Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
First Regular Session

1567

H. B. No.

Introduced by HONORABLE ROMMEL RICO T. ANGARA

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW TOWARDS QUALITY
HEALTH CARE SYSTEM, AND APPROPRIATING FUNDS THEREFOR

EXPLANATORY NOTE

Republic Act No. 9173 or “The Philippine Nursing Act of 2002” covers the practice of
nursing profession in the Philippines. At present, there are some 397 higher education
institutions offering BS Nursing Program from which some 77, 349 graduated out of 243,
258 students who enrolled from 2014 to 2018.

However, despite the seemingly large number of nursing graduates, there is a continuous
decrease in the results of the Philippine Nurse Licensure Exam, hence from 2014 to 2018,
the national passing rate decreased from 47. 46% in 2014 to 41.71% in 2018.

The Department of Health Standards of nurse to patient ratio is 1:12 but in the Philippines
the nurse to patient ratio ranges from 1:50 to 1:80, thus due to the shortage of competent
nurses, 7 out of 10 Filipinos die without ever seeing a health professional.

This bill seeks to improve the nursing profession in the Philippines by incorporating
measures which will develop not only the foundational skills for health care but it also
includes education, service, research, leadership and governance for nurses. The
Philippine Nursing Profession must constantly respond to both local and global demands
and standards through continuous development not only of the usual health care
services but also of the other aspects that go with it.

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

ROMMEL sco T. ANGARA
tepresentative

Lone District, Province of Aurora


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EIGHTEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES )
FIRST REGULAR SESSION )

H.B.No.__1567

Introduced by HONORABLE ROMMEL RICO T. ANGARA

AN ACT
PROVIDING FOR A COMPREHENSIVE NURSING LAW TOWARDS QUALITY
HEALTH CARE SYSTEM, AND APPROPRIATING FUNDS THEREFOR

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

ARTICLE I
General Provisions

Section 1. Title. — This Act shall be known as the "Comprehensive Nursing Law of
2019.”

Sec. 2. Declaration of Policy. — It is hereby declared the policy of the state to
uphold the dignity of the nurses and assume responsibility for the protection, respect,
and improvement of the nursing profession by insisting measures towards competent and
relevant nursing practice for health and safety of the public, just and humane conditions
of work, and promotion of professional growth. Thus, the State recognizes nurses as
prime movers of national development and contributors to international cooperation and
understanding.

‘The State further guarantees the delivery of accessible, affordable, and available
quality health care to all the people though implementation of adequate and competent
Nursing Personnel System (NPS) throughout the country.

Sec. 3. Definition of Terms. — The following terms when used in this Act shall
mean:

(a) Accredited Integrated Professional Organization (AIPO) refers to a professional
organization of nurses duly accredited by the Professional Regulation Commission

as per Republic Act No. 8981;

(b) Advanced Practice Nurse (APN) refers to a nurse who acquired substantial
theoretical knowledge and decision making skills in the specialty area of nursing
practice and proficient clinical utilization of this knowledge in implementing


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independent and inter-dependent nursing interventions. Specialties can be
differentiated in categories, according to function, disease, pathology, systems,
age, sex, acuity, setting, technology, and therapies. They must be given
certification/credentialing by the Board. An APN must be a master’s degree holder
in nursing;

Bachelor of Science in Nursing (BSN) refers to the basic program for nursing
education;

Certification/Credentialing refers to process undertaken by an individual nurse to
be recognized to practice in a specifically defined professional tract ie. General
Nursing, Nursing Specialty/Advanced Practice, Nursing Education, and Leadership
and Governance. The Board confers the certification or credential after a validation
process based on promulgated guidelines and mechanisms;

Commission on Higher Education (CHED) refers to the body created by law to
promulgate policies, standards and guidelines in the implementation of basic and
graduate program for nursing education;

Health Facility refers to an institution, establishment, clinic that offers health
services and nursing care, such as hospitals, barangay health centers, and clinics;
Nurse, as provided for in this Act, refers to a person who passed the Philippine
Nurse Licensure Exams (PNLE) and whose license has not been revoked by the
law. Thus, it pertains to a Registered Nurse (RN). A nurse may append before
his/her name the title “Nurse,” “Nars” or “Nrs.” or after his/her name the title R.N.;
Nursing Personnel System (NPS) refers to a system of human resource
Management in an institution that classifies the structure, organization, and
coordination within the workforce both in private and public health care facilities
and nursing educational institutions to advance the welfare and protect the rights
of the nurses and to ensure the employer-employee relationship, security of
tenure, just compensation, humane conditions of work and professional growth;
Philippine Nurse Licensure Exam (PNLE) refers to the written examination given
by the Board in order to obtain license to practice nursing;

Precarious Work is the term used to describe substandard employment conditions,
‘such as under-payment, absence of salary, no security of tenure, lack of employer
— employee relationship, no benefits, poor working conditions; and, deviation from
the standard employment relationships, such as contractual, false volunteerism,
job orders thru agencies, part time, self-employment, fixed term work, temporary,
on call, home workers, call center jobs, few benefits, lack of collective bargaining
representation, and no job security;


(k) Professional Regulation Commission (PRC) refers to the government agency
pursuant to Republic Act No. 8981 or as may hereafter be amended or repealed.
It shall be referred to in this law as the Commission;

(1) Professional Regulatory Board of Nursing (PRBON) refers to the administrative
body created by law to supervise and regulate the practice of the nursing
profession in the Philippines. As such, the Board shall be the ultimate authority in
the practice of the profession in the Philippines. It shall be referred to in this law
as the Board;

(m) Public Heaith Institution (PX) refers to any government-ied, owned or controlled
institutions 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 of the Health Care Delivery System
(HCDS — national to local) which include among others: Rural Health Units
(RHUs/Barangay Health Centers); Research Facilities e.g. Research Institute for
Tropical Medicine, etcetera; Training Resource Facilities e.g. the UP College of
Public Health and State or Local Colleges or Universities offering Health-Related
Programs; the Department of Health and all retained Health Facilities, and the like;

(n) Special Permit refers to the permit to practice nursing in the Philippines issued by
the Board to licensed nurses of foreign nationalities; and

(0) Temporary Permit refers to the permit to practice nursing in the Philippines issued
by the Board to Filipino nurses, who does not have a professional license from the
Philippines or have not renewed their license for five (5) years, but are licensed
from foreign countries.

ARTICLE II
Board of Nursing

Sec. 4. Creation and Composition of the Board. — There shall be created a
Professional Regulatory Board of Nursing composed of seven (7) members who shall elect
among themselves a Chairperson to serve for one (1) term, without a re-election. The
President of the Republic of the Philippines shall appoint the members of the Board from
among those recommended by the Commission and ranked from a list of three (3)
nominees, per vacancy, of the accredited integrated professional organization of nurses
in the Philippines and who possess the qualifications in this Act: Provided, That the
membership of the Board shall comprise the scope of nursing practice.

Sec. 5. Qualifications of the Members of the Board. - The members of the Board
must possess the following qualifications:


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(a) Must be a natural born citizen and resident of the Philippines for the past five (5)
consecutive years;

(b) Must be a Nurse in the Philippines and a holder of a valid and updated certificate
of registration and a current professional identification card;

(c) Must be a holder of a master’s degree in nursing and preferably with a doctorate
degree conferred by a university duly recognized by the government;

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

(e) Must be of good moral and has not been convicted of any offense involving moral
turpitude.

Sec. 6. Prohibition as Member of the Board. - A member of the Board shall not
hold a position nor have pecuniary interest in any educational institution offering BSN,
any review or training center for PNLE, training hospitals and health facilities with nursing
affiliates.

Sec. 7. Term of Office. — The members of the Board shall hold office for a term of
three (3) years. Any member of the Board may serve for two (2) terms or a maximum of
six (6) years.

Sec. 8. Vacancy. - Any vacancy in the Board must be filled in the manger
prescribed in this Act and only for the unexpired portion of the term. Each member of the
Board shall take the proper oath of office prior to the performance of duties.

Sec. 9. Compensation. - The members of the Board shall receive compensation
and allowances comparabie to the compensation and aliowances received by the
members of other regulatory boards.

Sec. 10. Administrative Supervision of the Board, Custodian of its Records,
Secretariat and Support Services. - The Board shall be under the administrative
supervision of the Commission. All records of the Board, including applications for
examinations, administrative and other investigative cases conducted by the Board must
be under the custody of the Commission. The Commission shall designate the Secretary
of the Board and shall provide the secretariat and other support services to implement
the provisions of this Act.

Sec. 11. 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, which includes the application, test
development, examination, correction and release of results. The use of


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appropriate technologies and modalities during the conduct of the PNLE is
encouraged to enhance efficiency while uphoiding integrity;

Issue, suspend, revoke or reissue certificates of registration for the practice of
nursing and ensure the widest publication through electronic and written media;
Enforce and monitor safe and quality standards of nursing practice, study the
conditions affecting the nursing practice in the Philippines, and exercise the powers
necessary to ensure the maintenance of efficient, ethico-moral, technical and
professional standards in the practice of nursing towards the optimal health and
common good of the nation;

Ensure quality nursing education by examining and monitoring higher educational
institutions offering and seeking permission to open nursing education programs
and to ensure that standards of nursing education are properly complied with and
maintained at all times: Provided, That the Board and the CHED shall have joint
authority to open and close nursing education programs offered by higher
educational institutions;

Conduct hearings and investigations to resolve complaints against actively
practicing nurses for unethical and unprofessional conduct and violations of this
Act, or its rules and regulations and in connection therewith, issue subpoena duces
tecum and subpoena ad testificandum to require the appearance of respondents
and witnesses and the production of documents and penalize with contempt
persons obstructing, impeding or otherwise interfering with the conduct of such
proceedings, upon application with the Board of Nursing;

Promuigate a Code of Ethics that is responsive to the needs of the nursing
profession in coordination with the AIPO of nurses within a year from the effectivity
of this Act;

Prescribe and operationalize, via necessary infrastructures, a National Nursing
Career Progression Program to ensure continuing professional development of
Filipino nurses, create the Council for Nursing Advancement, Recognition, and
Specialization as well as the various Nursing Specialty Boards to assist the Board
for this purpose;

Ensure performance of mandated duties and functions with the provision of
operational resources including human, financial and spatial resources to ensure
the confidentiality and sanctity of their functions as provided through the annual
budget of the Commission as promulgated in the General Appropriations Act;
Source and utilize funds earmarked for national nursing development;


(j) Prescribe, adopt, issue and promulgate guidelines, regulations, measures and
influence authorities and agencies on decision-making as may be necessary for the
improvement of nursing practice, advancement of the profession and for the
proper and full enforcement of this Act, subject to review and approval by
Commission; and

(k) Create a council for nursing recognition, accreditation and certification that will
assist the Board in:

i. Recognizing organized nursing groups;

ii, Setting standards for advanced nursing practice, education, research and

management;

ili. Accrediting specialty and advanced nursing programs based on established

mechanisms;

iv. Credentialing individual registered nurse based on accepted criteria; and

v. Monitoring and evaluating specialty and advanced nursing practice, education,

research and management.

Sec. 12. Annual Report. - The Board shail, at the close of its calendar year, submit
an annual report to the President and Congress of the Philippines through the Commission
giving a detailed account of its proceedings and the accomplishments during the year and
making recommendations for the adoption of measures that will upgrade and improve
the conditions affecting the practice of the nursing profession.

Sec. 13. Removal or Suspension of Board Members. — The President may remove
or suspend any member of the board, after due process, on the following grounds:

(a) Continued neglect of duty or incompetence;

(b) Commission or toleration of irregularities in the PNLE; and,

(c) Unprofessional, immoral or dishonorable conduct.

ARTICLE IIT
Examination and Registration

Sec. 14. Philippine Nurse Licensure Examination (PNLE). — In order to obtain a
certificate of registration, professional license, and professional identification card, all
nursing graduates must take and pass the PNLE. The Board shall administer the PNLE in
such place and date as designated by the Commission: Provided, That no nursing
educational institution may withhold any requirement or documents, or both, of any
nursing graduate for the purpose of preventing them to apply for the PNLE. All nursing
educational institution must ensure that their nursing graduates will take the nearest
scheduled PNLE after graduation. Any delay in taking the PNEL must be accordingly


justified by the President, Registrar of Dean of the educational institution through a public
instrument.

Sec. 15. Scope of Examination. — The board shall determine the scope of the PNLE
by taking into consideration the nursing core competencies, the nursing curriculum, the
scope and areas of nursing practice, and other related disciplines.

Sec. 16. Qualifications for Admission to the PNLE. — In order to be admitted to the
PNLE, an applicant:

(a) Must be a holder of a Bachelor of Science in Nursing degree from a recognized
educational institution that complies with the standards of nursing education duly
recognized by CHED;

(b) Must be of good moral character and have not been convicted, by final judgment,
of any criminal offense involving moral turpitude or guilty of immoral or
dishonorable conduct, or any person declared by the court to be of unsound mind;
and,

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

Sec. 17. Fees for Examination and Registration. — Applicants for licensure and for
registration must pay the prescribed fees set by the Commission.

Sec. 18. Ratings. - In order to pass the PNLE, an examinee must obtain at least
seventy-five percent (75%) of tested areas of ali competencies. An examinee who has
failed the PNLE three (3) times shall not be allowed to take any further PNLE, without
having undertaken a refresher program in a duly accredited institution. The board shall
issue guidelines on the refresher program requirement.

Sec. 19. Issuance of Certificate of Registration, Professional License and
Professional Identification Card. — A certificate of registration and professional license
shall be issued to all successful examinees, subject to Section 14 of this Article. A
certificate of registration and professional license shali show the full name of the
registrant, the signature of the Chairperson of the Commission, and the members of the
Board. The certificate shall bear the logo of the Board and the official seal of the
Commission.

The Commission shall likewise issue the professional identification card. The card
must bear the following: full name of the registrant nurse, the serial number, the date of


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issuance and expiration, the signature of the Chairperson of the Commission, date of
registration.

Sec. 20. Oath of Profession. - All successful examinees must take an oath of
profession before the Board or any government official authorized to administer oaths
prior to entering upon the nursing practice.

Sec. 21. Roster of Nurses. - The Commission shall maintain a roster of names
pursuant to the PRC Automated System. The Roster of Nurses shall serve as the
centralized database for nursing professionals for purposes of documentation, verification
of registrants, statistics, research, and development.

Sec. 22. Integration of the Nursing Profession. - The nursing profession shall be
integrated into one (1) national professional organization of nurses that is duly registered
with the Securities and Exchange Commission (SEC). The board, subject to approval by
the commission, shall accredit the said organization as the one and only Accreditation
Integrated Professional Organization (AIPO) of registered nurses. All nurses whose names
appear in the Registry Book of Nurses shall jpso facto or automatically become members
thereof and shall receive all the benefits and privileges appurtenant thereto upon
payment of AIPO membership fees and dues.

Members in the Accredited Integrated Professional Organization (AIPO) shall not
be a bar to membership in other nursing organizations.

Sec. 23. Foreign Reciprocity. - No foreign nurse shall be given a certificate of
registration/professional license and professional identification card or be entitled to any
privileges under this Act unless the country or state of which the foreign nurses is a
subject or citizen permits Filipino nurses to practice within its territorial limits on the same
basis as the subjects or citizens of said country or state.

Sec. 24. Practice through Special or Temporary Permit. - The Board may issue a
special or temporary permit to the following persons based on qualification, and
professional and moral standards as approved by the Commission: Provided, That a
completion report will be submitted to the Commission after every mission, to wit:

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

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

(c) Licensed nurses from foreign countries who are engaged by colleges/universities
offering the nursing program as exchange professors in a branch or specialty of
nursing; and,


(d) Licensed nurses from foreign countries who come to aid during declared disasters
and calamities.

The special or temporary permit shall be effective only for the duration of the
project, medical mission or engagement contract.

Sec. 25. Non-registration and Non-issuance of Certificate of Registration,
Professional License, Professional Identification Card, Special Permit or Temporary
Permit. — No person convicted by final judgment of any criminal offense involving moral
turpitude or any person guilty of immoral or dishonorable conduct or any person declared
by the court to be of unsound mind may be registered and issued a certificate of
registration, professional license, professional identification card, or a special temporary
permit.

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

Sec. 26. Revocation and Suspension of Certificate of Registration, Professional
License, and Professional Identification Card and Cancellation of Special or Temporary
Permit. - The Board shali have the power to revoke or suspend the certificate of
registration, professional license, professional identification card, or cancel the special or
temporary permit of a nurse upon any of the following grounds:

(a) Conviction, by final judgment, of any criminal offense involving moral turpitude or
guilty of immoral or dishonorable conduct or any person declared by the court to
be of unsound mind;

(b) Violation of this Act, its policies, rules and regulations, and of the Philippine code
of Ethics for Nurses;

(c) Gross negligence, grave misconduct, ignorance, and incompetence in the nursing
practice;

(d) Fraud, concealment, misrepresentation, or false statements in obtaining a
certificate of registration, professional license, professional identification card,
special permit or temporary permit; or

(e) Practice of the nursing profession pending suspension of license.

The suspension of the certificate of registration, professional license, and
Professional identification card, shall be for a period not to exceed four (4) years.

Sec. 27. Reinstatement and Re-Issuance of Revoked Certificates of Registration,
Professional License, and Professional Identification Card. - The Board may, after the
expiration of a maximum of four (4) years from the date of revocation of a certificate of
registration, professional license, and professional identification card, for reasons of
equity and justice, and when the cause for revocation has disappeared or has been cured


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and corrected, upon proper application thereof and the payment of the required fees,
reinstate and re-issue the certificate of registration, professional license and professional
identification card.
ARTICLE IV
Nursing Practice

Sec. 28. Nursing Practice. - The administration of nursing care through the
utilization of the nursing process: assessment, nursing diagnosis, planning,
implementation, and evaluation. Nursing practice encompasses various stages of
development towards the promotion of health, prevention of iliness, health care
techniques and procedures, restoration of health, alleviation of suffering, and end-of-life
care, may it be performed independently or collaboratively.

Sec. 29. Scope of Nursing Practice. - The following are the scope of nursing
practice: (1) nursing education; (2) nursing service; (3) nursing research; and, (4)
nursing leadership and governance.

Sec. 30. Nursing Care. — Nursing Care includes, but is not limited to: the provision
of physiological, psychological, spiritual, social and emotional care; essential health care,
safety and comfort measures, health techniques; executing health care techniques and
procedures; and, traditional and innovative approaches to individuals, families, population
groups and communities from conception to death.

A nurse shall be deemed to be practicing nursing when he or she, for a fee, salary
or compensation, singly or collaboratively, performs nursing care to individuals, families,
population groups and communities.

Sec. 31. Roles, Responsibilitie
possess and exercise the core competencies in the performance of the roles and
responsibilities, in accordance with the standards set by the Board.

Sec. 32. Continuing Professional Development (CPD). — All nurses shall abide by
the requirements, rules and regulation on continuing professional development to be
promulgated by the PRC Regulatory Board, subject to the approval of the commission, in

2s, and Competencies of a Nurse. — A nurse shail

coordination with the AIPO for nurses or any duly accredited education institutions. For
the purpose, a CPD council is hereby created to implement the CPD program.
Sec. 33. Requirement for Inactive Nurses Returning to Practice. - Nurses are
deemed to be inactive when:
(a) They are not utilizing nursing competencies as defined in the scope of nursing
practice for five (5) consecutive years;
(b) They have not renewed their professional identification card for five (5) years;
and

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(c) They do not have proof of five (5) years of continuous nursing practice.
Inactive nurses are required to undergo one (1) month didactic training and three
(3) months practicum in hospitals accredited by the Board.

ARTICLE V
Nursing Education

Sec. 34. Nursing Education. — Refers to the formal learning and training in the
science and art of nursing provided by higher educational institutions duly recognized by
the CHED.

There shall be a standard of Basic and Graduate Program for Nursing Education
which must be pursuant to the CHED Law (RA 7722).

Sec. 35. Basic Program for Nursing Education. - Refers to the nursing education
Program which envisions providing sound liberal and professional education and equips
basic nursing students with the necessary competencies for entry-level safe and quality
nursing practice.

Admission to the Basic Program for Nursing Education requires passing a National
Nursing Admission Test (NNAT).

The curriculum and the Related Learning Experiences (RLE) must be in accordance
with the National Nursing Core Competency Standards promulgated by the Board and
implemented though the Policies, Standards, and Guidelines of the CHED.

Sec. 36. Graduate Program for Nursing Education. — Refers to the post
baccalaureate nursing program, which builds on the experiences and skills of a nurse
towards mastery, expertise, and leadership in practice, research and education. It
includes a master’s degree and doctorate degree in nursing founded on the philosophies
and the scientific body of knowledge and practice.

Graduate Program for Nursing Education shall be offered only in higher educational
institutions as prescribed by the prevailing CHED Policies, Standards and Guidelines for
Graduate Education.

Sec. 37. Qualifications of the Dean. - The Dean of the College of Nursing (Dean)
shall formulate policies, plans in collaboration with the administration/school officials and
stakeholders. The Dean must adhere to the prescribed curriculum for the advancement
of nursing education.

The Dean:

(a) Must be a holder of a certificate of registration and a current professional
identification card issued by the Commission;

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(b) Must have the appropriate certificate of nursing proficiency, or its equivalent, to
be issued by the PRBON;

(c) Must be a holder of a master’s degree in nursing, conferred by a university duly
recognized by the Government of the Republic of the Philippines;

(d) Must have at least five (5) years of experience in teaching and supervision in

Nursing Education; and

(e) Must have at least three (3) years clinical experience in a general nursing service.

Sec. 38. Qualifications of the Faculty. -

(1) Basic Program for Nursing Education. — A member of the faculty in a College of
Nursing teaching professional courses:

a. Must be a registered nurse in the Philippines and holder of a certificate of
registration and a current professional identification card issued by the
Commission;

b. Must have at least three (3) years nursing practice;

c. Must be a holder of a master’s degree in nursing, conferred by a university duly
recognized by the Government of the Republic of the Philippines; and

d. Must have the appropriate certificate of nursing proficiency, or its equivalent,
to be issued by the PRBON.

(2) Graduate Program for Nursing Education. - A member of the faculty teaching
graduate professional courses:

a. Must follow prescriptions 1 and 2 of basic nursing education; and

b. Must be a holder of a doctoral degree in nursing conferred by a university duly
recognized by the Government of the Republic of the Philippines.

Sec. 39. Faculty-to-Student Ratio. - The faculty-to-student ratio must be in

accordance with the standard to be determined and prescribed by the CHED.
ARTICLE VI
Nursing Service

Sec. 40. Nursing Service. - Nursing Service is the promotion of health and
prevention of illness which includes, but not limited to, nursing care provided by a nurse,
either independently or collaboratively, to any individual, family or group in various health
care settings.

Nursing Service shall include the following functions: (1) Provide health education
to individuals, families and communities; (2) Ensure that information on healthy lifestyle
are incorporated in his or her health teachings; (3) Seek opportunities to promote a
healthy lifestyle within his or her influence; (4) Accept that he or she is a role model for
a healthy lifestyle; (5) Enable people to increase control over their health and to improve

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health; (6) Build healthy public policy; (7) Create supportive environment; (8) Strengthen
community action for heaith; and (9) Establish linkages with community resources and
coordination of services with the health team.

Sec. 41. Nursing Interventions. - Nursing interventions include, but is not limited
‘to: any or combination of essential primary health care, the application of traditional and
innovative approaches, health counseling, and administration of written prescription for
treatment, therapies, oral, topical, and parental medications, perform peripartal care
covering pre-intra-postpartum care including the performance of internal examination
during labor in the absence of antenatal bleeding, attend to normal delivery and suturing
of perineal laceration and immediate care of the newborn; perform perioperative care
covering pre-intra-post surgical care interventions; care during emergency and disaster.

Sec. 42. Health Interventions in Collaboration with Other Members of the Health
Team. — In the various stages of nursing practice from promotion of health to end-of-
life care, Nurses shall collaborate with other members of the health team.

Sec. 43. Advanced Practice Nursing. — Advanced Practice Nursing is the specialized
and expanded nursing care pursuant to SEC. 46 hereof. Advanced Practice Nursing
involves specialty training, through an Advanced Practice Nursing Program formulated by
the concerned agencies with certification to be issued by the Board after passing the
qualifying examination. A Registered Nurse (RN) who seeks to be an Advance Practice
Nurse (APN) must have a master’s degree in Nursing.

ARTICLE VII
Nursing Research, Policy Development, and Planning

Sec. 44. Nursing Research and Policy Development. — Nursing Research and Policy
Development shall involve study and pursuit of nurse related issues encompassing the
following areas:

(a) Professional nursing practice such as advancing nursing knowledge to ensure
quality nursing care for all and advocacy for sound health policies globally;

(b) Nursing regulation on credentialing, code of ethics, standards and competencies;
and

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

Sec. 45. Studies for Nursing Human Resource Needs, Production, Utilization and
Development. — The Board, in coordination with the accredited integrated professional
organization of registered nurses and the appropriate government or private agencies
shall initiate, undertake and conduct studies on healthcare human resources production,
utilization and development.

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Sec. 46. Advanced Practice Nursing Program. - Within ninety (90) days from the
effectivity of this Act, the Board in coordination with the accredited integrated
professional organization of registered nurses, recognized specialty organizations, and
the Department of Health (DOH) is hereby mandated to formulate and develop an
Advanced Practice Nursing Program that would upgrade the level of skill and competence
of specialty nurse clinicians in the country, such as, but not limited to, the areas of critical
care, oncology, renal and such other areas as may be determined by the Board: Provided,
That the beneficiaries of this program are obliged to serve in any Philippine hospital for
a period of at ieast two (2) years of continuous service.

Sec. 47. Salary. - To enhance the general welfare, commitment to service, and
professionalism of nurses, the Organization, Position Classification and Compensation
Bureau of the Department of Budget and Management (DBM) is hereby directed to
conduct a compensation study for the nursing profession, with the end view of developing
and recommending to the President a competitive compensation and remuneration
system for nurses.

Sec. 48. Incentives and Benefits. - The Board, in coordination with the DOH, other
concerned government and non-government institutions, association of hospitals and the
AIPO for registered nurses, shall establish an incentive and benefit system in the form of
free hospital care for nurses and their dependents, scholarship grants and other non-cash
benefits.

ARTICLE VIII
Nursing Leadership and Governance

Sec. 49. Nursing Leadership. — Nursing is a dynamic field that requires leaders who
will go through the changing aspects of the health sector as they are part of the workforce
that will toil and labor for the improvement of the health of the citizenry. Nurses adopt
specific roles in organizational structure, from being the policy makers in health facilities
and giving guidance to senior management on best practices in nursing and patient care.
They work with healthcare leaders to establish compensation and benefit programs and
are involved in nurse recruitment, training and retention. Thus, nurses in management
positions shall develop patient-care programs, manage nursing budgets, pian new patient
services, establish nursing policies and procedures, participate in cross-departmental
decision making, conduct performance improvement activities and represents the scope
of nursing practices at Board of director meetings and other stakeholder.

Sec. 50. Nursing Governance. - Governance in nursing practice is shifting from the
traditional view that nurses are subordinate and passive employees towards having more
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decision making and implementation of plans and policies for the patients and
communities. Governance in the practice of nursing shall empower each nurse in decision-
making over their professional practice while extending their power and control over the
administrative aspect of their practice.
ARTICLE IX
Nursing Personnel System

Sec. 51. Nursing Personnel System. — The nursing personnel system covers the
following fields: nursing service administration in the hospital setting, community health
practice, and the academe.

There shall be a nursing service office in every health institution, may it be
administrative or clinical, with at least ten nurses. The nursing service office must be
under the control and management of a chief nursing officer.

Sec. 52. Ratio. — The ratio of a staff nurse to a patient in a general nursing service
or general ward of a hospital shall be set at least 1:12, in order to effectuate the quality
nursing care for patients. There shall be a nurse for every barangay and industrial
establishment: Provided, That the nurse shall supervise other health workers in the work
area.

There shall be a nurse for every school, whether private or public, primary,
secondary or tertiary, subject to the applicable ratio prescribed by the appropriate
government agency.

Sec. 53. Beginning Registered Nurse. — A beginning registered nurse shall provide
for safe and quality care to an individual, family, or group that is independent or provided
as part of a team. The nurse must be able to assess, plan, implement, and evaluate the
care provided to clients based on evidence derived from research.

A beginning registered nurse must have the following minimum qualifications:

(1) Must be a Bachelor of Science in Nursing graduate from a higher educational
institution recognized by the CHED;

(2) Must be a registered nurse with current certificate of registration and professional
identification card issued by the Commission;

(3) Must by physically, mentally and psychologically fit to practice nursing; and

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

Sec. 54. Nursing Service Management. - Nursing Service Management refers to
the Management and Administration of Nursing Services by Nurses equipped with the
necessary competencies on governance and leadership, to wit:

(1) First Level Manager, is responsible directly for the physical set-up of the unit,
structure and other human resources for health care provision;

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(2) Middle Level Manager, is responsible for the department or section handling more
than one (1) or two (2) units, taking care of the financial, logistic, operational
functions and others;

(3) Top Level Manager, oversees all nursing units in terms of financial and human
resources for health such as nurses and nursing assistants/adjuncts.

Nursing Service Managers must have the following minimum qualifications in
addition to the requirements of a Beginning Registered Nurse:

(a) For first level managerial position in nursing, must have at least eighteen (18) units
of nursing management and clinical subjects in Master of Arts in Nursing or Master
of Science in Nursing, at least three (3) years of clinical work experience, and must
have participated in at least one (1) research project to improve quality of care;

(b) For middle level managerial position in nursing, must have completed all academic
requirements in Master of Arts in Nursing or Master of Science in Nursing and must
have at least three (3) years of clinical work and two (2) years of management
experience, and must have initiated at least one (1) research project to improve
quality of care;

(c)_ For top level managerial position in nursing, must have a post-graduate degree in
nursing or health management — related sciences and at least three (3) years of
dinical work and three (3) years of management experience, and must have
initiated at least two (2) research projects to improve quality of care; and

(d) For all managerial positions — Must present the appropriate Certificate of Nursing
Proficiency, or its equivalent, from the Board in observance of the Nursing
Leadership and Governance Certification Program (Nurse Administrator I, Nurse
Administrator II, Nursing Administration Specialist).

The above qualifications shall apply to all nurses occupying supervisory or
managerial positions across all health facilities.

Sec. 55. Public Health Practice. - A nursing service shall be organized and
operationalized in every local health agencies in order to ensure the nursing component
of public health programs. Thus, an ideal of having at least one (1) nurse in every
barangay shall be the thrust of public heaith in order to provide accessible, affordabie
quality health care to all. More so, the ideal of having at least one (1) nurse in every
school, whether private or public, shall be prioritized in every primary, secondary and
tertiary educational institution in order to instill health awareness at an early stage and
to improve the health status of the students.

Sec. 56. The Chief Nursing Officer (ONO). - The nursing service and delivery of
healthcare in a public health practice or community set-up must be under the control and

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management of the Chief Nursing Officer or CNO. The CNO shall carry full administrative
responsibility and shali have the authority on planning, organizing, directing and
controlling of public health nurses. A CNO must have a minimum of three (3) years
practice in a community setting as a Public Health Nurse, and must have at least five (5)
years of experience in relevant nursing practice setting. In addition, the CNO public health
agency must be a master’s degree holder in relevant nursing practice setting, conferred
by an educational institution duly recognized by the Government of the Philippines.

The CNO is responsible for the formulation of policies, strategic and operational
planning, financiai plan and resource ailiocation, policies and procedure development,
professional and organizational involvement to address epidemiologic problems and
provide statistical data, and shall exercise good governance and accountability of the
nursing personnel in a public health setting. The CNO shall also act as the advocate for
the rights and welfare of public health nurses.

Sec. 57. Nurse Supervisor (NS). — The Nurse Supervisor or NS shall be in charge
of planning, organizing, directing and controlling activities within a demographic unit. A
NS must have a minimum of three (3) years practice in a community setting as a Public
Health Nurse, and must be a master’s degree holder in Public Health Nursing or its
equivalent.

Sec. 58. The Public Health Nurse (PHN). — The Public Health Nurse or PHN shall
perform the functions and activities of health promotion, such as the prevention and
treatment of various diseases and illnesses, in a particular public setting. The PHN shall
exercise a supervisory role to the midwives and barangay health workers within her area.
The PHN shail initiate and participate in developing policies and guidelines to promote
basic nursing services.

ARTICLE X
Prohibited Acts and Penal

Sec. 59. Prohibited Acts. - Any of the following shall constitute unlawful and illegal
acts:

(a) Any person who is practicing the nursing profession in the Philippines:

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

2. Who uses a certificate of registration, professional license, professional
identification card, special permit or temporary permit of another;

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(d)

3. Who uses an invalid certificate of registration, professional license, a suspended
or revoked certificate of registration, professional license, or an expired or
cancelled special or temporary permits;

4. Who, by any means of misrepresentation, false evidence, or concealment,
obtained a certificate of registration, professional license, professional
identification card, special permit or temporary permit;

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

6. Who appends “Nurse,” “Nars”, or “Nrs” before his or her name or B.S.N./R.N.
(Bachelor of Science in Nursing/Registered Nurse) after his or her name without
having been conferred said degree or registration; or

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

Any natural or juridical person, educational institutions offering BSN without full

compliance with the requirements prescribed by law conducts Continuing

Professional Development for nurses without accreditation from the Board; or any

natural or juridical person or health facility who undertakes or offers in service

training programs, for a fee and without permit/clearance from the Board of the

Commission;

Any natural or juridical person or health facility who subscribes to substandard

quality of nursing care and/or nursing practice, such as non-compliance with the

nurse-to-patient ratio;

Any natural or juridical person or health facility who exercises and promotes

precarious working conditions to nurses, such as, but not limited to, the following:

1. Contracting or availing of the services of a nurse either without salary, for
allowance, for salary below the applicable wage prescribed under this Act,
whether or not under the pretext of a training, development program,
certification course and/or seminar;

2. Depriving or denying a nurse of the incentives and benefits as provided for the
existing laws;

3. Collecting any fees from a nurse or from any person or agent in his or her
behalf in exchange for a nurse’s voluntary services in a health facility;

4. Requiring or obliging a volunteer nurse to perform the regular work functions
and/or regular work load expected from a regular staff nurse employed by the
health facility without proper compensation, to render full-time service as a

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condition for the continued availment of his/her volunteer services, and/or to
be the sole nurse on duty, except during disasters, calamities, public
emergencies and war;

5. Contracting or availing of the services of a volunteer nurse, under the pretext
of On-The-Job Training (OJT), contract of service, and/or job orders, in order
to fill-up a vacant position that requires the hiring of a full-time regular
employed nurse, or for free in exchange for any type of certification to be
issued by the health facility for purposes of the nurse’s employment application;
or

6. Contracting or availing of the services of a nurse, under the pretext of training
or certification course, but requiring the nurse to render the tasks and
responsibilities expected of a regular staff or public health nurse, in violation of
Section 48 hereof;

(e) Any violation of the provisions of this Act.

Sec. 60. Sanctions. - A fine of not less than one hundred thousand pesos
(P100,000.00) nor more than 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 violation of any prohibited acts
enumerated in Section 59 (a) hereof.

A fine of not less than three hundred thousand pesos (P300,000.00) nor more than
five hundred thousand pesos (P500,000.00) and/or imprisonment of not less than one
(1) year nor more than six (6) years shall be imposed upon violation of any prohibited
acts enumerated in Section 59 (b), (c), (d), and (e) hereof. In addition, suspension or
revocation of license to operate the health facility may be issued upon the discretion of
the court. In case the violation is committed by a partnership, corporation, association,
or any other juridical person, the managing partner, president, director/s, or manager
who has committed or consented such violation shall be held directly liable and
responsible for the acts, as principal or as co-principal/s with the other participants, if
any.

Sec. 61. Refund and Compensation. — A nurse found to have been a victim of
Section 59 (d) hereof shall be entitled to a full refund of all fees illegally collected fees
and charges and the payment of unpaid salary, if any which should not be less than the
applicable wage for services rendered.

ARTICLE XI
Miscellaneous

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Sec. 62. Implementing Agencies. — The Department of Health (DOH) is hereby
designated as the agency tasked with monitoring the compliance with and
implementation of the provisions of this Act by public health facilities. The Department of
Labor and Employment (DOLE) is designated as the agency tasked with monitoring the
compliance with and implementations of the provisions of this Act by private health
facilities. The Commission and the Board are designated as the agencies tasked with
monitoring the compliance with and implementations of the provisions of this Act by
educational institutions, CPD providers and health facilities. The CHED is similarly
designated as the agency tasked with monitoring the compliance with and
implementations of the provisions of this Act by educational institutions with regard to
nursing education programs and curriculum.

Sec. 63. Appropriations. - The amount necessary to carry out the provisions of
this Act shall be charged to savings of the concerned agencies immediately upon
effectivity hereof. Every year thereafter, the amounts necessary to effectively implement
the provisions of this Act shall be included in the annual budget of the concerned agencies
to be incorporated in the Generai Appropriations (GAA).

In order to effectively carry out the advance practice of the nursing program, the
annual financial requirement needed to train at least ten percent (10%) of the nursing
staff of the participating government hospitals and institutions shall be chargeable against
the income of the Philippine Charity Sweepstakes Office (PCSO) and the Philippine
Amusement And Gaming Corporation (PAGCOR), which shall equally share in the costs;
the same shall be released to the Department of Health subject to the usual accounting
and auditing procedures: Provided, That the Department of Health shail set the budget
for, as well as the criteria for the availment of this program.

Sec. 64. Implementing Rules and Regulations. — Within ninety days (90) after the
effectivity of this Act, the Commission, the Board, the AIPO for registered nurses, the
Civil Service Commission, the Department of Budget and Management, the Department
of Health and other concerned nursing organizations and government agencies, shall
formulate the implementing rules and regulations necessary to carry-out the provisions
of this Act. The impiementing rules and regulations shall be published in the Official
Gazette or in at least two (2) newspapers of general circulation.

Sec. 65. Separability Clause. - Should any provision of this Act be declared
unconstitutional, the remaining parts not affected thereby shall remain valid and
operational.

Sec. 66. Repealing Clause. — Republic Act No. 9173, otherwise known as the
“Philippine Nursing Act of 2002” is hereby repealed. All other laws, decrees, orders,

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circulars, issuances, rules and regulations and parts thereof which are inconsistent with
this Act are hereby repealed, amended or modified accordingly.

Sec. 67. Effectivity. - This Act shall take effect fifteen (15) days after its publication
in the Official Gazette or in any two (2) newspapers of general circulation in the
Philippines.

Approved,

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