A.

BACKGROUND
 Philippine Nursing Act of 2002 (Republic Act No. 9173)
governs the nursing profession in the Philippines.
 It is also known as “An Act Providing for A More Responsive
Nursing Profession, Repealing for The Purpose Republic Act
No. 7164, Otherwise Known As The Philippine Nursing Act Of
1991 and for Other Purposes. “The State shall assume
responsibility for the protection and improvement of the
nursing profession by instituting measures that will result in
relevant nursing education, humane working conditions,
better career prospects and a dignified existence for our
nurses.”
The act includes the scope of nursing, primary
responsibilities of nurses as independent
practitioners, duties, and limitations of duties of
nurses.
In furtherance of this, the delivery of quality basic
health services through an adequate nursing
personnel system throughout the country is
guaranteed. (Section 2, Republic Act No. 9173
also known as the Philippine Nursing Act of 2002)
RA 9173 seeks to better protect and improve the
nursing profession, but still upholding the same
revered state policies and aspirations.
This law is a testament of the importance that the
government is giving to the health industry, to the
nursing profession, to their contribution to the nation
and the economy, and to each and every Filipino
nurse who is committed to serve with utmost
knowledge, skills and compassion, here in the
country and abroad.
Policies are not permanent, they may change over
time due to rapid changes in the society and
technological advancements, even in the nursing
field.
B. SPECIFIC PROVISION TO BE CHANGED, BE
INCLUDED, OR TO BE REVISED
IN THE PRESENT NURSING LAW

 If I were given the chance to change, include or revise the

present nursing law, it would be the Standardization of Nurse-
Patient Ratios.
 The present nursing law in the Philippines should include a
provision that establishes standardized nurse-patient ratios
across healthcare settings.
 Nurse-patient ratios refer to the number of patients assigned
to a nurse at a given time. Implementing standardized ratios
ensures patient safety, quality care, and optimal nurse
workload management.
Department of Health (DOH)’s nurse-to-patient
ratio standard of one nurse to 12 patients per
duty shift in the general ward, where patients
require a minimum level of care.
However, some researches showed contrary
situations. One example is the Filipino Nurses
United (FNU) said that after consulting several
nurse administrators from various health care
facilities, it found out that nurses suffer from
understaffing. “They attend to 20 to 50 patients
per shift, thus working 12 hours to 16 hours without
overtime pay,” the group said in a statement.
(Philippine Star, January 2023)
 C. RATIONALE
The rationale for including standardized nurse-
patient ratios in the nursing law is as follows:
Adequate nurse staffing levels and lower
nurse-patient ratios results with enhanced patient
outcomes like reduced mortality rates, lower rates
of complications, and decreased medication
errors. Standardized ratios promote patient safety
and quality of care can be prioritized.
 High nurse-patient ratios lead to burnout,
stress, and potential compromises in patient
care. Standardized ratios ensure a
manageable workload for nurses, allowing
them to provide safe and effective care
while preventing exhaustion and improving
job satisfaction.
 D. SUGGESTIONS FOR IMPLEMENTATION
 To implement standardized nurse-patient ratios, the
following steps can be considered:
1. Conduct research and evidence review:
Conduct comprehensive research and evidence review to
determine appropriate nurse-patient ratios based on
international best practices, scientific evidence, and patient
acuity levels across different healthcare settings.
2. Collaboration with stakeholders and policy makers:
Engage in collaborative discussions with nursing
organizations, healthcare institutions, policymakers, and other
relevant stakeholders to gather input, address concerns, and
build consensus on the implementation of standardized ratios.
3. Development of guidelines: Develop clear and
evidence-based guidelines that outline the specific
nurse-patient ratios for different healthcare settings,
taking into account factors such as patient acuity,
nursing skill mix, and unit-specific requirements.
4. Adequate staffing and resources: Ensure that
healthcare facilities have adequate staffing levels and
resources to meet the standardized nurse-patient ratios.
This may involve recruiting and retaining qualified nursing
staff, providing appropriate support personnel, and
allocating sufficient resources to support safe staffing.
5. Monitoring and enforcement:
Establish mechanisms for monitoring compliance
with the standardized ratios and enforcing them
effectively. This may include regular audits,
reporting systems, and penalties for non-
compliance.
 E. IMPACT ON NURSING PRACTICE

Including a standardized nurse-to-patient ratio in

the nursing law can have the following impacts on
nursing practice in the Philippines:
Adequate nurse staffing levels ensure that
nurses have sufficient time and resources to provide
safe and quality care to their patients. By reducing
workload burdens and increasing nursing presence,
the provision can contribute to improved patient
safety, reduced medical errors, and enhanced
overall patient outcomes.
Implementing a standardized nurse-to-patient
ratio acknowledges the importance of nurses;
physical and mental well-being. By ensuring
manageable workloads, nurses are less likely to
experience burnout, fatigue, and stress. This can
lead to higher job satisfaction, increased
retention rates, and a more resilient nursing
workforce.
 With a standardized nurse-to-patient ratio,
nurses can focus more on delivering comprehensive
and individualized care. They can devote time to
patient education, collaboration with the healthcare
team, and professional development activities,
leading to enhanced nursing practice and
professional growth.
The inclusion of a standardized nurse-to-patient
ratio in the nursing law demonstrates the
government’s commitment to patient safety and the
nursing profession. It instills confidence in nurses,
patients, and the general public, highlighting the
value of nursing and its critical role in healthcare
delivery.
 F. IMPACT ON NURSING EDUCATION

 The implementation of a standardized nurse-to-patient

ratio can have several impacts on nursing education in the
following ways:
Nursing education programs may need to revise their
curricula to ensure that students are adequately prepared to
work within the context of a standardized nurse-to-patient
ratio. The curriculum should emphasize the importance of
safe staffing, workload management, and the impact of
staffing levels on patient outcomes. This can include
incorporating relevant content and clinical experiences that
highlight the significance of appropriate staffing ratios in
delivering quality care.
 Clinical placements: Nursing schools may need to
collaborate closely with healthcare institutions to secure
appropriate clinical placements for students that align
with the standardized nurse-to-patient ratio. This ensures
that students have the opportunity to observe and
experience safe staffing levels and understand the
practical implications of staffing on patient care.
 Nursing education programs can utilize
simulation-based training to help students
develop critical skills in managing patient loads
and prioritizing care within the context of a
standardized nurse-to-patient ratio. Simulated
scenarios can provide students with hands-on
experience and decision-making opportunities
related to appropriate staffing levels and patient
safety.
 The inclusion of a standardized nurse-to-patient
ratio in nursing law can stimulate research efforts
in exploring the relationship between staffing
levels, patient outcomes, and nursing practice.
Nursing education programs can incorporate
research literacy and evidence-based practice
courses to equip students with the knowledge
and skills needed to contribute to the growing
body of evidence in this area.
 Nursing education plays a crucial role in cultivating
future nursing leaders and advocates.
The inclusion of a standardized nurse-to-patient ratio in
the nursing law can inspire students to engage in
advocacy efforts, research, and policy development
related to safe staffing. Nursing schools can provide
opportunities for students to actively participate in
discussions, research projects, and policy initiatives
aimed at promoting appropriate staffing ratios and
patient safety.
 G. IMPACT ON NURSING RESEARCH

 The implementation of a standardized nurse-to-patient ratio

can have significant impacts on nursing research in the
following ways:
The establishment of a standardized nurse-to-patient ratio
provides an opportunity to conduct research studies that
investigate the relationship between staffing levels and patient
outcomes. Nursing researchers can explore how variations in
nurse-to-patient ratios impact patient safety, quality of care,
patient satisfaction, and other relevant outcomes. This research
can contribute to the growing body of evidence supporting the
importance of appropriate staffing and its impact on patient
outcomes.
Nursing researchers can evaluate the
implementation of the standardized nurse-to-
patient ratio to assess its effectiveness and identify
any challenges or benefits associated with its
application. This research can help identify best
practices, barriers, and facilitators to
implementing the ratio in different healthcare
settings. It can also inform policy and practice
improvements related to nurse staffing.
Nursing researchers can contribute to the
development of evidence-based guidelines
and frameworks for determining appropriate
nurse-to-patient ratios in various healthcare
settings. Through rigorous research, they can
identify factors that influence staffing needs,
consider patient acuity, workload intensity, and
the impact on patient safety and quality of
care. These guidelines can assist policymakers,
administrators, and nurse leaders in making
informed decisions regarding nurse staffing
ratios.
Nursing researchers can explore the cost-
effectiveness of implementing a standardized
nurse-to-patient ratio. They can evaluate the
economic implications, resource allocation,
and financial outcomes associated with
maintaining appropriate staffing levels. This
research can provide valuable insights for
healthcare policymakers and administrators
when considering staffing decisions and
resource allocation in healthcare institutions.
The implementation of a standardized nurse-
to-patient ratio can foster collaboration
between nursing researchers, educators, and
healthcare institutions. Researchers can
collaborate with healthcare organizations to
access data, conduct research studies, and
evaluate the impact of staffing on patient
care. This collaboration can lead to knowledge
exchange, sharing of best practices, and the
development of research networks focused on
improving nurse staffing and patient outcomes.