CENTRAL PHILIPPINE UNIVERSITY

School of Graduate Studies

Lopez Jaena Street, Jaro, Iloilo City

Master of Arts in Nursing

MAN 606 (LAB) Nursing Education Administration

SUBMITTED BY:
Woody Vic Engle, R.N.
Maria Reylan Garcia, R.N.
Janelene Galindo, R.N.

A. Critique of 9173
By: Woody Vic Engle, R.N.
The following are the major changes from RA 7164 of 1991 and RA 9173 of 2002:
RA 7164 (November 21, 1991) The Philippine Nursing Act of 1991- introduced by Senator
Heherson Alvarez, codified and revised all the laws regulating the practice of nursing in the
Philippines.
1. Redefinition of the scope of the nursing practice to emphasize:
a.The use of nursing process as a scientific discipline in arriving at an appropriate nursing
action and care
b.The teaching, management, leadership and decision making roles of the nurse
c.The undertaking of and participation in studies and research by nurses
2. Requiring a faculty member who was appointed to the board of nursing to resign from his/her
teaching position at the time of appointment and not one year preceding his/her appointment as
provided in Republic Act 877
3. Updating a facultys educational qualifications by requiring a Masters Degree in Nursing or
related fields or its equivalent in terms of experience and specification as pre-requisite to
teaching
4. Specification of qualifications of administrators of nursing services
5. Inclusion of the phrase unethical conduct as one of the reasons for revocation and
suspension of certificate of registration.
RA 9173 (October 21, 2002) The Philippine Nursing Act of 2002

1. Authors: Cong. Carlos Padilla

Sen. Juan Flavier
2. House Bill 1084 and Senate Bill 2292
3. Composition of the board of nursing the board is now composed of a chairman and six
members instead of a chairman and four members.
4.Submission of names of qualified nominees by the Accredited Professional Organization
(APO) to the Commission, three nominees per vacancy, not later than three months before the
vacancy.
5. The Commission submits to the office of the President two nominees per vacancy not later
than two months before the vacancy occurs. The appointment must be issued not later than 30
days before the scheduled licensure examination.
6. Qualifications of board members
a. Educational requirement for members of the board is not limited to registered nurses
with Masters degree in Nursing but also to registered nurses with masters degree in
education, or other allied medical profession provided that the chairperson and majority
of the members are holders of Masters degree in nursing.
b. Of the ten years of continuous practice of the profession prior to appointment, the last
five years must be in Philippines.
7. Powers and duties of the board
a. Adopt and regulate a code of ethics and code of technical standards for the practice of
nursing within one year from the effectively of this act.
b. Recognize specialty organizations in coordination with accredited professional
organization
8. Licensure examination and registration
a. Specific dates of examination not earlier than one month and not later than two months
after the closing of each semestral term
b. Age requirement has been deleted
9. Ratings
a. Unlimited number of taking the exam without refresher
b. Removal examinations shall be taken within two years after the last failed examination

B. Amendments from different CHED Memorandum Orders

By: Woody Vic Engle, R.N.
CMO 18 series of 2011

Subject: Amendments to Article XI- SANCTIONS OF CMO NO. 14, S. 2009 Policies
and Standards for Bachelor of Science in Nursing (BSN) Program

CMO 14

Gradual phase out of the nursing program with an average of below 30% for three- year
period ( SY 2010- 2011, 2011 2012, 2012 2013)

CMO 18

Gradual phase out of the nursing program with an average of below 30% for three
consecutive years ( starting 2008,2009, 2010 and thereafter), and will be monitored
starting 2011.

C. Strengths and Weaknesses of CHED Memorandum Order 14

By: Maria Reylan Garcia, R.N.
STRENGTHS:
1. Provides the 11 Key Areas of responsibility as basis for the development of a nursing
graduate.
2. Professional courses already begin as early as in the first year level and threads through
the development of the competencies up the fourth year.
3. Delineates specific careers/professions and occupations for graduates of this
curriculum.
4. The student nurse from the first year up to the fourth year level is exposed to various
levels of health care with various client groups.
5. There are available Electives during the third and the fourth year levelElectives 1
and 2.
6. Recommendation of a Virtual Nursing skills laboratory.
7. There is an existing provision on Research Requirements that all students shall
complete a research project during the course of study.

8. Implementation of gradual phase-out of Nursing schools an average of below 30% for

a three-year period (SY 2010-2011, 2011-2012, 2012-2013) in the Philippine Nurse
Licensure Examination starting from 2013.

WEAKNESSES:
1. Deletion of the general entrance requirement of an applicant belonging to the upper
forty 40% of the graduating class in the general secondary course or high school.
2. Lesser number of cases (12: 3 actual deliveries; 3 cord care; 3 major operations scrub
nurse; 3 major cases circulating nurse) needed for scrub requirements for the
intrapartal, post-partal and intra-operative management.
3. The decrease in the number of years required of clinical practice in the field of
specialization for clinical instructors from 3 years to 1 year.

D. Reasons for change of the provisions in CHED Memo 14

By: Maria Reylan Garcia, R.N.
1. The development of the 11 Key Areas of responsibility as basis for the development of a
nursing graduate.
A nursing graduate that is professionally competent, research-based and enthusiastic
about professional growth. This program aims to prepare a nurse who, upon completion
of the program, demonstrates beginning professional competencies and shall continue to
assume responsibility for professional development and utilizes research findings in the
practice of the profession.
2. Professional courses already begin as early as in the first year level and threads through the
development of the competencies up the fourth year.
First year students already have their TFN and NCM 100 or the Theoretical Foundations
of Nursing and Fundamentals of Nursing practice respectively. The BSN program
provides an intensive nursing practicum that will refine clinical skills from the first year
level to ensure basic clinical competencies required of a beginning nurse practitioner.
3. Delineates specific careers/professions and occupations for graduates of this curriculum.
The curriculum wanted to prepare a nurse practitioner who is competent in the fields of
Clinical Nursing, Community Health Nursing, Private-duty Nursing, Occupational Health
Nursing, School Nursing, Military Nursing, Health Education, Research and
Entrepreneurship.

4. The student nurse from the first year up to the fourth year level is exposed to various levels of
health care with various client groups.
First year students are first immersed in self-awareness, so they may identify their roles
to their family, community and the society. Second year students focus on the care and
management of the mother and child. Third year students are trained in the care and
management of patients with physiologic and psychologic alterations. Fourth year
students focus on the disaster and emergency care as well as leadership, management and
research utilization. These opportunities shall be given in graduated experiences to ensure
that the competencies per course, per level and for the whole program are developed.
5. There are available Electives during the third and the fourth year levelElectives 1 and 2.
Elective 1 is taken in the 3rd Year 2nd Semester. Choices for Elective I are Parent-Child
Nursing, Spiritual Care Nursing, and Hospice Palliative Care.Elective 2 is taken in the
4th Year, 1st Semester. Choices for Elective II are Acute/Critical Care Nursing, Quality
Health Care and Nursing, and Care of the Chronically ill and the Older Person.
6. Recommendation of a Virtual Nursing skills laboratory.
Higher education institutions are encouraged to put up Virtual Skills Laboratory. This is
to supplement and complement the related learning experiences prior to actual
experience.
7. There is an existing provision on Research Requirements that all students shall complete a
research project during the course of study.
This will be regarded as a requirement for graduation. This is to encourage and support
research among its students and faculty and promote utilization of research findings to
guide and improve nursing practice, educational management and other aspects of the
nursing program.
8. Implementation of gradual phase-out of Nursing schools an average of below 30% for a threeyear period (SY 2010-2011, 2011-2012, 2012-2013) in the Philippine Nurse Licensure
Examination starting from 2013.
This is to fulfill the regulation function of the Commission of Higher Education among
the BSN programs. This is to maintain the quality and standard of nursing schools in the
country.
9. Deletion of the general entrance requirement of an applicant belonging to the upper forty 40%
of the graduating class in the general secondary course or high school.

This is a response to a constitutional provision that states: the state shall protect and
promote the right of all citizens to provide quality education at all levels and shall take
appropriate steps to make such education possible.
10. Lesser number of cases (12: 3 actual deliveries; 3 cord care; 3 major operations scrub
nurse; 3 major cases circulating nurse) needed for scrub requirements for the intrapartal, postpartal and intra-operative management.
This is as a response to be able to supply adequate number of cases for the completion of
scrub requirements for a considerably large population of nursing students.
11. The decrease in the number of years required of clinical practice in the field of specialization
for clinical instructors from 3 years to 1 year.
The decrease in the number of years of required clinical practice in the field of
specialization among clinical instructors as well as their Masters degree major expansion
was implemented to meet the increasing demands of clinical instructors to facilitate also
the mushroom growth of nursing schools following the rapid influx of nursing enrollees.
E. .Ethico-moral and legal cases and court decisions of actions
By: Janelene Galindo, R.N.
The types of ethics that are of particular concern to the nurse are:
1. BIOETHICS-branch of ethics that studies moral values in the biomedical sciences
2. CLINICAL ETHICS concerned with ethical problems at the bedside that arise
within the context of caring for actual patients
Ex.: Informed consent & how one ought to respond to requests for assisted
suicide
3. NURSING ETHICS study of ethical issues that arise in the daily practice of nursing
& of the analysis used by nurses to make ethical judgment
Ex.: cost-containment, breaches of patients confidentiality, illegal practices
of colleagues
MAJOR BIOETHICAL PRINCIPLES
1.Respect for person
a. The recognition of the equality possessed by every human being as unique, worthy,
rational, self determining creature having the capacity & the right to decide what is best
for himself
b. Responsibility of all to treat persons as an end never as a means
c.. The respect for persons autonomy(self governance). The person should be allowed to
determine his own destiny, to choose according to his own values to act accordingly

d. Best practiced in the principle of free & informed consent

e. The role of autonomy is refusal, confidentiality & veracity
2. Justice
Also termed fairness, means to give to each one what the deserves or what is due
Means to treat equals equally
3. Inviolability of life
Also proposed sanctity, dignity or respect for human life
It means choosing life to protect it
This principle includes measures for the survival of the human species & the freedom to
have children
It is be against violence, pollution of environment, drug/alcohol addiction ,euthanasia,
suicide & capital punishment
4. Non-maleficence
Duty to do NO HARM
Violations of the Principle
1. Physically harming a person as in suicide, abortion, infanticide(
person who murder infant),violence
2. Harming a persons reputation &honor by revealing confidential information
3. Exposing the person to harm as in subjecting the person to unnecessary treatment
5. Beneficence
Means to do well, provide a benefit
Bringing the action & choosing the mostbenefit & least harm
PRICIPLE UTILITYCircumstances/ Issues Involving Maleficence
-Situations where in not prolonging life is allowed
-Obligatory or optional treatment
-Euthanasia
TORT is a civil wrong committed against a person or a persons property.
- Person/persons responsible for the tort are sued for DAMAGES
- Is based on:
Classification of Tort
1.

Unintentional do not require intent but do require the element of HARM

a. Negligence misconduct or practice that is below the standard expected of ordinary,

reasonable and prudent person
- Failure to do something due to lack of foresight or prudence
- Failure of an individual to provide care that a reasonable person would
ordinarily use in a similar circumstance.
- An act of omission or commission wherein a nurse fails to act in accordance with the
standard of care.

Doctrines of Negligence:
1. Res ipsa loquitor the thing speaks for itself
the injury is enough proof of negligence
2. Respondeat Superior let the master answer command responsibility
3. Force majuere unforeseen event, irresistible force
b. Malpractice stepping beyond ones authority
failure to act as a professional to demonstrate careful and thoughtful action.
(6) Elements of nursing malpractice:
1.Duty the nurse must have a relationship with the client that involves providing care and
following an acceptable standard of care.
2.Breach of duty the standard of care expected in a situation was not observed by the nurse-is
the failure to act as a reasonable, prudent nurse under the circumstances
-something was done that should not have been done or nothing was done
when it should have been done.
3. Foreseeability a link must exist between the nurses act and the injury suffered.
4.Causation it must be proved that the harm occurred as a direct result of the nurses failure to
follow the standard of care and the nurse should or could have known that the failure to follow
the standard of care could result in such harm.
5. Harm/injury physical, financial, emotional as a result of the breach of duty to the client
Example: physical injury, medical cost/expenses, loss of wages, pain and suffering.
6. Damages amount of money in payment of damage/harm/injury

2. Intentional Tortthe act was done on PURPOSE or with INTENT

- No harm/injury/damage is needed to be liable
- No expert witnesses are needed
1.Assault an attempt or threat to touch another person unjustifiably
Example: (1) A person who threatens someone with a club or closed fist.
(2) Nurse threatens a client with an injection after refusing to take the meds orally.
2. Battery willful touching of a person, persons clothes or something the person is carrying
that may or may not cause harm but the touching was done without permission, without consent,
is embarrassing or causes injury.
Example: (1) a nurse threatens the patient with injection if the patient refuses his meds orally. If
the nurse gave the injection without clients consent, the nurse would be committing battery even
if the client benefits from the nurses action.

3. False Imprisonment unjustifiable detention of a person without legal warrant to confine the
person Occurs when clients are made to wrongful believe that they cannot leave the place
Example: (1) Telling a client no to leave the hospital until bill is paid
(2) Use of physical or chemical restraints
(3) False Imprisonment Forceful Restraint - Battery
4. Invasion Of Privacy intrusion into the clients private domain; right to be left alone
Types of Invasion the client must be protected from:
a. Use of clients name for profit without consent using ones name, photograph for
advertisements of HC agency or provider without clients permission
b. Unreasonable intrusion observation or taking of photograph of the client for
whatever purpose without clients consent.
c. Public disclosure of private facts private information is given to others who have no
legitimate need for that.
d. Putting a person in a false/bad light publishing information that is normally
considered offensive but which is not true.
5. Defamation communication that is false or made with a careless disregard for the truth and
results in injury to the reputation of a person
(2) Types:
Libel - defamation by means of print, writing or picture
Example: writing in the chart/nurses notes that doctor A is incompetent because he
didnt respond immediately to a call
Slander - defamation by the spoken word stating unprivileged (not legally protected) or
false word by which a reputation is damaged
Example: 1. Nurse a telling a client that nurse B is incompetent
2. Person defamed may bring the lawsuit
3. The material (nurses notes) must be communicated to a 3rd party in order
that the persons reputation maybe harmed
Criminal Law deals with actions or offences against the safety and welfare of the public.
Classification:
1. Misdemeanor- less infarction of the law
-punishable by fine or imprisonment less than 1 year
2. Felony- more serious violation of the law
-punishable by longer imprisonment
INTENTIONAL FELONIES
1.
2.
3.
4.
5.

Parricide
Child abuse
Homicide
Infanticide
Abortion

6.
7.
8.
9.
10.
11.

Mutilation
Sexual harassment
Rape
Giving assistance in suicide
Physical injuries
Simulation of births

LEGAL ISSUES COMMON IN NURSING PRACTICE

1. DUTY TO REPORT OR SEEK MEDICAL CARE FOR A PATIENT
`

2. CONFIDENTIALITY AND RIGHT TO PRIVACY

3. DEFAMATION OF CHARACTER
Libel- written
Slander- oral
4. PRIVILEDGE COMMUNICATION
-information shared by an individual with certain professionals that does not to be
revealed.
5. INFORMED CONSENT
Voluntary
-Information Patient need to know
Informed
-Current medical status and general course of illness
Competent
-Risk and Benefits
Knowledgeable
-Alternatives to proposed treatment
Information
-Proposed rationale
Signed prior to pre-op medication
6. ADVANCE DIRECTIVES
-legal document stating wishes of an individual regarding health care in situations
in which he/she is no longer capable of giving personal, informed consent.
1. Provides information on preferences regarding end of life issues
2. Power of Attorney for health care- document legally designates as substitute
decision maker should the person be incapacitated
3. DNR/No Code- comfortable care/compassionate care
Factors to determine NO CODE
1.
Clients wishes
2.
Prognosis
3.
Clients ability to cope
4.
CPR will provide benefits sufficient to make it worthwhile to
endure burdens of resuscitation
Reasons for NOT wanting to be resuscitated
1.
CPR no longer provide benefit
2.
Present quality of life is unacceptable

3.
4.

CPR-prolong suffering
Further deterioration caused by CPR

7. EMERGENCY CARE
8. FRAUD
9. ASSULT AND BATTERY
10. INVASION OF PRIVACY
11. MEDICATION ERRORS
NURSES OBLIGATIONS IN THE EXECUTION OF AWILL
The nurse should note the soundness of the patients mind
There was freedom from fraud or undue influence
Make a notation on the patients chart of the apparent mental and physical condition of
the patient at the time of making the will