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Nursing Notes: RA 9173 (Philippine Nursing Act of 2002)

Philippine Nursing Act of 2002 or RA 9173


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

Republic of the Philippines HOUSE OF REPRESENTATIVES Quezon City


FOURTEENTH CONGRESS Second Regular Session .~

House Resolution -, 724


Introduced by Gabriela Women's Party Representatives lIZA LARGOZA-MAZA and LUZVIMINDA C. ILAGAN
RESOLUTION DIRECTING THE HOUSE OF REPRESENTATIVES COMMITTEE ON APPROPRIATIONS,
AND THE COMMITTEES ON OVERSIGHT AND HEALTH, TO CONDUCT AN INQUIRY, IN AID OF
LEGISLATION, INTO THE FAILURE OF THE NATIONAL GOVERNMENT TO IMPLEMENT THE
UPGRADING OF SALARY lEVel OF GOVERNMENT NURSES SINCE THE EFFECTIVITY OF REPUBLIC
ACT NO. 9173, OTHERWISE KNOWN AS THE PHILIPPINE NURSING LAW OF 2002, AND FOR
CONGRESS TO INCLUDE THE CORRESPONDING BUDGET NEEDED FOR ITS IMPLEMENTATION IN
THE ANNUAL GENERAL APPROPRIATIONS
WHEREAS, the State, recognizing labor as a primary social economic force, has the obligation to protect the
rights and welfare of Filipino workers as mandated by the Philippine Constitution in Section 18, Article 2;
WHEREAS, the State has the obligation to protect and promote the right to health of the people as mandated
by the Constitution in Section 15, Article 2;
WHEREAS, the State must protect and improve the practice of nursing profession in the country to encourage
the best of Filipino nurses to serve our nation, rather than promoting the exodus of nurses abroad;
WHEREAS, the present basic pay of government nurses at Salary Grode 10, equivalent to P10,000.00 monthly
is inadequate to cope with the rising cost of living in the country. Accord ing to the National Wages and
Productivity Commission (NWPCl, the living wage for a family of six in the National Capital Region already
reached P894 as of June 2008. This means that the monthly living wage for a family of six must be at least
P26,820.00;
WHEREAS, in search of better income opportunities, an estimoted 13,000 nurses leove the country every year
to work abroad either as nurses, caregivers or domestic helpers consequently intensifying the lack of nurses for
our health centers and hospitals;
WHEREAS, Republic Act No. 9173 or the Philippine Nursing Act of 2002 was passed in October 2002 with the
aim af strengthening the nursing profession and encouraging nurses to stoy ond work in the country. Tawards
this end, RA 91 73 provided for an increase in basic so lary of nurses from solory grade 10 which is now
equivalent to P12,026, to not lower than solory grade 15, which is now pegged at P16,093.00;
WHEREAS, the increase can somehow, lessen the gop between the basic salory and the family living wage, as
well as cushion the impact of increasing prices of basic commodities on our nurses and their familYi
WHEREAS, the approximately 21,000 nurses working in public hospitals, government agencies and health
centers nationwide have long been waiting for the implementation of the said low;
WHEREAS, the Philippine Nurses Association reported that despite the enactment of RA 9173 in October 2002, the
corresponding increase in basic pay of government nurses as mandated by the aforementioned law has not yet been
granted to them due to lack of corresponding budget appropriations;
WHEREAS, the continuous inaction by the government to raise the basic pay of nurses as mandatedin RA 91 73 is
anapporent vioIation of the afarementioned Iawand our consti tution;
WHEREAS, Congress must look into this matter the soonest possible time and include in the General
Appropriations the corresponding budget needed for the implementation of the said law, including the unreleased
amount since RA 9173's effectivity in 2002;
NOW TH EREFOR E, BE IT RESOLVED that the House of Rep resentotives Committee on Appropriations, and the
Committees on Oversight and Health, conduct an inquiry into the failure of the Notional Government to implement the
upgrading of salary grade leve) of government nurses since the effectivity of Republic Act No. 9173 otherwise known
as the Philippine Nursing Law of 2002;
BE IT RESOlYEO FURTHER that Congress include in the Annual General Appropriations the corresponding budget
needed for the implementation of the aforesaid low.
Adopted,

The Patient's Bill of Rights

What is the Patient's Bill of Rights?


Here you will find a summary of the Consumer Bill of Rights and Responsibilities that was adopted by the
U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998. It is
also known as the Patient's Bill of Rights.
The Patient's Bill of Rights was created with the intent to reach 3 major goals:
1. to help patients feel more confident in the U.S. health care system; the Bill of Rights:
 assures that the health care system is fair and it works to meet patients' needs
 gives patients a way to address any problems they may have
 encourages patients to take an active role in staying or getting healthy
2. to stress the importance of a strong relationship between patients and their health care providers
3. to stress the key role patients play in staying healthy by laying out rights and responsibilities for
all patients and health care providers
This Bill of Rights also applies to the insurance plans offered to federal employees. Many other health
insurance plans and facilities have also adopted these values. Even Medicare and Medicaid stand by
many of them.
The 8 key areas of the Patient's Bill of Rights
Information disclosure
You have the right to accurate and easily-understood information about your health plan, health care
professionals, and health care facilities. If you speak another language, have a physical or mental
disability, or just don't understand something, help should be given so you can make informed health care
decisions.
Choice of providers and plans
You have the right to choose health care providers who can give you high-quality health care when you
need it.
Access to emergency services
If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious
danger, you have the right to be screened and stabilized using emergency services. You should be able
to use these services whenever and wherever you need them, without needing to wait for authorization
and without any financial penalty.
Participation in treatment decisions
You have the right to know your treatment options and take part in decisions about your care. Parents,
guardians, family members, or others that you select can represent you if you cannot make your own
decisions.
Respect and non-discrimination
You have a right to considerate, respectful care from your doctors, health plan representatives, and other
health care providers that does not discriminate against you.
Confidentiality of health information
You have the right to talk privately with health care providers and to have your health care information
protected. You also have the right to read and copy your own medical record. You have the right to ask
that your doctor change your record if it is not correct, relevant, or complete.
Complaints and appeals
You have the right to a fair, fast, and objective review of any complaint you have against your health plan,
doctors, hospitals or other health care personnel. This includes complaints about waiting times, operating
hours, the actions of health care personnel, and the adequacy of health care facilities.
Other bills of rights
This bill of rights focuses on hospitals and insurance plans, but there are many others with different
focuses. There are special kinds, like the mental health bill of rights, hospice patient's bill of rights, and
bills of rights for patients in certain states. Insurance plans sometimes have lists of rights for subscribers.
Many of these lists of rights tell you where to go or whom to talk with if you have a problem with your care.
The American Hospital Association has a list of rights along with patient responsibilities that can help a
person be a more active partner in his or her health care

Respect
Your Rights
· To be treated with respect and courtesy
· To receive safe, considerate, ethical and cost effective medical care
· To have your individual cultural, spiritual and psychological needs respected
· To have your privacy and personal dignity maintained
· To expect that information regarding your care will be treated as confidential

Your Responsibilities
· To respect hospital personnel
· To respect care givers’ effort to provide care for other patients
· To respect hospital property
· To be considerate of other patients and to see that your visitors do the same

Treatment
Your Rights
· To receive treatment regardless of race, religion or any other discrimination
prohibited by law.
· To receive emergency treatment regardless of ability to pay
· To expect reasonable continuity of care and to be informed of available and
realistic care
options when hospital care is no longer appropriate
· To have your needs for pain management addressed and treated
· To be free from the use of restraints and/or seclusion unless clinically
necessary.

Your Responsibilities
· To follow your caregivers’ instructions and help them in their efforts to return
you to health.
· To inform your caregiver if you think there may be problems in following their
instructions
· To participate in decision making about your medical care
· To recognize the impact of lifestyle on your personal health

Information
Your Rights
· To understand your diagnosis and treatment, as well as the possible
outcomes, risks and
benefits of your care.
· To have information regarding your medical treatment explained to your family
member or
other appropriate individual when you are unable to participate in decisions
about your care.
· To be advised of hospital policies, procedures, rules and regulations that may
affect your care.
· To understand that your caregiver may both be teachers and students
· To know the names/ titles of your caregiver.
· To see your medical records (in accordance with hospital policy and/or the
law)
· To review your bill and to have any questions or concerns you have
adequately addressed.
Your Rights
· To provide the hospital with accurate and complete information about your
medical history
· To ask your doctors for more information if you d not understand your illness
or treatment
· To provide the hospital with necessary payment and/or insurance information

Involvement

Your Rights
· To be involved in decisions concerning your care
· To have your family members and/or others from participating in decisions
about your care
· To discuss any treatment planned for you
· To give your informed consent or informed refusal for treatment
· To leave the hospital or request a transfer (in accordance with hospital policy
and/or the law)

Your Responsibilities
· To abide by hospital rules and regulations
· To keep your appointments
· To pay your bills on time
· To inform the hospital management if you believe your rights have been
violated

NANDA LIST
Below is a complete listing of all NANDA nursing diagnoses
through the 12th conference (1996).
Activity/Rest
Circulation
Ego Integrity
Elimination
Food/Fluid
Hygiene
Neurosensory
Pain/Discomfort
Respiration
Safety
Sexuality
Social Interaction
Teaching/Learning
Elimination
Activity/Rest
Activity intolerance (specify level) Bowel incontinence
Activity intolerance, for Constipation
Disuse syndrome, risk for Constipation, colonic
Diversional activity deficit Constipation, perceived
Fatigue Diarrhea
Sleep pattern disturbance Incontinence, functional
Circulation Incontinence, reflex
Adative capacity: intracranial, decreased Incontinence, stress
Cardiac output, decreased Incontinence, total
Dysreflexia Incontinence, urge
Tissue perfusion, altered (specify): cerebral, Urinary elimination, altered
cardiopulmonary, renal, pastrointestinal,
Urinary retention, (acute/chronic)
peripheral
Food/Fluid
Ego Integrity
Adjustment, impaired Breastfeeding, effective
Anxiety (mild, moderate, severe, panic) Breastfeeding, ineffective
Body image disturbance Breastfeeding, interrupted
Coping, defensive Fluid volume deficit (active loss)
Coping, individual, ineffective Fluid volume deficit (regulatory failure)
Decisional conflict Fluid volume deficit, risk for
Denial, ineffective Fluid volume excess
Energy field disturbance Infant feeding pattern, ineffective
Fear
Nutrition: altered, less than body
Grieving, anticipatory
Grieving, dysfunctional requirements
Hopelessness Nutrition: altered, more than body
Personal identity disurbance requirements
Post-trauma response (specify stage) Nutrition: altered, risk for more than body
Powerlessness requirements
Rape-trauma syndrome (specify) Oral mucous membrane, altered
Rape-trauma syndrome: compound reaction Swallowing, impaired
Rape-trauma syndrome: silent reaction Hygiene
Relocaction stress syndrome
Self-care deficit (specify level): feeding,
Self-esteem, chronic low
bathing/hygiene, dressing/ grooming,
Self-esteem disturbance
Self-esteem, situational low toileting
Spiritual distress (distress of the human spirit) Neurosensory
Spiritual well being, enhanced, potential for Confusion, aacute
Confusion, chronic
Infant behavior, disorganized
Infant behavior, disorganized, risk for
Infant behavior, organized, potential for
enhanced
Memory, impaired
Peripheral neurovascular dysfunction, risk
for
Sensory perception alterations (specify):
visual, auditory, kinesthetic, gustatory,
tactile, olfactory
Thought processes, altered
Unilateral neglect

Pain/Discomfort Sexuality(component of ego integrity and


Pain social interaction)
Pain, acute Sexual dysfunction
Pain, chronic Sexuality patterns, altered
Respiration Social Interaction
Airway clearance, ineffective Caregiver role strain
Aspiration, risk for Caregiver role strain, risk for
Breathing pattern, ineffective Communication, impaired verbal
Gas exchange, impaired
Community coping, enhanced, potential for
Community coping, ineffective
Spontaneous ventilation, inability to
Family coping, ineffective
sustain Family coping, potential for growth
Ventilatory weaning response, Family processes, altered: alcoholism
dysfunctional (DVWR) (substance abuse)
Safety Family processes, altered
Body tempurature, altered, risk for Loneliness, risk for
Environmental interpretation syndrome, Parental role conflict
impaired Parent/infant/child attachment, altered, risk for
Health maintenance, altered Parenting, altered
Parenting, altered, risk for
Home maintenance management,
Role performance, altered
impaired Socical interaction, impaired
Hyperthermia Social isolation
Hypothermia Teaching/Learning
Infection, risk for Growth and development, altered
Injury, risk for Health-seeking behaviors (specify)
Perioperative positioning injury, risk for Knowledge deficit (learning need) (specify)
Physical mobility, impaired Noncompliance (compliance, altered) (specify)
Poisoning, risk for Therapeutic regimen: community, ineffective
Protection, altered
management
Therapeutic regimen: families, ineffective
Self-mutilation, risk for
management
Skin integrity, impaired Therapeutic regimen: individual, effective
Skin integrity, impaired, risk for management
Suffocation, risk for Therapeutic regimen: individual, ineffective
Thermoregulation, ineffective management
Tissue integrity, impaired
Trauma, risk for
Violence, (actual)/risk for:
directed at self/others

Hypothermia

If our body temperature falls much below 35°C, the control centre in the brain stops working. The
result is that we can no longer control our body temperature: the metabolic rate falls and the body
temperature gets lower and lower. Eventually we go into a coma. This is called hypothermia, and if
no action is taken the person will die.

• Symptoms:
1. Low body core temperature.
2. Persistent shivering.
3. Blue lips and/or fingernails.
4. Speech slowed and slurred.
5. Memory lapses.
6. Unconsciousness.
• Treatment:
1. Move victim to warm environment.
2. Remove wet clothing.
3. Rewarm victim with blankets or body-to-body contact in a sleeping bag.
4. If victim is conscious, give warm (not hot) fluids.
5. Keep victim warm and quiet.
6. Do not give victim any alcohol, which is a blood-thinning agent, or caffeine, which is a
diuretic.
7. Contact medical professionals as soon as possible, if required.
• Hyperthermia is also an alternative remedy that has been used for hundreds of years in
treating infectious and non-infectious diseases. This treatment has been shown effective in
treating syphilis and, in addition to chemotherapy and radiation, some forms of cancer.
• The treatment itself involves gradually raising the temperature of the blood to over 104
degrees (F) for a short period of time. This can be done one of two ways:
1. Immersion of the patient in a hot bath for a period of about an hour or so.
2. Removing the blood from the body through a catheter, heating it, and re-inserting it back
into the patient. This method is called extracorporeal hyperthermia.
This second method is employed in the medical field as a valid treatment for some cancers
and syphilis. The complications of this procedure are high, and therefore, it still remains a last
resort, and rare method.
• The rationale behind the procedure is this; By raising the body temperature and artificially
creating a fever, pathogens and cancer cells that are sensitive to higher temperatures will be
killed off. Also, the body's immune system, due to the fever, is stimulated, and the amount of
interferon and white blood cells increase, further killing pathogens.

urse Practice Acts (NPAs) are laws in each
state that are instrumental in defining the
scope of nursing practice. NPAs protect
public health, safety, and welfare. This
N
protection includes shielding the public from unqualified and unsafe nurses. In each state, statutory law
directs entry into nursing practice, defines the scope of practice, and establishes disciplinary procedures.
State boards of nursing oversee this statutory law. They have the responsibility and authority to protect
the public by determining who is competent to practice nursing. NPAs are the most important pieces of
legislation related to nursing practice.

Common Law is derived from principles or social mores rather than from rules and regulations. It
consists of broad, interpretive principles based on reason, traditional justice and common sense.

Together, the NPAs and Common Law define nursing practice. It is a nurse's responsibility to be
informed on both the NPA and Common Law for the state(s) in which they are licensed and practice.

Listed below are links to the state boards of nursing for the United States. Each website has information
on that particular state's NPA. Also listed is a link to the National Council of State Boards of Nursing,
which maintains an online database of NPAs.

National Council of State Boards of Nursing:


The NCBSN maintains a database which contains available NPAs from 49 states, the District of
Columbia, and four U.S. territories (Guam, the Northern Mariana Islands, Puerto Rico and the Virgin
Islands). Maryland's NPA is not available, per state restrictions.
National Council of State Boards of Nursing

Republic Act No. 9173 October 21, 2002

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.

ARTICLE VI

Nursing Practice

Section 28. Scope of Nursing. - 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. It includes, but not limited to, nursing care during conception, labor, delivery,
infancy, childhood, toddler, preschool, school age, adolescence, adulthood, and old age. As independent practitioners,
nurses are primarily responsible for the promotion of health and prevention of illness. A members 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. It shall be the
duty of the nurse to:

(a) Provide nursing care through the utilization of the nursing process. Nursing care includes, but not limited to,
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;

(b) establish linkages with community resources and coordination with the health team;

(c) Provide health education to individuals, families and communities;

(d) 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