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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing

NURSING RESEARCH
Nursing Research
Kerlinger - the systematic, empirical, controlled and critical investigation of a
hypothetical proposition in relation to a natural phenomena/ problem
Conducted to affirm or deny a hypothesis
Phenomenon.
everyday phenomenon that affects the nurse (eg. bacteria, drugs, physician)
Phenomenon + hypothesis research problem
!"(educated guess/scientific/ tentative ans#er)
$ithout hypothesis there is no research problem, only a problem
Major Characteristics of a Good or Major Research
Systematic
o conduct research in a step by step process or procedure
Emirical
o ob%ective data should be observable/measurable or readily collected
using your senses
Controlled! maniulated
o &ethods/tool of controlling is research design
Critical in"estigation!fact finding in"estigation
o 'n order to ans#er the data is by using facts.
o (oo)ing for human beings #ho can give us facts
Purose of Research in Nursing Profession #$EE$%
$escriti"e
o observe, describe and record
o gain richer familiarity regarding the phenomena
o *++, )no#n to -.
E&loratory
o /0plore to those areas that are un)no#n
o 1bserve more
o 2+,-2+, (2+,)no#n to nurses and 2+, un)no#n to the nurses
E&erimental
o 3ctive intervention, active manipulation
o $ant to find out cause 4 effect
o 5one something before observing results
$e"elomental
o 6o improve the system of care for the your patient.
o 5evelop and improve e0isting system
Conducting research is for the benefit the pt or patient care/pt focus
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'lorence Nightingale
8irthplace < 'taly
6raining =round < =ermany
=reatest Contribution < environmental 6heory, training -.s in Crimean
$ar
9chool < 9aint 6homas 9chool of .ursing
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Ethics of a Researcher
S < Scientific ()jecti"e < conductive research for a good purpose or ob%ect for
your pt
C < Cooeration and Consent. 5o not conduct data/e0periment #/o a consent
(legally the patient o#ns the chart. >o#ever the hospital o#ns the chart)
* < *ntegrity < #or)ed hard on the research
E < E+uita)le < ac)no#ledging #or)s or contribution of others
N < No)ility < protect the rights of your sub%ects
o Right not to )e harmed
(physical, mental, moral harm) usually done during e0perimental
research
Physical ,arm! Negligence - undeliberate physical harm
Commission < done outside the standard practice of
nursing (eg. urinary catheter placed on the nose of the pt)
(mission < from the very start, you did not do something
about it.
Moral ,arm
Assault < mental fear/threat #ithout physical harm
-attery < physically you harm the pt
-estraint is never an independent nursing order
physical restraint < eg. 7ac)et
chemical restraint < eg. use of psychotropic drug
Moral harm
Slander < oral defamation
Li)el < published or placed in the ne#spaper
o Right to self.determination
o Right to ri"acy
Anonymity < identity of sub%ect may not be disclosed. Privacy of
the 'nformant (pt) eg. conduct a study on >'? pt. but the pt #ants
his name to be #ritten in the ne#spaper as &r. @, &r. A or &r. $
Confidentiality < information acBuired must be disclosed. Privacy
of the information eg. conduct a study on >'? pt. but the pt #ants
the nurse should only )no#
/ < /ruthfulness < put only the data you have collected
* < *mortance < importance to the nursing profession
' < 'actual < facts or data
* < *deal (follo# the ** steps of research)
C < Courage
Stes in Nursing Research Process
*dentification!formulation of research
o ro)lem - Canything that reBuires solution thru scientific investigation.
o 9ources of problem D
C < concepts (Ca, P68, &')
L < literature, essays, boo)s, %ournals
* < 'ssues
E < e0perience
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
N < .ursing problems
/ < theories
o Characteristics of a research problem
G < general applicability and use
Re < -esearchable
' < Eeasible and measurable
' 0 actors of a feasible research D
time, money, e0perience of the researcher, instruments,
population
* < importance to nursing profession
N < novelty/originality
Plagiarism/illegal replication < unauthoriFed use of
anotherGs literary #or) #ithout any consent or permission
S < significance to nursing
o 1 tyes of research according to use
)asic!ure research
only the research benefits the research
't is only for your personal necessity
3ns#ers your o#n Buestion
Alied research
problem solving
9olving the problems of the patient.
o 2aria)le < sub%ect to change
3inds of "aria)le
*ndeendent "aria)le
o use this to stimulate a target population
$eendent "aria)le!Effectual "aria)le
o results of the effects of the study
*nter"ening 2aria)le
o Comes bet#een dependent and independent
o /0ampleD orghanism variable, internal factor, se0,
gender, color
E&traneous 2aria)le
o /0ternal infuences that can be changed
o /0ampleD citiFenship, educational status
$ichotomous 2aria)le
o : choices/ : results
o /0ampleD &ale/ Eemale
Polychotomous 2aria)le
o &ultiple choices
o /0ampleD Preferred foods < Chinese, 7apanese,
3merican. . . . .
/0amples
H3 comparative 9tudy in the 'ncome of Eilipino .urses
/mployed in P.=.>. and ..A.=.>.I
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
'ndependent variable D P=> and .A=> (place of #or))
6arget population D Eilipino nurses
5ependent variable D income
Research4
*. 'dentify the Problem
:. Purpose < ob%ective using 9&3-6 (9ystematic, &easurable, 3ttainable,
-ealistic, 6ime 8ounded)
J. 5efine 6erms
a. Conceptual 5efinition < dictionary definition
b. 1perational 5efinition < defined in accordance on ho# the researcher
used the #ord
K. -evision of 6erms
Re"ie5 of related literature
o Puroses 4
to have an update regarding your topic
to have a basis of theoretical and conceptual frame#or)
o &ain sources of literatures
Conceptual
Eormulated
3uthors
Can be sold
8oo)s < general use
-esearch
-esearcher
-esearch #or)s only
Euture research purpose only
'ormulation of concetual and theoretical frame5or6
o 6hery < relationship bet#een concepts
o Conceptual frame#or)
diagrammatic and structural presentation of the problem
hypothesis
o Paradigm
actual structural presentation of your conceptual frame#or)
'ormulating hyothesis
o 7 tyes of hyothesis
Null!statistical hyothesis
sho#s no relationship or difference bet#een an
independent variable and dependent variable.
'5 5?
/g. H6here is no difference regarding professional
opportunities of Eilipino .urses #or)ing in the Philippines
from those #or)ing in L93.I
Simle!(erational hyothesis!Alternati"e hyothesis
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
this sho#s relationship bet#een a single independent
variable from single dependent variable.
/g. HEilipinos .urses #or)ing in L93 has more
professional opportunities than those #or)ing in the
Philippines.
Comle& hyothesis
this sho#s a relationship bet#een t#o or more
independent variable from t#o or more dependent
variable.
/g. HEilipino nurses #ho #or)ed for 2yrs and passed the
C=E.9, 61-E(, 69/, .C(/@ has greater opportunities in
.A as compared to those in &anila
$irectional hyothesis
specifies the direction of the relationship bet#een variables
/g. HEilipino .urses #or)ing in the L93 has more
professional opportunities than those #or)ing in the Phils.I
Non.directional
only predicts the relationship, but has no specific direction
bet#een variables.
/g. H6here is a big difference bet#een a Eilipino .urses
#or)ing in L93 than those #or)ing in the Phils.I
Selecting research design
o 9ystematic controlled plan for finding the ans#er to a problem
o -oadmap, blueprint of the study
o 9hould have a proper resign design
o 'f improper research design, there #ill be improper collection of data
o Purose D )ey or tool for proper collection of data
o /yes
According to Alication
-asic! Pure
o Eor personal )no#ledge, curiosity
Alied
o 8ased on problem solving approach
According to Methods
E&erimental
o performing active manipulation, observe and record
the result.
o /yes of E&erimental Reseach
control
divide grp into :.
=roup a < control/comparison grp <
#ill use the same soap everyday
=roup b < e0perimental grp < those
#ho #ill use the sample soap
randomi8ation
using sample by chance.
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Choose randomly to avoid
redundancy of result
Maniulation
Performing intervention
2alidation
comparison of the effects
9uasi.e&erimental
false e0periment.
.o control sample.
Non.e&erimental
o .o manipulation is done. 1nly observation,
describe and record do#n the result.
o /yes of non.e&erimental research design
)ase on time element
Retrosecti"e :E& Post 'acto;
=etting actual e0perience
9tudies a group of people after its
occurrence, e0perience or facts.
/0perience of people in the past
$escriti"e
1bserve, describe 4 record.
9tudy of current events.
Prosecti"e
9tudy of research about future
occurrence or future events.
,istorical
Past that is #ritten, documented,
published and recorded
Primary $ata
o 1bserve
o *
st
hand information
o person himself
Secondary $ata
o :
nd
>and 'nformation
3bout the past using records,
%ournals, boo)s.
9tudy of the dead people thru his
#ritten materials, facts
o according to data
+uantitati"e
data base on numerical
interpretation, datas that are
measurable, using your senses, data
that are observable.
+ualitati"e
sub%ective data, feelings, perception,
beliefs, culture, attitude
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
o Sur"ey Research $esign
=roup
9mall
Eace to face
(arge < not good result
&ethods
&ailed survey
Eace to face
6elephone survey
o According to /ime (rientation
Cross Sectional
3pplicable to : or more identical
group
9hort term
Eor comparison
Longitudinal
* group only
#ith initial and follo# up survey
long term study
for developmental study
Selecting your oulation and samles
o samle
part of population, data is collected.
6he recipient of the e0perimental treatment in e0perimental design
or the individuals to be observed in a non-e0perimental design
o /yes of samling
Pro)a)ility - eBual presentation/ chances in the population.
Simle random techni+ue
o Lsed a single/identical group.
o Eish bo#l techniBue
Stratified random samling
o Aou #ill first going to create a sub population from
the #hole population before doing randomiFation.
o 1ne population, you divide it.
Cluster random samling
o Aou #ill first create a sub area in a population
before doing the randomiFation. 'n one population,
you ma)e it smaller
Systematic random samling
o choosing a sample every nth name in the
population.
o &ultiple of *++ names
o Samling frame < list of names appearing as your
population
Non.ro)a)ility samling < you are not choosing by chance.
Accidental! con"enience samling
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
o 8ase on the accessibility/availability of your
sample.
o Kung sino pina)amalapit syo, yun ang )u)unin mo.
Purosi"e!judgmental samling
o base on the common )no#ledge or popular
)no#ledge.
Sno5.)all samling
o get sampling base on last referral
9uota Samling
o 9etting criteria and getting samples fitting the
criteria
Conducting ilot studies
Collecting data
o types D
Buestionnaires < use of pen and paper method
dichotomous < divided into t#o. /g. true or false. Aes or no
rating scale < poor *, good :, better J, best K
multiple choice
'ntervie# < use of oral method of collection of data. Lse of active
listening
9tructured < #ith chec)list, formal tal), list of Buestion
Lnstructured < informal tal), no pattern, anything goes
records < pre e0isting data
observation < use of ocular method using your senses
participant observation
non-participant observation
Problems D
o >a#thorneGs effects
6he data you get from your sample is not
accurate.
6he sample has a problem
9olution D double blind research < they
should not be conscious that they are being
studied
o >alo effect
6he researcher has a problem.
>e is manipulating the data collection.
't is affected by special feelings/treatment
bet#een the researcher and the sample.
Analysis of $ata
o part of research #hen the researcher is forming a body of )no#ledge out
of data collected for the purpose of affirming or denying your hypothesis
o Methods
Nominal method
get data by means of categories.
eg. male, female, income
(rdinal method < base on ran) eg. mild, moderate, severe
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
*nter"al
base on the distance bet#een : numerical values
eg. 8P < *2+/*++ < *:+/M+, #t, circumference, ht
ratio < JD*+ children are malnourish
*nterretation of $ata
o 1 Methods
+uantitati"e method < base on numerical or graphical standards
+ualitati"e method < use of narrative #ords
Communicating your conclusion
o /0plaining the results of your #or) to the public
o Conclusion < final ans#er to your research
o -ecommendation < suggestion to others
o 5issemination of 'nformation
&ethods D
thesis/boo) < #ritten form
symposia/symposium < oral presentation
publish < a lot #ill be able to read your research
LEADERSHIP
Nursing Leadershi
style or process #hereby a person is called by a nurse leader #ere influence of
group of people called his follo#ers for the purpose of attaining only one
goal/ob%ective.
Princile for Effecti"e Leadershi
<nity of Command < one group given by one leader
<nity of $irection < one group should al#ays have one ob%ective
Su)ordination of your ersonal to your general interest < patient first policy
o R < rescue your patient
o A < alert the fire alarm
o C < confine the fire in one area
o E < e0tinguisher application
o Esprit dG corp/team spirit - Eault of one is the fault of all
Resondeat Suerior!Command resonsi)ility
o let the master or the superior ans#er for the negligence of his
subordinates in half of his patient #ho suffer from in%ury or death.
o you can delegate responsibility but not the accountability
/heories of Nursing Leadershi
Great.Man theory < born as a leader
/rait theory < develop characteristics or born #ith the characteristics
o = traits of a leader
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
P < ersonality (adaptability, independence, creative/assertive,
advocate) ability to ad%ust to the need of the pt
* < intelligence (proper %udgment, proper decision ma)ing, proper
communication)
A < a)ility < (influence others, respect others, participate and
cooperate) Proper #ay to influence is thru health teaching
Charismatic theory < becomes a leader because of the charm
Situational theory!case to case )asis
o a person can be a leader in one situation but only a follo#er in another
situation. (eg. becomes a leader in #here he specialiFes)
Leadershi styles
3uthocratic/3uthoritarian/dictatorial/IhardI leader
o unilateral style of leadership. 1nly the leader here performs the decision
ma)ing #ithout getting the inputs from his members.
o 1ne sided style of leadership 8ehavior D
3 < apathy < insensitive to others
- 0 -oisterous seech
C 0 consistency
$ 0 $ominating
E 0 E&loitati"e )eha"ior
' 0 ferocious )eha"ior, to coerce or compel the group to follo# him
o not a good style of leadership but only best style during emergency or
intensive crisis
Permissi"e, ultra.li)eral, laisse8 faire, free.rein
o (oose style of nursing leadership.
o =iving e0cess freedom or liberality to#ards your subordinates if to lenient
in your subordinates, there #ill be N control and po#er O negligence
$emocratic!articiati"e
o best style of leadership. &utual style of nursing leadership
7 Po5er of a Good Leader
Legitimate! 'ormal! e&clusi"e Po5er
o /0ercise because you are appointed to a higher position
E&ert Po5er
o Aou acBuire e0tra < ordinary s)ills, talent or ability
Referent Po5er
o Charisma and charm
Re5ard Po5er
o + po#er for the part of the leader
o gives re#ards, bonus, promotion, compensation
Coerci"e Po5er
o < po#er on the part of the leader
o reprimand, suspend, terminate
A-C>s s6ills, +ualities and a)ilities
A 0 Authority
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
o basis of the leader to delegate tas)s, responsibilities, %obs to be
performed by his subordinates
o 1 tyes of authority
Centrali8ed < top to bottom for proper management
$ecentrali8ed < 8ottom, to manage directly
- 0 -eha"ioral
o S < specialiFed body of )no#ledge and s)ills to do safe care
o P < patient centered
o A < accountability < liable for the results of your actions
o C < confidentiality < nurse-patient relationship
/0ceptions to confidentiality of the contract D
P < patient consent, if there is
* < inform/report to healthcare team for purpose of
precautionary measures
C < Communicable disease
o RA =7?= (a# on .otifiable 5isease
o :K < Polio/ &easle
o * $ee) < 935/ >'?/6etanus .eonaturom
C 0 Crimes
o Child 3buse KM hours, 8aranggay, .=1
E < ethics
'? 6>/-3P'96D 1ld -., 6raining, 2+ 'nsertion, 3.93P
.e# -., 6raining
C 0 Communication s6ill
o transfer of information #ith understanding
o Communication barriers/communication bac)log < eg. 5ialect differences,
noise, deaf, high level of an0iety, hallucinating
$ 0 $ecision ma6ing s6ills
o 9teps
identify the problem
identify person affected
gather options/alternative
brainstorming
delphitechniBue < gathering solutions outside the group
(eg. specialiFed nurse)
choose and implement
/valuation
E 0 Ethics
o Princiles
o Princile of Autonomy
independent %udgment or decision ma)ing
in all situation the pt himself is the one #ho should decide for his
o#n care
Consent
respect the decision of the pt
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
e0plain the ris) to the patient/91
#aiver - a legal doc #hen the pt refuse for treatment.
o Princile of 2eracity
telling the truth to the patient
P* the patient has the right to )no# from the P>A9'C'3. (not the
nurse)
o Princile of $ou)le Effects
if the pt is made to choose bet#een : eBual danger and he only
needs to choose one, choose the one that #ill produce one good
effect and less evil effect.
o Princile of -eneficence
doing good to the patient (eg. providing therapeutic
communication, providing privacy)
o Princile of Non.Maleficence
do no harm
J types of >arm
Physical < negligence by commission
&ental < assault and battery
&oral < slander and libel
o Princile of @ustice
PrioritiFe the needs of the patient.
6o be able to provide nursing care to the patient, provide the
nursing process.
.ursing Process characteristics D
3 < acceptable universally
8 - based patients assessment needs
C < client focused
5 < dynamics < base on the ever changing needs of the pt
/ < eBuitable care
E < familiarity/rapport to the patient
= < goal directed to#ards solving the assess needs of the
patient (9&3-6)
o Princile of Resect!*n"iola)ility of life
9uicide and abortion is violation of this principle
' 0 'ace!sol"e Conflicts
o any clash of ideas resulting to crisis
o Methods of resol"ing conflict
a"oidance < by paying attention
smoothing < appealing to ones conscience and )indness
unilateral action < use of forced fear or threat
negotiation < best method in resolving conflict. 6he head nurse
should offer negotiation bet#een conflicting parties.
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
NURSING MANAGEMENT
N<RS*NG MANAGEMEN/
choosing the right person and giving them the appropriate tas) for the purpose of
achieving their goal/ob%ective in achieving total care
'rederic6 /aylor>s Scientific Management /heory
/lements
o choosing the appropriate person (631)
o choosing the appropriate team
o choosing the appropriate training
o choosing the appropriate tools
,uman Relations theory
the be a good manager, there should be a good interpersonal relationship
bet#een the leader and follo#er
$ouglas Mc Gregor>s Moti"ational theory
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
/heory A
o .egative #or)ers
o negligence, inefficient, ineffective #or)ers
/heory B
o Positive #or)ers
o diligent, effective, efficient #or)er
theory @ should be given focus because they are prone to negligence and
malpractice.
Ma& Ce)er>s -ureaucratic! authoritarian /heory
#hoever is on the top #ould perform the management function
centraliFed
Elton Mayto>s -eha"ioral /heory
overtime pay, rest day, day off
provide physical needs of the #or)ers
>a#thorneGs /ffect
o 'f #or)ers )no#s they are observed they become more efficient
,enry 'ayol>s Princile of Management
<nity of Command < one leader, one command
<nity of $irection < one group should al#ays have one goal
Remuneration of Personnel < patient first policy
Esrit de cors < team spirit
Command resonsi)ility!Resondeat Suerior < let the superior ans#er the
fault of his subordinates even harm or death
8alance bet#een centraliFation and decentraliFation
9ecurity tenure
5elegation of responsibility
Proer Comensation of 5or6ers
o RA ?=D7 :Magna Carta La5; < salary grade 2+ P*J,+++/month
o ("ertime ay < additional of :2,/hr
o Night $ifferential < additional of *+,/hr
o Legal holiday < 0 :
o Philhealth - 8enefit of #or)er both related and non-related #or)
(aesthetic, dental and cosmetics are not included)
o Maternity lea"e < ;+days leave is .95, QMdays if C9 only to first K
pregnancy only to legitimate spouse
o Paternity lea"e < Qday/*#ee) leave
o Senior Citi8en>s Act < :+, discount
7 stes in Management Process
Planning stage
o loo)ing ahead of time.
o Eormulating future goals/ob%ective
o /yes of lan
Standard!(erational Plan :NCP;
plans for everyday or ordinary activities
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Strategic!Contingency Plan
plan used during sudden or acute crisis
Long.range!future Plan
plans #hich you canGt evaluated immediately.
Lsually last months or yrs.
Lsed for chronic pt #hich reBuires longer period of care.
o Stages of Planning Process
Mission < present reason #hen established your organiFation
2ision - statement of your future purpose of your future
organiFation
Philosohy < set of values and beliefs of your organiFation
Goal < general statement of your purpose
()jecti"es < more specific statement of your purpose
Policies 0 set of rules and regulations in your organiFation
Procedures
-udgeting < proper allocation of your resources
o = tyes
Personnel
Compensation for salaries of
#or)ers
(erational
everyday use of eBuipment and
facilities (gloves, #ater, electricity)
Caital
long term use eBuipment (&-', C6
9can, hospital beds, hospital
buildings)
(rganiFing
o E stages
(rgani8e your team RN Su)ordinates
5uties of the -.
1nly assessment can perform the nurse
1nly the nurse can perform >6
1nly the nurse should e0plain the procedure to the patient
Preparation, administration, treatment of drugs to the
patient
6he nurse can only perform evaluation
6he nurse can only do %udgment
$elegate /as6
6hey can only delegate to subordinates the -outinary tas)
(standard, unchanging procedure) eg. monitoring of '41,
bathing, ambulating, toileting, shampooing, transporting,
feeding, clothing, #iping
9table patient - predictable outcome (eg. postmortem care
#ith direct supervision of the nurse only)
9upervision < need guidance
Staff Schedule! Staffing
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
9chedules (>o# many hours)
o 6raditional < Mhrs a day/K+hrs/#)
o 6en hour shift/K days a #ee)
o 8aylor plan < it consist of t#o shifting nurses
traditional < mon-fri Mhrs
:nd shift < *:hr shift during #ee)ends
o Part-time #or) < fe#er #or)ing hours per day and
may choose the day or #or). (ess than Mhrs %ob
o 1n < call < during shortage of nurses/staff but
increase in the number of patients.
Methods of Nursing care $eli"ery
$ifferent Methods
o Primary 0 1Ehrs a day
Primary nurse is the only nurse #ho is
responsible to ma)e a care plan of the
patient from the moment of admission till the
moment of discharge. (eg. private duty
nurse or special nurse)
o 'unctional Method
51> format/government hospitals
3ssign nurse D
$uty/tas)
(ne nurse, one tas)
,ighly recommended during a
period of shortage of nurses and
budget
poorest method of delivery because
communication is hindered
o Case &ethod/Case .ursing
provide total care #ithin your shift. Lsed in
'CL department
C < Case &ethod
6 < total care to the patient
1 < one is to one ratio
$irecting/5elegation stage
o a %ob or a tas) is done or performed by another perform for you
o $hat you cannot delegateD
you cannot delegate total control of the procedure
you canGt delegate discipline of subordinates or staff members.
Confidential tas)
6echnical tas)
&edical tas) performing surgical procedure is done by the doc not
the nurse
Coordination/Collaboration
o the nurse needs to collaborate to other members of the health care team.
o &ulti-interdisciplinary approach < to be able to provide holistic approach
to the patient.
o /yes of Colla)oration
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
*nterersonal!*ntradeartmental
1ne patient, one unit.
Collaboration bet#een one nurse to another healthcare
team in one unit/department
/g. &' patient - nurse, dietary, specialiFed in cardio
*nterdeartmental
K units in one hospital.
Coordination of the patients care bet#een :-more
units/departments but still under one same hospital or
institution
/g. patient due for appendectomy is transferred to the 1-
*nter Agency!*nstitutional
Coordination of patientGs care bet#een : or more
hospitals/health care institution for the benefit of the patient
/g. lying < in due for C/9 and #as transferred to a hospital
Evaluation/Controlling
o stage #herein you determine #hether or not your plans for your patient is
met or achieved
o Methods of e"aluating staff erformance
Chec6list
it is being evaluated higher than you. (eg. nurse
manager/supervisor or head nurse)
Nursing rounds
it is being evaluated higher than you. (eg. .urse
manager/supervisor or head nurse)
Psychiatric #ard is not done by nursing rounds
Peer re"ie5
same ran) or level is being evaluated you
poor method
Performance araisal
the patient evaluates you
best method in evaluation
PROFESSIONAL ADJUSTMENT AND NURSING JURISPRUDENCE
Professional
3 calling in #hich its members profess to have acBuired special values,
)no#ledge, training or by e0perience so that they may guide others in that
special field.
Nursing is a rofession
Calling < service oriented
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
1thers < patients
Characteristics )y rofession
A < accountability/liability for the result
C < caring profession Central Eocus
C < competent
E < ethics
S < service oriented
S < specialiFed scientific body of )no#ledge and s)ills
PR('ESS*(NAL $</*ES (' A N<RSE <N$ER RA FG?=
All are indeendent nursing actions
Promotive, preventive, curative and rehab care in all health care service
health education
utiliFes nursing process
lin) of patients in different health care services
collaboration of patientGs care for continuity of patient care
train nursing students
supervision of subordinates
accurate recording and reporting
e0ecution of valid doctorGs order (the only one that is dependent nursing action)
Perennial 9uturing after training
Perform '/ if antenatal bleeding is absent and before full delivery
A doctors order is valid when giving medication is when it is put into writing and signed
by the physician. Whatever is not put into writing is considered not ordered by the
physician.
Good Samaritan Act
5uring emergency, national calamity, national epidemic there is no doctor around
the life or the patient is in possible danger, then you can give drugs alone
provided you )no# the drugs for the patient.
RA H=EE < .o deposit policy during emergency cases only
Areas of Nursing Practice
GI *nstitutional Nursing
>ospital 8ased ?enue
5 < 5uties are routinary and supervised
3 < 3cBuired different learning and technical s)ills
C- Coordination #ith >C6
9 < 9pecialiFed areas
o .urse =eneralist < community nurse
o .urse specialist < staff nurse
1I Pu)lic ,ealth Nursing
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
1nce a Public nurse in the community, you are focus on the preventive and
promotive of health because this is the mandate of Primary >ealth Care (a#.
Gst P,C
o 5ate D *RQM
o Place D 3lma 3ta
o Country D -ussia
o (ocal version of E. &arcos after *yr of 3lma 3ta
o ConferenceD (etter of 'nstruction RKR that mandates that all public
#or)ers to have a duty of promotive and preventive care for the patient.
Promotion of Pu)lic ,ealth
o P5 MRQ; < &icronutrient 9upplement 3ct
?it. 3, iron supplements, iodine
o P$ H17 :En"ironmental sanitation la5 of the PhilsI;
't is cleanliness of the environment. 1utside the institution (eg.
proper disposal of e0creta, proper drainage system)
o P$ H7J :sanitation code of the PhilsI;
'nvolves proper sanitation of an institution that engage in food and
#ater supply. 'nside the institution. (eg. canteen, mineral #ater
store, public mar)et, 9e0 shop D 351.'9, P/=39L9, C>'C19)
not applicable to private se0 practitioners.
Pre"ention of $isease
o P$ FFJ :EP* la5;
Compulsory 'mmuniFation of children belo# R y/o
Psychological and social adjustments )ecause you 5ill )e ta6ing care of
numerous clients
o RA ?GJD :local go"ernment code;
decentraliFation or devolution of care. 6he 51> together #ith
5'(= and local government units (brgy, provincial) together #ith
community participation they made a local health board #hich is
the &3A1-.
Purpose of local health board D it ma)es Buality health care
available, accessible and pro0imal for all
Particiation is maintained 5ith all mem)ers of the community, health care
team and family
=I (ccuation ,ealth Nursing
industrial or company health nurse
$uties 4
o Curati"e!reha)ilitati"e
C < care for sic)/in%ured laborers
- < -eferral
? < ?isit and ff. ups (home visits)
o Promoti"e!Pre"enti"e
. < nutritional
9 < safety and sanitation
C < Counseling
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
EI Clinical *nstructor
o 9ualifications 4
A < accredited nursing 1rg
M < &3. in nursing or other health courses
( < 1ne yr clinical e0perience
R < -...
P,*L*PP*NE N<RSES ASS(C*A/*(N
o Chen 5as PNA founded D 1ct. ::, *R:: (*+-::- ::)
o Cho is the founder PNA D 3nastacia =. =uiron 6upas
o Puroses D
P < professional #ell-being
< - unity
P < promotes reciprocity even outside the Phils.
A < advancement of the )no#ledge and s)ills of the nurse
E < ethics promulgation
Proclamation (rder 7=F
5eclared by Pres. =arcia la# declaring the last #ee) 1ct as the official nurses
#ee).
School of Nursing in the Philiines

LPC. < *
st

9chools originated in the Phil.


o 'loilo &ission hospital
o P=>
o 9t. (u)eGs
o &ary 7ohnston >ospital
o 9t. Paul >ospital
o 9an 7uan de 5ios
Contracts and Consents
Characteristics of a 2alid Consent
2 < voluntariness
( < 1pportunities to as) BuestionCbe e0plained to ptC
/ < treatment e0plained to the patient
< < understood by pt
M < matured both physically and mentally
Criteria of a good consent 4
*M y/o < above
&entally capacitated (absence of insanity and imbecility)
'f belo# *M y/o and mentally incapacitated a pro0y consent D in chronological
order
o Parents
o =uardian
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Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
o physician (if parents and guardian are dead)
=uardian 3d (item < social #or)er or 9urgeon
Nurses and *llegal $etention
it happens if someone #ill limit the freedom of the patient to move or travel from
one place to another.
>'? Patient < should be )ept in one room
o Eelacio < oral se0 < most fastest mode of transfer
o Cannalingus < tongue on clitoris
o 3nalingus < tongue on anus < least mode of transfer
Last Cill and /estament
3ct #hereby a person is permitted by the la# to have control in the manner of
disposing/ giving his estate but #ill ta)e effect at the time of his death
6estate 9uccession < son or daughter #ill inherit the last #ill of the parents
'ntestate 9uccession < #ithout last #ill and testament
1 tyes of Last Cill and /estament
o Proerty
Notarial! (rdinary Cill
Chec) (1C
Chec) proper location of the signature < end part of all the
pages at the side
.urses can be a #itness
,olograhic Cill
5uring emergency cases
.o #itness involved call a persdon #ho )no#s and familiar
#ith the hand#ritten of the testator
/ntire last #ill and testament is hand #ritten dated and
signed by the testator
o Life -ody
Ad"ance $irecti"es
-espectful death
5irection/ instruction of the patient in advance
5.-, donate organ, cremation
Medications and rescrition
only registered medical, dental and veterinary practitioners are authoriFed to
prescribe drugs
J information
o name of the 3&5, address of his clinic/hosp and P6-C license P
o name of the pt, age, se0
o drug name, freBuency, duration of the drug
RA JJ?7 Generic Act
o all prescribe drug must be #ritten in generic and brand name or generic
name but never the brand name alone)
o Purpose D for the pt to choose #hat brand name they #ant
-emember the *+ -Gs of medication
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
-ight patient name by chec)ing the pt #rist tag
?erbal or telephone < only done during emergency
doubts or error < in case there is doubt in medication, refer to the physician
'? drugs < in proper training
$ocumentation, recording and charting
Patient Chart < absolutely legal
Purose of a atient Chart
o Communication and conitinuity of care
o Assurance of Buality of care
o Research
o Legal document
o Statistics of disease
Su)oena < order coming from the court
o 9ubpoena 5uces 6ecum < any documents, ob%ects, papers, materials
o 9ubpoena 3d 6estificandum < person #ho #ill testify (#itness)
$o>s in Charting
o ' < full, factual and ob%ectively accurate
o L < legible
o * < immediate
o P < Personal
Adendum < late entry/late documentation
$on>ts in charting
o L < language, %argons or #ords #hich are unacceptable
o * < improper corrections
o S < 9paces and s)ips
o Abbreviation
LEGAL $(C/R*NES *N N<RS*NG
Professional Negligence
Negligence
failure to do something #hich are reasonable and prudent nurse should have
done something under a particular situation. (eg. failure to raise side rales #hen
the pt is unconscious)
= elements of negligence
o duty on part of the nurse
o failure to do said duty
o in%ury, harm, death < most important negligence
Malractice
in%ury, harm or death is not important in malpractice
6he nurse is allo#ed to perform episiorrhapy
#ith proper training but not episiotomy
6he nurse is allo#ed to perform '/ but #ith : conditions D
o fetal aberration/ abnormal delivery
o prior to complete delivery
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Crimes affecting nurses
6ypes of crime D
Manner of Commission
o $(L( < crimes committed #ith deceit. Crime #ith real criminal intention
o C<LPA < crimes committed under negligence. Crimes that are intentional
stages of e&ecution
o consummated
#hen the crime intended is totally committed or perfected
o frustrated
the offended performs everything to consummate the crime but it
did not happen
o attemted
crime has not happened (overt acts < acts merely sho#ing the
intention to commit the crime)
degree of articiation
o rincial
degree of participation is very important/indispensable because he
is the primary author of the crime.. 'f no principle, there is no
crime.
o accomlice
participation is merely dispensable.
Lsually performs before (eg. referral by the nurse of a abortionist
to a pregnant #omen) or during the crime eg. 18 nurse is to
perform abortion. 6he nurse is loo) out for police. 6he nurse is
the accomplice.
o accessory
usually performs after the crime (eg. stole a nebuliFer in the
hospital. 9old the nebuliFer to an asthmatic pt) 6his is an
accessory because he benefited from the crime
RA ?H?? 0 Anti se&ual harassment la5
committed by any person #ho e0ercises authority. (eg. teacher to student, head
nurse to staff nurse).
6hat person #ho is in authority is as)ing for a se0ual favor in an e0change of
another favor.
/yes of Rae
(rdinary rae
o a forcible penetration of an organ for copulation to another organ for
copulation. (eg. #omen are only the victim)
se&ual assault
o anything that is forcible inserted to a body orifice #ith se0ual malice.
o 3lso form of rape (eg. hand or an ob%ect is being inserted in the anal.
Committed in both female or male)
o 'ntervention D
S < safety (emotional or physical safety)
R < report (N *M < report to brgy.)
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
R < referral (if father is the rapist, refer to 59$5)
A)ortion
is the e0pulsion or termination of a product of conception before the stage of
viability. (J-;month/*:-:K#ee)s)
*nfanticide
)ill the person in less than Jdays or Q:hrs of life.
Parricide
)illing another person to #hom you have a relationship (mother, father, husband)
,omicide
unintentionally )illing another person #ithout any relationship (eg. negligence in
giving meds)
Murder
intentionally )illing another person #ithout any relationship
Simulation of )irth
committed by any person #ho shall substitute one child to another child or alter
his identities for the purpose of losing his civil status. (eg. the mid#ife failed to
report the birth of the baby, giving #rong information of the gender of the baby)
P$ J7G :-irth registration act;
la# any person #ho assist in giving birth to report #ithin J+ days to the (ocal
Civil -egistration 1ffice
La5 Affecting Nurses
Act 1HDH :yrI GFGF; < first true nursing la#
o 't removed from the doctor the control of nurses #ith J man team (*
chairman and : members all nurses)
GF1D < *st official board e0am
Gst nursing school :Jmonths;
o 'loilo &ission >ospital (*R+;)
o P=> 9chool of .ursing (*R+Q)
o 9t. (u)eGs school of nursing (*R+Q)
o &ary 7ohnsonGs school of .ursing (*R+Q)
o 9t. Paul 'loilo *R+Q)
o 9an 7uan de 5ios (*R+Q)
Gst college of nursing :Eyears; 0 <P
RA ?GJE :GFFG;
RA FG?= :(ct 1G, 1DD1;
o -oard of Nursing
(ld
o & < &3.
o 3 < 3ccredited .ursing 1rg (P.3)
o E < five &3. team (* chairman, K members)
o 9 < ;2 y/o < * year interim period
o . < .ot convicted of any crime
o P < Pecuniary interest (3bsence)
o 6 < *+ years nursing practice
o C- CitiFen of -.P.
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Ne5
o & < &3.
o 3 < 3ccredited .ursing 1rg (P.3)
o 9 < Q &3. team (* chairman, ;members)
o ' < immediately resigned upon appt.
o . < .ot convicted of any crime
o P < Pecuniary interest (3bsence)
o 6 < *+ years nursing practice but 2 yrs must be in the
Phils.
o C- CitiFen 4 resident of -.P.
Cho formulates the +uestion of the -oard E&amK < 8oard of
.ursing
'n having a license it is a Privilege not a -ight
8oard of .ursing issues the license
P-C issues the certificate of registration
C>/5 are the ones #ho has the po#er to open and close a
nursing school
81. %ust inspects 2 consecutive years of belo# M+, passing rate,
the school #ill be closed
Po5ers and 'unctions of -(N
o L < (icensure e0am
o * < 'ssue C1-
o M < &onitor standards of nursing practice
o E < /ducation
o C < Code of ethics
o , < >ear and decides cases of negligence and malpractice
o A < 3ccredits different organiFations
o G < =uides .ursing Practice in the phils
o $ean
-...,C&3.
2 years nursing e0perience
o Clinical *nstructor
3 < allied in nursing or any allied health courses
& < member of P.3
1 < * yr e0perience
- < -...
o Nursing Administrator
Suer"isor!Manager , Community Military ,os
8 < 89. -.
3 < 3ccredited 1rg
. < R units
6 < : yrs
Chief/5irector
-. + &3. + 3dd only &3. +
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
2 yrs supervisor
e0perience
(..8. if primary
hosp)
masterGs in
P>. or
C>.
=9C
(=en.
9taffing
Course)
o E&aminees
C=& (=ood &oral Character)
Proofs of ?alid >older of Eilipino CitiFenship
Proofs of valid holder of a 89. 5egree only from schools #hose
curriculum is approved by the C>/5
J docs sub to P-C
-(/ certificate
61- #ith 9canned picture
(ist of cases
/0amination fee is PR++
(ast day 's D
1ther related la#s
P$ 11= 0 PRC Act
RA GDHD < Civil 9ervice e0am Cum (aude, 8oard passer < eligible in ta)ing C9/
RA JE17 0 $angerous drugs Act
o unisha)le 5ith 1 chemical su)stances
Prohi)ited drugs
chemical substance totally, abosultely canGt be consumed
by human being (eg. 9habu, &ariana, Cocaine, 1pium)
Regulated drugs
you can use this drug provided the pt has the prescription
and the 3&5 has appropriate license coming from the
8E35 or 5angerous 5rugs
RA ?JDD 0 -a)y 'riendly ,ositalI
o /arly bonding for mother is /arly -ooming in and early baby breast
techniBue for early bonding /arly bonding for father is thru cuddling
EI(I 7G 0 Mil6 Code :-reast Mil6;
o 3void manufactured or formula mil)
,o5 to )e an RINI under FG?=
o >ave all Bualifications
o ta)e the e0am
o acBuire the reBuired ratings
o 'n order to pass the e0amination, an e0aminee must obtain a general
average of at least Q2 , #ith a rating of not belo# si0ty percent (;+,) in
any sub%ect
o 3n e0aminee #ho obtains an average rating of Q2, or higher but gets a
rating belo# ;+, in any sub%ect must ta)e the e0amination again but
only in the sub%ect or sub%ects #here he/she us treated belo# ;+ ,
(;+,). 'n order to pass the succeeding e0amination, an e0aminee must
obtain a rating of at least Q2, in the sub%ect or sub%ects repeated.I
RA HFHG 0Moderni8ation ActI
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;
Pentagon Professional Adjustment, Legal Management, Ethics & Research in Nursing
Eor every 2,+++, results #ill be released after 2days
P-C rating .3&/
6e0t to :;J (smart) :JJ (globe)
Chat are the grounds for nurse not to )e registeredK
o $ < 5ishonorable conduct
o < < Lnsound mind
o M < moral turpitude
o * < 'ndecent immortal conduct
7omar 3nthony 5. &a0ion, 89., -. P(& College of .ursing 8atch :++;