Sei sulla pagina 1di 9

ISSUES and CONCERNS

NURSING EDUCATION
LEGAL BASIS: Phil. Nsg. Act of 2002 – RA 9173
ARTICLE 5: SECTION 5: NURSING EDUCATION PROGRAM
 Shall provide sound general and professional foundation for the practice of nursing
 The learning experience shall adhere strictly to the specific requirements embodied in the prescribed curriculum as
promulgated by the commission on higher education policies and standards of nursing education.

CHED MEMO ORDER #30: UPDATED POLICIES AND STANDARDS FOR NURSING EDUCATION
 In accordance with pertinent provisions of RA 7722
RA 7722 = “HIGHER EDUCATION ACT OF 1994”
PURPOSE: Rationalizing Nursing Education in the country with the end in view of meeting the health needs of people thru
quality health services and keeping it relevant and apace with the demands of GLOBAL COMPETETIVENESS.

• They came up with the policy in order for us to provide quality health services:

ARTICLE I: AUTHORIZATION
SEC 1: School of nursing must have a written recommendation from BON PRC, NSAC (National Student Affiliation
Committee) DOH
 Screening prior to approval from CHED.
SEC 2: Nursing Programs must be authorized by CHED
completion of cases
SEC 3: Rules and regulations must be duly recognized and authorized by the government to operate the programs

ARTICLE II: MISSION STATEMENT


 Nursing education aims to prepare a critical thinking Nurse practitioner who, upon completion of the program,
demonstrates beginning professional competencies and shall continue to assume responsibility for personal and
professional development and utilizes research findings in the practice of the profession.

NURSING EDUCATION IN THE PHILIPPINE SOCIETY IS COMMITTED TO:


a. Provide quality education that will harness the maximum potentials of the learners.
b. Develop a person who assumes responsibilities for personal and professional growth.
c. Develop a person who is caring, responsible, nationalistic, creative, and critical thinking generalist, who upon
completion of the program, demonstrates beginning professional competencies.
d. Inculcate ethico-legal, moral and spiritual values.
e. Develop a graduate who is responsive to national needs and aware of global concerns.

PERSONAL AND PROFESSIONAL PROFICIENCIES


1. Interest and willingness to work in a variety of setting
2. Warm personality and concern for people
3. Resourcefulness and creativity
4. Emotionally well balance
5. Capacity and ability to work cooperatively with others
6. Takes action to improve self and service

WHAT IS TO BE A NURSE:
1. Involving oneself in pressing problems of the country
 Social responsibility
e.g. go-abroad – share your knowledge
2. It means listening, understanding and communicating with others even if we have different styles, beliefs and
custom/ culture
 Do not go against the belief of your client.

9 AREAS OF CHED EVALUATION FOR NURSING SCHOOL


1. ADMINISTRATION
a. VISION, MISSION, PHILOSOPHY and OBJECTIVES
b. DEAN – Filipino Citizen
- RN in the Philippines
- Holder of MASTERS DEGREE IN NURSING
- Must have at least 5 years of competent teaching and supervisory experience in college / institute of
nursing
2. FACULTY – shall have academic preparation appropriate to teaching national
- Filipino citizen
- RN in the Philippines
- Masters degree holder
- One year of clinical practice in a field of specialization
- Be a member of good standing of the accredited national Nursing association

FUNCTIONS OF THE DEAN


1. Assist administrator to attain institutional goals
e.g. instruction, research
2. Initiate curriculum development programs – implement changes
3. Implement faculty development program – monthly meeting
- encourage us to take MAN
4. Recommend faculty for appointments promotion and tenure including leave and on reappointment – regular/
permanent, contract per sem
5. Approve faculty teaching load
6. Oversee faculty’s academic advisement of the students – adviser
7. Collaborate with students services, admission, policies and referrals based on established criteria.
8. Ensure adherence to established standards of instruction
9. Ascertain that requirements for graduation are complied with
10. Represent the school for professional and community civic affair
11. Attend to physical and budgetary resources
12. Collaborate with the health services and other academic units in the implementation of instructional programs –
communication letter

3) ART V CURRICULUM
SEC 1. The BSN curriculum maybe amended or revised provided it meet the minimum requirement of CHED
• The BSN curriculum is community oriented curriculum
• It aims to prepare Nurses for entry level positions in any health care settings in the country
e.g. hospital, clinics, health centers, homes and community

OBJECTIVE:
To produce professional nurses who demonstrate the following behaviors:
1. Possess caring behavior (compassionate, competent and committed)
2. Practice LEGAL, ETHICO-MORAL, SOCIAL RESPONSIBILITIES
• LEGAL – practice within context of profession
• ETHICO-MORAL – e.g. “making money out of the sick”
• SOCIAL – promotion, prevention, rehab of the community
3. Demonstrate critical and creative thinking
• sound judgment / open mindedness / maturity
4. Practice SKA for alleviation of suffering, assisting clients to face death with dignity and in peace

a) MAXIMUM REQUIREMENTS FOR LIBRARY QUARTERS


1. The building should provide adequate space for housing library collection, for study and for staff workroom and
offices.
• provision for expansion should be made
2. The library should be accessible to all employees and students of the institution > location
3. Facilities shall be attractive, safe and promote operational efficiencies and effectiveness of use
• attractive – clean and orderly
• safe – fire escape, doors, window – not only for emergencies but conducive
• Efficiency and effectiveness – quite, stimulating environment conducive
4. The size of the building shall commensurate the total of population, extent of collection, number of staff
5. The library should be open and accessible beyond class hours.
A] BASE HOSPITAL
 100 beds capacity – 80% occupancy
 Tertiary hospital accredited by DOH as a training and teaching hospital
= Quasi – owned by the school – the students can stay there for 80
 Government hospitals – cannot be used as a base hospital
B] AFFILIATION AGENCIES
C] COMMUNITY CENTER
- Coordinate with the barangay official

7) CURRICULUM
Art VI
4) INSTRUCTIONAL STANDARDS
 Institution must maintain high standard of instruction
 Must utilize appropriate and updated syllabi and updated instructional methods, strategies that contribute to sound
nursing education.

a) SYLLABI / RESOURCE UNITS


- books, references
b) CLINICAL TEACHING PROGRAMS
- program of activities with different areas
c) CLINICAL ROTATION
d) FACULTY MANUAL
e) DEVELOPMENT PLAN
- consist of activities and programs towards the development of faculty for intellectual, personal and
professional as well as moral and spiritual growth
- scholarship grants, graduate studies in service and continuing training programs, clinical skill, enhancement.
f) FACULTY EVALUATION
g) STUDENT HANDBOOK
h) EVALUATION – student – per subject
- per rotation

3) LIBRARY
LIBRARY HOLDINGS
1. 3,000 books
- books, journals, references
- up to date relevant books, serials, pamphlets, documents and non-book materials
- must be adequate to the curriculum, instructional, research, and recreational needs
- up to date electronic resources
2. The availability of CD-ROMS and on line data base
3. Core periodicals collection of current and relevant titles (local and foreign)
4. Filipiniana collection – 5% of the books
- Philippine nursing books of Filipino authors
5. A regular weeding program shall be undertaken to keep the collection relevant and up to date

6) STAFF – full time registered librarian with 3 years experience


ART IX LAB FACILITIES

4) LABORATORY
- general education
- nutrition
- anatomy and physiology

5) SKILLS LABORATORY
 must have adequate space with adequate instruments and equipments simulating a hospital setting, community,
home and health centers and lying in.
 demonstration room where there is one bed to eight students at one given time.
 supplies and equipment for every level.

6) RELATED LEARNING EXPERIENCE


 RLE must provide for continuity, sequence and integration of principles, concepts, skills and values that have been
previously learned in the classroom and other situation.

ART VIII RESEARCH


SEC 1. The administration should encourage and support research among students and faculty and promote utilization of
research findings for nursing care and other aspects of nursing program.
SEC 2. There should be budget for research and publication.

ARTICLE X
9] ADMISSION CRITERIA / SELECTION / RETENTION OF STUDENTS
 composite score

SEC 1: High school grade – must belong to upper 40% of the graduating class – certified by the principal.
SEC 2: The school must have a well defined admission, promotion and retention policies published and made known to
students
SEC 3: Admission Quota – must consider the capability of the school to provide the following
a. qualified faculty
b. teaching/ learning resources – books, skills lab, classrooms, manpower
c. resources of the base hospital
 clientele
 staffing
 facility . dialysis, x-ray, beds / rooms
 number of student affiliates
SEC 4: Grounds for dying admission/ re-admission:
1. academic deficiencies
2. violation of school policies
3. closure of prog/ school
4. uses/ health reasons
5. failure to meet financial obligation to school

NURSING PRACTICE: PNA OF 2002


RA 9173 ART VI SEC 28
The Fundamental Responsibility of the Nurse is:
a.) to promote health
b.) to prevent illness
c.) to restore health
d.) to alleviate suffering
e.) to promote the spiritual environment of the patient

III. SELF – GOVERNANCE AND PROFESSIONAL AUTONOMY

GOAL: Enhance care by standardizing nursing practices and policies across the region – CHN bag technique EPI
 allows for decentralized, collaborative decision making, and give the nursing profession the right and responsibility
to participate in decision that affect the provision of clinical care, themselves and their profession.
e.g. : PNA per chapter have their own guidelines

SELF-GOVERNANCE IS AN ORGANIZATION FRAMEWORK THRU WHICH REGIONAL AND SITE SPECIFIC


NURSING COUNCILS WILL:
1. Guide nursing clinical practice – SOP of every unit
2. Empower staff – self confidence increase because they have control over their own unit
3. Provide autonomy and accountability in the clinical setting
4. Enhance regional nursing team FXN – PNA chapter
5. Standardize nursing policies, procedures and standards of care
e.g. moral principles, code of conduct, legal
PROFESIONAL AUTONOMY:
- Right of self determination and governance without external control.
- Practitioners have the control over their own functions in the work setting.
- Accepts accountability and responsibility for all aspects of the knowledge – based services it provides to the society.
- Allowing professionals to have substantial control over professional practice.
- Significant room for exercise of their judgment.

PROFESSIONAL NURSE AUTONOMY


- Defined as belief in the centrality of the client when making responsible discretionary decision making, collegial
interdependence, pro-active advocacy for clients
- Accountability is the primary consequence of professional autonomy
- Empowerment, job satisfaction, commitment, professionalization of nursing
• P.A. provides justification for nurses acting according to their own professional judgment, rather than simply
being told by physicians what to do.
• When a physicians orders conflict with nursing standards or with a nurse expert judgment, the nurses
professional autonomy implies a right to object.

IV. INDEPENDENT NURSING PRACTICE


- Self governing or being free from anyone or anything.
- These independent nursing practitioners have the same duties and responsibilities just like the ones who are working
in the hospital setting.
- They do health care assessment, formulate plans for health maintenance and prevention strategies, and do supportive
care for their client and patients.
- These nurses make referrals and collaborate with physicians as needed by the client.
- They are responsible for their own acts or decisions.

Predicted Outcomes of the New Role of Nurse as Independent Nurse Practitioners


1. It will encourage professional nurses to extend their capabilities and assume greater responsibilities for designated
areas of generalized nursing practice.
2. The amount of health care will be more increased and accessible to people.
3. The nurse’s involvement in the client’s family or community will increase the nurse’s sensitivity and response to
their client’s needs.
4. Improvement of health services will help prevent serious illness and maintain positive community health programs.
5. It will provide data for nursing education, to validate and legitimate extended role practice for nurses.

WHY PRACTICE AS AN INDEPENDENT NURSE?


1. Substantial increase in income
2. Increased professional autonomy
3. More control of our personal lives

DEPENDENT – means the nurse is self employed and provides professional nursing services to clients and their families
• Some INP services to clients and the clinics near a hospital
e.g. Psychiatric nursing specialist
• Most of them are community – based
• These nurses reach out and offer their services rather than expect clients to seek their help.

VI. EVIDENCE –BASED NURSING


- Is the process by which nurses make clinical decisions using the best available research evidence, their clinical
expertise and patient preferences.
- Involves seeking out the best available evidence, assessing the credibility of research and deciding if the evidence is
clinically important.
- GOAL OF EBN: To apply valid and reliable nursing research to clinical practice.

3 AREAS OF RESEARCH COMPETENCE IMPORTANT TO EBN:


1. Interpreting and using research
2. Evaluating practice
3. Conducting research
FACTORS TO BE CONSIDERED IN CARRYING OUT EBN:
1. Sufficient research must have been published on the specific topic.
2. The nurse must have skill in accessing and critically analyzing research.
3. The nurse’s practice must allow her to implement changes based on EBN.

Evidence-based Nursing Practice solves problems encountered by nurses by carrying out 4 STEPS:
1. Clearly identify the issue or problem based on accurate analysis of current nursing knowledge and practice.
2. Search the literature for relevant research.
3. Evaluate the research evidence using established criteria regarding scientific merit.
4. Choose interventions and justify the selection with the most valid evidence.

MODELS FOR RESEARCH:


1. CURN Project-Conduct and Utilization of Research in Nursing.
2. Settler Model of Research Utilization
- individual practitioner level
6 PHASES:
a. Preparation
b. Validation
c. Research evaluation
d. Decision Making
e. Translation and application
f. Evaluation
3. IOWA Model to research in practice
- multidisciplinary approach
- research practice to improve quality nursing care

BARRIERS TO USE OF EBN:


1. Accessibility of research findings
2. Anticipated outcomes of using research
3. Organizational support to use research.
4. Support from others to use research.

V. ENTREPRENEUR
- An individual who assumes total responsibility and risk for discovering or creating unique opportunities to use
personal talents, skills and energy and who employs a strategic planning process to transfer that opportunity into a
marketable service or product.
- Is someone who creates a unique twist on a product or service in the successfully exploit that opportunity namely –
the money, people and organization.
Example:
- The one who made the athletic shoes
- The one who develop starbucks coffee

NURSE ENTERPRENEUR
- A proprietor of business that offers nursing services of a direct care, educational, research, administrative or
consultative in nature.
Ex. Nurse – owned nursing homes and consultancy agencies.

NURSE ENTREPRENEURS
- A salaried nurse who develops, promotes and delivers an innovative health/ nursing programme on project within a
given health setting.
ex. dx led rehabilitation unit, emergency service, clinic or telephone consultation service.

SCOPE OF ENTREPRENEURIAL PRACTICE


1. NURSING SERVICES – Nurses who provide patient care
 Must adapt to the legislative, financial, political realities and expectations of the country, province
and locality.
2. HEALTH CARE PRODUCTS AND DEVICES – nurses who design, manufacture and sell products
 Development
 Assessment
 Sale
3. LEGAL SERVICES – eg: Forensic Nursing
4. HEALTH CARE/ POLICY CONSULTATION
5. HEALTH CARE / POLICY PUBLICATIONS

FACTOR MOTIVATING NURSES TO BECOME ENTREPRENEUR


1. FRUSTRATION
 Changing health needs of population which were not adequately being met by the health services.
 Dissatisfaction of nurses in the workplace due to poor public image, unsatisfactory working
conditions, inadequate decision making authority, inability to put into practice the knowledge.
2. NECESSITY
 Shift works is a real concern for nurses who are trying to juggle career and family.
3. MONEY
 Making more money entices many nurses to become nurse entrepreneurs.
4. OPPORTUNITY
 Greater emphasis on health promotion, illness and accident prevention.

REHABILITATION AND SUPPORT SERVICES


 Significant advances in nursing knowledge
 Direct laboratory access
 Wider prescriptive referrals rights
 Higher level of basic education, and easier access to further education

PROFILE OF A NURSE ENTREPRENEUR


I. PERSONAL QUALITIES
1. PERCEPTIVE – are able to learn from real-world experiences and transfer that knowledge to now situations.
2. INNOVATIVE – introduce something new
3. CREATIVE – is facilitated when a person is able to pursue an individual style of discovery – originality
4. SELF DIRECTED – entrepreneurs have learned to take responsibility for their own career development
5. ACTION ORIENTED – entrepreneurs are risk takers
- They refuse to remain in jobs that bring boredom, burnout and frustration.
- Entrepreneurs are also lifelong learners who see the value of continuing education as a way to
acquire or update their skills.
6. CONFIDENT – entrepreneurs are able to strike out on their own because they have confidence in their abilities and
believe that they know the best way to do something.
- They have been empowered by positive coaching and feedback
7. COLLABORATIVE – to work jointly with others
8. PERSEVERING – to persist in any undertaking inspite of opposition and discouragement.
9. DECISIVE – the ability to make decisions and solve problems is a key to the success of every enterprise.
- An entrepreneur must be able to analyze and interpret a problem situation, consider a number of
solution options, reflect upon their viability and make a decision regarding a course of action.

II. PROFESSIONAL QUALIFICATIONS


 Work experience in nursing (3-15 years)
 Post basic education
 Competent in communication, negotiation, marketing and time management, public relations and accounting skills.
 Knowledgeable in legal, insurance, grants and tax matters

ADVANTAGES OF ENTREPRENEURSHIP
1. Freedom to focus on personal interests
2. Flexible time management – you are your own boss
3. Quality of practice
4. New opportunities for service requests – anytime clients can request your services.
5. Multiple sources of reimbursements
6. Enhanced problem solving skills and self-esteem.
- Provides endless challenges and opportunities for learning

BARRIES:
1. Higher cost of malpractice insurance Inability to obtain hospital privileges for some
2. Skepticism of physicians about the independent role of nurses
3. Statutory limitations – scope is limited
4. Start up costs for the practice
5. Hiring, training and retraining competent, enthusiastic personnel

VIII. GLOBALIZATION
- The emergence of a global society in which economic, political, environmental, and cultural events in one part of the
world quickly come to have significance for people in other parts of the world.
- The widening, intensifying, speeding up, and growing impact of world-wide interconnectedness.
- Is the result of advances in communication, transportation and information technologies.

Characterized by four types of changes:


1. It involves a stretching of social, political, and economic activities across political frontiers, regions and
continents.
2. It suggests the intensification, or the growing magnitude of interconnectedness and flows of trade,
investment, finance, migration, culture, etc.
3. The growing extensity and intensity of global interconnectedness can be linked to a speeding up of global
interactions and processes.
4. The growing intensity, intensity and velocity of global interactions can be associated with their deepening
impact such that the effects of distant events can be highly significant elsewhere.

POSITIVE EFFECTS:
 Sharing of basic knowledge
 Technology
 Investments
 Resources
 Ethical values
NEGATIVE EFFECT
 Rapid spread of disease
 Illicit drugs
 Crime
 Terrorism
 Uncontrolled migration
 Unemployment
 Government allowed the lease of large agricultural lands by foreigners
 Selling of publicity owned facilities

CHALLENGES:
 Reforms may have to be introduced in education in order to meet the new demands posed by globalization.
Curriculum use of computer.
 Undertake various means to develop and improve professional standards to make them at PAR with international
standard.

• Globalization requires nurses to adopt a global spirit and try to find a common bond among people to lessen the
impact of cultural differences.

TRANSCULTURAL NURSING
- A humanistic and scientific area of the formal study and practice in nursing which is focused upon differences and
similarities among cultures with respect to human care, health, and illness based upon the people’s cultural specific
or culturally congruent nursing care to people.
- To deliver culturally sensitive care, the nurse must remember that each individual is unique and a product of past
experiences, beliefs and values that have been learned and passed down from one generation to another.
4 Major Challenges for Health Providers and Cultural Competency in Health Care:
1. Recognizing clinical differences among people of different ethnic and racial groups.
2. Communication – this deals with everything from the need for interpreters to nuances of words in various languages.
3. Ethnics – respect for the belief systems of others and the effects of those beliefs on well being are critically
important to competent care.
4. Trust

TERMINOLOGIES:
1. CULTURE – refers to the norms and practices of a particular group that are learned, shared and guide thinking,
decisions, and actions.
2. CULTURAL VALUES – the individual’s desirable or preferred way of acting or knowing something that is
sustained over a period of time and which governs actions and decisions.
3. CULTURAL DIVERSE NURSING CARE – an optimal mode of health care delivery refers to the variability of
nursing approaches needed to provide culturally appropriate care that incorporates individual’s cultural values,
beliefs, and practices including sensitivity to the environment from which the individual comes and to which the
individual may ultimately return.
4. ETHNOCENTRISM – the perception that one’s own way is best when viewing the world.
5. ETHNIC – relates to group identification, large groups of people classified according to common traits or customs.
6. RACE – any of the different varieties of humans assumed by some people to exist, based on the discrete typological
model of human variation.
7. ETHNOGRAPHY – is the study of culture.

CULTURAL COMPETENCE
- The process through which the nurse provides care that is appropriate to the client’s cultural context.
- Means to really listen to the patient, to find out and learn about the patient’s beliefs of health and illness.

CULTURAL DIVERSITY
- Difference among people that result from ethnic, racial and cultural variables, where people interact with people
with different culture from their own, engaging in cultural diversity.

5 PHENOMENA OF CULTURAL DIVERSITY


1. Communication – verbal and non-verbal
2. Time orientation and space
3. Social roles
4. Health and illness
5. Health risks

CULTURE – the structure of knowledge, beliefs, behaviors, ideas, attitudes, values, habits, customs, languages, symbols,
rituals, ceremonies, and practices that are unique to particular group of peoples.

CHARACTERISTICS OF CULTURS:
1. Culture is learned and taught
2. Culture is transmitted from one generation to another
3. Culture is shared
4. Culture is social in nature