THE ETHICO LEGAL ASPECTS OF IV

THERAPY
BASIC

DUTIES AND
RESPONSIBILITIES OF
IV THERAPISTS

1. Interpret and carry out the

physicians prescriptions for IV
therapy.
2. Prepare, initiate and terminate IV
therapy based on physicians
written prescription.
3. Perform peripheral venipuncture
(all types of needles and
cannulas) excluding the insertion
of subclavian and cut down
catheter.

4. Determine solution and

medication incompatibilities.
5. Administer computed
medications, chemotherapeutic
drugs, flow rates of solutions,
compatible blood/blood
components and parenteral
nutrition as prescribed by the
physician.

6. Assess all adverse reactions

related to IV therapy and initiate
appropriate nursing interventions.
7. Establish nursing care plan
related to IV Therapy.
8. Adhere to established infection
control practices.

9. Maintain proper care of IV

equipments.
10. Document relevant data in the
preparation, administration and
termination of all forms of IV
therapy.

LEGAL BASIS

IV THERAPY AND LEGAL IMPLICATIONS

R.A. 7164 The Philippine
Nursing Act of 1991 Section 28
states that in administration of IV
injections, special training shall be
required.
IV Nursing Standards of Practice
developed by the ANSAP should be
used.

In giving IV injections, nurses should

follow the policies of their agencies.
Board of Nursing Resolution No.8
Sec.30 (c) Art.VII or administratively
under Sec.21 Art.III states that any
registered nurse without training and
who administers IV injections to
patients shall be held liable, either
criminally, administratively or both.

 R.A. 9173/The Philippine Nursing

Act of 2002, Article VI Nursing
Practice, SEC.28.Scope of Nursing
(a) Provide nursing care through the
utilization of the nursing process.
Nursing care includes, but not limited
to
administration of written presentation
for treatment, therapies, oral, topical
and parenteral medications

That in the practice of nursing in all

settings, the nurse is duty-bound to
observe the Code of Ethics for nurses
and uphold the standards of safe
nursing practice.

ETHICAL ISSUES

CODE OF ETHICS FOR

NURSES IN THE
PHILIPPINES

ETHICS according to Webster

Dictionary, is the study of the
standards of conduct and moral
judgment.
Therefore..
NURSING ETHICS is concerned
with the principles of right conduct
as they apply to the nursing
profession.

NURSES AND PEOPLE

Values, customs and spiritual beliefs
held by individuals are to be
respected.
Nurses hold in strict confidence
personal information acquired in the
process of giving nursing care.

NURSES AND PRACTICES

Nurses are accountable for their
own nursing practice.

Nurses maintain or modify

standards of practice within the
reality of any given situation.

 Nurses are the advocates of the

patients.
Nurses are aware that their

actions have professional, ethical,

moral and legal dimensions.

NURSES AND CO-WORKERS

Nurses maintain collaborative working
relationships with their co-workers and
other members of the health team.

They recognize their capabilities and

limitations in accepting responsibilities and
those of their co-workers when delegating
responsibilities to them.

NURSES AND SOCIETY

Nurses are contributing members
of society. They assume
responsibilities inherent in being
members and citizens of the
community/society in which they
live/work.

 Nurses recognize the need for

change and initiate, participate,
and support activities to meet the
health and social needs of the
people.

NURSES AND THE PROFESSION

Nurses are expected to be
members of professional
organizations of nurses.
Nurses help to determine and
implement desirable standards of
nursing practice and nursing
education.

 Nurses should initiate and involve

themselves in structured and nonstructured research activities within
their existing milieu.
Nurses should assert the
implementation of labor standards
and lobby for favorable legislations to
improve existing socio-economic
conditions of nurses.

CODE OF ETHICS
The Nursing Service
Administrators of the
Philippines

MISSION
Provision of efficient and effective
nursing services.
Promote quality health care for people
as a basic human right.
Be responsible for planning, organizing,
directing and controlling the programs
and activities of the Nursing Service
towards optimum quality nursing care.

ARTICLE II
THE ANSAP CREED; CORE VALUES
& BELIEFS
1. The nursing profession is a
commitment to God and people;
2. The nursing service is responsible
and accountable for quality nursing
care;

3. The nursing service is a major

function in any health care delivery
system and deserves a
corresponding importance in the
organizational structure;
4. A high level of self-discipline and
committed leadership are essential
factors in the effective management
of health care services;

5. The nursing services is most

important asset, aside from its
clients, are its caring, competent and
productive personnel;
6. Competence enhances the publics
assurance of quality nursing care,
therefore, nursing personnel must be
selected and appointed to positions
consistent with their qualifications;

7. The client is the reason for the

existence of the nursing profession;
all efforts should be directed to his
care and should consider his
uniqueness, personal worth, dignity,
and socio-cultural values;
8. The implementation and
maintenance of approved standards
of nursing practice and nursing
administration are bases for effective
and efficient nursing service;

9. Nursing service is integral in the

quality of education of students; and
10. A unified stand is vital in achieving
their objectives through membership
in professional organizations, such
as the Philippine Nurses Association
(PNA), the Association of Nursing
Service Administrators of the
Philippines (ANSAP), and other
specialty groups in nursing.

ARTICLE III
NORMS OF PROFESSIONAL
CONDUCT
SECTION 1. Dedication to God and
people.
SECTION 2. Responsibility and
accountability for quality nursing
service.

SECTION 3. Leadership and Technical

Competence.
SECTION 4. Responsibility and
Accountability for Nursing Practice.
SECTION 5. Commitment to the
Nursing Profession.

ARTICLE IV
GENERAL PROVISIONS
Section 1. Creation of Ethics
Committee that shall be responsible
to adjudicate violations against the
NSA Code of Ethics and adopt such
rules and sanctions as the association
is authorized to do.

SECTION 2. Legal Force.

SECTION 3. Moral Force.
SECTION 4. Dissemination.

SECTION 5. Sanctions.
SECTION 6. Amendment.
SECTION 7. Effectivity

CODE OF GOOD
GOVERNANCE FOR
THE PROFESSIONS IN
THE PHILIPPINES

 E.O. No. 220 - Directing the

adoption of the Code of Good
Governance for the Professions in
the Philippines on June 23, 2003.

General Principle of Professional

Conduct
Professionals are required not
only to have an ethical
commitment, a personal resolve
to act ethically, but also have both
ethical awareness and ethical
competency.

Specific Principles of Professional

Conduct
1. Service to Others
2. Integrity and Objectivity
3. Professional Competence
4. Solidarity and Teamwork

5. Social and Civic Responsibility

6. Global Competitiveness
7. Equality of All Professions

PROFESSIONAL
VALUES

CARING
is the locus of all attributes used to
describe NURSING. It is not only the
main value of NURSING but the
Essence. It is not only a nursing act
because to care is human and to be
human is caring.

5 Cs of Caring
Compassionate
Concern
Caring
Committed
Willingness to
perform her
responsibilities

Confident
Assertive
Smart
Conscientious
Honest
Competent
Knowledgeable
Effective/
Efficient

Wholistic
Approach

Nurse Practitioner
I.V. Nurse Therapist
Ethico legal
Responsibility Accountability
In
Varied Health Setting

Industrial
Setting
-Company
Clinics
-Occupation
Health
Units

Community
Setting
Health Center
Rural Health
Units
Periculture
Centers

Hospital and
Institutional
Setting
Lying- in
Hospice Center
Day Care Center

Quality
care
Impact to
Health Care
Delivery sites

Educational
Setting
-Colleges
of Nursing
Universities
-Other
colleges &
Schools

Home Care
Setting
-Independent
Practitioners
-Self
employed

RELATED LAW OFFENSES

LEGAL ASPECTS AND THE NURSE

The Republic Act 9173 or the
Philippine Nursing Act of 2002 is
the best guide the nurse can
utilize as it defines the scope of
nursing practice.

Negligence
Commission or omission of an
act, pursuant to a duty, that a
reasonably prudent person in the
same or similar circumstance
would or would not do.

The Doctrine of Res Ipsa Loquitur

Three conditions are required to
establish a defendants negligence
without proving specific conduct:
1. That the injury was of such nature
that it would not normally occur
unless there was a negligent act on
the part of someone;

2. That the injury was caused by an

agency within control of defendant;
3. That the plaintiff himself did not
engage in any manner that would
tend to bring about the injury.

Example:
A patient came in walking to the
out-patient clinic for injection.
Upon administering the injection
to his buttocks, the patient
experienced extreme pain. His leg
felt weak and he was
subsequently paralyzed.

Malpractice
Refers to a negligent act committed
in the course of professional
performance.
Example is the giving of anesthesia
by a nurse or prescribing
medicines.

Incompetence
The lack of ability, legal qualifications
or fitness to discharge the required
duty.
Example:
Although a nurse is registered, if shes
not yet an IV therapists, she is not
allowed to give IV medications or do
the IV insertion.

Assault and Battery

Assault is the imminent threat of
harmful or offensive bodily
contact.
Battery is an intentional, un
consented touching of another
person.

It is, therefore, important that

before a patient can be touched,
examined, treated or subjected to
medical/surgical procedures, he
must have given a consent to this
effect.
Example: If a patient refuses an
injection and the nurse gives it
anyway, the latter can be charged
for battery.

LEGAL TERMINOLOGIES
THAT ALSO APPLY IN IV
THERAPY

 CIVIL ACTION
a non-criminal action whereby one seeks
to protect, enforce, or declare a right or
address a civil wrong close to him or her.
When the harm occurs, the guilty party
may be required to pay damages to the
injured person.

 CRIMINAL ACTION
an action brought about by a state or
federal law enforcement agency or by an
official agency on behalf of an individual,
to protect ones person or property or to
protect society in general. Punishment
includes imprisonment, fine or both.

 DEPOSITION
a discovery procedure which is an oral
question and answer proceeding, under
oath and recorded, wherein the attorneys
seek to find out what testimony and
evidence will be confronting them in a
lawsuit. It is an informal proceeding with
lawyers of all parties present.

 INTERROGATORY
another discovery procedure which is the
written equivalent of a deposition.

RULE OF PERSONAL LIABILITY

every person is liable for his own
wrongdoing. No one can bypass this rule
with personal assurance.

 STATUTE OF LIMITATIONS
the time limit set by each state
legislature in which civil or criminal action
can be brought.

TORT
a private wrong by act or omission, which
can result in a civil action by the harmed
person.

 SUBPOENA
the process or "paper command" by which
the person served must appear at a
certain time and give testimony to the
court. It is an order under the seal of the
court for which one can be held for
contempt of court for ignoring the
subpoena.

SUMMONS
notification served upon defendant to
appear before the court.

NURSING LIABILITIES AND

PREVENTIVE MEASURES

Points to Observe in Order to Avoid

Criminal Liability
1. Be very familiar with the
Philippine Nursing Law.
2. Beware of laws that affect
nursing practice.
3. At the start of employment, get a
copy of your job description, the
agencys rules, regulations and
policies.

4. Upgrade your skills and competence.

5. Accept only such responsibility that
is within the scope of your
employment and your job description.
6. Do not delegate your responsibility to
others.

7. Develop good interpersonal

relationships with your co-workers,
whether they be your supervisors,
peers or subordinates.
8. Consult your superiors for problems
that may be too big for you to handle.
9. Verify Doctors prescriptions that are
not clear to you or those that seem to
be erroneous.

10. The doctors should be informed

about the patients conditions.
11. Keep in mind the value and
necessity of keeping complete and
accurate recording.
12. Patients are entitled to an informed
consent.

STANDARDS OF
NURSING INFUSION
CARE

REQUIREMENTS TO
BECOME AN IV
THERAPIST

Structure Criteria (NOT INCLUDED)

1. Entrance Requirements
Level of academic preparation:
A BSN graduate, RN, with a
current license from the PRC.
Behavioral characteristics :
Honesty, reliability, initiative,
flexibility and judgment.

 Demonstrates communication
and technical skills.
2. Completion Requirements
3 days Basic IV Therapy Training
Program must have successfully
participated.

3. Renewal/Revalidation of an IV
Therapy Card
The IV Therapy Card is
renewable every three (3) years.
Attendance to IV related Updates
equivalent to 24 CEU.

4. Loss of The IV Therapy Nurse

Card
Presenting an affidavit of loss.
Submitting Certificate of Training.
Photocopy of the official list of
participants of the IV therapy
training attended.

5. Cancellation of the IV Card

PRC License is not renewed.
Any violation of Nursing Law
9173.
IV Card is not renewed for more
than 3 years.
Violations in the Standards of IV
Therapy practice.

Process Criteria(NOT INCLUDED)

The IV Therapy Program consists
of discussions of concepts in IV
therapy and demonstration of
skills in access-related situations.
It has a twenty-four (24)-hour
didactic lecture and a practicum
with the following evaluation
methods:

1. Written examinations: pre and

post tests
2. Completion of the required
number of actual cases for each
of the following competencies:
Initiating and maintaining
peripheral IV infusion (3 cases).
Administering IV drugs (3 cases)

 Administering and maintaining

blood and blood components
(2 cases).

The participants will be rated as

follows: (a) Didactic 50%; and
(b) Practicum 50%.

REFERENCES

Association of Nursing Service

Administrators of the Philippines, Inc.
(ANSAP). 2000. Nursing Standards on
Intravenous Practice 7th EDITION.
Atty. Rustico T. De Belen, BA, BSN, LLB,
MNSA, PhD and Donna Vivian V. De
Belen, BSN, RN, CCRN, CRNA, MS
Anesthesia. Nursing Law, Jurisprudence
& Professional Ethics 1st EDITION.

Lesnik, M.J. and Anderson, B. Nursing

Practice and the Law. 2nd EDITION with
revisions. Philadelphia: J.B. Lippincott.
Pallock: Torts, 14th EDITION.
Philippine Nursing Act of 1991, Republic
Act No.7169 Sec.28.
Philippine Nursing Law, Republic Act No.
9173 Section 28 (a), (e).
Prescer: Torts, 3rd EDITION.

PRIMER CODE OF ETHICS THE

NURSING SERVICE
ADMINISTRATORS OF THE
PHILIPPINES.
Professional Regulation Commission,
Board of Nursing Resolution No. 8.
Professional Regulation Commission
Board of Nursing Souvenir Program Oath
taking as Professionals of the Successful
Examinees June 6 & 7, 2004 Nurse
Licensure Examination.

Venzon, Lydia M. R.N., M.A., FPCHA.

2003. Professional Nursing in the
Philippines 9th EDITION .
Websters New World Dictionary of the
American Language. Cleveland and New
York: World Publishing Co.