Nursing interventions to Promote healthy Psychological Responses

 Self-concept
 Stress and Adaptation
 Loss, grief, and dying
 Sensory functioning
 Spirituality

Evidence-based Practice (EBP)

⮚ It is the integration of best current evidence with clinical expertise and patient/family preferences and values
for delivery of optimal health care (Cronenwett et.al. 2007).

⮚ It is a problem-solving approach to clinical practice that integrates the conscientious use of best evidence in
combination with clinical expertise & patient preferences & values in making decisions about patient care
(Melnyk & Fineout-Overhold, 2014).

⮚ Is a way of providing nursing care that is guided by the integration of the best available scientific knowledge
with nursing expertise. This approach requires nurses to critically assess relevant scientific data or research
evidence and to implement high quality interventions for their nursing practice. (NLM PubMed)

(https://www.slideshare.net/pramodkumarsikarawar/evidence-based-practice-66624987)

⮚ It is a systematic, problem-solving process that facilitates the achievement of best practices.

Why is there a need for EBP?

1) For making sure that each client get the best possible services.
2) Update knowledge and is essential for lifelong learning.
3) Provide clinical judgement.
4) Improvement care provided and save lives.
(https://www.slideshare.net/pramodkumarsikarawar/evidence-based-practice-66624987)

What are the goals of EBP?

1) Provide practicing nurse the evidence based data to deliver effective care.
2) Resolve problem in clinical setting.
3) Achieve excellence in care delivery.

1
 4) Reduces the variations in nursing care and assist with efficient and effective decision making.
(https://www.slideshare.net/pramodkumarsikarawar/evidence-based-practice-66624987)

Seven (7) Steps of Evidence-based Practice

Barriers to EBP
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 1) Lack of value for research in practice
2) Difficulty in bringing change
3) Lack of administrative support
4) Lack of knowledge mentors
5) Lack of time for research
6) Lack of knowledge about research
7) Research reports not easily available
8) Complexity of research reports
9) Lack of knowledge about EBP
What is the relationship of Research to EBP?

❖ EBP is the integration of the best available research evidence & the nurse’s clinical expertise to make patient
care decisions.
❖ EBP allows the nurse to address questions and problems by reviewing the research, clinical guidelines, &
other resources to determine practice.
❖ EBP results in better patient outcomes, keeps nursing practice current, & increases the nurse’s confidence in
professional decision making.
Ex.

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Documentation and Reporting

Definition of Terms
• Record or chart or client record – is a formal, legal document that provides evidence of a client’s care and
can be written or computer-based.
• Report – is an oral, written, or computer-based communication intended to convey information to others.
• Recording, charting or documenting – is the process of making an entry on a client record .
DOCUMENTATION – is a nursing action that produces a written account of pertinent patient data, nursing clinical
decisions and interventions, & patient responses in health record (O’Toole, 2013).
Is any written or electronically generated information about a patient that describes the patient, the patient’s
health & the care & services provided, including the dates of care.
Is anything written or printed on which you rely as record or proof of patient actions & activities.

Purposes of Client Records

1) Communication
 The record serves as the vehicle by which different health professionals who interact with a client
communicate with each other.
 This prevents fragmentation, repetition, and delays in client care.
2) Planning Client Care
 Each health professional uses data from the client’s record to plan care for that client.
 Nurses use baseline and ongoing data to evaluate the effectiveness of the nursing care plan.
 The physicians plans treatment after seeing the laboratory reports of patient.
3) Auditing Health Agencies
 An audit is a review of client records for quality assurance purposes .
 Accrediting agencies such as The Joint Commission may review client records to determine if a
particular health agency is meeting its stated standards.
4) Research
 The information contained in a record can be a valuable source of data for research.
 The treatment plans for a number of clients with the same health problems can yield information
helpful in treating other clients.
5) Education
 Students in health disciplines often use client records as educational tools.
 A record can frequently provide a comprehensive view of the client, the illness and effective
treatment strategies and factors that affect the outcome of the illness.
6) Reimbursement
 Documentation also helps a facility receive reimbursement from the government.
 For a patient to obtain payment through Medicare or insurance agencies the client’s clinical record
must contain the correct diagnosis and reveal that the appropriate care has been given.

7) Legal Documentation
 The client’s record is a legal document and is usually admissible in court as evidence.
8) Health Care Analysis
 Information from records may assist health care planners to identify agency needs, such as over
utilized and underutilized hospital services.
 Records can be used to establish the costs of various services and to identify those services that cost
the agency money and those that generate revenue.
The Shift to Electronic Documentation
COMPUTERIZED DOCUMENTATION
• Traditionally, healthcare professionals documented on paper medical records. Paper records are episode
oriented, with a separate records for each patient visit to a health care agency.

4
• Key information such as patient allergies, current medications, and complications from treatment are
sometimes lost from one episode of care to the next, jeopardizing a patient’s safety.
• Electronic Health Records (EHRs) – are used to manage the huge volume of information required in
contemporary health care. It can integrate all pertinent client information into one record.
• Nurses use computers to store the client’s database, add new data, create and revise care plans and
document client progress. Some institutions have a computer terminal at each client bedside, or carry a
small handheld terminally to document care immediately once given.
• Hence, it makes care planning and documentation easy.
Inter-professional Communication within the Medical Record
COMMUNICATION WITH IN THE HEALTH CARE TEAM
• The quality of patient care depends on your ability to communicate with other members of the healthcare
team.
• Whether the documentation is done electronically or on paper, each member of the HCT needs to document
patient information in an accurate, timely, concise and effective manner to develop and maintain an
effective, organized and comprehensive plan of care.
• When a plan is not communicated to all members of the HCT, care becomes fragmented , tasks are
repeated, delays & omissions in care occur.
CONFIDENTIALITY, PRIVACY & SECURITY MECHANISMS

Confidentiality - the ethical principle or legal right that a physician or other health professional will hold secret
all information relating to a patient, unless the patient gives consent permitting disclosure.
Privacy -  is the right of an individual to have some control over how his or her personal information (or personal
health information) is collected, used, and/or disclosed.
Security – data protection.
Guidelines for Quality Documentation
1) FACTUAL
2) ACCURATE
3) COMPLETE
4) CURRENT
5) ORGANIZED
Guidelines for Good Documentation and Reporting
1) Fact – information about clients and their care must be factual. A record should contain descriptive,
objective information about what a nurse sees, hears, feels and smells
2) Accuracy – information must be accurate so that health team members have confidence in it
3) Completeness – the information within a record or a report should be complete, containing concise and
thorough information about a client’s care. Concise data are easy to understand
4) Currentness – ongoing decisions about care must be based on currently reported information. At the time of
occurrence include the following:
a. Vital signs
b. Administration of medications and treatments
c. Preparation of diagnostic tests or surgery
d. Change in status
e. Admission, transfer, discharge or death of a client
f. Treatment for a sudden change in status
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 5) Organization – the nurse communicate in a logical format or order
6) Confidentiality – a confidential communication is information given by one person to another with trust and
confidence that such information will not be disclosed
DOCUMENTATION SYSTEMS
1) SOURCE –ORIENTED RECORD
 The traditional client record
 Each person or department makes notations in a separate section or sections of the client’s chart
 It is convenient because care providers from each discipline can easily locate the forms on which to record data
and it is easy to trace the information
o Example: the admissions department has an admission sheet; the physician has a physician’s order
sheet, a physician’s history sheet & progress notes
 NARRATIVE CHARTING is a traditional part of the source-oriented record. It consists of written notes that
include routine care, normal findings & client problems, often in chronological order.

2) PROBLEM-ORIENTED MEDICAL RECORDS (POMR)

 Established by Lawrence Weed
 The data are arranged according to the problems the client has rather than the source of the information.
 The four (4) basic components:
o Database – consists of all information known about the client when the client first enters the health care
agency. It includes the nursing assessment, the physician’s history, social & family data
o Problem List – derived from the database. Usually kept at the front of the chart & serves as an index to
the numbered entries in the progress notes. Problems are listed in the order in which they are identified
&    the list is continually updated as new problems are identified & others resolved
o Plan of Care – care plans are generated by the person who lists the problems. Physician’s write
physician’s orders or medical care plans; nurses write nursing orders or nursing care plans
o Progress Notes – chart entry made by all health professionals involved in a client’s care; they all use the
same type of sheet for notes. Numbered to correspond to the problems on the problem list and may be
lettered for the type of data
 Example: SOAP Format or SOAPIE and SOAPIER
 S – Subjective data
O – Objective data
A – Assessment
P – Plan
I – Intervention
E – Evaluation
R– Revision
3) PIE (PROBLEMS, INTERVENTIONS & EVALUATION
 Groups information in to three (3) categories
 This system consists of a client care assessment flow sheet & progress notes
 FLOW SHEET – uses specific assessment criteria in a particular format, such as human needs or functional
health patterns
 Eliminate the traditional care plan & incorporate an ongoing care plan into the progress notes
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
4) FOCUS CHARTING (FDAR)
 Intended to make the client & client concerns & strengths the focus of care
 Three (3) columns for recording are usually used: date & time, focus & progress notes
 Focus charting describes the patient’s perspective and focuses on documenting the patient’s current status,
progress towards goals and response to interventions.
 PURPOSE: It brings the focus of care back to the patient and the patient’s concern.
 The narrative portion of focus charting includes DATA, ACTION and RESPONSE (DAR).
 The principal advantage of focus charting is in the holistic emphasis on the patient and his/her priorities
including ease in charting.
 4 elements of Focus charting:
1) Focus – identifies the content or purpose of the narrative entry and is separated from the body of
the notes in order to promote easy data retrieval and communication.
2) Data – the subjective/objective information supporting the stated focus or describing the
observation at the time of a significant event.
3) Action – describes the nursing interventions (independent, basic & perspective) past, present,
future.
4) Response – describes the patient outcomes/response to interventions or describes how the care
plan goals have been attained.

p
5) CHARTING BY EXCEPTION
•  Documentation system in which only abnormal or significant findings or exceptions to norms are recorded
• Incorporates three (3) key elements:
1) Flow sheets
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 2) Standards of nursing care
3) Bedside access to chart forms
6) COMPUTERIZED DOCUMENTATION
 Developed as a way to manage the huge volume of information required in contemporary health care
 Nurses use computers to store the client’s database, add new data, create & revise care plans & document
client progress.
7) CASE MANAGEMENT
 Emphasizes quality, cost-effective care delivered within an established length of stay
 Uses a multidisciplinary approach to planning & documenting client care, using critical pathways.
DOCUMENTING NURSING ACTIVITIES

DOCUMENTATION DO’S and DON’T’S

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REPORTING & its GENERAL GUIDELINES

• Reports are oral, written, or audio taped exchanges of information among caregivers.
• Common reports given by nurses include change-of- shift reports, telephone reports, hand-off reports, and
incident reports.
• A health care provider calls a nursing unit to receive a verbal report on a patient’s condition. The laboratory
submits a written report providing the results of diagnostic tests and often notifies the nurse by telephone if
results are critical.
•  Team members communicate information through discussions or conferences. For example, a discharge
planning conference involves members of all disciplines (e.g., nursing, social work, dietary, medicine, and
physical therapy) who meet to discuss the patient’s progress toward established discharge goals.

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Nursing Leadership and Management
“ Management is efficiency in climbing the ladder of success; while, leadership determines whether the ladder is
leaning against the right wall.” -Stephen R. Covey, The Seven Habits of Highly Effective People

LEADERSHIP DEFINITION:
(Maloney) an interpersonal process of influencing the activities of an individual or group toward goal attainment in a
given situation.
(Gardner)1986 the process of persuasion and example by which an individual induces a group to take action that is in
accord with the leader’s purpose or the shared purpose of all.
LEADERSHIP
(Bennis)2001 says that the leader makes a vision so palpable and seductive that others eagerly sign on.
Tourangeau(2003)”leaders are those who challenge the process, inspire a shared vision, enable others to act, model
the way & encourage the heart”.
LEADERSHIP
Leadership can be formal when a person is in a position of authority or in a sanctioned, assigned role in an
organization that connotes influence /power is determined by the position occupied in the organization/one
officially invested with organizational authority & power
Leadership can be informal when individual demonstrates leadership outside the scope of a formal leadership role or
as a member of a group/don’t have & will not have the official leadership title but exercise a leadership function (e.g.
staff nurse demonstrate leadership when they advocate for patient needs and take action to improve health care
and also when they speak up to improve quality of care).

Different Kinds of Leaders in an Organization

1.Formal Leader- one officially invested with organizational authority & power
 Given the title manager,executive,or supervisor
 Power is determined by the position occupied in the organization
 A person is in a position of authority or in a sanctioned,assigned role within an organization
2.Informal Leader
 Don’t have and will not have the official leadership title but exercise a leadership function
LEADERSHIP
 Leader  Follower
 Abilities  Leadership researchers and theorists do not
 Personality agree exactly what leadership is, it is perhaps
 Intelligence wiser to focus on what roles are inherent in
 Situation leadership.

LEADER ROLES
 Decision maker  Coach
 Communicator  Counselor
 Evaluator  Teacher
 Facilitator  Critical thinker
 Risk taker  Fair in dealing with subordinates
 Mentor  Keen observe
 Energizer
 Listener  Forecaster
 Tactful  Influencer
 Motivator  Creative problem solver
 Buffer  Change agent
 Advocate  Diplomat
 Visionary  Role model

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LEADERSHIP QUALITIES
 A leader possesses a striking physical personality and is energetic.
 A leader possesses a sense of purpose & direction. A leader know his/her personal objectives & those of the
group. He or she is able to set goals and move towards that direction.
 A leader has the power of ready speech. He or she is able to communicate in both written and spoken
language.
 A leader is enthusiastic about the purpose of the group and is devoted to its cause.
 A leader has keen insights into the human nature of people. He oe she has faith & trust in the people he/she
leads.
 A leader display courage & persistence even in the face of opposition.
 A leader is decisive. He or she uses independent judgment and does not hesitate to consult others when
needed.
 A leader is cheeerful and even tempered.
 A leader shows technical mastery that inspires others to do above average performance in their jobs.
 A leader is intelligent, versatile and has a sense of humor.
 A leader has a moral vision, integrity and idealism.

COMPONENT OF ESSENTIAL LEADERSHIP

An effective leader:
 Sets goals that are clear, congruent and  Takes action.
meaningful to the group.  Goals
 Has adequate knowledge and skills in  Action
leadership and on his/her professional skills.  Energy
 Possesses self awareness and use of  Communication
understanding to recognize both personal  Self-Awareness
needs and the needs of other people.  Skills & Knowledge
 Communicates clearly and effectively.
 Mobilizes adequate energy for leadership
Theories of Leadership
A.Genetic Theory
B.Trait Theory
C.Charismatic Theory
D.Behavioral Approach
E.Situational Approach

1.Fiedler’s Contingency Model

THEORIES OF LEADERSHIP
GENETIC THEORY (GREAT MAN THEORY) ARISTOTOLIAN PHILOSOPHY
 asserts that some people are born to lead, whereas others are born to be led.
 There is a belief that leadership ability is transmitted genetically.
 The premise of this theory is that “leaders are born not made”.

TRAIT THEORY
 This theory suggests that for a person to become a leader, he must have a certain innate or inherited traits.
Or assumes that some people have certain characteristics or personality trait that makes them better leaders
than others.
 Though later studies revealed that traits could be learned and experienced.

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Common leadership traits
 Intelligent  Persuasive
 Initiative  Perceptive
 Emotionally mature with integrity  Creative
 Communicates well  Participates in social activities

CHARISMATIC THEORY
The charismatic leader is someone who can inspire people to be loyal, obedient and committed to a vision or a
cause. His/her follower tend to idolize and worship him/her. (Leadership requires collaboration more than
charisma).

BEHAVIORAL APPROACH
This is a part of human relation movement wherein researchers moved away from studying the traits of the leader
and placed emphasis on what she/he did – the leader style of leadership.
White & Lippit (1960) isolated common leadership styles.

Authoritarian: Democratic:
 Strong control is maintained over the work  Less control is maintained.
group.  Economic and ego awards are used to
 Others are motivated by coercion. motivate.
 Others are directed with commands.  Others are directed through suggestions and
 Communication flows downward. guidance.
 Decision making does not involve others.  Communication flows up and down.
 Emphasis is on difference in status (I & you).  Decision making involves others.
 criticism is punitive.  Emphasis is on “we” rather than “I” and
“you”.
 Criticism is constructive.

University of Michigan & Ohio State Studies

a. task orientation(initiating structure or job-centered)-consists of actions taken by the leader to accomplish the job
like assigning tasks,organizing work,supervising & evaluating performance.
b.employee orientation(consideration or employee centered)consists of the actions that characterize the way in
which a leader relates to & approaches subordinates.

Two dimentional leadership matrix as to w/c combination work best,situation determines the style:
 high consideration & low structure produces less resignee & less absence
 high structure & high consideration produces less resignee & less absence
 low structure & low consideration produces high turnover & increase in absence
 high structure & low consideration produce increase in resignee & increase in absence
Therefore:both high leads to > leadership effectiveness
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 less resigned low absenteism
:low employee orientation high job satisfaction more resignees & high in levels of absenteism

THEORIES OF LEADERSHIP
 Both studies came up with the following conclusions:
 Leadership has at least 2 dimensions & is more complex than advocated by either a genetic or leadership
trait theory.
 Leadership styles are flexible.
 Leadership styles are not innate: they are learned.
 There’s no one right style of leadership.

Situational Approach (Contingency Approach)

A complex view of leadership that examines leadership styles, abilities and skills and the needs of the situation.
Also known as the contingency approach since a leader’s effectiveness in influencing others will be dependent upon
the needs of the situation itself. He/she must understand the dynamics of the situation and adapt his or her abilities
to those dynamics.

THEORIES OF LEADERSHIP
 Situation factors would include:  Nature of the organization.
 Personal characteristics of the manager.  Worker characteristics.
 Nature of the job.

THEORIES OF LEADERSHIP
E1. Fiedler’s Contingency Model (Fred Fiedler, 1967)
o This model highlights the need for flexibility in leadership behaviors.
o Introduced the contingency model of leadership.
o Leader’s effectiveness will be dependent upon the leader’s behavior and how it interacts with aspects of the
situation.
THEORIES OF LEADERSHIP
He identified 3 aspects of a situation that structures the leader’s role:
Leader-member relations – represents the amount of confidence and loyalty followers have in their leader.
Task structure – refers to the number of correct solutions to a given situational dilemma.
Position of power – the amount of organizational support available to the leader.
Fiedler’s Contingency Matrix
No one leadership style is ideal for every situation
-leader/member were most influenced by the manager’s ability to be a good leader
-task structure & power associated with leader’s
position are key variables
In each of these areas,the leader-manager may rank
high or low,resulting in numerous combinations of leadership behaviors.Various formations can be effective
depending on the situation & the needs of the worker.

LEADER
L-lead,love,learn
E-enthusiastic,energetic
A-assertive,achiever
D-dedicated,desirous
E-efficient,effective
R-responsible,respectful

A good leader:knows the way shows the way goes that way while a good dealer:goes the other way!
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ETHICO-MORAL & LEGAL CONSIDERATIONS IN THE PRACTICE OF NURSING
MODULE 6

CONTENTS
1. The Philippine Nursing Law of 2012 RA 9173 – Article VI Sec. 28: Scope of Nursing Practice
2. National Nursing Core Competency Standards
3. Patient Bill of Rights
4. Informed Consent
5. Data Privacy Law
6. Code of Ethics for Nurses
7. Philippine Professional Nursing Roadmap

THE PHILIPPINE NURSING LAW OF 2012 RA 9173

The Philippine Nursing Act of 2002: An Act for a more Responsive Nursing Profession

THE PHILIPPINE NURSING LAW

o It defines, regulates and limits the practice of the nursing profession.
o It provides for the organization of the Board of Nursing.
o Sets regulations concerning schools and colleges of nursing, sets requirements for certification, its revocation
or suspension. Describes the scope of nursing practice, as well as health human resources and penal
provisions.

SCOPE OF NURSING PRACTICE (Article 6, Section28)

o A person shall be deemed to be practicing nursing within the meaning of this Act when he/she singly or in
collaboration with another, initiates and performs nursing services to individuals, families and communities
in any health care setting.
o It includes, but not limited to, nursing care during conception, labor, delivery, infancy, childhood, toddler,
preschool, school age, adolescence, adulthood, and old age.
o As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of
illness. As member of the health team, nurses 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 a peaceful death.

SCOPE OF NURSING PRACTICE (Article 6, Section28)

o It shall be the duty of the nurse to:
o Provide nursing care through the utilization of the nursing process. Nursing care includes: traditional and
innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential
primary health care, comfort measures, health teachings, and administration of written prescription for
treatment, therapies, oral topical and parenteral medications, internal examination during labor in the
absence of antenatal bleeding and delivery. In case of suturing of perineal laceration, special training shall be
provided according to protocol established;
o Establish linkages with community resources and coordination with the health team;
o Provide health education to individuals, families and communities;
o Teach, guide and supervise students in nursing education programs including the 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; and
o Undertake nursing and health human resource development training and research, which shall include, but
not limited to, the development of advance nursing practice;

SCOPE OF NURSING PRACTICE (Article 6, Section28)

14
 o Provided, that this section shall not apply to nursing students who perform nursing functions under the
direct supervision of a qualified faculty. Provided further, that in the practice of nursing in all settings, the
nurse is duty-bound to observe the Code of Ethics for nurses and uphold the standards of safe nursing
practice.
o The nurse is required to maintain competence by continual learning through continuing professional
education to be provided by the accredited professional organization or any recognized professional nursing
organization: Provided, That the program and activity for the continuing professional education shall be
submitted to and approved by the Board.

2012 NATIONAL NURSING CORE COMPETENCY STANDARDS

BACKGROUND:
Heightened by the escalating complexity of globalization, dynamics of information technology, demographic
changes, health care reforms and increasing demands for quality nursing care from consumers, expectations for
contemporary nursing practice competencies emerged. Thus, in 2005, as an output of a key project, Board of Nursing
Resolution no. 112 Series of 2005, adopted and promulgated the Core Competency Standards of Nursing Practice in
the Philippines. As mandated, the Board of Nursing ensured, through a monitoring and evaluation scheme, that the
core competency standards are implemented and utilized effectively in nursing education , in the development of
test questions for the Nurse Licensure Examination (NLE),and in nursing service as a basis for orientation, training
and performance appraisal.
Through the years of implementation, global and local developments in health and likewise, professional
nursing developments prompted the Board of Nursing to conduct a “ revisiting “ of the Core Competency Standards
of Nursing Practice in the Philippines. In 2009, the Board of Nursing created the Task force on Nursing Core
Competencies Revisiting Project in collaboration with the Commission on Higher Education Technical Committee on
Nursing Education with the primary goal of determining the relevance of the current nursing core competencies to
expected roles of the nurse and to its current and future work setting.

LEGAL BASIS
Article III, section 9 (c) of Republic Act No. 9173 or the Philippine Nursing Act of 2002, which states that:
The Professional Regulatory Board of Nursing is empowered to “monitor and enforce quality standards of nursing
practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient, ethical and
technical, moral and professional standards in the practice of nursing taking into account the health needs of the
nation.”

SIGNIFICANCE OF THE 2012 NATIONAL NURSING CORE COMPETENCY STANDARDS (2012 NNCCS)
The 2012 National Nursing Core Competency Standards (2012 NNCCS) will serve as a guide for the development of
the following:
o Basic Nursing Education Program in the Philippines through the Commission on Higher Education (CHED).
o Competency-based Test Framework as the basis for the development of course syllabi and test questions for
“entry level” nursing practice in the Philippine Nurse Licensure
Examination.
o Standards of Professional Nursing Practice in various settings
in the Philippines.
o National Career Progression Program (NCPP) for nursing
practice in the Philippines.
o Any or related evaluation tools in various practice settings in
the Philippines

CONCEPTUAL FRAMEWORK

15
2012 NATIONAL NURSING CORE COMPETENCY STANDARDS (2012 NNCCS)
BEGINNING NURSE’S ROLE ON CLIENT CARE
Responsibility 1: Practices in accordance with legal principles and the code of ethics in making personal and
professional judgment.

Responsibility 2: Utilizes the nursing process in the interdisciplinary care of clients that empowers the clients and
promotes safe quality care.
Responsibility 3: Maintains complete and up to date recording and reporting system.
Responsibility 4: Establishes collaborative relationship with colleagues and other members of the team to enhance
nursing and other health care services.
Responsibility 5: Promotes professional and personal growth and development.

2012 NATIONAL NURSING CORE COMPETENCY STANDARDS (2012 NNCCS)

BEGINNING NURSE’S ROLE ON MANAGEMENT AND LEADERSHIP
Responsibility 1: Demonstrates management and leadership skills to provide safe and quality care.
Responsibility 2: Demonstrates accountability for safe nursing practice.
Responsibility 3: Demonstrates management and leadership skills to deliver health programs and services effectively
to specific client groups in the community settings
Responsibility 4: Manages a community/village based health facility /component of a health program or a nursing
service.
Responsibility 5: Demonstrates ability to lead and supervise nursing support staff.
Responsibility 6: Utilizes appropriate mechanisms for networking, linkage building and referrals.

2012 NATIONAL NURSING CORE COMPETENCY STANDARDS (2012 NNCCS)

BEGINNING NURSE’S ROLE ON RESEARCH
Responsibility 1: Engages in nursing or health related research with or under the Supervision of an experienced
researcher.
Responsibility 2: Evaluates research study/report utilizing guidelines in the conduct of a written research critique.
Responsibility 3: Applies the research process in improving client care in partnership with a quality improvement
/quality assurance/nursing audit team.

FILIPINO PATIENT’S BILL OF RIGHT

RIGHTS OF A PATIENT
PATIENT’S RIGHT – means the moral and inviolable power vested in him as a person to do, hold, or demand
something as his own.
Every right in one individual involves a corresponding duty in others to respect this right and not to violate it.

Filipino Patient’s Bill of Rights

o The patient has the right to a considerate and respectful care.
o The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant,
current, and understandable information concerning diagnosis, treatment and prognosis.
o Except in emergencies when the patient lacks decision-making capacity and the need for treatment is
urgent, the patient is entitled to the opportunity to discuss and request information related to the specific
procedures and/or treatments, the crisis involved, the possible length of recuperation, and the medically
reasonable alternatives and their accompanying risks and benefits.
o The patient has the right to know the identity of physicians, nurses, and others involved in his/her care, as
well as when those involved are students, residents, or trainees. The patient also has the right to know the
immediate and long-term financial implications of treatment choices, in so far as they are known.
o The patient has the right to make decisions about the plan of care prior to and during the course of
treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and
hospital policy and to be informed of the medical consequences of this action. In case of such refusal, the
patient is entitled to other appropriate care and services the hospital provides or transfer to another
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 hospital. The hospital should notify patients of any policy that might affect patient choice within the
institution.

o The patient has the right to have an advance directive (such as a living will, health care) concerning
treatment or designating a surrogate decision maker with the expectation that the hospital will honor the
intent of that directive to the extent permitted by law and hospital policy.

Filipino Patient’s Bill of Rights

o The patient has the right to every consideration of his privacy. Case discussion, consultation, examination,
and treatment should be conducted so as to protect each patient’s privacy.
o The patient has the right to expect that all communications and records pertaining to his/her care should be
treated as confidential by the hospital, except in cases such as suspected public health hazards where
reporting is permitted or required by law.
o The patient has the right to review the records pertaining to his/her medical care and to have the
information explained or interpreted as necessary except when restricted by law.
o The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable
response to the request of a patient for appropriate and medically indicated care and services.
o The patient has the right to ask and be informed of the existence of business relationships among the
hospital, educational institutions, other health care providers, or players that may influence the patient’s
treatment and care.
o The patient has the right to consent to or decline to participate in proposed research studies or human
experimentation affecting his care and treatment or requiring direct patient involvement, and to have those
studies fully explained prior to consent.
o The patient has the right to expect reasonable continuity of care when appropriate and to be informed by
physicians and other caregivers available and realistic patient care options when hospital care is no longer
appropriate.
o The patient has the right to be informed of hospital policies and practices that relate to patient care,
treatment, and responsibilities.

INFORMED CONSENT
Every person is primarily responsible for his own body – to protect patient’s personal integrity and enhance his
active role in his own care.
Main Functions:
a) Protective
b) Participative

INFORMED CONSENT ELEMENTS

Knowledge
Information disclosure by
healthcare giver.
Comprehension by the subject
Consent PROXY CONSENT
Subject competence What does a health professional
Subject freedom do when the patient is not in his
or her right sense when obtaining
the informed consent?
Who serves as the patient’s
advocate when a patient is in
coma?
What about minors, who makes
the decision for them?

Proxy Consent…

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The field of Bioethics as promoted by the Institute of Ethics and Human Rights in Houston, Texas (1993) specifies the
following:
o When the patient is in a coma, unconscious or incapable of making a decision - those closest to him or her
such as the family or relatives may decide for the best benefit of the patient.
o In instances when there is no close relatives and decisions must be made - the health professionals with
honest desires and intentions to give the best strategy or intervention to the patient may decide for the
patient. They are expected to execute their ADVOCACY ROLE to the best outcome of the patient.
o In case of minors – parents and the family of the patient will assume the patient’s autonomy and make the
decision which should always be the best for the patient.

SCENARIOS:
A bystander seen a person on the street with multiple gunshot wound, and he was brought to the ER. Upon
assessment by the medical doctor, he needs an immediate surgery because of blood loss. There is no significant
others with him to sign consent. Patient needs a STAT surgery.
A patient is scheduled for TAHBSO. During the operation, doctor has seen the appendix and it needs to be taken
because its about to rupture. Consent that was signed was only for TAHBSO procedure, what will be done?

DATA PRIVACY LAW

RA 10173 – DATA PRIVACY ACT 2012

What is the Data Privacy Act & its purpose?

AN ACT PROTECTING INDIVIDUAL PERSONAL INFORMATION IN INFORMATION AND COMMUNICATIONS SYSTEMS IN
THE GOVERNMENT AND THE PRIVATE SECTOR, CREATING FOR THIS PURPOSE A NATIONAL PRIVACY COMMISSION,
AND FOR OTHER PURPOSES.
o It is a 21st century law to address 21st century crimes and concerns. It
o protects the privacy of individuals while ensuring free flow of information to promote innovation and
growth;
o regulates the collection, recording, organization, storage, updating or modification, retrieval, consultation,
use, consolidation, blocking, erasure or destruction of personal data; and
o ensures that the Philippines complies with international standards set for data protection through National
Privacy Commission (NPC).

Who Administers the Provision of this Act?

The National Privacy Commission (NPC) protects individual personal information and upholds the right to privacy by
regulating the processing of personal information.

RIGHTS OF THE DATA SUBJECT

CODE OF ETHICS FOR NURSES
CODE OF ETHICS
o Means by which professional standards of practice are established, maintained & improved.
o Formal guidelines for professional actions.
o Gives members of the profession a frame of reference for judgements in complex situations.
CODE OF NURSING ETHICS
o A four-fold responsibility of nurses
o Nursing universality
o Scope of services rendered by the nurses
o Responsibilities to the people, their practice, to society, their co-workers and profession
Purpose of Ethical Codes
A basis for it regulates the relationship between the nurse, client, co-workers, society & profession.

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 o Provides a standard basis for excluding unscrupulous nursing practitioner & for defending a practitioner who
is unjustly accused.
o Serving as a basis for professional curricula and for orienting the new graduate to professional nursing
practice.
o Assisting public in understanding professional nursing conduct.

PHILIPPINE PROFESSIONAL NURSING ROADMAP

Philippine Nursing Profession Roadmap 2030

The BOARD OF NURSING has mandated itself to pursue the challenge in the nursing profession. Adopted the
"The Philippine Professional Nursing Roadmap 2030: A Program of Good Governance of the Nursing Profession.
VISION: Philippine Professional Nursing Care: The BEST for the Filipino and the Choice of the World by 2030
MISSION: We, the Filipino nurses, responding to the needs of society, are engaged in providing humane and globally
competent nursing care.
CORE VALUES: Love of God; Caring; Integrity; Excellence; Nationalism

Strategic Objectives:
o Develop dynamic leaders and provide opportunities for innovative management in education, training and
research.
o Ensure adherence to professional, ethical and legal standards for the health and safety of the public.
o Practice good governance to sustain participative efforts among nurses and nursing organizations.
o Maintain linkages with domestic and international stakeholders.
o Sustain growth and productivity that improve the quality of life of nurses, the Filipino and the people of
world.

AREAS & their SPECIFIC OBJECTIVES:

o The Filipino Nurse
o To live the core values and to manifest the desired qualities of a Filipino Nurse.
o Foster sense of accountability among all nurses.
Collaborative and Partnership
o To advocate collegiality and mutual respect that cut across all health disciplines.
o To engage stakeholders and make them co-owners of nursing issues and concerns.
o To actively participate in the socio-economic and political arena of the country.

Service Excellence
o To put into committed practice the quality standards in education and nursing service.
o To institutionalize sustainable organizational support for nursing positions.

Competency Enhancement
o To promote functional integration between education and service.
o To institutionalize a sustainable and effective continuing professional education and development for
individual nurses and institutions.

AREAS & their SPECIFIC OBJECTIVES:

Linkages / Networking
o To institutionalize best practice resource generation.
o To adopt local and global best practices in the management of resources.
o To forge linkages to generate funds from governments and NGOs.

Social Impact
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o Empowered clients to maintain the highest level of wellness and well-being.
o Nursing Profession as a recognized leader in primary health care.
o Ensure "positive practice environments" for nurses.

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