Ske
Republic of the s
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

TWENTIETH CONGRESS,
First Regular Session

3582_

Introduced by Representatives MARIA RACHEL J. ARENAS.

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW,
PROMOTING A MORE RESPONSIVE AND EFFECTIVE HEALTH
CARE SYSTEM, AND APPROPRIATING FUNDS THEREFOR

EXPLANATORY NOTE

‘The COVID-19 pandemic greatly impacted the country’s healthcare system and burdened our medical
professionals, especially nurses. Nurses were thrust in the frontlines, overwhelmed with keeping the COVID-19
cases under control. Equipped with the needed competencies to ensure patient health and wellness, nurses are vital to
the healthcare of all Filipinos. They also play a significant role in ensuring the successful delivery of the Uni cereal
Health Care (UHC) Act. However, there are persistent challenges, such as terrible working conditions, lack of
professional development, delayed benefits, and unjust compensation, that affect the number of nurses needed to

‘meet population needs!.

TThe shortage of nurses became even more evident with the record high cases of COVID-19 in the country.
Underpaid paired with the delayed release of benefits and overwhelmed by working long shifts, many nurses were
tempted to leave their jobs. In 2020, around 40% of Filipino nurses resigned in private hospitals2. The high salary
offers and better allowances and benefits in other countries also aggravated the understaffing of nurses in hospitals.

In recent weeks, $-10% of nurses in private hospitals have quit their jobs to pursue work« abroad3.
It is crucial that the government take immediate steps and address the mass resignation and several understaffing of
nurses, or else there will be a shortfall, and our healthcare system will be crippled. There is a dire need to ensure that
nurses are secured with proper wages, manageable workload, healthy environments, and opportunities for career growth.
Greater investment must be made so our nurses are empowered and supported and will stay in the country.

|As such, this bill seeks to protect and care for murses through just employment, welfare compensation, and
practice environments through the following, among others:
(1) strengthening the regulation of the profession through the empowerment of the Professional Regulatory of
‘Nursing; (2) ensuring top level leadership in nursing regulation, education, service, and research; (3) promoting competent


and credentialed professionals through continuing professional development and carcer progression; (4) ensuring safe
staffing and nursing skill mix for quality care through the institutionatization of the Nursing Human Resource for Health
‘Management System (NHRHMS) in all settings and sectors; and (5) preparing, credentialing, and recognizing nurses for
advanced practice in nursing to meet the gap created by increasingly complex healthcare needs, the strong focus of
universal healthcare on primary care, and the need to reach Filipinos in inaccessible or underserved settings.

The immediate passage of this bill is earnestly sought.



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Mani

TWENTIETH CONGRESS
First Regular Session

3582

HOUSEBILLN

Introduced by Representatives MARIA RACHEL J. ARENAS

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW, PROMOTING
A MORE RESPONSIVE AND EFFECTIVE HEALTH CARE SYSTEM,
AND APPROPRIATING FUNDS THEREFOR.

Be itenacted by the Senate and Haseof Representatives of the Philippines in Congress
assembled:

ARTICLE I
GENERAL PROVISIONS

Section 1, Title. -

is Act shall be known as the "New Philippine Nursing Practice
Act’

Section 2. Declaration of Policy. -In pursuit of the constitutional precept that Health is a right of
every Filipino, itis hereby declared the policy of the State to uphold the welfare of healthcare workers as an important
objective towards achieving the goals of universal health care in the country. It is likewise declared as the policy of the
‘State to uphold the dignity of nurses, to accord them the respect befitting the service they render to the nation, and to
improve the practice of the nursing profession by instituting measures to ensure their professional growth, promote
comprchensive and relevant nursing practice standards, and provide just and humane working conditions in every
health facility, institution, or establishment in order to ensure their well-being and the health and safety of the public.
Nurses comprise a great majority of the healtheare workers both in the institutional and community levels. Thus. the
Slate recognizes nurses as prime movers of national development and contributors to international cooperation and
understanding. The State furthermore, recognizes the necessity of implementing an adequate and comprehensive
‘Nursing Human Resource for Health Management System (NHRHMS) throughout the country in order to adequately
deliver accessible, affordable, and quality health care.

Section. 3, Definition of Terms. ~ As used in this Act:

a) Accredited Professional Organization (APO) refers to the national professional organization
‘of nurses duly aceredited by the Professional Regulation Commission (PRC);

b) Bachelor of Science in Nursing (BSN) refers to the baccalaureate program that provides sound
and liberal education that equips graduates with competencies for registration as a
professional and is the sole required academic standard for entry into nursing practice in the
Philippines, in accordance with the appropriate qualification framework. The BSN program is
effectively promulgated under Memorandum Order No. 15, series of 2017, on the Policies,
Standards and Guidelines for the Bachelor of Science in Nursing (BSN) Program prescribed
and issued by the Commission on Higher Education (CHED),

©) Career Progression and Specialization Council for Nursing (CPSCN) refers tothe body
deputized by the Professional Regulation Commission to develop standards of practice for
cach nursing-level standards, establish mechanisms and criteria fr credentialing of specialty
‘organizations and interest groups, cenification of individuals at different levels of Post
‘Baccalaureate nursing and advanced practice, for recommendation tothe Board;


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Career Progression and Specialization Program for Nurses (CPSPN) refers tothe Program
recognized by the PRC and the Board involving the progressive transfer of knowledge and
skill forthe various level ofthe nursing, practice the system of credentialing specialty
‘organizations and interest groups. and the certification of individuals at different levels of
practice;

Certification refers tothe process of validating achievements through a variety of measures
‘and assessment strategies to confirm or attest to the competency of an Advance Practice Nurse
(APN) upon completion of a specialty program or Continuing Professional Development
(CPD) program, or both. The certification is issued by the Board and the PRC upon the
endorsement of the specified recognized and credentialed specialty organization in accordance
with the PSG:

Chief Nursing Officer (CNO) refers to the highest nursing administrative and clinical official
in healthcare facilities. The CNO is responsible for leading and coordinating an organization's
nursing services and its daily operation. The CNO is the primary spokesperson for nurses in
the facility and must be a registered nurse;

Clinical Practice refers to professional practice rendered in any healthcare setting whether in
the private or public sector;

CCredentialling refers to the formal recognition ofa speci
‘conferred by the PRC and the Board, upon the recommendation of the CPSPN..
‘complying with the policies, standards and guidelines issued by the Board;

ty organization or interest group
fler

Decent Work refers to aspirations by people in their working lives. It involves opportunites
for productive work that delivers a fair income, affords security inthe workplace, social
protection for families, better prospects for personal development, psychological well-being,
‘opportunities fo social integration, including the frcedom for pcople to expres their concerns
and organize and participate in decisions that affect thei lives, and promotes equality of
‘opportunity or treatment regardless of ethnicity, gender, position or religion;

Expanded Role refers to the broadening ofthe roles of an APN by virtue of the nurse's
‘expertise and the scope of nursing practice. An APN has a recognized autonomous role within
a specialized field of practice;

Geographically Isolated and Disadvantaged Areas (GIDAS) refer t0
barangay specifically disadvantaged due to the presence of both physical and socio-economic
factors:

Healtheare Facility refers to a publie or private institution, establishment or clinic devoted
primarily to the provision of services that include the following: nursing, health promotion,
prevention of linss. diagnosis, treatment, rchabilitaton, and palliation of individuals
suffering from illness, discase, injury or disability, or deformity, or in need of obstetrical,
psychiatric or other medical and nursing care, and includes hospitals, barangay health center,
and other clnis;

Individual-based Health Services refer to services which can be accessed remotely of within a
health facility that focuses primarily on treating individuals;

National Chief Nursing Officer (NCNO) refers to the highest-ranking nursing official ofthe
Department of Health (DOH) whose main function i to promote safe nursing and quality
standards and implement nursing policies for both the public and private sectors. The
responsibilty of the NCNO is 0 assist the government to achieve the health goals ofthe
county through expert advice based on timely accurate local data and national and
international evidence, and by promoting quality nursing standards inthe nursing profession
and the healthcare industry;

[Nurse refers to a person duly registered and licensed to practice the nursing profession, with
all the rights and privileges appurtenant thereto;

‘Nursing care refers to the physiological, psychological, spiritual, social and emotional care,
‘essential care, essential health care, safety and comfort measures, and health teachings:
‘execution of health care techniques and procedures and traditional and innovative approaches
10 individuals, families, population groups and communitics, from conception to death;

‘Nursing Fluman Resource for lealth Management System (NHRHMS) refers to an organized
human resource management and development information system based in the DOH and
<ireeted by the NCNO, that provides meaningful data used to support policies affecting nurses
and nursing;

Nursing practice refers to varius stages of development towards the promotion of health,
prevention of lines, health care techniques and procedures, restoration of health alleviation
Of suffering, and end-of life ere. t encompasses the care of clients in various stages of human
growth and development from conception, labor, delivery. infancy. childhood. toddler, pre=


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school, school age, adolescence, adulthood to old age, be it performed independently or
collaboratively with other professions.

[Nursing Service refers to an office within a public or private healthcare institution, responsible
for administrative and clinical supervision of nurses and nursing personnel headed by a CNO;

Patient Acuity refers to the imtensity of care provided to a patient by a registered nurse, or the
use od patient classification systems that can forceast patient care requirements for nursing,
care and are therefore vital in the management of nursing personnel;

Philippine Professional Nursing Practice Standards (PPNPS) refers to the authoritative
statements of the core competencies and duties that all registered nurses, regardless of role,
designation, or specialty, are expected to perform. The PNPS promotes, guides, and directs
professional practice:

Philippine Professional Nursing Roadmap (PNR) refers to program towards good
‘governance of the nursing profession, the goal of which is to develop and promote a culture of
excellence and dynamic leadership in Philippine nursing. The PPNR is anchored on five
initiatives: collaborative partnership, competency enhancement, linkages, social
‘impact, embedding the core values and positive qualities of the Filipino nurse;

Population-based Health Services refer to interventions such as health promotion, disease
surveillance, and vector control, which have population groups as recipients;

Positive practice environment refers to a practice setting that promotes economic welfare,
professional autonomy, job satisfaction and retention of nurses by ensuring safe staffing,
‘managerial support, professional development, occupational safety and psychological health
and prevention of workplace violence to promote patient and nurse safety;

Procarious work refers to working conditions which are contingent, atypical or non-standacd.
I is usually characterized by characterized by uncertainty and instability in one’s employment
status, such as when there is a threat of change or diminution in one's rank or position, or
When there is ambiguity in the employee-emaployer relationship, lack of access to social
protection benefits usually associated with employment, low pay and substantial legal and
practical obstacles to joining a trade union in order to avail of the right to bargain
collectively:

Primary Care refers to initil-contact, continuous, comprehensive and coordinated, and
culturally appropriate care that is accessible a the time of need, including a range of services
for all presenting conditions, and the ability to coordinate referrals to other health care
providers in the healthcare delivery system, when nocessary;

Public Health Institution (PHI) refers to any government-led, owned, or controlled institution
‘which pursues and realizes the lofty goals and objectives of providing and managing safe,
efficient, effective, and quality public health programs and services and advocacies for health
in all levels ofthe national to local Health Care Delivery System (HCDS), which include rural
health units (RIUs) and barangay healthcare centers; research facilities such as the Research
Institute for Tropical Medicine, and the like raining resource facilities such as the University
of the Philippines College of Public Health and State or Local Colleges or Universities
offering health related programs; the DOH and all retained healthcare facilities, and the like;

Retum Service Agreement refers o an agreement whereby graduates of the nursing course
‘who are recipients of government-funded scholarship programs arc required to serve in
priority areas in the public sector, subject to the conditions prescribed by R.A. No. 11223,
‘otherwise known as “The Universal Health Care Act”;

Special Temporary Permit (STP) refers tothe authority to engage in limited nursing practice
‘granted to foreign registered or licensed nurses and Filipino nursing graduates under the
condition set forth in this Act


ARTICLE It
BOARD OF NURSING

Section. 4. Creation and Composition of the Board. — There shall be created, under the administrative
supervision of the PRC, the Professional Regulatory Board of Nursing which shall be composed of seven (7)
Members who shall elect from among themselves a Chairperson to serve for one (1) year only but may be re elected
as Chairperson on a year-to-year basis. The President of the Republic of the Philippines shall appoint the members of
the Board (rom among those recommended and ranked from a list of at least three (3) nominees per vacancy as
provided by the APO, Preferably, the membership of the Board shall be distributed to proportionately represent both
‘nursing service and nursing academe, and that the members’ areas of expertise cover all the areas ofthe licensure
examination,

Section. 5. Mission of the Professional Regulatory Board of Nurses, — The mission of the Board is to
protect and promote the welfare ofthe people ofthe Philippines by ensuring that each person holding a license as @
nurse in the Philippines is competent to practice the nursing profession safely. Pursuant thereto, the Board shall
regulate the practice of nursing and in collaboration with the CHED, review and approve nursing education programs
to be offered by authorized higher educa tutions. The Board, acting in accordance withthe highest standards
of ethics, accountability, efficiency, effectiveness, and transparency, shall approach its mission with a deep sense of
purpose and responsibility and affirms that the regulation of nursing isa public trust.

Section. 6. Qualifications of the Chairperson and Members of the Board. — The Chairperson and
“Members must be natural-born citizens of the Philippines and have resided thercin for atleast five (5) consecutive

years immediately preceding the date of thei respective appointments. Furthermore, atthe time of theit
Appointment, they must possess the following:
a) A valid and current certificate ——of_—registration and professional
identification card:

b) A Master's Degree in nursing, and preferably, with relevant Doctorate Degree conferred by a
duly recognized HEL;

©) Atleast ten (10) continuous years nursing practice prior to appointment: Provided: That the
last five (5) years of such practice must have been served in tae Philippines;

4) Good moral character as evidenced for not having convicted of any offense involving moral
turpitude; and

©) Physical and mental fitness,

Section. 7. Prohibition as Members of the Board. — The Members of the Board shall not, at the time of
‘their appointments and during their incumbeney, hold any position nor have pecuniary interest, direet or indirect, in
any {EI offering BSN. or in any review or training,center for the PNLE, training hospital or healtheare facility with
nursing affiliates, and is not an officer of the APO.

Section. 8. Term of Office. — The Members of the Board shall hold office fora term of three (3) years.
‘Any Member of the Board may serve for a maximum of two (2) terms ora total of six (6) years, oF until their
‘successors shall have been appointed and qualified

Section. 9. Vacancy. — Any vacancy in the Board must be filled in the manner prescribed in this Act and.
‘only for the unexpired portion ofthe term, Each member of the Board shall take the proper oath of office prior to the
performance of duties.

Section. 10. Compensation. — The Members of the Board shall receive compensation and allowances
‘comparable to those received by the Members of other regulatory boards under the PRC.


Section. 11. Limited Practice of the Profession. —- During theie incumbency, the Members of the Board
may be allowed to practice their profession or maintain employment or affiliation in the public or private sector
subject to the conditions and limitations prescribed by law and upon proper and timely disclosure of possible or
actual conflict of interest

Section. 12. Administrative Supervision of the Board, Custodian of its Records, Secretariat and
‘Support Services. —The Board shall be under the administrative supervision of the PRC. All records of the Board,
including applications for examinations, administrative and other investigative eases conducted by the Board must be
under the custody of the PRC. The PRC shall designate the Secretary of the Board and shall provide the secretariat
and other support serviees to implement the provisions of this Act

Section. 13. 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) Ensure the proper conduct of the PNLE, including the evaluation of examination applications,
test development, administration of the examination, and the correction and release of the results
thereof. The use of appropriate technologies and modalities on the conduct of the PNLE is
encouraged to enhance efficiency while upholding integrity;

’) Enforce and monitor safe and quality standards of nursing practice, study the conditions affecting
nursing practice in the Philippines, and exercise the powers necessary to ensure the maintenance
‘of efficient, cthico-moral technical and professional standards inthe practice of nursing towards
‘optimal health and the common good:

©) Ensure quality nursing in coordination with the CHED through the monitoring of HEI offerings,
‘The continuing review of the nursing curriculum and the timely application for authority to offer
new nursing education programs in order to ensure that the standards of nursing education are
properly complied with and systematically updated in accordance with the latest development in
health care:

4) Within one (1) year from the effectivity ofthis Act, promulgate a Code of Ethics and Ethical
‘Standards that is responsive to the needs of the nursing profession, in coordination with the APO
for nurses;

©) Prescribe and operationalize a Career Progression and Specialization Program for Nursing
(CPSPN) which shal include the recognition and credentialing of organized nursing sroups
andthe cenification of advanced practice nurses to ensure the continuing professional
development of nurses;

4) Work in partnership with the appropriate agencies to identify and utilize resources earmarked for
national nursing development:

8) Prescribe, adopt, issue and promulgate guidelines, regulations, measures and to submit
recommendations to authorities and agencies to aid in policy formulation and decision-making as
may be necessary for the improvement of nursing practice, advancement ofthe profession, and
for the proper and full enforcement of this Act, subject to review and approval of the PRC;

fh) SpearheaD and oversee the Philippine Profession Nursing Roadmap:

') Conduct hearings and investigations to resolve complaints against nurses for unethical or
unprofessional conduct or any violation of this Act, or its rules and regulations, and in connection
therewith, issue subpoena ad testficandum or subpoena duces tecum, or both, 10 require the
appearance of respondents and witnesses or the production of documents, or both and to
penalize for contempt persons obstructing, impeding or otherwise interfering with the conduct of
such proceedings, upon application with the regular courts;

j) Issue, suspend, revoke, or reinstate certificate of registration and special temporary permits for
the practice of nursing: and

k) Ensure performance of mandated duties and functions.

Section, 14. Annual Report. — The Board shall, atthe close of every calendar year, submit an annual report
to the President and Congress of the Philippines, through the PRC, giving a detailed account of its proceedings and
the accomplishments during the year and recommending the adoption of measures that will upgrade and improve the
conditions affecting the practice of the nursing profession,


Section. 15. Removal or Suspension of Board Members. — The President may remove ot suspend any
member of the Board, after due process, upon recommendation of the PRC on any of the following grounds:

4) Continued neglect of duty or incompetence;
6) Commission or toleration of irregularities in the conduct of the PNLE;
©) Unprofessional, immoral, or dishonorable conduct; or

4) Non-disclosure of conflict of interest.

ARTICLE I
EXAMINATION AND REGISTRATION

Section. 16. Philppine Nurse Licensure Examination (PNLE). — In otder to oblain a Certificate of
registration and professional identification card, all nursing graduates must take and pass the PNLE. The Board shall
administer the PNLE in such places and dates as may be designated by the PRC.

Section. 17. Scope of Examination. — The Board shall determine the scope of the PNLE, taking into
considcration the nursing core competencies, the nursing curriculum, the scope and arcas of nursing practice, and other
related disciplines.

Section. 18, Qualifications for Admission to the PNLE. — At the time of the filing of application for the
PNLE, an applicant must be:

2) Aboldcr of a BSN degree from an HEI tha is compliant with the standards of nursing
‘education recognized by the government;

) Of good moral character and has not been convicted by final judgment of any criminal offense
involving moral turpitude or found guilty of immoral or dishonorable conduct or judicially
declared to be of unsound mind: and

©) Acitizen of the Philippines, or ofa forcign country or State which permits Filipino nurses to
practice within is territorial limits on the same basis as the subject or citizen of such country
(or State: Provided, That the requirements for the registration or licensing of nurses in said
‘country or State are substantially the same as those prescribed inthis Act,

Section. 19. Professional Nurse Licensure Examination and Registration Fees. —Applicants for the
PNLE and registration must pay the prescribed fees set by the PRC.

Section. 20. Professional Nurse Licensure Examination Ratings. — To be considered as having passed the
PNLE, an examinee must pass atleast seventy-five percent (75%) of the tested areas of all the nursing competencies.
‘An examince who has failed the PNLE three times (3x) shall not be allowed to take it any further without first
undertaking a refresher program in a duly accredited institution. The Board shall issue the guidelines on the refresher
program requirement,

Section. 21. Issuance of Certificate of Registration and Professional Identification Card. —The
certificate of registration and professional identification card shall be issued to all successful examinees, upon
‘compliance with al the requirements for registration. The certificate of registration shall show the full name of the
registrant, critica of registration number, and date of inital registration, The same must be duly signed by the
CChaieperson and Members ofthe Board andthe Chairperson ofthe PRC, with their corresponding scals. The
professional identification card shall bear the full name of the registrant, the ceriicat of registration number, date of
intial registration, and date ofthe expiration, and which must be duly signed by the Chairperson ofthe PRC. The


professional identification card shall be renewed every three (3) years upon satisfaction by the applicant of the
requirements set by the PRC, including the payment of the required fees and compliance with the Continuing
Professional Development (CPD) requirement

Section, 22. Oath of Profession. — All successful examinees must take the Oath of Profession before any
‘member of the Board or government official authorized to administer oaths prior to practicing their profession.

Section, 23. Registry of Nurses. — The PRC shall maintain a roster of nurses which shall serve as the
centralized database of nurses for purposes of documentation, verification of registrants, statistics, research, and
development.

Section. 24. Accredited Professional Organization (APO). — All nurses whose names appear in the
Registry of Nurses of the PRC may become members preferably of the APO for nurses and shall receive all the
‘benefits and privileges therefrom upon payment of membership fees and duties. Membership in other organizations of
nurses shall not be barred.

Section. 25. Foreign Reciprocity. — No forcign nurse shall be given a certificate of registration and
professional identification card or be entitled to any ofthe privileges under this Act unless the country of State of
Which such foreign nurse isa subject or etizen permits Filipino nurses to practice within its territorial limits on the
same basis a the subjects or citizens of said country or State.

Section. 26. Limited Practice Through Open/a/ Temporary Permit, — "The Board may issue special
temporary permits based on qualifications, and professional and moral standards as approved by the Board and the
PRC to the following persons:

8) Registered or Licensed Nurses of foreign citizenship: (i) whose services are either fora fee of
free if they are introatonally well known specialists or outstanding experts in any branch or
specialty in nursing; (i) who are on medical mission whose services shall be free in a
particular hospital, center or clini: (i) who are engaged by IEls offering the BSN program
as exchange professors in a branch or specialty of nursing; o (iv) who come wo provide aid
during declared disasters and calamities,

) Nursing graduates with Philippine citizenship who may render nursing service during
epidemics or national emergencies under the supervision of a registered and licensed nurse:
Provided, That they have graduated within the last five (5) years prior tothe occurrence of the
epidemic or national emergency in which they shall serv.

‘The special temporary permit issued to registered and licensed murses of foreign citizenship shall be
effective only for the duration of the project, health mission, or engagement, but which in no case shall exceed one (1)
‘year, subject to renewal. The special temporary permit issued to nursing graduates with Philippine citizenship shall
‘automatically cease upon the lifting or termination of the epidemic or national emergency. A completion report shall
bbe submitted to the Board and the PRC after the conduct of such project, medical mission, engagement or contract. In
the case of nurses of Philippine citizenship who rendered services during an epidemic or national emergency, the
completion report shall be submitted by the registered nurse authorized to supervise them. The Board shall issue the
corresponding guidelines in the issuance of the special temporary permit pursuant to this Section.

Section, 27. Non-Registration and NOT-Issuance of Certificate of Registration, Professional
Identification Card, Special Temporary Permit. Any person who has been convicted by final judgment of any
criminal offense involving moral turpitude or found guilty of immoral or dishonorable conduct or judicially declared to
be of unsound mind shall not be registered and issued a certificate of registration, professional identification card, or a
special temporary permit. The Board shall furnish the applicant a writen statement setting forth the reasons for such
action, which shall be incorporated in the records of the Board.

Section. 28, Revocation and Suspension of Certificate of Registration, Professional identification Card
‘and Cancellation of Special Temporary Permit. — The Board shall have the power to reprimand a nurse or revoke
‘or suspend the certificate of registration, professional identification card, or special temporary permit, after due notice
‘and hearing, on any of the following grounds:


a) Conviction by final judgment of any criminal offense involving moral turpitude or of immoral
‘dishonorable conduct or having been judicially declared to be of unsound mind;

) Violation of this Act, the Code of Ethics and Ethical Standards for nurses, and other policies,
rules and regulations of the Board and the PRC;

©) Nes
x

4) Commission of fraud, non-disclosure of disqualification, or
:isrepresentation in obtaining a centficate of registration, professional identification card, or
special temporary permit;

©) Practicing the nursing profession during the period of suspension of license:

1) Breach of ethical practice in research in, accordance with prevailing national
and intemational guidelines; or

12) Other grounds analogous to the foregoing.

igence, misconduct, or incompetence in the nursing practice resulting to injury, harm,
iy of death;

{fthe penalty imposed is suspension or revocation of a nurse's license, the certificate of registration and
professional identification card issued to the respondent shall be surrendered to the PRC.

Section. 29. Reinstatement and Re-issuance of Revoked Certificate of Registration and Professional
Identification Card. — The Board may, upon proper application therefor and payment of the required fees, reinstate
‘or reissue a revoked certificate of registration after two (2) years from the effectivity ofthe period for revocation, for
reasons of equity and justice, and when the cause for revocation has disappeared or has been cured or corrected,

ARTICLE IV
NURSING PRACTICE

Section. 30. Scope of Nursing Practice. — The scope of nursing practice isthe range of roles, functions,
responsibilities, and activities on which a registered nurse is educated, compotent, and has authority to perform. It
inchudes nursing service, education, research, leadership, and governance as defined inthis Act. A person shall be
‘deemed practicing the nursing profession when singly oF in collaboration with other professionals, with or without foe
or compensation, the person assumes any oral of the four (4 role: (1) provider of direct client cae, (2) educator, (3)
researcher, and (4) manager and leader. The nurse's clients shall include individuals, families, population groups, and
‘communities, with varying age groups, gender, healillnss status, in any health care, industrial or community
sting. Additionally, nurses shall ulize the fll exten of their education, training and expericace and shal perform
work that quires their highest skill set. Nurses are primarily responsible for the promotion of health and prevention of
illness, Nurses shall collaborate with other health eare providers forthe promotive, preventive, curative and
rehabilitative aspects of care, restoration of health, alleviation of sufering and, when recovery is not possible, in the
provision of palliative and end-of-life care. In performing independent and collaborative functions, it shall be the duty
of the nurse to:

1) Provide nursing care through the conscientious observance of the nursing process and
established protocols. Basic nursing care is holistic care which includes, the provision of
physiological, psycho-social, emotional and spiritual care. This shall comprise any or
‘combination of essential primary health care, the application of traditional, complementary,
and innovative approaches, the therapeutic use of sclf- rendering health care procedures and
interventions; safety and comfort measures, health education, health counselling and
‘administration of written prescription for treatment, therapies, oral topical and parenteral
‘medications, performance of peripartal care covering pre-intra-postpartum care including the
performance of internal examination during labor in the absence of antenatal bleeding,
‘management of normal delivery and suturing of perinea; laceration and immediate care of the
newborn; performance of perioperative care covering before and after surgery; provision of
life-saving interventions during emergency and disasters; palliative and cnd- of-life care;

b) Provide advanced nursing care based on the Carcer Progression
Specialization Programfor Nursing (CPSPN) and the Philippine Qualifications
Framework (PQF), a quality assured national system for the development, recognition and



award of qualifications at defined levels based on standards of knowledge, skills and values
acquired in different ways and methods by professionals, learners and workers, The POF is
‘competency-based, labor-market driven and an assessment-based qualification recognition;

(©) Establish linkages with community resources and coordination with the healthcare workers in
any health care, industrial or community setting;

4d) Provide health education and health counselling to empower individuals, families, population
groups and communities towards the promotion of health, prevention of illness, and caring
towards people living with a serious illness by providing relief from the symptoms of pain and
stress of illness;

©) Guide and supervise students in nursing education programs, including the administration of
nursing services in varied settings such as hospitals clinics and other health, industrial or
community settings where practice of the nursing profession exists;

1) Provide duly compensated professional nursing services. such a consultation services and
private nursing practice;

8) Supervise nursing and ancillary nursing personnel in the delivery of safe and quality healthcare
services in varied settings;

hh) Maintain competence by adhering to the CPSP standards and the PPNPS as well as engage in
CPD and lifelong learning within the context of the CPSP;

1) Observe, a all times, the Code of Ethics and Ethical Standards for nurses promulgated by the
Board, uphold the standards of safe and quality nursing practice, and demonstrate cultural and
gender sensitivity and Social responsibility,

4) Undertake nursing and health human resource development taining and research for
continuous quality improvement and evidence-based practice; and

k) Exercise the core competencies in the performance of their respective roles and
responsibilities, in accordance with the PPNPS.

Section. 31. Qualifications of a Registered Nurse. — A nurse shall have a broad and coherent knowledge
and skills in the field of nursing to provide safe and quality care to an individual, family, population group or
community, independently or as part of a tcam. A nurse must be able to assess, plan, implement, and cvaluate the
care provided to clients based on evidence derived from practice and research. A nurse may practice in special areas,
such as a high dependency unit, critical care unit, disaster areas, or in a special procedure or interventional aca:
Provided, That the nurse has acquired relevant Competencies.

8) General Practice Nursing refers to the role of a newly licensed nurse in the provision of safe,
holistic and to advocate quality care to individuals, families, population groups, or
communities, which include the assessment, planning, implementation and evaluation of
evidence-based care to the clients. A general practice nurse must have the following
‘minimum qualifications:

1) Must be a BSN graduate from an HEI recognized by the government;
2) Must have a valid certificate of registration and current professional

‘identification card as a nurse issued by the PRC:
3) Must be physically, mentally and psychologically fit to practice nursing:
and

4) Must not be convicted of any crime involving moral turpitude.

'b). Specialty Practice Nursing refers to the practice of a nurse in a specialty area for which the
rhurse needs to obtain specialty recognition after having undergone specialty training.
Specialties can be differentiated in categories, according to function disease, pathology,
systems, age, sex, acuity, setting, technology, and therapies. Nurses who practice within this

field are referred to as “Specialists”
{A Specialty Practice Nurse or Specialist must have the following minimum qualifications:

1) Must be a BSN graduate from an HEI recognized by the government:


2) Must have a valid certificate of registration and current professional
identification card as a nurse issued by the PRC:

3) Atleast three (3) years of clinical experience in the are of specialization:

4) Must have received a CPD Couneil-Accredited specialty training from a
Career Progression and Specialization Council for Nurses credentialed
organization;

5) Must be physically, mentally, and psychologically fit to practice nursing;
6) Must not be convicted of any crime involving moral turpitude; and

7) Preferably a member of the appropriate Board-credentialed specialty
‘organiza

©) Advanced Practice Nursing refers to the specialized and expanded role of an Advanced
Practice Nurse (APN) It involves certification of nurses with higher degree of qualifications
by the Board and the PRC, thereby providing opportunities for role recognition within the
human resource for health framework and expanded professional scope of practice. It
‘maximizes the use of graduate education in nursing and the nurse's expertise to ensure safe,
holistic, and quality care to individuals, families, population groups or communities towards
achieving quality, accessible, and affordable health care forall Filipinos. It also refers to a
or, coordinator. and initial and continuing point of contact of the patient to ensure care
‘continuity during transitions of care. An APN must have at least a master’s degree in nursing,
and must possess substantial specialty experience. An APN must be endorsed by a specialty
‘organization based on the recommendation of the Career Progression and Specialization
Council for Nurses (CPSCN), and certified by the Prafessional Regulatory Board for nurses
and the PRC.

‘The scope of practice is Individual-based health services as defined in Republic Act No. 11223, otherwise
known as “The Universal Health Care Act.”

‘The APN is eligible to receive performance-driven, closc-end, prospective payments from the Philftealth
‘based on disease or diagnosis related groupings and validated costing methodologies as described in R.A. No, 11223,

‘An APN must have acquired substantial theoretical knowledge and decision-making skills reflecting
specialized and expanded competencies over and above the General Practice Nurse requirements. An APN must have
the following minimum qualifications:

1) A graduate with relevant master's degree from a government recognized HEI, With substantial specialty
experience as may be determined by the Board;

2) just have satisfied the requirements for certification as promulgated by the Board: and
3). Preferably be a member of the appropriate Board-credemtialed specialty organization

‘An APN shall have following responsibilities in collaboration with, and under the terms specified in a
Collaborative Agreement, with a Collaborating Physi

1) Initiate patient admission to a primary, secondary. or tertiary healthcare facility:

2). Provide direct primary-care services to patients ofall ages:
3) Diagnose diseases and injuries,

4) Provide continuum of care of discase conditions;

5) Provide promotive, preventive, rchablitative and end-of-life care:
6) Exercise prescriptive authority:

7) Order and interpret laboratory and diagnostic tests;

8) Provide anesthetic care:

9) Refer patients to specialists, other health professionals, and institutions for appropriate carc: and

te patient discharge.

Section. 32. Continuing Professional Development (CPD). — All nurses shall abide by the requirements,


rules and regulations on the CPD to be promulgated by the PRC, in coordination with the APO for nurses, and the duly
‘authorized representative of the organization of deans of HEls offering the BSN program, For this purpose, a CPD.
‘Council shall be created to accredit CPD providers and programs for nurses.

Section. 33. Requirement for Inactive Nurses Returning to Practice. — inactive nurses intending to return
to practice must undergo a refresher course as prescribed by the Board. Nurscs are considered to be inactive under any
of the following circumstances:
a) They have not utilized nursing competencies as defined in the scope of nursing practice for at
least five (5) consecutive years:

b) They have not renewed their professional identification card for five (5) years; oF

©) They do not have proof of five (5) years of continuous nursing pract

Section. 34, Salary and Compensation. — Nurses shall, at all times, receive compensation that is just and
‘due them and commensurate the level of education, training, experience and complexity of nursing skill required for
the services rendered

[Nurses providing nursing services in both government and private scetors, and who are integral to the functioning of
hospitals and healthcare institutions, must be classified as regular staf after a reasonable probationary period, as
‘mandated by law.

‘The minimum base pay of all nurses, whether they are working inthe publi sector, in private healthcare facilites, in
industrial or community settings shal not, upon entry, be lower than the rate assigned to Salary Gade 15 (SG 15) in
the government service.

‘The pay for aurses working in Nursing Education, both in government and noo- government schools and universities,
shall be in accordance with academic rank.

‘Non-government or private healthcare facilities, or both, institutions and industrial establishments shall comply with
the salary rate requirement in tranches within three (3) years from the effectivity of this Act.

Subject to existing labor laws, outsourcing nursing work is acceptable under certain circumstances to be provided in
the rules and regulations to be issued to implement this Act.

Section. 35. Incentives and Benefits. — The Board shall, in coordination with the DOH, other concemed
‘government and non-government institutions. association of hospitals and the APO for nurses, establish an incentive
and benefit system in the form of free hospital care, scholarship grants and other non-cash benefits for nurses and their
dependents subject to cxisting regulations.

Section, 36. Non-Diminution of Benefits and incentives. ~~ The implementation of Sections 34 and 35 of
this Act shall not result in the diminution of existing grants of salaries, benefits and incentives for murses.

ARTICLE V
NURSING EDUCATION

Section. 37. Basic Nursing Education. — Nursing education refers to the formal leaming and training in
the science and art of nursing provided by HEIs duly recognized by the CHED. There shall be a standard
Baccalaureate and a Graduate Program for Nursing Education pursuant to Republic Act No. No, 7722, otherwise
known as the “Higher Education Act of 1994”



Section 38. Baccalaureate Program for Nursing Education. ~The Baccalaureate Program for Nursing
Education refers to the basic nursing education program which is envisioned as a sound and liberal professional
‘education that will adequately equip nursing students with the necessary competencies for entry level nursing practice.
Admission to the Bachelor of Science in Nursing Program requires passing the National Nursing Admission. Test
(NNAT). The curriculum and the Relate Learning Experiences (RLE) of the Baccalaureate Program for Nursing
Education must be in accordance with the Policies, Standards and Guidelines.

Section. 39. Graduate Program for Nursing Education. — The Graduate Program for nursing education
refers to the post baccalaureate nursing program which builds on the experiences and skills of a nurse towards mastcry,
‘expertise, and leadership in practice, education, and rescarch. This includes the Masters Degree and Doctorate Degree
in Nursing.

‘The Graduate Program for Nursing Education shall be offered only through accredited HEIs in accordance with the
prevailing policies, standards and guidelines of the CHED on the graduate program for nursing education.

Section. 40. Qualifications of the Dean, —

4) The Dean of the College of Nursing of a BSN program shall formulate polices and plans, in
collaboration withthe school officals and stakeholders and must adhere to the prescribed
curriculum for the advancement of nursing education. The Dean must have the following
qualifications:

1) Bea Filipino citizen, physically and mentally fit, and with good moral character:

2) Be a holder ofa valid certificate of registration and a current professional identification
card issued by the PRC;

3) Bea holder of a Masters Degrec in Nursing conferred by an HEI duly recognized by the
government.

4) Have at least a total of five (5) years of experience in teaching, administration, and
supervision in nursing education;

5) Preferably be a member of the organization of Deans duly recognized by the Board;

6) Not hold a concurrent Dean position in another HET and no other teaching assignments
‘or administrative function in other public/private institution or higher education
institution; and

7) Have a duly notarized employment contract as dean of the nursing program of atleast
cone (1) academic year with corresponding academic rank renewable annually.

b)_ The Dean or administrator of the academic unit shall be a holder of a doctorate degree in the
discipline or allied field and has published works in referred journals in one of the disciplines
under the academic unit,

Section, 41. Qualifications of the Faculty.

) For the Baccalaureate Program in Nursing Fducation, A member of the facility teaching in an
undergraduate program must possess the following qualifications:

1) Bea Filipino citizen, physically and mentally fit, and with good moral character;

2) Bea BSN degree holder;

3) Bea holder of a master’s degree in nursing for teaching professional nursing subjects or
‘2 master’s degree in health-related programs for teaching non-professional nursing
subjects conferred by a duly recognized HEI;

Bea holder of a valid certificate of registration and a current

4) professional identification card as a nurse issued by the PRC;

5) Have atleast three (3) years clinical experience in any nursing practice setting: and

6) Preferably be a member of an accredited professional nursing organization of good


standing and of a specialty nursing organization.

b). For the Graduate In-Nursing Education. A member of the faculty teaching in a post-graduate
program must possess the following qualifications:

1) Bea Filipino citizen, physically and mentally
2) Bea BSN degree holder;

3) Be a holder preferably of a Doctorate Degree in Nursing or allied field conferred by a
duly recognized HEL;

snd with good moral character;

4) Beaholder of a valid and current certificate of registration and professional
‘identification card as a murse issued by the PRC

'5) Have at least three (3) years elinical experience in any nursing practice setting:
6) Have published works in refereed Nursing or health-related journals; and

7). Preferably be a member of an accredited integrated professional nursing organization of
‘200d standing and ofa specialty nursing organization.

Section. 42. Faculty-to-Student-Ratio. — The faculty-to-student ratio must be in accordance with the
standards to be determined and prescribed by the CHED.

ARTICLE VI
NURSING SERVICE

Section. 43. Nursing Service. — Nursing service refers to the healthcare services provided by nurses. It
includes the provision of general nursing services, specialized, and advanced practice of nursing, including nursing
‘management in various health, industry, or community settings where the competencies of a nurse are required.

Section 44. Public Health Nursing Service. —~ There shall be adequate provision of essential health
services in every local health facility to effectively implement public heath programs for community and population
groups, These essential services shal include: health information and education; expanded program of immunization
Against major infectious diseases; matemal and child health cae including family planning and counselling;
micronutient and nutritional food supplementation: prevention, treatment and control of communicable and non-
communicable diseases including locally endemic diseases; mental health promotion: occupational health and safety:
safe water and environmental sanitation; basie drugs supply: and emergency and disaster management

Section 45. Public Health Nurse (PHN). — Public Health Nurses participate inthe delivery of essential
hncalth care services as described in Sec. 44. They work with the individuals, families, and population groups that are
the nucleus of the community. They collaborate with other members ofthe service delivery network with the goal of
promoting health, preventing disease and disability, and treating common discases. A PHN may progress to become a
Public Health Nurse Specialist (PHINS) aficr obtaining specialty training focused on public health-based programs and
‘substantial experience in managing public health conditions.

APHNS may progress to become an APN in public health after obtaining advanced nursing education either through a
‘master's or doctoral degree with emphasis on public health sciences, or their equivalencies as promulgated by the
CHED, and as defined in Section 31 of this Act.

‘As Advanced PHN Practitioners, their duties and responsibilities include the following:
4) Delivering population-centered services and programs and other public health services such as
‘occupational health; school health: emergency and disaster, and home and hospice services;
b)_ Providing direct and indirect care to population groups and communities. Direct care consists of
assessing and diagnosing population or communities; planning nursing actions: mobilizing community

responses; monitoring population health status and evaluating outcomes. Indirect care consists of
‘engaging in policy change, education and taining of public health murse practitioners in



interdisciplinary research, and acting as consultants to pol

makers; and

‘©) Exercising collaborative leadership and political skills for successful population outcomes.

Section. 46. The Chief Nursing Officer(CNO) and the National Chief Nursing Officer ~~ ‘There shall be
‘a nursing service office in every healthcare institution and in all levels and classifications of these institutions, whether
administrative or clinical, with a complement of a least ten (10) Nurses. Nursing services must be under the control
and management ofa registered nurse designated as Chief Nursing Officer (CNO) in each health institution.

Within the framework of health cate delivery, nursing services in private and public institutions or community settings
‘must be led and managed by a CNO, of the equivalent of Chief Nurse (CN) of Director of Nursing. The CNO shall be
bestowed full administrative responsibility as leader and manager of nursing services within cach institution. The CNO-
shall have the authority and accountability over the planning, organizing, directing, and controlling including
monitoring, evaluation, and policy development of nursing resources related to nursing services. The CNO
responsibilities include strategic and operational planning, financial and resource allocation, policies and procedures
‘development, professional and organizational involvement to address issues that have relevance for nursing.

‘There shall also be @ National Chief Nursing Officer (NCNO) in the DOH who shall oversee and coordinate national
nursing personnel utilization nurses’ welfare, the observance of decent work standards in all healthcare facilites and
institutions, and the adaptation of nursing care development trends in nursing education and practice in both the public
and private sectors.

‘The NCNO, being the highest-ranking nursing official in the DOH, shall be responsible for overseeing and
‘coordinating strategic management, financial and resource allocation, policies and standards development,
professional and organizational development to relevantly address national epidemiologic and nursing personnel
‘supply, demand, and distribution trends. The NCNO shall oversee the development of the Nursing Human Resource
for Health Management System (NHRHMS), a national nursing information system and utilize statistical data
and other nursing outcome metrics in the exercise of good governance and full accountability over nursing personnel,
systems in both private and public health care and community settings. The NCNO shall also act as the advocate for
the rights and welfare of nurses in both public and private institutions. Furtber, the NCNO shall serve a term of three
() years, subject to renewal

ACNO and NCNO must possess the qualifications as prescribed under the Policies, Standards and Guidelines to be
promulgated by the Board

“The CNO must have the following minimum qualifications:
4) Be arogistered nurse inthe Philippines:
b) Be aholder of a Master’s degree in Nursing conferred by an HEI duly recognized by the government;

©) Bea holder of a valid certificate of registration and a current professional identification card as a nurse
issued by the PRC: and

d)_ Have at least five (5) years of experience in general nursing service administration with experience in
policy development;

©) Preferably be a member of good standing of the APO of nurses; and

1) Preferably be a member of the organization of nursing service administrators duly recognized by the
Board,

‘The NCNO must have the following minimum qualifications:
8) Be a registered nurse in the Philippines;
b) Have a degree of Bachelor of Seience in Nursing:

¢) Beaholder of a Doctorate degree conferred by an HEI duly recognized by the government in a relevant
healthcare and business administration field;

4) Be aholder oa valid certificate of registration anda curent professional identification card asa aurse
issued by the PRC;



©) Must have the nocessary Career Executive Service Officer (CESO) rank:

1) Have at leat five () years of experience in general nursing service administration with experience in
policy development;

18) Preferably be a member of good standing of the APO of nurses; and

hh) Preferably be a member ofthe organization of nursing service
') administrators duly recognized by the Board

NURSING RESEARCH, POLICY DEVELOPME!

ARTICLE VII

Section. 47. Nursing Research and Policy Development. — Nursing Research and Policy Development

shall involve the study of nurse-related is

Section. 48. Nursing Leadership and Governance.
process of influencing other people through the exercise of authori

such as:

) Professional nursing practice and nursing development such as advancing nursing knowledge,
health and nursing governance, to ensure quality nursing care forall and advecacy for sound
‘health policies nationally and globally:

)_ Information and knowledge management and communication technology;
©) Regulation of nursing standards, competencies and the process of credentialing; and

4) Socio-economic welfare for nurses like occupational health and safety, human resources
planning and policy, remuneration, career development.

ARTICLE VU
NURSING LEADERSHIP AND GOVERNANCE,

‘Nursing leadership and governance involve the
direction, control, and regulation inthe practice

‘of the nursing profession to achieve desired goals. To accomplish this, nursing services must be managed by

competent nursing personnel. Nut

service management refers to the management and administration of nursing

services by nurses who must be equipped with the following necessary competencies on governance and leadership:

a)

A First Level Service Manager is responsible for the management of a nursing unit and
supervision of nursing support personnel including, Caregivers. Healthcare Dialysis

Technicians, Medication Technicians, Orderlies, Orthopedics Technicians, Patient
Care Technicians, Siters, Surgical Technicians, and Ward Clerk of Secretaries.

b) A Middle Leve! Service Manager is responsible forthe leadership and govemance of more

o)

than one (1) nursing unit, particulary them management of operational systems, financial
resources, and human resources:

‘An Executive Level Service Manager is responsible for establishing the strategic direction for
the entire nursing division, and the development and implementation of policies, standards and
‘guidelines in nursing services.

Nursing Service Managers shall have the following minimum qualifications:


) Fora first level managerial position in nursing:

1) Completion of atleast eighteen (18) units of nursing management and clinical subjects in a
Master of Arts Degree Program in Nursing or Plaster of Science in Nursing Degree Program,
with atleast three (3) years of clinical work experience, and

b) For a middle level managerial position in nursing:

1) Completion of all the academic requirements of a Master of Arts in Nursing Degree Program
lor Master of Science in Nursing Degree Program;

2) Atleast three (3) years of clinical work and two (2) years of management experience, and
3) Conduct of at least one (1) esearch projeet related tothe improvement of the quality of care.

ARTICLE IX
NURSING HUMAN RESOURCE FOR HEALTH MANAGEMENT SYSTEM.

Section. 49. Nursing Human Resource for Health Management System. — The Nursing Human
Resource for Heath Management System (NHRHMS) shall cover ll nursing human resources inthe nursing service
‘of both public and private sectors, andthe healthcare, industrial and community settings. Institutions shall be mandated
to report their information to ensure accurate nursing human resource and workforce projections and 1 reconcile these
with supply data fom CHED and PRC.

Healthcare facilites and institutions, including industrial establishments that hire nurses, shall implement strategic
NHRHMS in all levels of the nursing service, and in this pursuit, shall adopt and define appropriate nursing

‘organizational structures to support competency development, carcer and professional growth, and promote job
delight which is a state of mental and emotional satisfaction over one's productivity, conditions at work, and job
fulfilment,

It shall be mandatory for each healthcare facility to employ an evidence-based human resources for health (HRH)
assessment tool for nursing workload and workload pressure, preferably the World Health Organization Workload
Indicators for Staffing Needs, to determine annually minimurn safe staffing needs for registered nurses and nursing
‘personnel. These nursing staffing ratios, nursing plantill, and skill-mix standards are requisites for safe and quality
care for pationts and must be upheld and practiced for a healthcare facility to be granted continued permission to
‘operate the facility. The facility mus use tis assessment to plan and provide a budget for regular and platilla
Positions to ensure that safe and quality care i provided by the institution

Additionally, a registry of nursing professionals shall be incorporated in the NHRHNS in coordination with DOH,
private institutions, and nursing organizations and groups indicating, among others, their current number of
practitioners and location of practice

Section. 50. Nursing Staff Complement. — The Board shall, in consultation with the DOH and other
stakeholders, ensure the provision of « safe nursing workforce for any healthcare sctting guided by the following
principles:

4) Use of evidence-based, reliable, and up-to-date stalling and workforce data;

') Regular review and updating of staffing based on up-to-date evidence and best nursing
‘practices within healthcare facility, and nurse, nurse-sensitive patient, organizational and
system outcomes;

©) Non-substitution of nurses by other healthcare professionals in performing nursing functions:
4) On-delegation of nurses in management positions to augment staff limitations;
©) Respect for nurses! professional judgment in determining the required safe workforce staffing;

1) Active involvement of direct care nursing staff and nursing management in all stages and
aspects of the institution's HRH design, policy development, and decision making

2) Timely adjustments to nurse staffing based on changes in patients and population healthcare
nceds.

1h) The nursing workforce complement is designed to ensure patient safety, quality service
delivery, and the maintenance of a positive practice environment that promotes economic


welfare, professional autonomy, job satisfaction and retention, and ensures safe staffing,
‘managerial support, professional development, occupational safety and psychological health
‘and patient and nurse safety.

‘The appropriate number of nurses must be available at all times across the continuum of care, and a suitable
‘mix of education, skills, and experiences must be maintained to ensure that patient care needs are met and the working
environment is kept safe and conducive to optimal performance of support staf.

‘The maximum number of patients cared for by cach nurse assigned in a healthcare facility, setting, or unit shall be
determined by the ratio of stafT nurse-to-patient in a general nursing service, or in the case of a general ward of a
hospital, shall be based on patient acuity. complexity of work, nurse competencies, and nursing modalities to
effectuate positive practice environment, safe, and quality nursing care for patients

For general units the maximum number of patients that a nurse may effectively and safely handle at any given time is
{en (10), Thus, the minimum safe staffing ratio standard for general units is 1:10 or one nurse for every ten patients.
However, this stafF-to-patient ratio may vary based on the assessed Safe Staffing Standard

Failure to comply withthe above minimum safe staffing ratios must be justified through the assessment tool findings
nd analysis as provided in this section. Non- compliance shal be referred to the Board for action,

‘A nurse may invoke the process of safe harbour for protection against employer retaliation, suspension, termination,
discipline, discrimination, licensure sanction when asked to accept an unsafe assignment in activities beyond the scope
‘of the nursing practice, or in an unprofessional and illegal act. In this case, the nurse shall submit a written notification
+o the supervisor who requested the conduct of such unsafe, unprofessional or illegal assignment invoking safe harbor.
fa nurse is unable to submit such written notification due to patient care needs, the nurse may orally invoke it, and the
supervisor must record the record the request in writing.

‘The Board shall, from time to time, and in consultation with the DOH and other stakeholders, revie v and modify the
rurse-to-population ratio as may hereinafter be established for the healthcare and industrial settings, and for the
‘comunity setting taking into consideration the eurrent community characteristics and population necds.

{In the community, there shal be a nurse in every barangay health center, primary, secondary, and tertiary school, and
industrial establishment, subject to the applicable staffing ratio by the appropriate government agency.

Section, 51. Return Service Agreement, — All nursing graduates who are recipients of government-funded
Scholarship programs shall be required to serve in priority arca in the public sector frat least three (3) year, with
compensation, and under the supervision of the DOH: Provided, That those who will serve for an additional two (2)
years shal be provided with additional incentives as determined by the DOH. Graduates of nursing from state
imiversites and colleges and private schools shall be encouraged to serve in these arcas,

ARTICLE X
PROHIBITED ACTS AND PENAL PROVISIONS

Section. $2. The following acts are prohi

4) Practicing the nursing profession without a certificate of registration, professional
identification card, special temporary permit or without having declared exempted from taking
the licensure examination in accordance with this Act:

ted:

b)__ Using the certificate of registration, professional ident ‘card, or special temporary

permit of another registered nurse;

©) Using fraudulent, suspicious, or an expired suspended or revoked certificate of registration,
professional identification card, or special temporary permit,

44) Misrepresenting one's self or proffeing false evidence to obisin a certificate of registration,

professional identification card or special temporary permit;

©) Falsly advertises one's self through any means to convey the impression that one isa nurse;

4) Appending to one's name the abbreviations “B.S.N"“R.N" or “APN” for Bachelor of Science
in Nursing, Registered Nurse and Advance Practice Nurse respectively, without having been
conferred the corresponding degre, registration, or certification by the PRC:

12) Abetting or assisting inthe illegal practice of the nursing profession through the following
‘acts and entities:



1) An HEL offering the BSN program which shall withhold any requirement or document, or
both, of any graduate for the purpose of preventing them to apply for the PNLE without
any justifiable reason;

2) Any natural or juridical person or health facility which subscribes to sub-standard quality
of nursing care or nursing practice, such as non-compliance with the nurse-patient ratio
requirement;

3) Any natural or juridical person or health facility that abets and promotes precarious
‘working conditions for nurses, such as the following:

i, Contracting or availing of the services ofa nurse but provides compensation
blow the rate prescribed under this Act, whether or not under the pretext of
1 training development program, certification, or course, or seminar,

ii, Depriving or denying a nurse of the incentives and benefits as provided for
under existing laws;

Collecting any fee from a nurse or from any person or agent in
exchange for a nurse's voluntary services in a health, industrial or similar
facility oF institution;

iv. Requiring or obliging a volunteer nurse to perform regular work
functions or work load expected from a regular staff nurse without proper
compensation, orto render fulltime service as a condition for the continued
availment of their volunteer services, orto be the sole nurse on duty, except
daring disasters, calamities, public emergencies and war;

¥.Contracting or availing of the services of a volunteer nurse, under the
pretext of On-The-Job Training, contract of service, or job orders, in order
{0 fill-up a vacant position that requires the hiring of a fulltime regular
employed nurse, oF for free in exchange for any type of certification to be
‘issued by the health facility or institution or industrial establishment for
purposes ofthe nurse's employment application;

vi. _ Contracting or availing ofthe services of a nurse, under the pretext of
training or certification course, but requiring the nurse to render the tasks
and responsibilities expected ofa regular staff or public health nurse;

vii, Practicing job-splitting or hiring two part-timers in place of one full-
time employee and deploying the two nurses ona full-time basis

viii, Making mandatory, asa pre-hiring requirement, training that should
hhave been acquired during the BSN program or which, rightfully should be
provided by the hiring institution;

ix. Repeatedly subjecting or allowing the nurse to experience prejudice,
violence, or discrimination; and

x. Imposing mandatory overtime service without valid reason or corresponding
‘compensation, as mandated by law; and

xi, _ Non-compliance with the minimum safe staffing requirement mandated

in Section 50.

1h) Any violation of the provisions of this Act or any existing laws such as the Labor Code of the
Philippines and the civil service laws.

Section, $3. Sanctions. — A fine of not less than One hundred thousand pesos (Php 100,000.00) nor more
than Three hundred thousand pesos (Php300,000.00) or imprisonment of not less than one (1) year nor more than six
(6) years, or both, shall be imposed, atthe discretion of the court, for the commission of any of the prohibited acts,
‘enumerated in Section 52 (a) of this Act.

A fine of not less than Three hundred thousand pesos (Pip300,000.00) nor more than Five hundred thousand pesos
‘PhkpS00,000.00) or imprisonment of not less than one (1) year or more than six (6) years, or both, shall be imposed, at
the discretion of the court, for the commission of any of the prohibited acts enumerated in Section 52(b),(c), (4) and.
{(@) hereof. In addition, the court may, at its discretion, order the suspension or revocation of the license to operate of
the erring healthcare facility, institution, or industrial establishment In case the violation is committed by a partnership,
‘corporation, association, or any other juridical person, the managing partner, president, managing director/s, or officer
who has committed or consented to such violation shall be held directly liable and responsible forthe acts as principal,
‘oF as co-principal with the other participants, if any.



Section. $4. Refiund and Compensation. — Any nurse found to have been a victim under Section $3 (e)
hhcreof shall be cnitled to a full refund ofall fees illegally collected and the payment of unpaid salary if any, which
should not be less than the applicable wage for services rendered without prejudice to other reliefs that may be claimed
under applicable laws.

ARTICLE XT
MISCELLANEOUS PROVISIONS

Section. 55. Implementing Agencies. — The Department of Budget and Management (DBM),
Department of Health (DOI), Department of Labor and Employment (DOLE), Department of Interior and Local
Government (DILG), Civil Service Commission (CSC), Commission on Higher Education (CHED), shall be
responsible forthe implementation and monitoring of the compliance withthe provisions of this Act.

‘The DOH, asthe lead agency, the DILG, and CSC shall be responsible for monitoring the compliance with and
implementation ofthe provisions of this Act by public health facilities and institutions.

‘The DOLE shall be the agency responsible for monitoring the compliance and implementation of the
provisions of this Act by private health facilities and institutions and industrial establishments. In addition, the DOLE
shall create a separate category for health workers befitting the importance and complexity of the wark performed by
‘nurses and other healthcare professionals.

‘The PRC and the Board shall be the designated agencies responsible for monitoring the compliance with and
implementation of the provisions of this Act by nurses, HEls, CPD providers, health facilities and institutions, and
industrial establishments. The CHED shall be the agency responsible for monitoring the compliance with and
‘implementation ofthe provisions ofthis Act by HEEls with regard to nursing education programs and curriculum,

Section. 56. Funding for the Advance Practice Nurse (APN) Training. — The participating government
hospitals and institutions shall include their budgets the annual financial requirement needed to tain atleast ten
percent (10 %) oftheir nursing staf: Provided however, That non-government hospitals and institutions shall support
‘he training requirements of their nursing staff employed by them. Nothing inthis provision shall prevent, diminish or
‘otherwise revoke existing company policies that are more favorable to the employee.

Section. 57. Appropriations. ~ The Chairperson of the Professional Regulation Commission and the
‘Seeretary of the Department of Health shall immediately include in their program the implementation ofthis Act, the
funding of which shall be included in the annual General Appropriations Act.

Section. $8. Implementing Rules and Regulations. — Within ninety days (90) after the effectivity of this
‘Act, the PRC and the Board shal, in consultation with the APO for nurses, CSC, DBM, DOI and other concerned
‘nursing organizations and goverament agencies formulate the implementing rules and regulations (IRR) necessary 10
carry out the provisions ofthis Act.

Section. 9. Separability Clause. — Should any provision of this Act be declared unconstitutional, the
remaining parts not affected thereby shall remain valid and operational

Section. 60. Repealing Clause. — Republic Act No. 9173, otherwise known as the ‘Philippine Nursing
Act of 2002 is hereby repealed. Ail 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. 61. Effectivity. — This Act shall take effect fifteen (15) days aftr its publication in the Official
Gazette or in a newspaper of general circulation,

Approved,