WOUND DRAIN

1. Removal of wound drainage
2. Types
1. closed drain
1. drain attached to collection system
2. uses vacuum to draw drainage into system
3. example: Jackson-Pratt, Hemovac
4. specific nursing interventions
1. maintain patency of drain
2. empty collection system and reactivate suction device
3. record amount and characteristics of drainage
4. asepsis
5. standard precautions
2. open drain
1. removes drainage from wound, deposits it on skin surface
2. example: Penrose drain
3. safety pin usually attached to outside end of drain
4. specific nursing interventions
5. prevent inadvertent removal of drain
1. protect skin
2. record characteristics of drainage
3. asepsis
4. standard precautions
6. protect skin surface from irritating effects of drainage
7. wound vacuum
1. removes and collects infectious material from wound
2. computer controlled
3. requires a seal at wound site with pressure distributing wound packing
4. client may be discharged with device 

HIGH RISK GROUPS FOR POST-OP INFECTIONS

1. Impaired immunologic system
2. Extremes of age
3. Diabetes mellitus
4. Corticosteroid therapy
5. Chemotherapy
6. Infection elsewhere in the body
7. Malnutrition
8. Presence of staphylococcus aureus on client
9. Contaminated environment where injury or trauma occurred

CLASSIFICATIONS OF SURGICAL WOUNDS RELATIVE TO RISK OF INFECTION

The higher the class, the higher the risk: a class IV wound carries much more risk than a class I.

1. Class I (clean wound)
1. No break in sterile technique
2. No inflammation encountered
3. GI, Respiratory or GU tract not entered
2. Class II (clean-contaminated wound)
1. GI, GU or respiratory tract entered with no spillage of contents
2. Minor breaks in technique
3. Operations involving the biliary tract, appendix, vagina, and oropharynx
3. Class III (contaminated wound)
1. Acute inflammation without pus
2. Spillage from a hollow viscus occurs
3. Trauma from a clean source
4. Class IV (dirty)
1. Pus or a perforated viscus
2. Trauma from a dirty source
3. Organism causing infection present before surgery
4. Surgical variables that increase risk of infection
5. Prolonged preoperative hospital stay
6. Body location of surgery
7. Surgical technique: delayed wound closure, excess blood loss, presence of drain, improper suture tension
8. Presence of bacteria at closure

Principles of Surgical Asepsis

1. A sterile object remains sterile only when touched by another sterile object.
• Sterile touching sterile remains sterile.
• Sterile touching clean becomes contaminated.
• Sterile touching contaminated becomes contaminated.
• Sterile touching questionable is contaminated.
• Only sterile objects may be placed on a sterile field.
2. A sterile object or field out of range of vision, or an object held below a person's waist, is contaminated.
3. Never turn your back on a sterile field.
4. A sterile object or field becomes contaminated by prolonged exposure to air.
5. When a sterile surface comes in contact with a wet, contaminated surface, the object or field becomes contaminated by capillary action.
6. Always hold your hands above the level of your elbows.
7. The edges of a sterile field or container are considered contaminated.

Cardiovascular Anatomy and Physiology

CARDIOVASCULAR SYSTEM     

A. Anatomy

              1.Layers

                   a.Pericardium: fibrous

                   b.Epicardium: covers surface of heart

                   c.Myocardium: muscular portion of the heart

                   d.Endocardium: lines cardiac chambers and covers surface of heart valves

              2.Chambers of Heart 

                   a.Right atrium: collecting chamber for incoming systemic venous system

                   b.Right ventricle: propels blood into pulmonary system

                   c.Left atrium: collects blood from pulmonary venous system

                   d.Left ventricle: thick-walled, high-pressure pump that propels blood into system

              3.Heart Valves: membranous openings that allow one way blood flow

                   a.Atrioventricular valves: prevent backflow from ventricles to atria during systole

                   b.Tricuspid - right heart valve

                   c.Mitral - left heart valve

                   d.Semilunar valves prevent backflow from aorta and pulmonary arteries into ventricles during diastole

                        1.Pulmonic

                        2.Aortic 

             4.Blood supply to heart 

                   a.Arteries

                        1.Right coronary artery supplies right ventricle and  part of left ventricle

                        2.Left coronary artery supplies mostly left ventricle

                   b.Veins

                        1.Coronary sinus veins

                        2.Thebesian veins

              5.Conduction system 

                   a.SA (Sinoatrial) node

                   b.Junctional tissue

                   c.Bundle branch Purkinje system

        

B. Physiology

              1.Function of the heart is the transport of oxygen, carbon dioxide,  nutrients and waste products

              2.Cardiac cycle consists of:

                   a.Systole - The phase of contraction during which the chambers eject blood

                   b.Diastole - The phase of relaxation during which the chambers fill with blood. When heart pumps, myocardial layer contracts and relaxes.

              3.Blood flow: 

                   a.Deoxygenated blood enters the right atrium through the  superior and inferior vena cava

                   b.Enters the right ventricle via the tricuspid valve

                   c.Travels through the pulmonic valve to pulmonary arteries and lungs

                   d.Oxygenated blood returns from lungs through the pulmonary veins into left atrium and enters the left ventricle via bicuspid (mitral) valve.

                   e.From the left ventricle, through the aortic valve through the aorta to the systemic circulation

              4.The heart itself is supplied with blood by the left and right coronary arteries

              5.The vascular system is a continuous network of blood vessels.

                   a.The arterial system consists of arteries, arterioles and capillaries and delivers oxygenated blood to tissues

                   b.Oxygen, nutrients and metabolic waste are exchanged at the microscopic level

                   c.The venous system, veins and venules, returns the blood to the heart

How to schedule Prometric Exam (Saudi Council Exam) for Filipino Nurses

Step by Step Procedures

Go to the website: http://www.prometric.com

1. Under For Test Takers, tick the dropdown list box on Academic, Professional, Government & Corporate, scroll down and click Saudi Commission for Health Specialties.

2. You will be directed to a new window of SCHS: Saudi Commission for Health Specialties Testing and you may read on some articles there regarding the organization itself. On the Get Started Box click Start.

3. From the Program Name drop down list box: choose the Saudi Commission for Health Specialties (Non-elig) 

***NOTE: the other options apply only to those who are currently in the kingdom --- then choose Philippines then click Next.

4. You will then be directed to a new window. Click Schedule an Exam. A new window will appear showing the details of registration (requirements, scheduling, payment, etc.). Click Next.

5. You will tick "I Agree on the Policy Statement" and click Next.

6. Under Exam Selection you will choose Nurse technician --- There are actually 2 options for nurses: Nurse Specialist and Nurse Technician. 

Nurse Specialist - more than 3 years and beyond practice. 

Nurse technician - 2 years experience

***NOTE: Nurses from Saudi Recruitment Office (SRO) and recruitment agencies instruct applicants to take the Nurse Technician Exam regardless of years of experience.

7. For Test Center Selection, type Manila or Cebu then click Search. Check the information of the testing Centers below:

#8475 and #8479: MANILA, Philippines

Acess 2 Floor Ateneo Professional Schools, 

130 H. Dela Costa St., Salcedo Village, Makati City

Telephone No.: (632) 892-0383

For Manila the schedule of exams are from Tuesdays to Fridays.

Directions: Prometric Testing Center-Manila is located at the Ateneo Professional Schools Salcedo (APS Salcedo) on H.V. de la Costa Street, Salcedo Village, Makati City. APS Salcedo is between Tordesillas and Sanchez Streets. Across APS Salcedo are the Megaworld Center and GF Partners. From the EDSA – Buendia Metro Rail Transit (MRT) station or Gil Puyat – Light Rail Transit (LRT) station, take a jeepney going to Gil Puyat Avenue. Disembark at Yupangco Building or Mapua Information Technology, cross to the covered walk between ACT Tower and GF Partners to get to APS Salcedo at H. V. de la Costa Street.

#8473: CEBU CITY, Philippines

Tread, Inc., Suite 308, Centro Maximo D., 

Jakosalem St., Cebu City

Tel no. 032-2535514

For Cebu the schedule of exams are from Mondays to Thursdays.

Directions: Name of the building is Centro Maximo, it is located at the corner of Jakosalem and Ranudo Sts. Cebu City. It is across the AMWAY. Other landmarks are near the Bayantel Building and IAU Building.

8. Click Schedule an Exam. You will be prompted to select your desired exam month, date and time.

9. You will be directed to another window and you will type some additional information. Type the required information including your name, address, birth date, e-mail address, government identification card, etc.Type PRC ID.  You may use other government issued card like Driver’s License and Passport. --- and in the Government ID Issuing the Card, choose: Philippines.

10. After that, you will proceed to another window and you will be typing the necessary information under the Payment Information. Type the Card Number, the Security Code.. Take in mind that they would only accept credit card payment from major credit card companies such as MasterCard, Visa and America Express. Type in the Name (the owner of the card) and the Expiration Date of the card. Review the information and click Next.

Exam Cost: 90 USD

11. After that you will be asked to review the entered information once again and you will click Complete Registration.

PRINT the Appointment Summary or save it as PDF to print at a later time. You can also check your email for the Appointment Confirmation.

Prometric Exam by Saudi Commission for Health Specialties (Saudi Council Exam)

Prometric Examination for Nurses is the popular name for Saudi Council Examination. In order to ensure a better employment status in the Kingdom of Saudi Arabia, this is a priority requirement on all agencies sending nurses there. According to news in 2009 by the Manila Bulletin, the Philippine Overseas Employment Administration (POEA) emphasized that nurses must pass this kind of exam when intending to work in Saudi Arabia. There is a great reason why it is being encouraged since working in foreign lands may mean that nurses must be competent enough in meeting the different nursing needs of the international clients.

This type of examination is actually similar to the nursing licensure examination that nurses must pass in the Philippines. It is the Saudi Commission that mandates the existence and efficacy of this type of examination.

The Exam Parts:

The Prometric Examination for Nurses is composed of 70 questions in multiple choice formats. In about two hours, the examinee is required to finish the whole test set. In browsing the site of Prometric Exam, http://www.prometric.com/NurseAide/CT.htm you will find that the description for nurses belongs to the category nurse aide.

As a nurse technician the exam is made in order to comprise the following parts:

Nursing Fundamentals: 28%

Medical – 23%

Surgical – 20%

Pediatric – 16%

Community – 13%

For Nurse Specialists, there is a different way of dividing the exam. This is how it is broken down:

Assessment – 10%

Nursing Problem – 6%

Planning – 20%

Implementation – 50%

Evaluation – 14%

For nurse technicians, the passing rate is 45% while for nurse specialists it is 50%. What is interesting here is that the rate of the examinee is readily released after the examination. It is in a form of Score Report that the examinee will know if he or she has passed the examination.

Prometric Exam Location

The Saudi Commission for Health Specialties has granted the accreditation to this exam center:

Prometric Testing Center
Ateneo Professional Schools, 130 H. Dela Costa St., Salcedo Village, Makati City
Telephone No.: (632) 892-0383

and/or

Prometric Testing Center
Tread, Inc., Suite 308, Centro Maximo D., Jakosalem St., Cebu City
Tel no. 032-2535514

Prometric Exam Payment Procedures

Once you have decided to get this examination, another thought would come into your mind is the price of this exam. Registration may come in a form of online registration of through mail. Your type of registration determines the mode of payment that you will be applying.

For online registrants, take in mind that they would only accept credit card payment from major credit card companies such as MasterCard, Visa and America Express. Those who opted to send their applications via mail, they must also send the payment using the form provided as well as the payment is in a form of cheque.

According to recent reports, registrants in Saudi Arabia must pay an Examination Fee of $80.00. Those in Asia entail them to pay $90, while nurses coming from Africa, Europe, North America and the Middle East are required to pay $100.

Prometric Exam Registration Procedure

In order to start the registration process, please go to their website: http://www.prometric.com. A tab is allotted for exam takers, click it and browse the list box for the following items, Academics, Professional, Government and Corporate. Finally, choose among the items Saudi Commission for Health Specialties.

A new site will then pop out wherein the true process of registration starts as well as the selection of the job description is needed. For Nurses, the type of exam should be selected will be either Nurse Technician or Nurse Specialist.

A form is then supplied for you to fill in. Take in note all of the information you are entering so that in order to avoid incongruence. After that the payment information will be opened. Once you have entered the information being asked, review it and finally click the complete registration tab.

Schedule of examination and sitting arrangement can readily be available on the web. For more information about the Prometric Exam, just visit their official website http://www.prometric.com/

14 R's in Drug Administration

Complete Requirements for Nursing Licensure Examination Repeaters or Second Takers (Original and Photocopy)

1. Duly accomplished Nurses’ Application Form (NAF);

2. NSO Birth Certificate

3. NSO Marriage Contract (female married applicant)

4. Transcript of Records with degree/course, exact date of graduation , Special Order (S.O)/exemption/ accreditation/deregulation status, SCANNED PICTURE and remarks "FOR BOARD EXAMINATION PURPOSES ONLY"

Other Requirements:

a.) Examination Fee Php : 900.00 (complete)/ 450.00 (conditioned)

b.) 4 pcs passport pictures in white background with complete name tag

c.) 1 piece window mailing envelope with metered postage stamp

d.) Current Community Tax Certificate (cedula)

Steps in Applying for Nursing Licensure Examination

The repeaters or second takers will follow the steps in applying for Nursing Licensure Examination below:

Step 1: Secure Nurses' Application Form (NAF) at the Information Desk

Step 2: Fill-up Application Form and proceed to Processing Counters (windows 5,6,7,8) or other designated counters.

For :

Other Degree Holder/Second Courser - proceed to the Rating Division for

interview by the Board of Nursing; Regional Filing Center - submit and return at appointed

schedule.

Repeater/Conditioned - proceed to Records Section/Unit for rating/result verification

Repeater with Change of Civil Status - proceed to the Asst. Secretariat's

office for change status approval

Foreign Sounding Surname/Born Abroad/Foreign Parents - proceed to Legal Division/Unit for approval of citizenship

Step 3: Pay examination fee at the Cashier's Counters (windows 1,2,3,4) or other designated counters.

Step 4: Accomplish all PRC Forms. Copy Application Number on the Notice of Admission.

Step 5: Proceed to the Customer Service Center/ PRC Coop Store for the metered stamps and window mailing envelope.

Step 6: Proceed to the Issuance Counters (windows 9,10,11,12) or other designated counters.

Step 7: Return to PRC 2-3 days before the exam date for verification of school/building/room assignment.

BLS-ECG-ACLS Simulation Training (Pulse HTC- Zamboanga City)

BLS-ECG-ACLS Simulation @ Pulse Htc. Credentials with Worldwide/ International Recognition ( U.S.A, Australia, Canada, SAUDI Arabia, U.A.E, Qatar, Kuwait).

 

JULY 2013 Training CCNAPI

Hyperkalemia

Heat Stroke VS Heat Exhaustion

Causes of Acid-Base Imbalances

500 Filipino Nurses for Germany

FM-POEA-04-EF-07-A

Effectivity Date: April 15, 2012

Department of Labor and Employment

Philippine Overseas Employment Administration

Government Placement Branch

RSF NO._130021___

RECRUITMENT SPECIFICATION FORM (RSF)

EMPLOYER : GERMAN FEDERAL EMPLOYMENT AGENCY (BA/ZAV)

WORKSITE : Federal Republic of Germany

CLASSIFICATION : Government

ANNOUNCEMENT:

Philippine Nurses for Germany

In accordance with the Agreement on Triple Win Migration between POEA and

the German Federal Employment Agency on the placement of Filipino Health

Professionals for Employment in the Federal Republic of Germany

Employment location: Federal Republic of Germany

Employment designation: Nursing staff (Female/Male)

Job description: Work at hospitals. Initially as assistant nurse;

after recognition of the foreign qualification work as a qualified nurse.

First Announcement:

Total number of nursing staff to be recruited until the end of 2014: 500

Requirements:

· Filipino citizen and permanent resident of the Philippines with:

          -  Bachelor of Science in Nursing (four years professional education;B.S.N.)

          -Active Philippine Nursing License

          -At least two years of professional experience as nurse in hospitals,Rehabilitation centers and care institutions

• Knowledge of German language

          -minimum Level B1 in accordance with the Common European Framework of Reference for Languages or

          -willing to undergo German language training in the Philippines for up to six (6) months (to be paid by the employer)

Employment and residence conditions:

· Nature of employment relationship

The employment contract initially is limited to one year working mainly in the job profile

of nursing assistance until the recognition of the foreign qualification.

Based on the recognition of the foreign qualification, the employment contract can be

extended after twelve months.

It is possible to apply for a permanent residence permit in Germany after five years.

· Recognition of certification:

In accordance with the provisions of the Federal Republic of Germany, the recognition

of the foreign qualification is mandatory. It has to be approved within the first year of

employment by the relevant German authorities.

· Remuneration:

Starting monthly salary amounts to €1,900 (gross), until recognition as a qualified

nurse.

· Board and Lodging:

The employer will assist the employee find a suitable accommodation and the

expenses in full or in part will be borne by the employee.

· Travel expenses:

The employer will pay the travel expenses from the Philippines to Germany.

Required application documents:

• Cover letter and curriculum vitae with colored passport size picture (in English and in German, if possible)

• High School Diploma (notarized copy)

• Diploma of nursing (notarized copy)

• Board Certificate from the Professional Regulation Commission

• Certificate/s of employment from former employers (notarized copy)

• Certificate of German language skills, if available

• Copy of valid NBI clearance

• Copy of valid passport

Application and selection process:

Submit the documents listed above to POEA under the following heading: “Triple Win”

Incomplete applications will not be considered.

Candidates who are short-listed will be informed about the location and time of their

interview with representatives of the Federal Employment Agency (BA/ZAV). Preferably,

the interview will be in German language.

In the framework of the cooperation of the German Federal Employment Agency

(BA/ZAV) and the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)

GmbH on the recruitment of nurses, GIZ will support local partners as well as provide

language, professional and orientation training in the Philippines. Furthermore, it will

support the visa procedure and serve as focal point during the first integration phase in

Germany. BA/ZAV, in cooperation with POEA, is responsible for the selection process

of nurses as well as for the placement of nurses to German employers and the approval

of working conditions.

For further information candidates can contact triplewin.poea@yahoo.com.

Please submit applications at Counter Triple Win, Employment Branch,

Manpower Registry Division, Ground Floor, POEA, Blas F. Ople Building, Ortigas

Avenue corner EDSA, Mandaluyong City.

Deadline for submission of applications: 30 June 2013

Calcium- Phosphorus Relationship

CANCER

Alkalosis VS Acidosis

Philippine Nursing Act of 2002

Republic of the Philippines
Congress of the Philippines
Metro Manila

Twelfth Congress
Second Regular Session

Begun and held in Metro Manila, on Monday, the twenty-second day of July, two thousand two.

Republic Act No. 9173             October 21, 2002

AN ACT PROVIDING FOR A MORE RESPONSIVE NURSING PROFESSION, REPEALING FOR THE PURPOSE REPUBLIC ACT NO. 7164, OTHERWISE KNOWN AS "THE PHILIPPINE NURSING ACT OF 1991" AND FOR OTHER PURPOSES

Be it enacted by the Senate and the House of Representatives of the Philippines in Congress assembled:

ARTICLE I

Title

Section 1. Title. - This Act shall be known as the "Philippine Nursing Act of 2002."

ARTICLE II

Declaration of Policy

Section 2. Declaration of Policy. – It is hereby declared the policy of the State to assume responsibility for the protection and improvement of the nursing profession by instituting measures that will result in relevant nursing education, humane working conditions, better career prospects and a dignified existence for our nurses.

The State hereby guarantees the delivery of quality basic health services through an adequate nursing personnel system throughout the country.

ARTICLE III

Organization of the Board of Nursing

Section 3. Creation and Composition of the Board. - There shall be created a Professional Regulatory Board of Nursing, hereinafter referred to as the Board, to be composed of a Chairperson and six (6) members. They shall be appointed by the president of the Republic of the Philippines from among two (2) recommendees, per vacancy, of the Professional Regulation Commission, hereinafter referred to as the Commission, chosen and ranked from a list of three (3) nominees, per vacancy, of the accredited professional organization of nurses in the Philippines who possess the qualifications prescribed in Section 4 of this Act.

Section 4. Qualifications of the Chairperson and Members of the Board. - The Chairperson and Members of the Board shall, at the time of their appointment, possess the following qualifications:

(a) Be a natural born citizen and resident of the Philippines;

(b) Be a member of good standing of the accredited professional organization of nurses;

(c) Be a registered nurse and holder of a master's degree in nursing, education or other allied medical profession conferred by a college or university duly recognized by the Government: Provided, That the majority of the members of the Board shall be holders of a master's degree in nursing: Provided, further, That the Chairperson shall be a holder of a master's degree in nursing;

(d) Have at least ten (10) years of continuous practice of the profession prior to appointment: Provided, however, That the last five (5) years of which shall be in the Philippines; and

(e) Not have been convicted of any offense involving moral turpitude; Provided, That the membership to the Board shall represent the three (3) areas of nursing, namely: nursing education, nursing service and community health nursing.

Section 5. Requirements Upon Qualification as Member of the Board of Nursing. - Any person appointed as Chairperson or Member of the Board shall immediately resign from any teaching position in any school, college, university or institution offering Bachelor of Science in Nursing and/or review program for the local nursing board examinations or in any office or employment in the government or any subdivision, agency or instrumentality thereof, including government-owned or controlled corporations or their subsidiaries as well as these employed in the private sector. He/she shall not have any pecuniary interest in or administrative supervision over any institution offering Bachelor of Science in Nursing including review classes.

Section 6. Term of Office.. - The Chairperson and Members of the Board shall hold office for a term of three (3) years and until their successors shall have been appointed and qualified: Provided, That the Chairperson and members of the Board may be re-appointed for another term.

Any vacancy in the Board occurring within the term of a Member shall be filled for the unexpired portion of the term only. Each Member of the Board shall take the proper oath of office prior to the performance of his/her duties.

The incumbent Chairperson and Members of the Board shall continue to serve for the remainder of their term under Republic Act No. 7164 until their replacements have been appointed by the President and shall have been duly qualified.

Section 7. Compensation of the Board Members. - The Chairperson and Members of the Board shall receive compensation and allowances comparable to the compensation and allowances received by the Chairperson and members of other professional regulatory boards.

Section 8. Administrative Supervision of the Board, Custodian of its Records, Secretariat and Support Services. - The Board shall be under the administrative supervision of the Commission. All records of the Board, including applications for examinations, administrative and other investigative cases conducted by the Board shall be under the custody of the Commission. The Commission shall designate the Secretary of the Board and shall provide the secretariat and other support services to implement the provisions of this Act.

Section 9. Powers and Duties of the Board. - The Board shall supervise and regulate the practice of the nursing profession and shall have the following powers, duties and functions:

(a) Conduct the licensure examination for nurses;

(b) Issue, suspend or revoke certificates of registration for the practice of nursing;

(c) Monitor and enforce quality standards of nursing practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient, ethical and technical, moral and professional standards in the practice of nursing taking into account the health needs of the nation;

(d) Ensure quality nursing education by examining the prescribed facilities of universities or colleges of nursing or departments of nursing education and those seeking permission to open nursing courses to ensure that standards of nursing education are properly complied with and maintained at all times. The authority to open and close colleges of nursing and/or nursing education programs shall be vested on the Commission on Higher Education upon the written recommendation of the Board;

(e) Conduct hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional conduct and violations of this Act, or its rules and regulations and in connection therewith, issue subpoena ad testificandum and subpoena duces tecum to secure the appearance of respondents and witnesses and the production of documents and punish with contempt persons obstructing, impeding and/or otherwise interfeming with the conduct of such proceedings, upon application with the court;

(f) Promulgate a Code of Ethics in coordination and consultation with the accredited professional organization of nurses within one (1) year from the effectivity of this Act;

(g) Recognize nursing specialty organizations in coordination with the accredited professional organization; and

(h) Prescribe, adopt issue and promulgate guidelines, regulations, measures and decisions as may be necessary for the improvements of the nursing practice, advancement of the profession and for the proper and full enforcement of this Act subject to the review and approval by the Commission.

Section 10. Annual Report. - The Board shall at the close of its calendar year submit an annual report to the President of the Philippines through the Commission giving a detailed account of its proceedings and the accomplishments during the year and making recommendations for the adoption of measures that will upgrade and improve the conditions affecting the practice of the nursing profession.

Section 11. Removal or Suspension of Board Members. - The president may remove or suspend any member of the Board after having been given the opportunity to defend himself/herself in a proper administrative investigation, on the following grounds;

(a) Continued neglect of duty or incompetence;

(b) Commission or toleration of irregularities in the licensure examination; and

(c) Unprofessional immoral or dishonorable conduct.

ARTICLE IV

Examination and Registration

Section 12. Licensure Examination. - All applicants for license to practice nursing shall be required to pass a written examination, which shall be given by the Board in such places and dates as may be designated by the Commission: Provided, That it shall be in accordance with Republic Act No. 8981, otherwise known as the "PRC Modernization Act of 2000."

Section 13. Qualifications for Admission to the Licensure Examination. - In order to be admitted to the examination for nurses, an applicant must, at the time of filing his/her application, establish to the satisfaction of the Board that:

(a) He/she is a citizen of the Philippines, or a citizen or subject of a country which permits Filipino nurses to practice within its territorial limits on the same basis as the subject or citizen of such country: Provided, That the requirements for the registration or licensing of nurses in said country are substantially the same as those prescribed in this Act;

(b) He/she is of good moral character; and

(c) He/she is a holder of a Bachelor's Degree in Nursing from a college or university that complies with the standards of nursing education duly recognized by the proper government agency.

Section 14. Scope of Examination. - The scope of the examination for the practice of nursing in the Philippines shall be determined by the Board. The Board shall take into consideration the objectives of the nursing curriculum, the broad areas of nursing, and other related disciplines and competencies in determining the subjects of examinations.

Section 15. Ratings. - In order to pass the examination, an examinee must obtain a general average of at least seventy-five percent (785%) with a rating of not below sixty percent (60%) in any subject. An examinee who obtains an average rating of seventy-five percent (75%) or higher but gets a rating below sixty percent (60%) in any subject must take the examination again but only in the subject or subjects where he/she is rated below sixty percent (60%). In order to pass the succeeding examination, an examinee must obtain a rating of at least seventy-five percent (75%) in the subject or subjects repeated.

Section 16. Oath. - All successful candidates in the examination shall be required to take an oath of profession before the Board or any government official authorized to administer oaths prior to entering upon the nursing practice.

Section 17. Issuance of Certificate of Registration/Professional License and Professional Identification Card. - A certificate of registration/professional license as a nurse shall be issued to an applicant who passes the examination upon payment of the prescribed fees. Every certificate of registration/professional license shall show the full name of the registrant, the serial number, the signature of the Chairperson of the Commission and of the Members of the Board, and the official seal of the Commission.

A professional identification card, duly signed by the Chairperson of the Commission, bearing the date of registration, license number, and the date of issuance and expiration thereof shall likewise be issued to every registrant upon payment of the required fees.

Section 18. Fees for Examination and Registration. - Applicants for licensure and for registration shall pay the prescribed fees set by Commission.

Section 19. Automatic Registration of Nurses. - All nurses whose names appear at the roster of nurses shall be automatically or ipso facto registered as nurses under this Act upon its effectivity.

Section 20. Registration by Reciprocity. - A certificate of registration/professional license may be issued without examination to nurses registered under the laws of a foreign state or country: Provided, That the requirements for registration or licensing of nurses in said country are substantially the same as those prescribed under this Act: Provided, further, That the laws of such state or country grant the same privileges to registered nurses of the Philippines on the same basis as the subjects or citizens of such foreign state or country.

Section 21. Practice Through Special/Temporary Permit. - A special/temporary permit may be issued by the Board to the following persons subject to the approval of the Commission and upon payment of the prescribed fees:

(a) Licensed nurses from foreign countries/states whose service are either for a fee or free if they are internationally well-known specialists or outstanding experts in any branch or specialty of nursing;

(b) Licensed nurses from foreign countries/states on medical mission whose services shall be free in a particular hospital, center or clinic; and

(c) Licensed nurses from foreign countries/states employed by schools/colleges of nursing as exchange professors in a branch or specialty of nursing;

Provided, however, That the special/temporary permit shall be effective only for the duration of the project, medical mission or employment contract.

Section 22. Non-registration and Non-issuance of Certificates of Registration/Professional License or Special/Temporary Permit. - No person convicted by final judgment of any criminal offense involving moral turpitude or any person guilty of immoral or dishonorable conduct or any person declared by the court to be of unsound mind shall be registered and be issued a certificate of registration/professional license or a special/temporary permit.

The Board shall furnish the applicant a written statement setting forth the reasons for its actions, which shall be incorporated in the records of the Board.

Section 23. Revocation and suspension of Certificate of Registration/Professional License and Cancellation of Special/Temporary Permit. - The Board shall have the power to revoke or suspend the certificate of registration/professional license or cancel the special/temporary permit of a nurse upon any of the following grounds:

(a) For any of the causes mentioned in the preceding section;

(b) For unprofessional and unethical conduct;

(c) For gross incompetence or serious ignorance;

(d) For malpractice or negligence in the practice of nursing;

(e) For the use of fraud, deceit, or false statements in obtaining a certificate of registration/professional license or a temporary/special permit;

(f) For violation of this Act, the rules and regulations, Code of Ethics for nurses and technical standards for nursing practice, policies of the Board and the Commission, or the conditions and limitations for the issuance of the temporarily/special permit; or

(g) For practicing his/her profession during his/her suspension from such practice;

Provided, however, That the suspension of the certificate of registration/professional license shall be for a period not to exceed four (4) years.

Section 24. Re-issuance of Revoked Certificates and Replacement of Lost Certificates. - The Board may, after the expiration of a maximum of four (4) years from the date of revocation of a certificate, for reasons of equity and justice and when the cause for revocation has disappeared or has been cured and corrected, upon proper application therefor and the payment of the required fees, issue another copy of the certificate of registration/professional license.

A new certificate of registration/professional license to replace the certificate that has been lost, destroyed or mutilated may be issued, subject to the rules of the Board.

ARTICLE V

Nursing Education

Section 25. Nursing Education Program. - The nursing education program shall provide sound general and professional foundation for the practice of nursing.

The learning experiences shall adhere strictly to specific requirements embodied in the prescribed curriculum as promulgated by the Commission on Higher Education's policies and standards of nursing education.

Section 26. Requirement for Inactive Nurses Returning to Practice. - Nurses who have not actively practiced the profession for five (5) consecutive years are required to undergo one (1) month of didactic training and three (3) months of practicum. The Board shall accredit hospitals to conduct the said training program.

Section 27. Qualifications of the Faculty. - A member of the faculty in a college of nursing teaching professional courses must:

(a) Be a registered nurse in the Philippines;

(b) Have at least one (1) year of clinical practice in a field of specialization;

(c) Be a member of good standing in the accredited professional organization of nurses; and

(d) Be a holder of a master's degree in nursing, education, or other allied medical and health sciences conferred by a college or university duly recognized by the Government of the Republic of the Philippines.

In addition to the aforementioned qualifications, the dean of a college must have a master's degree in nursing. He/she must have at least five (5) years of experience in nursing.

ARTICLE VI

Nursing Practice

Section 28. Scope of Nursing. - A person shall be deemed to be practicing nursing within the meaning of this Act when he/she singly or in collaboration with another, initiates and performs nursing services to individuals, families and communities in any health care setting. It includes, but not limited to, nursing care during conception, labor, delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood, and old age. As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness. A members of the health team, nurses shall collaborate with other health care providers for the curative, preventive, and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, towards a peaceful death. It shall be the duty of the nurse to:

(a) Provide nursing care through the utilization of the nursing process. Nursing care includes, but not limited to, traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral topical and parenteral medications, internal examination during labor in the absence of antenatal bleeding and delivery. In case of suturing of perineal laceration, special training shall be provided according to protocol established;

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

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

(d) Teach, guide and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services; engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse; and

(e) Undertake nursing and health human resource development training and research, which shall include, but not limited to, the development of advance nursing practice;

Provided, That this section shall not apply to nursing students who perform nursing functions under the direct supervision of a qualified faculty: Provided, further, 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. The nurse is required to maintain competence by continual learning through continuing professional education to be provided by the accredited professional organization or any recognized professional nursing organization: Provided, finally, That the program and activity for the continuing professional education shall be submitted to and approved by the Board.

Section 29. Qualification of Nursing Service Administrators. - A person occupying supervisory or managerial positions requiring knowledge of nursing must:

(a) Be a registered nurse in the Philippines;

(b) Have at least two (2) years experience in general nursing service administration;

(c) Possess a degree of Bachelors of Science in Nursing, with at least nine (9) units in management and administration courses at the graduate level; and

(d) Be a member of good standing of the accredited professional organization of nurses;

Provided, That a person occupying the position of chief nurse or director of nursing service shall, in addition to the foregoing qualifications, possess:

(1) At least five (5) years of experience in a supervisory or managerial position in nursing; and

(2) A master's degree major in nursing;

Provided, further, That for primary hospitals, the maximum academic qualifications and experiences for a chief nurse shall be as specified in subsections (a), (b), and (c) of this section: Provided, furthermore, That for chief nurses in the public health nursing shall be given priority. Provided, even further, That for chief nurses in military hospitals, priority shall be given to those who have finished a master's degree in nursing and the completion of the General Staff Course (GSC): Provided, finally, That those occupying such positions before the effectivity of this Act shall be given a period of five (5) years within which to qualify.

ARTICLE VII

Health Human Resources Production, Utilization and Development

Section 30. Studies for Nursing Manpower Needs, Production, Utilization and Development. - The Board, in coordination with the accredited professional organization and appropriate government or private agencies shall initiate undertake and conduct studies on health human resources production, utilization and development.

Section 31. Comprehensive Nursing Specialty Program. - Within ninety (90) days from the effectivity of this Act, the Board in coordination with the accredited professional organization recognized specialty organizations and the Department of Health is hereby mandated to formulate and develop a comprehensive nursing specialty program that would upgrade the level of skill and competence of specialty nurse clinicians in the country, such as but not limited to the areas of critical care, oncology, renal and such other areas as may be determined by the Board.

The beneficiaries of this program are obliged to serve in any Philippine hospital for a period of at least two (2) years and continuous service.

Section 32. Salary. - In order to enhance the general welfare, commitment to service and professionalism of nurses the minimum base pay of nurses working in the public health institutions shall not be lower than salary grade 15 prescribes under Republic Act No. 6758, otherwise known as the "Compensation and Classification Act of 1989": Provided, That for nurses working in local government units, adjustments to their salaries shall be in accordance with Section 10 of the said law.

Section 33. Funding for the Comprehensive Nursing Specialty Program. - The annual financial requirement needed to train at least ten percent (10%) of the nursing staff of the participating government hospital shall be chargeable against the income of the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation, which shall equally share in the costs and shall be released to the Department of Health subject to accounting and auditing procedures: Provided, That the department of Health shall set the criteria for the availment of this program.

Section 34. Incentives and Benefits. - The Board of Nursing, in coordination with the Department of Health and other concerned government agencies, association of hospitals and the accredited professional organization shall establish an incentive and benefit system in the form of free hospital care for nurses and their dependents, scholarship grants and other non-cash benefits. The government and private hospitals are hereby mandated to maintain the standard nurse-patient ratio set by the Department of Health.

ARTICLE VIII

Penal and Miscellaneous Provisions

Section 35. Prohibitions in the Practice of Nursing. - A fine of not less than Fifty thousand pesos (P50,000.00) nor more than One hundred thousand pesos (P100,000.00) or imprisonment of not less than one (1) year nor more than six (6) years, or both, upon the discretion of the court, shall be imposed upon:

(a) any person practicing nursing in the Philippines within the meaning of this Act:

(1) without a certificate of registration/professional license and professional identification card or special temporary permit or without having been declared exempt from examination in accordance with the provision of this Act; or

(2) who uses as his/her own certificate of registration/professional license and professional identification card or special temporary permit of another; or

(3) who uses an invalid certificate of registration/professional license, a suspended or revoked certificate of registration/professional license, or an expired or cancelled special/temporary permits; or

(4) who gives any false evidence to the Board in order to obtain a certificate of registration/professional license, a professional identification card or special permit; or

(5) who falsely poses or advertises as a registered and licensed nurse or uses any other means that tend to convey the impression that he/she is a registered and licensed nurse; or

(6) who appends B.S.N./R.N. (Bachelor of Science in Nursing/Registered Nurse) or any similar appendage to his/her name without having been coferred said degree or registration; or

(7) who, as a registered and licensed nurse, abets or assists the illegal practice of a person who is not lawfully qualified to practice nursing.

(b) any person or the chief executive officer of a judicial entity who undertakes in-service educational programs or who conducts review classes for both local and foreign examination without permit/clearance from the Board and the Commission; or

(c) any person or employer of nurses who violate the minimum base pay of nurses and the incentives and benefits that should be accorded them as specified in Sections 32 and 34; or

(d) any person or the chief executive officer of a juridical entity violating any provision of this Act and its rules and regulations.

ARTICLE IX

Final Provisions

Section 36. Enforcement of this Act. - It shall be the primary duty of the Commission and the Board to effectively implement this Act. Any duly law enforcement agencies and officers of national, provincial, city or municipal governments shall, upon the call or request of the Commission or the Board, render assistance in enforcing the provisions of this Act and to prosecute any persons violating the same.

Section 37. Appropriations. - The Chairperson of the Professional Regulation Commission shall immediately include in its program and issue such rules and regulations to implement the provisions of this Act, the funding of which shall be included in the Annual General Appropriations Act.

Section 38. Rules and Regulations. - Within ninety (90) days after the effectivity of this Act, the Board and the Commission, in coordination with the accredited professional organization, the Department of Health, the Department of Budget and Management and other concerned government agencies, shall formulate such rules and regulations necessary to carry out the provisions of this Act. The implementing rules and regulations shall be published in the Official Gazette or in any newspaper of general circulation.

Section 39. Reparability Clause. - If any part of this Act is declared unconstitutional, the remaining parts not affected thereby shall continue to be valid and operational.

Section 40. Repealing Clause. - Republic Act No. 7164, otherwise known as the "Philippine Nursing Act of 1991" is hereby repealed. All other laws, decrees, orders, circulars, issuances, rules and regulations and parts thereof which are inconsistent with this Act are hereby repealed, amended or modified accordingly.

Section 41. Effectivity. - This act shall take effect fifteen (15) days upon its publication in the Official Gazette or in any two (2) newspapers of general circulation in the Philippines.

Approved,

FRANKLIN DRILON President of the Senate

JOSE DE VENECIA JR. Speaker of the House of Representatives

This Act, which originated in the House of Representative was finally passed by the House of Representatives and the Senate on October 15, 2002 and October 8, 2003 respectively.

OSCAR G. YABES Secretary of Senate

ROBERTO P. NAZARENO Secretary General House of Represenatives

Approved: October 21, 2002

GLORIA MACAPAGAL-ARROYO

President of the Philippines