experimental group (diffusion) or a
similar treatment available from another source (imitation).
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College of Nursing
Threats to External Validity
Interaction of selection and treatment If a large number of subjects

approached declined to participate, they tend to be volunteers or do-gooders
Quantitative research design
Non Experimental
Descriptive design
Typical descriptive design used to examine characteristics of a single sample
Comparative descriptive- examines and describes differences in variable in two

or more groups that occur naturally -----
According to time dimension

o
Longitudinal designs examines changes in the same subjects over an

extended period
Long period of time one sample
Limitation: expensive and greater danger of mortality of subjects
Cross sectional different sample, representing each stages
Examines groups of subjects in various stages of development

simultaneously
The assumption is the stages are part of a process that will

progress over time.
Limitations:
Many extraneous variables that may affect result
Correlation studies
Examines relationships between variables
A representative sample must be selected for the study
No attempt is made to control or manipulate the situation simply observe the

relationship
Types
o
Case control method begins with effect and looks for a cause;
retrospective
No way of ensuring individual characteristics
Weak when establishing cause and effect
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Hawthorne effect on sample

College of Nursing
o
Cohort design begins with cause and wait for effect ; prospective
design
Ensured of comparable characteristics
Good form of testing causal relationship in a natural setting
Good for determining relationship in natural setting
Experimental Designs
True Experiment
Features of True Experiment:

o
Manipulation of IV
Control of extraneous variables
Randomization
Quasi Experimental Design
When randomization or control of major extraneous variables is not possible or

cannot be done.
Criteria to establish causality
Co-variation between presumed cause and effect
Causal direction- X must precede the Y
Non spuriousness of results the effect or results were the intended results;
how? After repeating the procedure same results
Phases in the Qualitative Design the researchers are learners from their sample
Orientation and overview
To get a handle on what is salient about the phenomenon of interest
Focused exploration more focused scrutiny and in=depth exploration of those aspects
of the phenomenon that are judges to be salient
Confirmation and closure goes back to participant to validate results
In this final phase, the researcher undertake efforts to establish that their
findings are trustworthy, often by going back and discussion their understanding
with study subjects
There 3 phases are nor discrete events; they may overlap
Different research designs
Ethnography
Provides a framework for studying the meaning, patterns, and experiences of a

defined cultural group in a holistic fashion
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College of Nursing
o
How do they think, how they express themselves specific culture
The aim is to learn from (rather than study) members of the cultural group to
understand their world view as they define it.
Phenomenology
It is concerned with the lived experience of humans
Question asked: What is the essence of this phenomenon as experienced by
Grounded Theory
Primary purpose: to generate comprehensive explanation of phenomena that are

grounded in reality
It seeks to describe and understand the social psychological and structural

processes that occur in a social setting.
Case Study
In depth investigation of a single entity or small series of entities eg individual,

family, institution
It determines the dynamics of why individuals think, behave or develop in a

particular manner rather than what his or her status, progress, actions or
thoughts
Limitations: lack of generalizability small group
Historical Research
Systematic collection and critical evaluation of data coming from past events/
occurrences
It is undertaken to answer questions concerning causes, effects or trends

relating to past events that may shed light to present behaviors or practices.
Sources of data
o
Primary interview of an eyewitness, birth certificate, autobiography
Secondary biography
Evaluation of historical data

o
External criticism authenticity and genuineness of data
Internal criticism the evaluation of the worth and accuracy of the

evidence
Methods of Data Collection
Observation
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College of Nursing
Degree of investigators involvement
Participant (bias) or non participant (Hawthorne) observation
Degree of structure
Self report:
Questionnaire (respondent writes the answer) or interview (interviewer writes the

answer)
Available or existing data
Degree of structure open or close ended questions
Problem: incomplete or inaccurate existing data
Physiologic measure or Biomedical instrumentation
Differentiation between data collection techniques and data collection tools

Data Collection technique
Data Collection Tools
Using available info
Checklist, data compilation form

Eyes and other senses, pen and paper, watch, scales,
Observing
checklist
Interview schedule tool used (questionnaire),
Interviewing
checklist rating scale, tape recorder
Administering written questionnaire

-
Questionnaire
Sampling
A process of selecting a subset from a population to obtain info about the phenomenon in a
way that represents the population
Population aggregate of elements which share common characteristics:
Sample subset selected of population of interest
Element a unit of the population of interest
Purpose of sampling
Achieve representativeness
Minimize cost
Sampling strategies
Probability sampling
Every element known every element can be selected
Non zero probability of being included
Involve random procedures
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College of Nursing
Allow estimate population characteristics
Can estimate sampling error
Permits use of inferential statistics
Types of probability sampling
Simple random fish bowl technique; homogenous population
Stratified / modified simple random heterogenous population; smaller more
Cluster/ Multi stage element for sampling: cluster
Systematic with random start: arranged in some kind of order, seating

arrangement, alphabetical order
Non probability sampling
Population enumeration not possible
Enumeration expensive, inconvenient
Rarity / unpredictability of phenomenon
Types: common: convenience
Convenience
Quota
Purposive
Snowball
General Guidelines in Estimating Sample Size
The larger the sample (n), the more reliable the estimate
Purpose of the study
Homogeneity of phenomenon in population
Univariate Analyses use only descriptive statistics
Know or understand DV
Characteristics of sample
Determine characteristics of IV preparatory to further analyses
Bi variate / multi variate analyses
What relationship exist, what do they look alike, how strong are they
Alternative hypothesis to be ruled out
Statistics Key Concept
A tool / aid
organizing summarizing data
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homogenous groups apply simple random

College of Nursing
meaningful communication of findings
Factors that affect statistical analysis
making inferences
Levels of measurement
How the number are used to measure
4 levels
Nominal 2 nominal: chi square
Ordinal
Interval
Ratio
3 major parts of a research report
Preliminary pages
Title page
Table of contents
Body of the report
Research problem hypothesis, definition, framework
RRL
Methodology- methods, stools, sampling, statistical test, design
Presentation, analysis and interpretation of findings
Summary, conclusion and recommendations
Supplementary pages
Bibliography / References
Appendices
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University of Santo Tomas

Nursing Law and Code of Ethics for Nursing

Elements of a TRUE Profession

3. Acceptance of service motive/ orientation

4. Autonomy self governance

Sections 3 Composition of the Board

7 member of the board

Section 4 Qualifications of the Board

Natural born citizen or resident of Philippines no foreigner can

Member of good standing of accredited profession PNA

Registered nurse in the Philippines

Holder of masters degree in nursing, education or allied medical

Chairperson shall have a MAN

At least 10 years of continuous practice prior to application; 5

Not convicted of any offense involving moral turpitude

Membership to the board shall represent the 3 areas of nursing:

Section 5 no conflict of interest

PNA agency that is tasked to nominate member of the board

For every vacancy 5 nominees

Immediately resign from any teaching position in any school or

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

Resign from any office or employment in the government

No pecuniary interest in or administrative supervision over any

Term of office 3 years

More than 3 years allowed to be re-appointed once

Section 9 Powers of the board

Conduct the licensure exams

Issue, suspend or revoke the certificate of registration

Monitor and enforce quality standards of nursing practice to

Ensure the quality of nursing educational authority to open or

Investigate case of unethical or unprofessional conduct and

Promulgate the code of ethics

Recognize specialty organization

Not simple just generalist

MCNAP, ORNAP, GNAP

Prescribe, adopt, issue and promulgate resolution, regulations,

3 Broad Powers of the Board

Quasi Legislative make laws; board resolution = law

Quasi Judicial investigate violation to issue and revoke

Executive implement the nursing law

Sec 11 causes for removal or suspension of BON

Continue neglect of duty or incompetence

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

Commission or tolerance of irregularities in the licensure of the

Sec 28 Scope of Nursing

Definition of practice of nursing a person, singly or in

- all stages of development; labor and delivery not

As an independent nurse practitioner, a nurse is primary

Own private birthing clinic possible.

As member of health team, nurse shall collaborate with other

rehabilitative aspects of care, restoration of health, alleviation of

Hospice care for the dying

Duties of the nurse

Provide nursing care using the nursing process.

We are allowed to do IV by law