FUNDAMENTALS OF NURSING PRACTICE
2016, Nov. 18, 2016
IV THERAPY AND LEGAL IMPLICATIONS
“In the administration of intravenous injections, special training
shall be required according to protocol established.”
 PHILIPPINE NURSING ACT OF 1991, SECTION
28
R.A. 7164 “The Philippine Nursing Act of 1991”
ARTICLE V - NURSING PRACTICE
Section 27. Scope of Nursing. - A person shall be deemed to be
practicing nursing within the meaning of this Act when he, for a
fee, salary or other reward or compensation, singly or in
collaboration with another, initiates and performs nursing
services to individuals, families and communities in various
stages of development towards the promotion of health,
prevention of illness, restoration of health, and alleviation of
suffering through:
(a) Utilization of the nursing process, including assessment,
planning, implementation and evaluation of nursing care.
Nursing care includes, but not limited to, traditional and
innovative approaches in self-executing nursing techniques and
procedures, comfort measures, health teaching and
administration of legal and written prescription for treatment
therapies, medication and hypodermic intramuscular or
intravenous injections: Provided, however, That, in the
administration of intravenous injections, special training
shall be required according to protocol established;
(b) Establishment of linkages with community resources and
coordination of the health team;
(c) Motivation of individuals, families and communities;
resources and coordination of services with other members of
the health team;
(d) Participation in teaching, guidance and supervision of
student in nursing education programs, including administering
nursing services in varied settings such as hospitals, homes,
communities and the like; undertaking consultation services; and
engaging in such other activities that require the utilization of
knowledge and decision-making skill of a registered nurse; and
(e) Undertaking nursing and health manpower development
training and research and soliciting finances therefor, in
cooperation with the appropriate government or private agency:
Provided, however, That this provision shall not apply to
nursing students who perform nursing functions under the direct
supervision of qualified faculty.
PRC BOARD OF NURSING RESOLUTION NO. 08, s.
1994, February 04, 1994
 “Any registered nurse without such training and who
administers intravenous injections to patients, shall be
held liable, either criminally under Sec. 30, Art. VII of
said law or administratively under Sec. 21, Art. III or
both.”
 “WHEREAS the Association of Nursing
Administrators of the Philippine (ANSAP) with an
aim for quality and safe nursing practice has the
expertise and resources to conduct such special
training program in the administration of intravenous
injection for nurses”
WHEREAS, in pursuance thereof, the Professional Regulatory
Board of Nursing (Board) issued Resolution No. 08, s. of 1994,
requiring all nurses who are to administer "intravenous
injections" to undergo a special training therein at least under a
nursing administrator who is a member of the Association of
Nursing Administrators of the Philippines (ANSAP) and who is
qualified under Section 28, Article V of R. A. No. 7164, either
before or after his/her registration as nurse, subject to such
penalties for non-compliance therewith;
PRC BOARD OF NURSING RESOLUTION NO. 38, s.
WHEREAS, on January 21, 2011, the Board issued an advisory
declaring Resolution No. 08, s. of 1994, as null and void in light
of the Repealing Clause of the new nursing law;
WHEREAS, as early as 2009, the basic intravenous therapy
training has already been incorporated in the Bachelor of
Science in Nursing (BSN) curriculum by virtue of CHED
Memorandum Order No. 14, s. of 2009;
WHEREAS, the Board issued Resolution No. 31, s. of 2015,
prescribing the guidelines on the regulation and monitoring of
in-service training programs for nurses in government and
private hospitals and healthcare institutions in the Philippines;
WHEREAS, on July 21, 2016, R. A. No. 10912 or the
Continuing Professional Development Act of 2016 lapsed into
law which institutionalized the CPD requirement in the practice
of all the regulated professions;
WHEREFORE, in light of the foregoing developments in the
nursing practice, the Board has RESOLVED, as it so
RESOLVES, to prescribe new set of rules on the
implementation of the special training requirement on
intravenous therapy for nurses, to wit:
1. Nurses are expected to possess the basic competencies in
intravenous therapy, being an integral component of the BSN
curriculum. Nevertheless, hospitals and healthcare institutions
may employ such tests as may be necessary to verify the level of
the nurse's competency or skills on intravenous therapy prior to
hiring. If the nurse demonstrates basic competence in
intravenous therapy, no further training shall be required of the
nurse. Otherwise, the hospital or healthcare institution shall
provide or offer such training at no expense to the nurse.
2. Completion of intravenous therapy training shall not be
required for employment or promotion but may be credited or
favorably considered in the evaluation of the nurse's application
for employment or promotion.
3. Special training in intravenous therapy shall be provided by a
hospital or healthcare institution to its staff nurses as part of its
in-service training program at no cost to the latter, subject to
other requirements set forth in Resolution No. 31, s. of 2015.
4. Training programs for intravenous therapy shall be conducted
or offered by providers accredited by the Continuing
Professional Development (CPD) Council for Nursing. The
program/module design and content for intravenous therapy
must be developed in strict adherence with the framework of the
National Nursing Core Competency Program (NNCCP) and the
existing guidelines on the CPD.
5. Accredited providers shall issue certificates to nurses who
have satisfactorily completed the special training in intravenous
therapy.
Board Resolution No. 08, s. of 1994 and all other issuances or
parts thereof inconsistent with this Resolution are hereby
repealed or amended accordingly.
NO NEED FOR IV THERAPY TRAININGS
 In multiple occasions during the PNA National
Convention, DOH Usec. Roger Tong-an has
 reiterated that there is NO NEED to renew trainings
for IV Therapy.
 The ANSAP has made it de facto mandatory to have
IV Therapy training in most hospitals only through
having its network of chief nurses simultaneously
require their staff to undergo such trainings.
 Even worse, the IV therapy training cost is 6x greater
than the renewal of a nurse's PRC license itself.
 Since RA 9173 became a law, the requirement of RA
7164 (the Philippine Nursing act of 1991) to have
"special training" for the administration of intravenous
medications, has been completely removed.
 Under the Philippine Nursing Act of 2002, the
administration of parenteral medications no longer
needs any additional training as per Section 28, The
Scope of Nursing.
 There is NO LEGAL BASIS in requiring RNs to
undergo IV Therapy training.
SCOPE OF DUTIES AND RESPONSIBILITIES OF
NURSING IN IV THERAPY:
 Interpretation of the doctor’s orders for IV therapy
 Performance of venipuncture, insertion of
needles,cannulas, except TPN and cutdown
 Preparation, administration, monitoring, and
termination of IV solution such as additives, IVmeds,
and IV push
 Administration of blood/blood products as ordered
by physicians
 Recognition of solution and medicine
incompatibilities
 Maintenance and replacement of sites,
tubings,dressings, in accordance with established
procedures
 Establishment of flow rates of solutions,medicines,
blood and blood components
 Utilization of thorough knowledge and proficient
technical ability in the use/care, maintenance, and
evaluation of intravenous equipment
 Nursing management of Total Parenteral Nutrition,
outpatient care
 Maintenance of established infection control and
aseptic nursing interventions; and
 Maintenance of appropriate documentation,
associated with the preparation, administration, and
termination of all forms of IV therapy
TELEPHONE ORDERS
RISKS WHEN TAKING TELEPHONE ORDERS
 May be misunderstood or misinterpreted by the
receiving nurse
 Messages may sound unclear or garbled
 Mispronunciation of words
 Orders are not signed by the physician
RESPONSIBILITIES OF THE NURSE TAKING
TELEPHONE ORDERS:
 Read back the order to the physician to make sure the
order has been correctly received.
 Ask the physician to sign the telephone order within
24 hours since it was given.
 Sign the name of the physician per her own and not
the time the order was received.
CONSENT TO MEDICAL AND SURGICAL
PROCEDURES
Consent is defined as a “free and rational act that presupposes
knowledge of the thing to which consent is being given by a
person who is legally capable to give consent.”
NATURE OF CONSENT
- Is a written authorization that changes a specific act
from non-consensual to consensual. It serves as proof
against any liability that may arise due to an alleged
unlawful touching of a patient.
- The nurse primarily secures the consent upon
admission.
- Initial consent is usually for diagnostic procedures and
initial treatment deemed necessary by the medical
staff.
INFORMED CONSENT
 The diagnosis and explanation of the condition;
 A fair explanation of the procedures to be done
andused and the consequences;
 A description of alternative treatments and procedures;
 A description of the benefits to be expected;
 Material rights if any; and
 The prognosis, if the recommended care, procedure is
refused.
PROOF OF CONSENT
- Written consent should be signed to show that the
procedure is the one consented to and that the person
understands the nature of the procedure, risks
involved, and the possible consequences.
- Signed special consent is necessary before any
medical or surgical procedure.
WHO MUST CONSENT?
- Patient is the one who gives consent.
- If he/she is incompetent or physically unable and is
not an emergency case, consent must be taken from
another who is authorized to give it in his behalf.
CONSENT OF MINORS
- Parents, or someone standing in their behalf.
- Parental consent is not needed if the minor is married
or otherwise emancipated.
CONSENT OF MENTALLY ILL
- Patients who are mentally incompetent cannot legally
consent to medical or surgical treatment.
- Consent must be taken from the parents or legal
guardian
EMERGENCY SITUATIONS
Can the nurse take action during emergency situations
without obtaining consent?
EMERGENCY SITUATIONS
No consent is necessary because in action at such time may
cause greater injury.
REFUSAL TO CONSENT

- A patient who is mentally and legally competent has the right

to refuse the touching of his body orto submit to a medical or
surgical procedure no matter how necessary, nor how imminent
the danger to his life of health if he fails to submit to treatment.

DISSENT

- If after the explanation, he still refuses to sign the consent

form, he should be made to fill out the release form to protect
the hospital and/oragency and its personnel from any liability
that may result from his refusal. If he refuses to sign the release
form, this should be noted in his chart.

CONSENT FOR STERILIZATION

- Husband and wife must consent to the procedure if the

operation is primarily to accomplish sterilization.
- If procedure is medically necessary (abruptio
placentae), patient’s consent alone is sufficient.

MEDICAL RECORDS

IMPORTANCE OF MEDICAL RECORDS:

1. Saves duplication in future cases and aids in prompt

treatment.
2. Supplies rich material for medical and nursing
research.
3. Serves as a legal protection for the hospital, doctor,
and nurse by reflecting the disease or condition of the
patient and his management

MEDICAL RECORDS IN LEGAL PROCEEDINGS

Used to give important evidence in legal proceeding such as

police investigations, determining cause of death, extent of
injury incurred by the patient, etc.

It is usually the medical records librarian, by virtue of a

subpoena duces tecum, who testifies that the patients’ records
are kept and protected from unauthorized handling and change.

Subpoena ad testificandum is a court summons to appear and

give oral testimony for use at a hearing or trial.