Professional Adjustment and Research

University of Santo Tomas
College of Nursing
MICHAEL JOHN VALLARIT
Professional Adjustment and Research Teresita I Barcelo, RN PhD
NOYNOY, Ikaw ang aming Pag-asa.
Nursing Law and Code of Ethics for Nursing

Elements of a TRUE Profession
1. Special body of knowledge and skill which can be obtained through formal
education
2. More or less permanent membership
Nurses- biggest group of health professionals
3. Acceptance of service motive/ orientation
Justly compensated it is okay for nurses to charge patients for their service
4. Autonomy self governance
Code of Ethics
Nursing Law
RA 9173
o Sections 3 Composition of the Board
7 member of the board
o Section 4 Qualifications of the Board
Natural born citizen or resident of Philippines no
foreigner can be a board; not even a naturalized citizen
Member of good standing of accredited profession PNA
Registered nurse in the Philippines
Holder of masters degree in nursing, education or allied
medical profession; majority holders of MAN
Chairperson shall have a MAN
At least 10 years of continuous practice prior to
application; 5 years of which shall be in the Philippines
Not convicted of any offense involving moral turpitude
Membership to the board shall represent the 3 areas of
nursing: Education, Service and Community health
o Section 5 no conflict of interest
PNA agency that is tasked to nominate member of the
board
For every vacancy 5 nominees
Immediately resign from any teaching position in any
school or university offering BSN and or review program
for local boards
Resign from any office or employment in the government
No pecuniary interest in or administrative supervision
over any institution offering BSN --o Section 6
Term of office 3 years
More than 3 years allowed to be re-appointed once
o Section 9 Powers of the board
Conduct the licensure exams
Issue, suspend or revoke the certificate of registration
Monitor and enforce quality standards of nursing practice
to ensure the maintenance of efficient ethical, moral,
NOYNOY FOR PRESIDENT

College of Nursing
technical and profession standards in the practice of

nursing
Ensure the quality of nursing educational authority to
open or close nursing schools is vested with CHED upon
recommendation of BON
Investigate case of unethical or unprofessional conduct
and violation of this act
Promulgate the code of ethics
Recognize specialty organization
Not simple just generalist
-NAP
16 specialty organization
MCNAP, ORNAP, GNAP
Prescribe, adopt, issue and promulgate resolution,
regulations, measures and decision as maybe necessary
for the improvement of nursing practice and full
enforcement of this Act.
3 Broad Powers of the Board
Quasi Legislative make laws; board resolution =
law
Quasi Judicial investigate violation to issue and
revoke license
Executive implement the nursing law
Sec 11 causes for removal or suspension of BON
Continue neglect of duty or incompetence
Commission or tolerance of irregularities in the licensure
of the exam
Unprofessional, immoral and dishonorable conduct
Sec 28 Scope of Nursing
Definition of practice of nursing a person, singly or in
collaboration with another, initiates and performs nursing
services to AFC 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.
RA 7164 - all stages of development; labor and delivery
not included
As an independent nurse practitioner, a nurse is
primary responsible for the promotion of health and
prevention of illness.
Own private birthing clinic possible.
As member of health team, nurse 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 peaceful death.
Hospice care for the dying
2

College of Nursing
Duties of the nurse
Provide nursing care using the nursing process.
o We are allowed to do IV by law
Establish linkages with community resources and
coordination with the health team
Provide health education to IFC
Teach guide and supervise nursing students;
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.
o If nursing functions supervised by other
nurse, not any other professional.
Undertake nursing and health human resource
development training and research
This section does not apply to students who
perform nursing functions under the supervision of
a qualified faculty.
In the practice of nursing, the nurse must observe
the Code of Ethics and uphold the standards of safe
nursing practice
o COE Boards Resolution
o The nurse is required to obtain competence
through continuing professional education
provided by recognized professional org; ----RA 877 created the first board of nursing -2 nurses, 1 MD
(chairperson)
RA 6704 amended RA 877 about the composition of the board
1966 5 members of the board (all nurses)
of Ethics
Guide to professional behavior of the nurse
Norms of conduct
BON Resolution 220 Series of 2004
o Previous COE:
1984 simple adaption of the International Council of
Nurses COE
1989 developed by PNA
o Original version developed by BON
BON resolution 425 series 2003 Implementing rules and regulations
(IRR) Rule V the nurse while in practice of nursing in all settings is
duty bound to observe COE
Any violation revoke or suspension of license
4 basic ethical principles applied to nursing
o The fundamental responsibility of the nurse is four-fold ; all are
of equal performance
To promote health
Code

College of Nursing
o
o
Basic
o
o
To prevent illness
To restore health a
To alleviate suffering
1st three = HEALTH is the primary goal of nursing
The nurse renders service regardless of race, creed, nationality
or political belief
We observe medical neutrality
The nurse protects life and respects the dignity of man
The nurse works in collaboration with the members of the team
RIGHTS of the Patient
The right to information or to know about his or her condition
The right to make decisions about his or her own care or
autonomy
Informed consent
The right to privacy and confidentiality
Privacy body
Confidentiality information
Privileged Communication all information personal to the
patient which must be kept secretly
Illness, diagnosis, prognosis
Not absolute;
o Communicable disease it involves public
welfare and safety; inform only the proper
authority DOH
o Welfare and safety of the patient abuse
Domestic and child abuse
o There is a court order in a criminal case
with written order with the court
o With patients consent
The basis of a trusting relationship with the client
The right to quality care
o
Trends in Nursing Service
1. Automation
Nursing informatics
2. Independent/ Private Practice
Entreprenurse
3. Specialization RA 9173 ***
Section 31 Comprehensive Nursing Specialty Program
The BON in coordination with the PNA, recognized specialty
organization and the DOH shall formulate and develop a
comprehensive nursing specialty program
The purpose of the comprehensive specialty programs to upgrade the
level of skill and competence of specialty nurse clinicians such as but
not limited to the areas of critical care --- Beneficiaries of the program are obliged to serve in any Philippine
Hospital for a period of at least 2 years of continuous service
Section 33 Funding for the Nursing Specialty Program
DOH shall set the criteria for the availment of this program
4

College of Nursing
Train at least 10% of the nursing staff annually of the participating

government hospital
Funds shall be given by the PCSO and PAGCOR to be released by DOH
4. Primary Nurse
PDN
The nurse is responsible and accountable for total nursing care of the patient
from admission to discharge, 24 hours a day
Attending nurse of the patient
First, assessment >> then NCP
Kardex contains the NCP
5. Holistic Nursing
6. Hospice care care of the terminally ill clients
Trends in Nursing Education
1. Ladder- Type Curriculum every step in the ladder is a terminal course you get a
degree each step
Step is the foundation to the next step
2. Post graduate education
3. Team teaching
4. Distance Education
National Nurses Organization
1. Only registered nurses can be members of PNA
2. PRC accredited professional organization for nursing PNA
That organization is the official representative of the profession
accreditation
3. Code of Ethics Article VI section 17 states that registered nurses must be members
of the accredited professional organization
Accreditation lasts for only 3 years
4. To be part is not a legal obligation; ethical obligation, as stated in the COE
5. LOI 1000 gives priority to members of PNA when they are going to hire or select
delegates to official function
6. May get benefits from PNA
Member of ICN Indirectly
Complimentary copy of the Philippine Journals for Nursing two times per
year
Upon death, family will get a fund
Fields of Practice
1. Hospital Nursing
2. CHN
3. Nursing Education
4. Private Practice
5. Nursing Research
Qualifications in various fields
1. Hospital Nursing
Staff nurse > RN
Head Nurse
Educational no requirement
Experience of at least 1 year experience
Supervisor / Nursing Service Administrators
Section 29
o Nurse Supervisor
5

College of Nursing
RN
At least 23 years experience in general nursing service
administration at least 2 years head nurse
BSN with at least 9 units in management and
administration courses at the graduate level
Member of good standing of accredited professional
organization of nurses
Chief nurses
o Must posses
o At least 5 years of being a supervisor or managerial position in
nursing
o MA in nursing
o For primary hospitals, the maximum academic qualifications and
experiences for a chief nurse is the same as that of nursing
supervisor
PH less than 50 beds
o For chief nurse in public health agency, priority is given to one a
masters degree in public health or CHN
o For chief nurse in military hospital, priority shall be given to
those with MAN and have completed the General Staff course
2. CHN
PHN RN only; apply at the local health department of own place

Chief Nurse
Categories
PHN in DOH
Military nurse RN; board rating not more than 80%; single for women
only for three years
Occupational Health Nursing
3. Nursing Education
Qualifications
Faculty members
o RN
o At least 1 year clinical practice in a field of specialization
o Member of PNA
o MA in Nursing, education or allied medical health sciences;
including MD
Dean Section 27
o MA in Nursing
o 5 years experience in teaching and supervising a nursing
education program
o Member of PNA
4. Private Practice
Various areas hospital PDN, home care, private practice
PDN > RN with affiliation with the hospitals
Private practice breathing center, day care center for children or
elderly, hospice care, ostomy care nurse, diabetes education center
How to obtain a license to practice
1. By examination
6

College of Nursing
RA 9173 Sec 13 qualifications for admission to licensure exam
Graduate RLE and TOR
Filipino citizen and resident in the Philippines birth certificate;
resident certificate - cedula
Good moral character no document to check
Sec 15 GA of 75 with nor rating below 60 in any subject
If GWA is 75 or higher but gets a rating below 60 in any subject must
take exam again in the subjects rated below 60; to pass examinee
must obtain at least 75 in the repeated subjects
Removal exam shall be taken within 2 years after the last failed exam
(BON Res. 425 s 2003 IRR)
2. By reciprocity for foreigners
Section 20 of RA 9173
Conditions:
o Requirements for registration or licensing nurses in said country
is substantially the same.
o The laws of said country grants the same privileges to Filipino
nurses as their own citizens.
3. By special permit
Section 21 Special or temporary permit
Granted to:
o Licensed foreign nurses whose service is either for a fee or fee if
internationally known specialist or outstanding experts
o Licensed foreign nurses on FREE medical mission
o Licensed foreign nurses employed by school or colleges of
nursing as exchange professors
Very specific and temporary time, place or mission; no renewal if
expired
4. Mutual Recognition Agreement agreement among ASEAN
Indonesia, HK, Thailand, Brunei, Vietnam, Myanmar
RA 9173 Section 16 OATH
1. Successful examinee must take oath of the profession before the Board or
authorized government official prior to entering the practice
Only if the mass oath taking is done
To register and get license where you took the Board Examination
RA 9173 Section 17 Issuance of certificate of registration/ professional license and ID
1. Certificate of registration or professional license shall be issued to a successful
examinee upon payment of prescribed fee (permanent)
Renewal of ID every 3 years at birth month; PRC office
Revocation and suspension of certificate of registration Section 23
1. Causes
Unprofessional and unethical conduct
Gross incompetence or serious ignorance
Malpractice or negligence in the practice of nursing
Use of fraud, deceit or false statement in obtaining license
Violation of provisions of this act
Negligence within your scope
Malpractice beyond the scope
RA 9173 Section 24 Re-issuance of revoked certificate
7

College of Nursing
1. The BON may re-issue with the following conditions:

After at least 4 years from date of revocation
When the cause of revocation has been removed or corrected
Sec 26- Requirements for inactive nurses returning to practice
1. Nurses who have not actively practiced the profession for 5 consecutive years are
required to undergo 1 month of didactic training and 3 months practicum
2. BON shall accredit hospitals to conduct said training
ONLY PGH is accredited.
Obtaining Filipino Citizenship
1. Ways
By birth natural born Jus sanguinis based on the citizenship of parents
By naturalization foreigners
Legal process >> court >> apply >> 10 years of residence
RA 9225 Citizenship Retention and Re-acquisition Act of 2003 natural born
Filipinos doo not lose citizenship when they become naturalized in another
country provided they make the oath of allegiance so they can vote, run for
office, or practice profession with proper authority.
Duties of a Filipino Citizen
1. Pay Taxes
Income tax
Professional Tax 50 pesos every year, not later than January 31.
PTR, Privilege Tax, Occupational Tax
Where to pay: BIR
Government officials are free from paying PT Magna Carta for Health
Professionals
2. Show love of country or Allegiance to the country
Working Contract
1. Contract is an agreement between at least 2 parties which creates an obligation
recognized by law.
2. Elements of a VALID working contract
TRUE Consent
True means it is voluntary, freely given, no coercion, no pressure
COMPETENT PARTIES
Sound mind
Major age 18 years old
LAWFUL object
Object or subject must be something within the bounds of law
VALID consideration something of value
Compensation
Service with no compensation cannot be sued for liability that have
occurred
3. At least 2 witnesses NOT AN ELEMENT
4. Written > Verbal; with witness; better but not essential
If with breech of contract there is a proof
5. TYPES
According to form
Formal written and signed; follows the legal format
Informal either verbal or format; does not follow the legal format
According to terms of contract
8

College of Nursing
Expressed either verbal or written the terms of the contract period

of validity, salary and benefits
Implied terms are not specified but the actions will tell the terms of
contract
Last Will and Testament
1. Is the will an action or document? Action
2. Document testament
3. The will is an act allowed by law whereby a person makes a decision about the
distribution of ones estate and the decision will be carried out upon his death.
4. Not compelled
5. Qualifications of a testator who makes the testament
Major age
Competent or sound mind
6. Qualifications of a witness
Sound mind
Legal age
Can read and write
Acceptable form of last will and testament WRITTEN
Not under the influence of alcohol
Not convicted of perjury
Not deaf or dumb
Not a beneficiary prevent of conflict of interests
7. Types
Holographic will hand written entirely by the testator
From the date to the content to the signature
No need for witnesses
Authenticated Will dictated by the testator but written by somebody else.
With witnesses at least 2 witnesses
It is not the duty of the nurse to act as a witness in the making of the will.
Only out of willingness or voluntariness of the nurse
Lawsuit
1. It is a proceeding in court for a purpose
2. Possible purposes
To redress a wrong done to a person
To enforce a right
3. The 2 parties involved in a lawsuit
Complainant or plaintiff the one who files the case
Defendant or the respondent object of the lawsuit
4. Summons respondent
Written court order asking the defendant to appear in court
5. Subpoena witness
Written court order
Subpoena duces tecum = witness + documents
CRIMES
1. Violation of law
2. An act or an omission punishable by law which may be committed with deceit or by
fault
3. Commission or omission
4. Deceit is present if the person committed the crime with full knowledge and
understanding of the gravity of the act and with full consent.
9

College of Nursing
5. Fault ignorance of the law
6. Conspiracy when a crime is committed by a group of people who agree to commit
a crime together
Roles in conspiracy
Principal
o Mastermind
o Actually performing the act
o Assisted in the commission of the crime>> act is essential to
the commission of the crime
Accessory or accessory after the act
o Ways:
Destroying the evidence of a crime
Planting evidence in a crime
Assisting principal to escape or hiding the principal
Assisting the principal to benefit or you yourself benefits
from the effects of the crime
Accomplice or accessory before the act
o Accomplice the person refers someone so that a crime can be
done
7. Types
According to punishment
Grave minimum imprisonment is 6 years and 1 day; Php 6,001 and
above
Less grave maximum is 6 years; 1 month and 1 day minimum; Php
201 to 6000
Light 30 days maximum ; Php 200 or less
According to degree of execution
Consummated objective of the crime is achieved
Frustrated completed all actions but objectives are not achieved
Attempted did not achieve object because you did not finish all
actions
8. Forms of punishment
Imprisonment
Fine
9. Circumstances affecting liability in a crime
Justifying no liability
Exempting the law excuses the person who commits the crime; the action
carries a liability but the person who commits the act is exempted
Mitigating reduces liability
Aggravating increases liability
Alternating may decease or increase liability depending on the situation
10.Examples of justifying circumstances
In defense of ones self
In defense of ones property
Conditions for self- defense to be justified:
The unlawful aggression was started by the offended party
No provocation on part of the offender
Reasonable means employed to repel or prevent the aggression
10

College of Nursing
11.Examples of Exempting circumstance

Offender is below 9 years old no full capacity on the gravity of his actions
Offender is between 9-15 years old but acted without discernment (full
understanding)
Mentally retarded or insane
Doing the act under the compulsion of an irresistible force or force majeure
When the person is doing the lawful act, with due care, causes injury by mere
accident, there was neither fault nor intention to commit the crime.
12.Examples of Mitigating Circumstance
Offender is a minor or above 70 years old minor(below 18 not fully
accountable with the action)
There was no intention to commit such a grave offence.
Voluntary surrender so that measures can be done to counteract the problem
Offender committed the act under the compulsion of a very strong emotion or
passion.
When the offender is deaf, dumb or blind- seen in Penal Code; with limitations
13.Examples of aggravating circumstance
Offender committed the crime in abuse of power or confidence: incest
Offender committed the crime during a calamity or conflagration
Offender fire or sabotage- big destruction of property which is uncontrolled
Offender uses fraud or deceit in the commission of the crime
Offender gets paid or reward to do the crime
Crimes done with pre-meditation planning and intention
14.Examples of alternating circumstance
Intoxication of alcohol
Level of education
Definition of Crimes
1. Infanticides killing of infant less than 3 days old, regardless of relationship
2. Parricide- killing an immediate member of family spouse, child, parent
3. Murder with pre-meditation
4. Homicide- no intention
5. Assault- attempting to harm others VS. Battery with physical contact
Always get informed consent- invasive procedure and admission
6. Illegal distention or false imprisonment
Sign a waiver
Some crimes
1. Substitution of a child with another
2. Simulation of a birth
3. Child abuse
First to do: Report to medico-legal MD if diagnosis is confirmed, report to
DSWD (Child Welfare) and Police (crime)
4. Abandonment of a child left alone but not harmed
5. Slander defamation false statement given in public intended to destroy
reputation of a person - verbal
6. Libel written
Neligence
1. It is doing an act which a prudent nurse would not do; or not doing an act which a
prudent nurse would have done in the same situation
2. Imprudence does not know when or when not to do things
11

College of Nursing
3. Voluntary, causes harm RECKLESS IMPRUDENCE doing an act voluntarily and
causing injury without the intention to cause such
4. Doctrine affecting liability; even no doctrine applies there is still a liability
Res ipsa loquitor
Injury that was caused is the proof the there was a negligent act
Example: patient got burned in application of hot water bath; left
sponge in the abdomen circulating nurse
3 conditions for the doctrine to apply: - all three must be present
o Injury would have not occurred in the absence of someones
negligence
o There is voluntary control on the part of the nurse of the
instrumentality that caused the injury
o There is lack of voluntary participation on the part of the patient
to the occurrence of the injury
Respondeat superior
Superior is ALSO accountable for the action of the subordinates
When does it apply?
o When the subordinate committed the error while on duty
because there is an active employer- employee relationship
When do you consider that the order is legal? written and signed by a
licensed MD
Telephone orders to be countersigned by the MD within 24 hours to
make it legal
o When ACCEPTABLE? If there is an emergency; what exempts to
the liability: the emergency
Strategies to protect superior from being accountable for subordinates
error
o Hire only qualified nurses
o Orient the staff nurses properly and adequately
o Issue memoranda, policies, bulletins, circulars to remind the
staff nurses of their duty
Force majeure
Irresistible force or an act of God
Key element: it cant be predicted or it cant be controlled
5. Analysis to determine liability in a negligent act
First Question: Is there a duty to protect the injured party from the injury
received?
IF yes, proceed to second question
Good Samaritan Act: Nurse does not have the obligation to help the
person, thus, if client got more injured
o In NY- does not recognize the GSA
Second question: was there a failure to do the duty?
Third: Did an injury result from the failure?
All 3 questions must be answered with a yes to have a criminal liability.
Some situations where negligence will likely to occur:
Admission: consent on admission (covers routine procedure);
orientation
Surgery OR consent
12

College of Nursing
Laws
o RN makes sure that the patient signs the consent

o Should come from a legitimate person
Invasive procedure needs written consent every time
o Key element in IC: explain at the level of the patients
understanding
Discharge instructions
Charting - What is not written was not done; erasures in charting
affecting the Practice of Nursing
RA 9173 Nursing Act (other provisions)
Section 32 salary: salary of the beginning nurse must be salary grade 15
Php15000
Section 34- Incentives and Benefits depend on the hospital ; free
hospitalization, scholarships, fellowship
Section 35- Prohibitions in the practice of nursing
In 7164 less penalty
PD 651 Compulsory Birth Registration register the birth within 30 days from the
date of birth the one who assisted the delivery office of the local civil registrar
RA 9255 An act allowing illegitimate children to use the surname of the father
amending Article 176 of E0 209 Family Code- provide that father acknowledge the
child signs the back of the birth certificate
PD 825 Garbage Disposal
RA 8749 Clean Air Act of 2000
Incinerations of hospital waste is prohibited
RA 9003- Solid Waste Management Act of 2000
Zero Waste Management
Reuse, Reduce, Recycle
RA 6675 Generics Act
We should only promote generic drugs
PD 996 Compulsory immunization Law
If there is an impending epidemic, parents cannot refuse for their child to be
immunized
Needs parental consent EPI no impending epidemic
RA 6972 Establishment of Barangay Day Care Center
Your services should go beyond what the barangay can give
RA 7600 Rooming In and Breastfeeding Act
Baby Friendly hospital practices rooming in and BF
Promotion of these services
EO 51 Milk Code
Health professionals are inhibited in endorsing commercially prepared
formula
RA 9231 Special Protection of Children against child abuse, exploitation and
discrimination
Previously, RA 603
RA 7170 Organ Donation Act
RA 9211 Tobacco Regulation Act
Prohibited to smoke in close public places, hospitals and schools
RA 9251- Expanded Senior Citizen acct
13

College of Nursing
20% discount on diagnostic procedure, PF, hospitalizations, transportations,
domestic and basic requirements
RA 8423 Creation of the Institution of Traditional and alternative Health Care
Alternative modes of treatment have been legitimized
Herbs, massage
RA 8172 Salt Iodization Law
Hyperthyroidism is endemic; due to iodine deficiency
Requiring that all processed foods use iodized salts
RA 8344 Prohibitions of hospitals to refuse care in emergencies
Health is a right of a citizen
RA 8505 Establishment of rape crisis center in hospitals and other suitable
agencies
RA 3573 Requirement to report all communicable diseases
RA 9262 An act defining violence against women and their children providing for
protective measures for victims
RA 9288 National system for ensuring NB screening
Health practitioners are obliged to inform parents of availability or newborn
screening test
RA 1054 requires owner or lessee of any industrial, commercial or agricultural
establishments to provide free emergency medical and dental services to his
employers or laborers
At least 100 employees- regularly employed RN
RA 9165- Comprehensive Danger Drugs Act of 2002 possession of 5 grams of
prohibited drugs is punishable by 12-20 years of imprisonment and 500,000 1M
fine
Kinds of Dangerous Drugs
Prohibited
Regulated medical purposes
o Morphine pain
o Demerol
o Codeine
o Specifies who can handle them
o Where to keep: cabinet with lock; key hang a key on the
chain, where it on your neck (principle: key should only be
accessible to authorized people)
RA 8976 Food Fortification Act of 2000
Foods should have Vit A,D, B
RA 9502 Universally Accessible Cheaper and Quality Medicine Act of 2008
RA 1080 Civil Service Eligibility Law
Exemptions from CS Exam can work in government as a permanent
employee
RA 7875 Amended National Health Insurance Law Philhealth
Once employed, automatically a member of Philhealth
Hospital benefits for 45 days per year
Covers outpatient cases cataract, breast cyst, sterilization
With benefits Normal delivery
First delivery with episiotomy (surgical procedure)
At least 60 years old and not employed and single dependent - single
14

College of Nursing
Married: spouse (not employed) , children below 21 (unemployed)

RA 6713 Code and Conduct and Ethical Standards for Public Officials and Employees
RA 6809 major age lowered to 18 years old
RA 7160 Local Government Code (devolution of DOH)
Health services is no longer the responsibility of DOH, not a responsibility of
Local Health Department
RA 7305 Magna Carta for Public Health Workers
Benefites and incentives:
Exempted from paying professional tax
RA 7877 Anti Sexual Harassment at work and Education
PD 442 Labor Code private employers
Permanent status if you work continuously for 6 months - regular
Cannot be removed unless there is a valid cause
Contractual or regular no benefits
Overtime pay more than regular
Regular: +25% of hourly rate
Holiday:
o Special: +30% of hourly rate
o Legal: according to law: +100% of hourly rate or double pay
Night differential pay:
10PM -6AM
10% night DFP
Regular day : Any eight hour work
Regular week: any 40 hours
Sick Leave: 15 days paid leave
Maternity leave
60 days 4 pregnancies
PD 626 Employee Compensation and State Insurance Fund
Injury, illness or death work related compensable
Private sector: SSS
Public: GSIS
RA 8981- PRC modernization Act
Computerization of Board Exam
LOI 1000 Government agencies to give preference to members of accredited
professional organization when hiring or when selecting official delegates to official
functions
RA 8187 Paternity Leave
7 days 4 pregnancies also
Only for legal spouse
RA 9225
BON Res 112 Series 2005- Core Competencies standard for nursing practice
Presidential Proclamation 539 proclamation declaring nurses week every last week
of October (promulgated October 1958)
RA 1612 Payment of privilege tax/ professional tax for professionals
BON Res 4595 series 2002 MCN standard of practice
15

College of Nursing
NURSING RESEARCH
- Definition: scientific process that validates and refines existing knowledge and generates
new knowledge that directly and indirectly influences nursing care.
- Primary Goal:
To develop scientific knowledge base for nursing practice. The knowledge generated
through research is essential for description, explanation, prediction and control of
nursing phenomena
- Specific Purposes
Generate new knowledge
Develop new gadgets and techniques
Evaluate a program or technique
Generate or validate theory (tentative explanation of a phenomenon event that is
not fully understood)
Scientific Law - explanation is universally accepted as correct
- Types of Quantitative Research
According to Purpose:
Basic or Pure
Knowledge for knowledge sake
Applied
Purpose is to solve problems, to make decisions, to predict or control
outcomes in the real world
- First researcher- Florence Nightingale
- Limitations of Nursing Research
Ethico-legal considerations
Measurement Problems
Validity measures what you intend to measure.
Reliability yield the same result even repeatedly used
Control Problem
- Ethics of research
Nuremberg Code of Ethics informed consent
Germany
Made Jews human guinea pigs
Belmont Report
Articulated 3 primary ethical principles
Beneficence significance of the study
Respect for human dignity
Justice
Vulnerable groups for research unable to protect themselves
Children
Mentally or emotionally disabled persons
Physically disabled
Prisoners
Hospitalized persons (may feel pressured to participate)
Pregnant women (fetus)
- Steps in Quantitative Research
The Conceptual Phase
Formulating and Delimiting the Problem
Reviewing the Literature
16

College of Nursing
Developing a Theoretical Framework

Design and Planning Phase (RESEARCH PROPOSAL)
Selecting an appropriate research design
Specifying the Population
Specifying the Methods
Designing the plan for selecting the sample
Finalizing and reviewing all aspects of the research plan
Conducting a Pilot Study and making revisions mini research / whole
research
Objective: run a study and look for possible areas of problems and
gaps to be revised
Empirical Phase
Collecting the Research Data
Preparing the Data for Analysis
Analytic Phase
Analyzing through appropriate quantitative or qualitative methods the
research data
Interpreting the results of the analyses
Dissemination Phase
Communicating the findings through written or oral presentations
Undertaking steps to utilize the findings or to promote their utilization
First Step in the research Process: To find a topic for Research
Where do you search for research topics:
Own thoughts, observations and experiences
Review of literature
Theories concepts e.g. Role theory, sick role, the nurses role, the interaction
between the patients role and the nurses role
Testing assessment and intervention strategies
Criteria for Selecting a Research Topic
Relevance and Significance
Avoidance of duplication
Feasibility personnel time, equipment, money, availability of student participants
Political acceptability getting the permission of authorities involved
Ethical acceptability
Capability of researcher
3 levels of Research questions
Level I Exploratory in nature
Answers provide a complete description of the topic
Level II Descriptive level
Focus on relationships between 2 or more variable previously studied but
never studied together before
Level III Experimental level require considerable knowledge of the topic
Tests predictive hypothesis about the variables
Causal relationship
Hypothesis
Formal statement of the expected relationship between 2 or more variables in a
specified population
17

College of Nursing
Translates the research problem and objectives into clear explanation or prediction
of the expected results of outcomes of the study
Hypothesis differs from objectives and research questions by predicting the
outcomes of a study and the researcher indicates the rejection or non rejection or
support or nonsupport of each hypothesis.
Uses:
Indicates the variable (trait, property or characteristic of the population being
studied) to be manipulated and the variable to be measured
Identifies the population to be studied
Directs the conduct of the study by indicating the type of research
It influences the study design, sampling technique, data collection and
analysis methods and the interpretation of the results.
Types of variables
Research variables main focus of the study
Independent variables variable that is manipulated by researcher
Dependent variables- variable that you observe and measure; shows
the result of the manipulation
Extraneous Variables / Confounding variables
Variables present in the population but is not the main interest can
affect the result
May not be recognized or uncontrolled
Maybe recognized but cant be controlled
As control decreases, the potential influence of recognized and
unrecognized confounding variables increase
Characteristics of a Hypothesis
Statement of anticipated relationship causal or non causal
Testability
There is a predicted relationship
Variables are observable or quantifiable definition of variables
(operational definitions)
Hypothesis that involves moral, ethical, or value laden issues are not
testable
Justifiability Theoretical Framework
Maybe deduced from theory if there is
If new area being investigated, maybe based on logical reasoning or
personal experience
Consistent with existing body of research findings
Types of Hypothesis according to complexity
Simple one independent and one dependent variable
Complex or multivariable 2 or more IV and or 2 or more DV
Types
Research or alternate hypothesis
Statement of expected relationship
Statistical. null hypothesis
Statement of no relationship
Predicted relationship of alternate hypothesis
Directional direction is specified
18

College of Nursing
Non Directional
Example:
There is no difference in the nutritional status of children given nutribun with those
given a liter of milk daily.
IV type of food
DV nutritional
Null, simple, non directional
The incidence of nosocomial infection can be reduced by 50% when using the new
technique of HW than when using the traditional HW technique
Research Framework
Brief explanation of a theory or those portions of a theory to be tested
Every study has a framework
Must identify and define the concepts and the relational statements being studied
Design and Planning Phase
Elements of a good quantitative research
Appropriate to the purpose of the study
Cause and effect- experimental design; quasi-experimental design
Feasible given realistic constraints
Effective in reducing threats to validity
Concepts important in choosing design
Causality
Bias
Means to slant away from the true or expected result/ situation
The sources of bias need to be eliminated to arrive at valid and reliable
results
If present unreliable results
Sources:
o Researcher
o Measurement Tools
o Individual study subjects
o Sample
o Data sources- definitions maybe different
Possible sources of bias during data collection
o Defective instruments
Questionnaires with:
Fixed or closed question on topics about which little
is known yes/no ; with choices
Open ended questions without guidelines on how to
ask/answer them
Vaguely phrased questions
Questions placed in an illogical manner
o Mechanical devices that are not standardized
o The source of bias in the instrument can be prevented by:
Carefully planning the data collection process
Pre-testing the data collection tools groups of experts
sample population
o Observer bias
Halo effect with pre conceived idea about the sample
19

College of Nursing
Hawthorne effect- knowing that the samples are being
observed, they will act artificially
This can be prevented by:
Having training of the observers
Supervising them during the data collection
Effect of observer on the subjects (hawthorne effect)
Prevented by:
Prolong the observation time HE is usually
observed in the early stage of data collection and
diminishes over time
Observer must try to maintain the naturalness of
the situation and be as unobtrusive as possible
How the observer should behave and relate with
the subject during the observation must be
included in the training
Manipulation
Control
Having the power to direct or manipulate factor to achieve a desired
outcome
In uncontrolled confounding variables increases effect
The greater amount of control the research has of the study situation,
the more credible the findings
The purpose of a research design is to maximize control factors in the
study situation
Controlling of treatment strategies:
o Make a detailed description of the treatment.
o Be consistent in implementing the treatment. Variation in the
treatment reduces effect size.
Controlling of measurement
o Measures must have documented validity and reliability test
o Data collectors must be observed for consistency of
measurement
Strategies of control
o Controlling the environment- consistent for all subjects
o Controlling equivalence of subjects and groups
Equal number in E and C group to say that they are the
same in the beginning
Define selection criteria
Random sampling (how you choose the sample) followed
by random assignment (control and experimental)
Examine the extent of equivalence by measuring and
comparing characteristics for which the groups must be
equivalent. This comparison is usually reported in the
description of the sample.
o Controlling extraneous variables
Design strategies used to control extraneous variables:
Random sampling
20

College of Nursing
Random assignment
Homogeneity
Heterogeneity obtain subject with a wide variety
(heterogenous) to reduce the risk of biases. This is
designed to increase generalizability.
Stratification involves even distribution of the
subjects throughout the sample
Matching
Validity - Study validity is the measure of the truth or accuracy of the claim.
Internal the extent to which the effects detected in the study are a
true reflection of reality rather than the result of extraneous variables
External extent to which study findings can be generalized beyond
the study group
Factor that can affect internal validity:
o History an event that is not related to the planned study but
occurs during the time of the study.
o Maturation described as growing older, wiser, hungrier, more
tired, stronger, or more experienced during the study
o Testing effect- effect being measured can be due to the number
of times the subjects responses have been tested.
o Instrumentation effects can be due to changes in the
measurement instruments between pretest and posttest; when
observer or data collectors become more experienced between
pre-test and post test, thus altering in some way the data to
collect
o Selection a selection threat is more likely to occur when
randomization is not employed
Volunteer group least acceptable; with acknowledge
biased
o Mortality due to the subjects who drop out before the
completion of the study
Problem: if more loss on one group over the other
unequal number of participants per group
o Diffusion or imitation of treatments the control group may gain
access to the treatment intended for the experimental group
(diffusion) or a similar treatment available from another source
(imitation).
Threats to External Validity
Interaction of selection and treatment If a large number of subjects
approached declined to participate, they tend to be volunteers or
do-gooders
Hawthorne effect on sample
Quantitative research design
Non Experimental
Descriptive design
Typical descriptive design used to examine characteristics of a single
sample
21

College of Nursing
Comparative descriptiveexamines and describes differences in

variable in two or more groups that occur naturally ---- According to time dimension
o Longitudinal designs examines changes in the same subjects
over an extended period
Long period of time one sample
Limitation: expensive and greater danger of mortality of
subjects
o Cross sectional different sample, representing each stages
Examines groups of subjects in various stages of
development simultaneously
The assumption is the stages are part of a process that
will progress over time.
Limitations:
Many extraneous variables that may affect result
Correlation studies
Examines relationships between variables
A representative sample must be selected for the study
No attempt is made to control or manipulate the situation simply
observe the relationship
Types
o Case control method begins with effect and looks for a cause;
retrospective
No way of ensuring individual characteristics
Weak when establishing cause and effect
o Cohort design begins with cause and wait for effect ;
prospective design
Ensured of comparable characteristics
Good form of testing causal relationship in a natural
setting
o Good for determining relationship in natural setting
Experimental Designs
True Experiment
Features of True Experiment:
o Manipulation of IV
o Control of extraneous variables
o Randomization
Quasi Experimental Design
When randomization or control of major extraneous variables is not
possible or cannot be done.
Criteria to establish causality
Co-variation between presumed cause and effect
Causal direction- X must precede the Y
Non spuriousness of results the effect or results were the intended
results; how? After repeating the procedure same results
Phases in the Qualitative Design the researchers are learners from their sample
Orientation and overview
To get a handle on what is salient about the phenomenon of interest
22

College of Nursing
Focused exploration more focused scrutiny and in=depth exploration of
those aspects of the phenomenon that are judges to be salient
Confirmation and closure goes back to participant to validate results
In this final phase, the researcher undertake efforts to establish that
their findings are trustworthy, often by going back and discussion their
understanding with study subjects
There 3 phases are nor discrete events; they may overlap
Different research designs
Ethnography
Provides a framework for studying the meaning, patterns, and
experiences of a defined cultural group in a holistic fashion
o How do they think, how they express themselves specific
culture
The aim is to learn from (rather than study) members of the cultural
group to understand their world view as they define it.
Phenomenology
It is concerned with the lived experience of humans
Question asked: What is the essence of this phenomenon as
experienced by these people?
Grounded Theory
Primary purpose: to generate comprehensive explanation of
phenomena that are grounded in reality
It seeks to describe and understand the social psychological and
structural processes that occur in a social setting.
Case Study
In depth investigation of a single entity or small series of entities eg
individual, family, institution
It determines the dynamics of why individuals think, behave or develop
in a particular manner rather than what his or her status, progress,
actions or thoughts
Limitations: lack of generalizability small group
Historical Research
Systematic collection and critical evaluation of data coming from past
events/ occurrences
It is undertaken to answer questions concerning causes, effects or
trends relating to past events that may shed light to present behaviors
or practices.
Sources of data
o Primary interview of an eyewitness, birth certificate,
autobiography
o Secondary biography
Evaluation of historical data
o External criticism authenticity and genuineness of data
o Internal criticism the evaluation of the worth and accuracy of
the evidence
Methods of Data Collection
Observation
23

College of Nursing
Degree of investigators involvement
Participant (bias) or non participant (Hawthorne) observation
Degree of structure
Self report:
Questionnaire (respondent writes the answer) or interview (interviewer writes
the answer)
Degree of structure open or close ended questions
Available or existing data
Problem: incomplete or inaccurate existing data
Physiologic measure or Biomedical instrumentation
Differentiation between data collection techniques and data collection tools

Data Collection technique
Data Collection Tools
Using available info
Checklist, data compilation form
Eyes and other senses, pen and paper, watch,
Observing
scales, checklist
Interview schedule tool used (questionnaire),
Interviewing
checklist rating scale, tape recorder
Administering written questionnaire
Questionnaire
- Sampling
A process of selecting a subset from a population to obtain info about the
phenomenon in a way that represents the population
Population aggregate of elements which share common characteristics:
Sample subset selected of population of interest
Element a unit of the population of interest
- Purpose of sampling
Achieve representativeness
Minimize cost
- Sampling strategies
Probability sampling
Every element known every element can be selected
Non zero probability of being included
Involve random procedures
Allow estimate population characteristics
Can estimate sampling error
Permits use of inferential statistics
Types of probability sampling
Simple random fish bowl technique; homogenous population
Stratified / modified simple random heterogenous population;
smaller more homogenous groups apply simple random
Cluster/ Multi stage element for sampling: cluster
Systematic with random start: arranged in some kind of order, seating
arrangement, alphabetical order
Non probability sampling
Population enumeration not possible
Enumeration expensive, inconvenient
Rarity / unpredictability of phenomenon
Types: common: convenience
24

College of Nursing
Convenience
Quota
Purposive
Snowball
General Guidelines in Estimating Sample Size
The larger the sample (n), the more reliable the estimate
Purpose of the study
Homogeneity of phenomenon in population
Univariate Analyses use only descriptive statistics
Know or understand DV
Characteristics of sample
Determine characteristics of IV preparatory to further analyses
Bi variate / multi variate analyses
What relationship exist, what do they look alike, how strong are they
Alternative hypothesis to be ruled out
Statistics Key Concept
A tool / aid
organizing summarizing data
making inferences
meaningful communication of findings
Factors that affect statistical analysis
Levels of measurement
How the number are used to measure
4 levels
Nominal 2 nominal: chi square
Ordinal
Interval
Ratio
3 major parts of a research report
Preliminary pages
Title page
Table of contents
Body of the report
Research problem hypothesis, definition, framework
RRL
Methodology- methods, stools, sampling, statistical test, design
Presentation, analysis and interpretation of findings
Summary, conclusion and recommendations
Supplementary pages
Bibliography / References
Appendices
25

College of Nursing
26

Professional Adjustment and Research

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Professional Adjustment and Research

Hochgeladen von

Copyright:

Verfügbare Formate

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

Nursing Law and Code of Ethics for Nursing

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

technical and profession standards in the practice of

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

Train at least 10% of the nursing staff annually of the participating

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

PHN RN only; apply at the local health department of own place

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

1. The BON may re-issue with the following conditions:

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

Expressed either verbal or written the terms of the contract period

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

11.Examples of Exempting circumstance

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

o RN makes sure that the patient signs the consent

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

Married: spouse (not employed) , children below 21 (unemployed)

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.

NOYNOY FOR PRESIDENT

NOYNOY, Ikaw ang aming Pag-asa.

University of Santo Tomas

Developing a Theoretical Framework

NOYNOY FOR PRESIDENT

University of Santo Tomas

NOYNOY, Ikaw ang aming Pag-asa.