Fifieenth Congress
First Regular Session

House Bnaino, 4567

Introduced by Honorable Carlos M. Padilla

EXPLANATORY NOTE

This bill seeks to institute reforms to further protect and develop the nursing,
profession, amending for the purpose Republic Act (RA) No. 9173, otherwise
known as the “Philippine Nursing Act of 2002.”

RA 9173 was enacted in 2002 to provide a comprehensive definition and
understanding of the nursing profession. It delineates the scope of work of
registered Filipino nurses, establishes linkages with community resources and
requires the updating of professional knowledge in the nursing field, patient care,
levels of nursing practice and development of nursing education. This is in
recognition of the vital role nurses play in the delivery of quality health services
not only in the country, but al! over the world.

Since the enactment of RA 9173 almost a decade ago, significant factors
critical to the development of nursing practice in the country have emerged. This
includes providing humane and globally competent nursing care, ensuring, positive
practice environment for nurses, strengthening the Philippine nursing profession as
a recognized leader in primary health care, enforcing quality standards in nursing
education and practice, and providing guidelines toward nursing career
progression.

RA 9173 must be amended 1 achieve the vision of the Philippine
professional nursing care to be the best for the Filipino and the choice of the world
by 2030. Such amendments provide restructuring of the scope and practice of
nursing to include certification, specialization and educational requirements,
expanding the powers of the Board of Nursing to strengthen its role in decision-


making processes concerning the nursing practice, providing additional educational
requirements for different levels of nursing practice to ensure competitiveness and

further strengthen the nursing profession and provide a better practice
environment.

Nursing remains a top career choice among, Filipinos. The Commission on
Higher Education reported that the number of nursing students rose from 30,000 in
2000 to 450,000 in 2007. The total number of registered nurses as of 2003 was
332,206 according to data provided by the Professional Regulation Commission.
In addition, demand for Filipino nurses abroad has risen steadily over the past two
decades. Given the statistics, it is but necessary to institute reforms RA 9173 so
that the nurses are accorded further protection and their welfare enhanced. It must
be amended to better respond to the needs of nurses, their patients and the whole
nursing practice.

In view of the foregoing, approval of this bill is earnestly sought.

LA. LA

LOS M. PADILLA


Fifteenth Congress
First Regular Session

HOUSE BIEL NO. 4967

Introduced by Honorable Carlos M. Padilla

AN ACT
INSTITUTING REFORMS TO FURTHER PROTECT AND DEVELOP
THE NURSING PROFESSION, AMENDING FOR THE PURPOSE
REPUBLIC ACY NUMBERED NINETY-ONE HUNDRED AND
SEVENTY-THREE, OTHERWISE KNOWN AS THE “PHILIPPINE
NURSING ACT OF 2002”

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

SECTION 1. Section | of Republic Act No. 9173 is hereby amended to
tead as follows:

“SECTION 1. Short Title. - This Act shall be known as the
“Philippine Nursing PRACTICE REFORM Act of (2002) 2011"
SEC. 2. Section 2 of the Act is also hereby amended to read as follows:

“ARTICLE It
DECLARATION OF POLICY
SEC. 2. Declaration of Policy. — \t is hereby declared the

policy of the State to [assume] RECOGNIZE NURSES AS PRIME


MOVERS OF NATIONAL DEVELOPMENT AND
CONTRIBUTORS TO INTERNATIONAL COOPERATION AND
UNDERSTANDING. AS SUCH, THE STATE ASSUMES
responsibility for the —_ protection, improvement AND
DEVELOPMENT of the nursing profession by instituting measures
that will result in relevant AND QUALITY nursing education,
humane working conditions, better carecr prospects, and a dignified
existence for our nurses.

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

SEC. 3. Section 28, Article VI of the same Act is hereby amended and
designated as Section 3, Article III, to read as follows:
“ARTICLE [V1] TT
[ORGANIZATION OF THE BOARD OF NURSING]
NURSING PRACTICE

SEC. [28] 3. 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, As members of the health team, nurses shall
collaborate with other health care providers for the PROMOTIVE,
PREVENTIVE, 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 parental medications,
internal examination during labor in the absence of antenatal bleeding
and delivery. [lu case of suturing of perineal laceration, special

training shall be provided according to protocol established];


b) [Establish linkages] COLLABORATE with community
resources and [coordination] COORDINATE with THE MEMBERS
OF the health team IN ANY HEALTH CARE SETTING;

c) Provide health education to AND COLLABORATE
WITH individuals, families and communities TO MAINTAIN,
ATTAIN AND RECOVER OPTIMAL HEALTH AND QUALITY
OF LIFE;

x x x

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) MANDATED to observe the
Code of Ethics for Nurses and uphold the standards of safe nursing
practice. The nurse is required to maintain competence by
PROFESSIONAL continual learning (CPL) {through continuing
professional education (CPE) to be provided by the accredited
professional organization or any recognized professional nursing
organization.] AS PRESCRIBED BY THE BOARD OF NURSING:

Provided, finally, That the program and activity for the


PROFESSIONAL continual LEARNING shall be submitted to and
approved by the Board.”
SEC. 4 Sections 3, 4 and 9 of Article III of the same Act is hereby
amended to read as follows:
“ARTICLE [III] IV
ORGANIZATION OF THE BOARD OF NURSING

SEC. [3] 4. 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 quatifications prescribed
in Section [4] 5 of this Act.

SEC. [4] 5. 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
FOR THE LAST THREE YEARS,

x x x

(c) Be a registered nurse IN THE PHILIPPINES AND A
HOLDER OF A VALID PROFESSIONAL [DENTIFICATION
CARD [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);

(D) BE A HOLDER OF A MASTER’S DEGREE IN
NURSING, OR OTHER ALLIED MEDICAL PROFESSION
CONFERRED BY AN ACCREDITED UNIVERSITY; Provided,
That the majority of the members of the Board shall be holders of a
masters’ degree in nursing: Provided, further, That the chairperson
shall be a holder of a masters’ degree in nursing;

[d] (E) 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, }

{e] (F)[Not have been convicted of any offense involving morat
turpitude] MUST BE OF PROVEN HONESTY AND. INTEGRITY;

x x x


SEC. [9] 10. 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]
FORMULATE GUIDELINES AND OVERSEE THE PROPER
CONDUCT OF THE LICENSURE EXAMINATION FOR NURSES.

b) Issue, suspend, revoke OR REISSUE certificates of
registration for the practice of nursing AND ENSURE WIDEST
PUBLICATION THRU ELECTRONIC AND WRITTEN MEDIA;

¢) Monitor and enforce quality standards of nursing practice
in the Philippines and exercise the powers necessary to ensure the
maintenance of efficient, [ethical] ETHICO-MORAL, [and] technical,
[moral} AND professional standards in the practice of nursing [ taking
into account the health needs of} TOWARDS OPTIMUM HEALTH
AND THE COMMON GOOD OF THE NATION;

d) Ensure quality nursing education by examining AND
MONITORING the prescribed facilities of universities or colleges of
nursing or departments of sursing 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 10 open and close colleges of nursing and/or nursing
education programs shall be vested [on] IN the Commission on Higher
Education upon the written recommendation of the Board;

e) [Conduct hearings and investigations fo resolve
complaints against nurse practitioners for] ADDRESS unethical and
unprofessional conduct and violations of this Act, or its rules and
regulations MOTU PROPIO and in connection therewith, ENFORCE
SANCTIONS AND 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 interfering with the conduct of
such proceedings, upon application with the court;

fy Promulgate a Code of Ethics TLIAT IS RESPONSIVE.
TO THE NEEDS OF THE NURSING PROFESSION, in coordination
and consultation with the accredited professional organization of
aurses within one (1) year from the effectivity of this Act;

8) Recognize nursing speciaty AND INTEREST
organizations [in coordination with the accredited professional

organization];


H) PARTICIPATE FULLY AT ALL. LEVELS OF
DECISION-MAKING IN MATTERS THAT MAY AFFECT THE
LIVES AND WELFARE OF NURSES BY COORDINATING WITH
OTHER GOVERNMENT AND NON-GOVERNMENT AGENCIES
IN RELATION TO NURSING PROGRAMS AND ACTIVITIES.
CONSEQUENTLY, NURSES SHALL BE GIVEN MANDATORY
REPRESENTATION IN POLICY-MAKING BODIES;

1) IDENTIFY AREAS OF ADVANCED NURSING
PRACTICE AND FORMULATE GUIDELINES FOR
AUTHORIZATION AND CERTIFICATION. AS USED IN THIS
ACT, ADVANCED NURSING PRACTICE SHALL MEAN A
SPECIALTY AREA OF NURSING PRACTICE UTILIZING
SUBSTANTIAL, THEORETICAL KNOWLEDGE AND
PROFICIENCY IN CLINICAL SKILI.S AND IN IMPLEMENTING
INDEPENDENT AND COLLABORATIVE NURSING.
INTERVENTIONS,

dtd INITIATE THE CREATION OF A BODY WHICH
SHALL ASSIST iN THE IMPLEMENTATION OF GUIDELINES
AND STANDARDS OF NURSING PRACTICE AND

EDUCATION, JNCLUDING THE ACCREDITATION OF


NURSING SERVICES AND HEALTH FACILITIES, SUCH BODY
SHALL BE UNDER THE SUPERVISION OF THE BOARD,

K) ESTABLISH STANDARDS OF NURSING PRACTICE
AND NURSING POSITION LEVELS,

[h] L) Prescribe, adopt, issue and promulgate guidelines,
regulations, measures and decisions as may be necessary for the
improvement 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.”

SEC. 5. Section 13 of the same Act is hereby amended to read as
follows:

“SEC, [13] 14. Qualifications for Admission to the Licensure
Fxamination. — 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) x x x

¢) He/she is a holder of a Bachelor’s Degree in Nursing,
AND IS FILING THE APPLICATION WITHIN THREE (3) YEARS

AFTER GRADUATION from a college or university that complies


with the standards of nursing education duly recognized by the proper
government agency.”
SEC. 6, Section 15 of the same Act is hereby amended to read as
follows:

“SEC, [15] 16, Ratings AND EXAMINATION, — In order to pass
the examination, an examinee must obtain a [general average]
RATING of at least seventy-five percent (75%). [with a rating of not
below sixty percent (60%) in any subject. An examince 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%), 1n 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.]: PROVIDED,
THAT EXAMINEES SHALL BE DISQUALIFIED FROM TAKING
FUTURE NURSING LICENSURE EXAMINATIONS AFTER
FAILING THREE (3) EXAMINATIONS.”
SEC. 7. Section 25 of the same Act is hereby amended to read as

follows:


“ARTICLE [V] Vi
NURSING EDUCATION

SEC. [25] 26, Nursing Education Program, - Vhe nursing
education program shall provide sound general and professional
foundation for the practice of nursing.

x x x

NO PERSON SHALL BE ADMITTED [N1Q THE
BACCALAUREATE NURSING PROGRAMS — WITHOUT
PASSING THE NATIONAL NURSING ADMISSION TEST
(NNAT) THE PASSING RATE OF WHICH SHALL BE SEVENTY-
FIVE PERCENT (75%). THE NNAT SHALL BE ADMINISTERED
ONCE A YEAR UNDER THE SUPERVISION OF AND. IN
COORDINATION WITH THE BOARD.

SUBJECTS ON LEADERSHIP AND MANAGEMENT
CAPABILITIES, NURSING LAW AND JURISPRUDENCE, CODE
OF NURSING ETHICS AND STANDARDS OF SAFE NURSING
PRACTICE SHALL BE INCLUDED IN THE NURSING
CURRICULA AT THE TERTIARY, GRADUATE AND POST-
GRADUATE LEVELS: PROVIDED, THAT GRADUATE AND

POST-GRADUATE NURSING PROGRAMS SHALI. BE


OFFERED ONLY BY INSTITUTIONS OF HIGHER EDUCATION

THAT ARE LEVEL 3 ACCREDITED. AS USED IN THIS ACT,

LEVEL 3 SHALL MEAN _

SEC. 8. Section 27 of the same Act is hereby amended to read as
follows:

“SEC. [27] 28. 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 AND A
HOLDER OF A VALID PROFESSIONAL LICENSE;

{b) Have at least fone (1)] THREE (3) years of clinical
practice in a field of specialization;

x x x

(E) MUST UNDERGO COMPETENCY ENHANCEMENT
EVERY TWO (2) YEARS, AS PRESCRIBED AND ACCREDITED
BY THE BOARD,

x x x

ANY MEMBER OF FACULTY OF ANY NURSING
PROGRAM WHO FAILS TO POSSESS THE NECESSARY

QUALIFICATIONS AS SPECIFIED UNDER THIS ACT SHALL


SUFFER THE PENALTY OF REVOCATION OF PROFESSIONAL
LICENSE: PROVIDED, THAT ANY EDUCATIONAL
INSTITUTION WHO, DESPITE WILLFUL KNOWLEDGE OF
SUCH LACK OF QUALIFICATION, CONTINUES TO EMPLOY
SUCH PERSON, SHAJ.L. SUFFER THE PENALTY OF
REVOCATION OF LICENSE IN ACCORDANCE WITH THE
RULES AND REGULATIONS OF CHED.”

SEC. 9. Section 29 of the same Act is hereby amended to read as

follows:

“SRC. 29, Quatifications of Nursing Service Administrators,
— A person occupying supervisory or managerial positions requiring
knowledge of nursing must:

(a) Be aregistered nurse in the Philippines,

(b) [Have at least two (2) years experience in general nursing
service administration] POSSESS APPROPRIATE UNITS IN POST-
GRADUATE STUDIES AND RELEVANT WORK EXPERIENCE
SUCH AS:

1 FOR FIRST LEVEL MANAGER, AT LEAST

NINE (9) UNITS IN MASTER OF ARTS IN NURSING OR

MASTER OF SCIENCE, MAJOR IN NURSING


ADMINISTRATION OR MANAGEMENT AND AT LEAST
TWO (2) YEARS OF CLINICAL WORK EXPERIENCE,
2. FOR CHIEF NURSING MANAGER, A
DEGREE IN MASTER OF ARTS IN NURSING OR
MASTER OF SCIENCE IN NURSING, WITH THESIS, AT
ALL HOSPITAL CATEGORY LEVELS, AND FIVE (5)
YEARS WORK EXPERIENCE IN NURSING SERVICE
MANAGEMENT.
(C) PASS REQUISITE EXAMS TO QUALIFY THEM AS
NURSING SERVICE ADMINISTRATORS.
x x x
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 masters’ degree major in nursing OR ALLIED
HEALTH RELATED SCIENCES,
PROVIDED, THAT SAID QUALIFICATIONS SHALL

APPLY TO ALL NURSES OCCUPYING SUPERVISORY OR


MANAGERIAL POSITIONS AND CHIEF NURSES OF FIRST
AND SECOND LEVELS, IN ALL MEDICA}, CENTERS
NATIONWIDE, AS WELL AS IN ALJ. HOSPITALS SUCH AS,
BUT NOT LIMITED TO, PRIMARY, PUBLIC, PRIVATE OR
MILITARY HOSPITALS: — [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 (¢) 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 masters’ degree in nursing and the completion of
the General Staff Course (GSC): Provided, [finally] FURTHER,
That those occupying such positions before the effectivity of this Act
shall be given a period of five (5) years within which to qualify.”
SEC.10. Section 30 of the same Act is hereby amended to read as
follows:
“ARTICLE VII
HEALTH HUMAN RESOURCES PRODUCTION,

UTILIZATION AND DEVELOPMENT


SEC. 30. Studies for Nursing Manpower Needs, Production,
Utilization and Developmen, — The Board in coordination with [the
accredited professional] RELEVANT NURSING organizations and
appropriate government or private agencies shall initiate, undertake
and conduct CONTINUING studies on [health] NURSING human
resource production, utilization and development. THE BOARD
SHALL LIKEWISE ENSURE THE EFFECTIVE
IMPLEMENTATION OF HUMAN RESOURCES FOR HEALTH
(HRH) DEVELOPMENT STRATEGIES FOR NURSES AND
OTHER RELATED PERSONNEL TO ATTAIN A LIGHLY
MOTIVATED AND PRODUCTIVE NURSING PERSONNEL
SYSTEM AND WORKFORCE.”

SEC. 11. Section 31 of the same Act is hereby amended to read as
follows:

“SEC. 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 aot Simited to the
areas of critical care, oncology, rena) and such other areas as may be
determined by the Board: PROVIDED, THAT ANY REGISTERED
NURSE, BEFORE BEING ALLOWED TO WORK IN SPECIALTY
AREAS TO PERFORM BEYOND GENERALIST FUNCTION OR
HAVE SPECIFIC SPECIALTIES, MUST FINISH THE FORMAL
EDUCATION AND TRAINING TOWARDS SPECIALIZATION,
POSSESS: RECOGNIZED ADVANCED PRACTICE
COMPETENCIES AND MUST BE CERTIFIED BY THE BOARD
TO BE AN ADVANCED PRACTICE NURSE AND MUST BE A
MEMBER OF A RELEVANT AND ACCREDITED NURSING
SPECIALTY ORGANIZATION: PROVIDED FURTHER, THAT
NURSING SPECIALTY ORGANIZATIONS WITH ADVANCED
PRACTICE SHALL BE RECOGNIZED AND CERTIFIED BY THE
BOARD, [N COORDINATION WITH THE ACCREDITED
PROFESSIONAL ORGANIZATION.
x x x”

SEC.12. Section 32 of the same Act is hereby amended to read as

follows:


“SEC. 32. {Salary} COMPENSATION. Tn 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 prescribed under
Republic Act No. 6758, otherwise known as the “Compensation and
Classification Act of 1989:" Provided, That for nurses working in
local government units, adjustment to their —_ [salaries]
COMPENSATION shall be in accordance with Section 10 of the said
law: PROVIDED, FURTHER, THAT ADVANCED PRACTICE

NURSES IN PUBLIC AND PRIVATE HEALTH INS'

TUTIONS
SHALL BE ENTITLED TO ADDITIONAL REMUNERATION,
BASED ON QUALIFICATIONS AS PRESCRIBED BY THE
BOARD.”

SEC. 13. Section 33 of the same Act is hereby amended to read as
follows:
“SEC. 33. Funding for the Comprehensive Nursing Specialty
Program. — The annual financial requirement needed to train at feast
ten percent (10%) of the nursing staff of the participating government
hospital shall be [chargeable against] FUNDED FROM THE

FOLLOWING SOURCES:


A. TEN PERCENT (10%) OF THE ANNUAL BUDGET
OF THE DEPARTMENT OF HEALTH AS SPECIFIED UNDER
THE ANNUAL GENERAL APPROPRIATIONS ACT;

B. TEN PERCENT (10%) OF the income of the Philippine
Charity Sweepstakes Office and the Philippine Amusement and
Games 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, AND

cC. 20% OF THE PROFESSIONAL REGULATION
COMMISSION’S INCOME FROM THE REGULATION OF THE
NURSING PROFESSION. 7
SEC. 14. Section 35 of the same Act is hereby amended to read as

follows:
“ARTICLE VIE
Penal and Miscellaneous Provisions

SEC. 35. Prohibitions in the Practice of Nursing. - A fine of
not less than [Fifty thousand pesos (P50,000.00)] ONE HUNDRED
THOUSAND PESOS (P100,000.00) nor more than [One hundred

thousand pesos] THREE HUNDRED THOUSAND PESOS


(P300,000,00) 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:

x x x”

SEC.15, Sections 5, 6, 7, 8, 10 and LI of Article JI are hereby
renumbered as Sections 6, 7, 8,9, [1 and 12 respectively, of Article [V.

SEC. 16. Sections 12, 14, 16, 17, 18, 19, 20, 21, 22, 23 and 24 of Article
IV are hereby renumbered as Sections 13, 15, 17, 18, 19, 20, 21, 22, 23, 24 and 25
respectively, of Article V.

SEC. 17. Section 26 of Article V is hereby renumbered as Section 27 of
Article V1.

SEC. 18. This Act shall take effect fifteen (15) days after its publication in
the Official Gazette or in two (2) national newspapers of general circulation

Approved,