CPD (CONTINUING PROFESSIONAL Development (CPD) units in the 3

DEVELOPMENT) year renewal period. That’s only 5

• The CPD law, sponsored by Senator units per year.
Antonio Trillanes III and passed in July • Professional Regulation Commission
2016, provides that all registered and (PRC) has amended the Implementing
licensed professionals shall complete Rules and Regulations (IRR) of the
the required credit units (CUs) every Continuing Professional Development
three years of compliance period. (CPD) Law and it will take effect
• The law has mandated PRC to require starting March 1, 2019.
earning CPD units for nurses and other CPD Amendments and Exemptions
professionals for renewal of license • On February 27, PRC and CPD Councils
cards. came up with IRR Amendments
• The law mandates that professionals through Resolution No. 2019-1146
must earn required CPD units by which take effect March 1. Here are
attending seminars, trainings, and the salient points in the amendments:
other programs as pre-requisite to • PRC provides a “transition period” for
renewal of their license card or the the professional to comply with the
professional identification cards (PIC). unit requirements. During this
• Professional Regulations Commission transition period, the following shall be
(PRC) started to require CPD units for observed:
renewal after Republic Act 10912 or • a) Professionals working overseas shall
the CPD of 2016 was enacted. not be covered by the CPD
• PRC then issued Resolution No. 1032 requirement.
or Implementing Rules and Regulations b) Newly licensed professionals shall
(IRR) for CPD Law. not be covered by CPD requirement for
• Professional Regulatory Board of the first renewal cycle after obtaining
Nursing issued Resolution No. 21 series their license.
of 2017 which provides the c) The various CPD Councils shall
Operational Guidelines for the nurses. reduce the required CPD credit units to
• During the Senate committee hearing, a minimum, which shall not be more
Senators Antonio Trillanes IV (principal than 15, as provided for under
author of CPD Law), Ralph Recto, and applicable laws.
Miguel Zubiri urged PRC Commissioners • Professionals who lacked CPD units but
and CPD Council members to look into were able to renew through
the implementation of the law after an Affidavit of Undertaking shall only
numerous complaints received by their comply with the required number of
offices regarding the measure. units as amended pursuant to this
• Initially, the nurses were required 45 Resolution equivalent to not more
CPD units for the 3-year renewal cycle than 15 credit units.
or 15 units per year. • Nurses lacking or without CPD units
• Effective March 1, 2019, nurses need may renew license cards until
only 15 Continuing Professional December 31, 2021.
Why require CPD? Beneficence- for the goodness and welfare of
• Nurses have to expand their knowledge the clients
and technical competencies as Justice – equality/fairness in terms of
stipulated in PRC Operational resources/personnel
Guidelines. Veracity – the act of truthfulness
• These would help them in light of the Fidelity – faithfulness/loyalty to clients
complexities of the healthcare needs Terms
and demands for better delivery of safe Law – rule of conduct commanding what is right
nursing care services. and what is wrong. Derived from an AngloSaxon
• Nurses need to attend programs term that means “that which is laid down or
accredited by the CPD Council to earn fixed”
units. These may include Formal Court -body/agency in government wherein the
learning, Nonformal learning, Informal administration of justice is delegated.
learning, Self-directed learning, Online Plaintiff – complainant or person who files the
learning activities, Professional work case (accuser)
experience. Defendant – accused/respondent or person
• CPD programs are offered by accredited who is the subject of complaint
nursing organizations such as the Witness – individual held upon to testify in
Philippine Nurses Association (PNA), reference to a case either for the accused or
Association of Nursing Service against the accused.
Administrators of the Philippines Written orders of court
(ANSAP), CCNAPI, and AngNars. Writ – legal notes from the court
A. Subpoena
ETHICO-MORAL ASPECTS IN NURSING  Subpoena Testificandum – a
writ/notice to an
CODE OF ETHICS individual/ordering him to
Definition appear in court at a specific
Ethos - comes from Greek work w/c means time and date as witness.
character/culture Branch of Philosophy w/c  Subpoena Duces Tecum- notice
determines right and wrong given to a witness to appear in
Moral - personal/private interpretation from court to testify including all
what is good and bad. important document.
Private/Civil Law :
Ethical Principles Contract law – involves the enforcement of
Autonomy – the right/freedom to decide (the agreements among private individuals or the
patient has the right to refuse despite the payment of compensation for failure to fulfill
explanation of the nurse) Example: surgery, or the agreements
any procedure Ex. Nurse and client nurse and insurance Nurse
Nonmaleficence – the duty not to harm/cause and employer client and health agency
harm or inflict harm to others (harm maybe Types of Contract:
physical, financial or social) 1. Expressed –when 2 parties discuss and agree
orally or in writing the terms and conditions
during the creation of the contract. Example: a. Negligence – misconduct or practice that is
nurse will work at a hospital for only a stated below the standard expected of ordinary,
length of time (6 months),under stated reasonable and prudent person failure to do
conditions (as volunteer, straight AM shift, with something due to lack of foresight or prudence
food/transportation allowance) - Failure of an individual to provide care that a
2. Implied – one that has not been explicitly reasonable person would ordinarily use in a
agreed to by the parties, but that the law similar circumstance.
considers to exist. Example: Nurse newly -An act of omission or commission wherein a
employed in a hospital is expected to be nurse fails to act in accordance with the
competent and to follow hospital policies and standard of care.
procedures even though these expectations Doctrines of Negligence:
were not written or discussed. Likewise: the 1. Res ipsa loquitor – the thing speaks for itself
hospital is expected to provide the necessary – the injury is enough proof of negligence
supplies, equipment needed to provide 2. Respondeat Superior – let the master answer
competent, quality nursing care. command responsibility
3. Force majuere – unforeseen event,
Feature/Characteristics/Elements of a lawful irresistible force “Act of God” Classification of
contract: b. Malpractice – when a nurse fails to
1. Promise or agreement between 2 or more competently perform his or her medical duties
persons for the performance of an action or and that failure harms the patient
restraint from certain actions Elements of nursing malpractice:
2. Mutual understanding of the terms and (1) a professional duty owed to the patient;
meaning of the contract by all. (2) breach of such duty;
3. A lawful purpose – activity must be legal (3) injury caused by the breach; and
4. Compensation in the form of something of (4) resulting damages.
value-monetary II. Intentional Tort Intentional tort – the act was
Persons who may not enter into a contract: • done on PURPOSE or with INTENT
Minor, insane, deaf, mute and ignorant - No harm/injury/damage is needed to be liable
Tort Law - No expert witnesses are needed
A tort is an act or omission that gives rise to Common Intentional Tort
injury or harm to another and amounts to a civil Assault – an attempt or threat to touch another
wrong for which courts impose liability. Civil person unjustifiably Ex.: A person who
wrong committed against a person or a person’s threatens someone with a club or closed fist.
property. Nurse threatens a client with an injection after
Person/person’s responsible for the tort are refusing to take the meds orally.
sued for DAMAGES Is based on : Battery – willful touching of a person, person’s
ACT OF COMMISSION –something that was clothes or something the person is carrying that
done incorrectly may or may not cause harm but the touching
ACT OF OMMISION – something that should was done without permission, without consent,
have been done but was not. is embarrassing or causes injury. Example: A
Classification of Tort nurse threatens the patient with injection if the
I. Unintetional patient refuses his meds orally. If the nurse
gave the injection without client’s consent, the false word by which a reputation is damaged
nurse would be committing battery even if the Example: Nurse A telling a client that nurse B is
client benefits from the nurse’s action. incompetent person defamed may bring the
False Imprisonment – unjustifiable detention of lawsuit the material (nurse’s notes) must be
a person without legal warrant to confine the communicated to a 3rd party in order that the
person occurs when clients are made to person’s reputation maybe harmed
wrongful believe that they cannot leave the Public Law:
place Example: Telling a client no to leave the 1. Criminal Law – deals with actions or offenses
hospital until bill is paid Use of physical or against the safety and welfare of the public.
chemical restraints False Imprisonment Forceful a. homicide – self-defense
Restraint=Battery b. arson- burning or property
Invasion Of Privacy – intrusion into the client’s c. theft – stealing
private domain: right to be left alone d. sexual harassment
Types of Invasion the client must be protected e. active euthanasia
from: f. illegal possession of controlled drugs
 Use of client’s name for profit without • Homicide – killing of any person without
consent criminal intent may be done as self-defense •
 Using one’s name, photograph for PATIENTS BILL OF RIGHTS
advertisements of HC agency or provider 1. Right to Appropriate Medical Care and
without client’s permission Humane Treatment
 Unreasonable intrusion – observation or 2. Right to Informed Consent
taking of photograph of the client for whatever 3. Right to Privacy and Confidentiality
purpose without client’s consent. 4. Right to Information
 Public disclosure of private facts – private 5. The Right to Choose Health Care Provider
information is given to others who have no and Facility
legitimate need for that. 6. Right to Self-Determination
 Putting a person in a false/bad light – 7. Right to Religious Belief
publishing information that is normally 8. Right to Medical Records
considered offensive but which is not true. 9. Right to Leave
10.Right to Refuse Participation In Medical
Defamation Research
Communication that is false or made with a 11. Right to Correspondence and to Receive
careless disregard for the truth and results in Visitors
injury to the reputation of a person 12. Right to Express Grievances
Types: 13. Right to be Informed of His Rights and
Libel – defamation by means of print, writing or Obligations as a Patient
picture Example: writing in the chart/nurse’s INFORMED CONSENT
notes that doctor is incompetent because he • Doctors will give information about a
didn’t respond immediately to a call particular treatment or test in order for the
Slander – defamation by the spoken word patient to decide whether or not they wish to
stating unprivileged (not legally protected) or undergo a treatment or test. This process of
understanding the risks and benefits of they are not, you should request that
treatment is known as informed consent. information:
• Informed consent is based on the moral and • An explanation of the medical condition that
legal premise of patient autonomy: warrants the test, procedure, or treatment
• The patient will have the right to make • An explanation of the purpose and benefits of
decisions about your his health and medical the proposed test, procedure, or treatment
conditions. • An explanation or description of the
• The patient must give voluntary, informed proposed test, procedure, or treatment,
consent for treatment and for most medical including possible complications or adverse
tests and procedures. The legal term for failing events
to obtain informed consent before performing a • A description of alternative treatments,
test or procedure on a patient is called battery procedures, or tests, if any, and their relative
(a form of assault). benefits and risks
• For many types of interactions (for example, a • A discussion of the consequences of not
physical exam with the doctor), implied consent accepting the test, procedure, or treatment
is assumed. DATA PRIVACY ACT
• For more invasive tests or for those tests or • Republic Act No. 10173, otherwise known as
treatments with significant risks or alternatives, the Data Privacy Act is a law that seeks to
they will be asked to give explicit (written) protect all forms of information, be it private,
consent. personal, or sensitive. It is meant to cover both
• Under certain circumstances, there are natural and juridical persons involved in the
exceptions to the informed consent rule. The processing of personal information.
most common exceptions are these: – An PHILIPPINE NURSING ACT
emergency in which medical care is needed Republic Act No. 9173 October 21, 2002 AN ACT
immediately to prevent serious or irreversible PROVIDING FOR A MORE RESPONSIVE NURSING
harm – Incompetence in which someone is PROFESSION, REPEALING FOR THE PURPOSE
unable to give permission (or to refuse REPUBLIC ACT NO. 7164, OTHERWISE KNOWN
permission) for testing or treatment AS "THE PHILIPPINE NURSING ACT OF 1991"
4 principles of informed consent: AND FOR OTHER PURPOSES
• Must have the capacity (or ability) to make Section 1
the decision. • This Act shall be known as the "Philippine
• The medical provider must disclose Nursing Act of 2002."
information on the treatment, test, or Article II
procedure in question, including the expected Declaration of Policy. – It is hereby declared the
benefits and risks, and the likelihood (or policy of the State to assume responsibility for
probability) that the benefits and risks will the protection and improvement of the nursing
occur. profession by instituting measures that will
• Must comprehend the relevant information. result in relevant nursing education, humane
• Must voluntarily grant consent, without working conditions, better career prospects and
coercion or duress. a dignified existence for our nurses.
The following components should be discussed The State hereby guarantees the delivery of
and included in the written consent form. If quality basic health services through an
adequate nursing personnel system throughout Added the powers and duties of the Board
the country. Adopt and regulate a Code of Ethics and Code
Summary of Philippine Nursing Act of 2002 of Technical Standards for the practice of
Article III: The Board is now composed of a nursing within one year from the effectivity of
Chairman and six members instead of a this act.
Chairman and four members Submission of Recognize specialty organization in coordination
names of qualified nominees by the Accredited with accredited professional organization.
Professional Organization (APO) to the Requirements Upon Qualification as Member
Commission, three (3) nominees per vacancy, of the Board of Nursing.
not later than three months before the vacancy • Any person appointed as Chairperson or
The Commission submits to the office of the Member of the Board shall immediately resign
President two (2) nominees per vacancy not from any teaching position in any school,
later than two months before the vacancy college, university or institution offering
occurs. The appointment must be issued not Bachelor of Science in Nursing and/or review
later than thirty (30) days before scheduled program for the local nursing board
licensure examination examinations or in any office or employment in
Qualifications of Board Members the government or any subdivision, agency or
(a) Be a natural born citizen and resident of the instrumentality thereof, including government-
Philippines; owned or controlled corporations or their
(b) Be a member of good standing of the subsidiaries as well as those employed in the
accredited professional organization of nurses; private sector.
(c) Be a registered nurse and holder of a Term of Office
master’s degree in nursing, education or other • The Chairperson and Members of the Board
allied medical profession conferred by a college shall hold office for a term of three (3) years
or university duly recognized by the and until their successors shall have been
Government: Provided, That the majority of the appointed and qualified:
Members of the Board shall be holders of a Powers and Duties of the Board
master’s degree in nursing: Provided, further,
That the Chairperson shall be a holder of a • The Board shall supervise and regulate the
master’s degree in nursing; practice of the nursing profession and shall
(d) Have at least ten (10) years of continuous have the following powers, duties and
practice of the profession prior to appointment: functions:
Provided, however, That the last five (5) years (a) Conduct the licensure examination for
of which shall be in the Philippines; and nurses;
(e) Not have been convicted of any offense (b) Issue, suspend or revoke certificates of
involving moral turpitude; Provided, That the registration for the practice of nursing;
membership to the Board shall represent the (c) Monitor and enforce quality standards of
three (3) areas of nursing, namely: nursing nursing practice in the Philippines and exercise
education, nursing service and community the powers necessary to ensure the
health nursing. maintenance of efficient, ethical and technical,
moral and professional standards in the practice
of nursing taking into account the health needs • The President may remove or suspend any
of the nation; • member of the Board after having been given
(d) Ensure quality nursing education by the opportunity to defend himself/herself in a
examining the prescribed facilities of proper administrative investigation, on the
universities or colleges of nursing or following grounds:
departments of nursing education and those (a) Continued neglect of duty or incompetence;
seeking permission to open nursing courses to (b) Commission or toleration of irregularities in
ensure that standards of nursing education are the licensure examination; and
properly complied with and maintained at all (c) Unprofessional, immoral or dishonorable
times. The authority to open and close colleges conduct.
of nursing and/or nursing education programs ARTICLE IV (EXAMINATION AND
shall be vested on the Commission on Higher REGISTRATION)
Education upon the written recommendation of All applicants for license to practice nursing
the Board; • shall be required to pass a written examination,
(e) Conduct hearings and investigations to which shall be given by the Board in such places
resolve complaints against nurse practitioners and dates as may be designated by the
for unethical and unprofessional conduct and Commission: Provided, That it shall be in
violations of this Act, or its rules and regulations accordance with Republic Act No. 8981,
and in connection therewith, issue subpoena ad otherwise known as the “PRC Modernization
testificandum and subpoena duces tecum to Act of 2000.”
secure the appearance of respondents, and Qualifications for Admission to the Licensure
witnesses and the production of documents and Examination
punish with contempt persons obstructing, In order to be admitted to the examination for
impeding and/or otherwise interfering with the nurses, an applicant must, at the time of filing
conduct of such proceedings, upon application his/her application, establish to the satisfaction
with the court; of the Board that:
(f ) Promulgate a Code of Ethics in coordination (a) He/she is a citizen of the Philippines, or a
and consultation with the accredited citizen or subject of a country which permits
professional organization of nurses within one Filipino nurses to practice within its territorial
(1) year from the effectivity of this Act; • limits on the same basis as the subject or citizen
(g) Recognize nursing specialty organizations in of such country: Provided, That the
coordination with the accredited professional requirements for the registration or licensing of
organization; and • nurses in said country are substantially the
(h) Prescribe, adopt, issue and promulgate same as those prescribed in this Act;
guidelines, regulations, measures and decisions (b) He/she is of good moral character; and
as may be necessary for the improvement of (c) He/she is a holder of a Bachelor’s Degree in
the nursing practice, advancement of the Nursing from a college or university that
profession and for the proper and full complies with the standards of nursing
enforcement of this Act subject to the review education duly recognized by the proper
and approval by the Commission. government agency
Removal or Suspension of Board Members. Scope of Examination.
 • The scope of the examination for the practice • (d) For malpractice or negligence in the
of nursing in the Philippines shall be determined practice of nursing;
by the Board. • (e) For the use of fraud, deceit, or false
• The Board shall take into consideration the statements in obtaining a certificate of
objectives of the nursing curriculum, the broad registration/professional license or a
areas of nursing, and other related disciplines temporary/special permit;
and competencies in determining the subjects • (f ) For violation of this Act, the rules and
of examinations. regulations, Code of Ethics for nurses and
Ratings technical standards for nursing practice, policies
In order to pass the examination, an examinee of the Board and the Commission, or the
must obtain a general average of at least conditions and limitations for the issuance of
seventy-five percent (75%) with a rating of not the temporary/special permit; or
below sixty percent (60%) in any subject. An • (g) For practicing his/her profession during
examinee who obtains an average rating of his/her suspension from such practice;
seventy-five percent (75%) or higher but gets a Provided, however, That the suspension of the
rating below sixty percent (60%) in any subject certificate of registration/professional license
must take the examination again but only in the shall be for a period not to exceed four (4)
subject or subjects where he/she is rated below years.
sixty percent (60%). In order to pass the Article 5:Nursing Education
succeeding examination, an examinee must • The nursing education program shall provide
obtain a rating of at least seventy-five percent sound general and professional foundation for
(75%) in the subject or subjects repeated the practice of nursing. The learning
Oath experiences shall adhere strictly to specific
• All successful candidates in the examination requirements embodied in the prescribed
shall be required to take an oath of profession curriculum as promulgated by the Commission
before the Board or any government official on Higher Education’s policies and standards of
authorized to administer oaths prior to entering nursing education.
upon the nursing practice Added: Requirement for inactive nurses
Revocation and Suspension of Certificate of returning to practice Nurse who have not
Registration/Professional License and actively practiced the profession shall undergo
Cancellation of Special/Temporary Permit. one (1) month of didactic training and three (3)
• The Board shall have the power to revoke or months of practicum
suspend the certificate of Qualifications of Faculty – Registered Nurse,
registration/professional license or cancel the with Masters Degree, Requirement of clinical
special/temporary permit of a nurse upon any experience in a field of specialization has been
of the following grounds: reduced from three (3) years to one (1) year in a
• (a) For any of the causes mentioned in the field of specialization
preceding section; The Dean of the College of Nursing must have at
• (b) For unprofessional and unethical conduct; least five (5) years of experience in teaching and
• (c) For gross incompetence or serious supervising a nursing education program.
ignorance; Article VI: Nursing Practice
 • Scope of Nursing. — A person shall be consultation services; engage in such activities
deemed to be practicing nursing within the that require the utilization of knowledge and
meaning of this Act when he/she singly or in decision-making skills of a registered nurse; and
collaboration with another, initiates and • (e) Undertake nursing and health human
performs nursing services to individuals, resource development training and research,
families and communities in any health care which shall include, but not limited to, the
setting. It includes, but not limited to, nursing development of advanced nursing practice;
care during conception, labor, delivery, infancy, Provided, That this section shall not apply to
childhood, toddler, pre-school, school age, nursing students who perform nursing functions
adolescence, adulthood and old age. As under the direct supervision of a qualified
independent practitioners, nurses are primarily faculty: Provided, further, That in the practice of
responsible for the promotion of health and nursing in all settings, the nurse is duty-bound
prevention of illness. As members of the health to observe the Code of Ethics for nurses and
team, nurses shall collaborate with other health uphold the standards of safe nursing practice.
care providers for the curative, preventive, and The nurse is required to maintain competence
rehabilitative aspects of care, restoration of by continual learning through continuing
health, alleviation of suffering, and when professional education to be provided by the
recovery is not possible, towards a peaceful accredited professional organization or any
death. It shall be the duty of the nurse to: recognized professional nursing organization:
• (a) Provide nursing care through the Provided, finally, That the program and activity
utilization of the nursing process. Nursing care for the continuing professional education shall
includes, but not limited to, traditional and be submitted to and approved by the Board.
innovative approaches, therapeutic use of self, Nursing Practice
executing health care techniques and Scope of Nursing – Duties and responsibilities of
procedures, essential primary health care, the Nurse
comfort measures, health teachings, and Deleted: Special training for intravenous
administration of written prescription for injections but Nursing Service Administrators
treatment, therapies, oral, topical and still require formal training for the safety of the
parenteral medications, internal examination patient and the protection of the nurse and of
during labor in the absence of antenatal the institution.
bleeding and delivery. In case of suturing of Added: Special training for suturing the
perineal laceration, special training shall be Lacerated perineum
provided according to protocol established; Note: This is being undertaken by the
• (b) Establish linkages with community Association of Nursing Service
resources and coordination with the health Administrators of the Philippines (ANSAP) with
team; the Maternal and Child Association of the
• (c) Provide health education to individuals, Philippines (MCNAP)
families and communities; Added: Observe the Code of Ethics and the
• (d) Teach, guide and supervise students in Code of Technical Standards to maintain
nursing education programs including the competence through continual professional
administration of nursing services in varied education
settings such as hospitals and clinics; undertake
Health human resource production and
Utilization additions
Comprehensive Nursing Specialty Program. The
Board is mandated to formulate and develop a
comprehensive nursing specialty program that
would upgrade the level of skills and
competency of specialty nurse clinicians in the
country