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BASIC ETHICO – LEGALASPECTS OF IV THERAPY



DUTIES AND

RESPONSIBILITIES OFIV THERAPISTS



1. Interpret and carry out thephysician’s prescriptions for IV

therapy.2. Prepare, initiate and terminate IV

therapy based on physician’s

written prescription.3. Perform peripheral venipuncture

(all types of needles and

cannulas) excluding the insertionof subclavian and cut downcatheter.



4. Determine solution and

medication incompatibilities.5. Administer computed

medications, chemotherapeutic

drugs, flow rates of solutions,compatible blood/bloodcomponents and parenteralnutrition as prescribed by thephysician.



6. Assess all adverse reactionsrelated to IV therapy and initiate

appropriate nursing interventions.7. Establish nursing care plan

related to IV Therapy.

8. Adhere to established infection

control practices.



9. Maintain proper care of IV

equipments.

10. Document relevant data in the

preparation, administration andtermination of all forms of IV

therapy.



LEGAL BASIS



IV THERAPY AND LEGALIMPLICATIONS

R.A. 7164 – The PhilippineNursing Act of 1991 Section 28

states that in administration of IVinjections, special training shall berequired.

IV Nursing Standards of Practicedeveloped by the ANSAP should

be used.



In giving IV injections, nurses should

follow the policies of their agencies.

Board of Nursing Resolution No.8

Sec.30 (c) Art.VII or administrativelyunder Sec.21 Art.III – states that anyregistered nurse without training and

who administers IV injections topatients shall be held liable, either criminally, administratively or both.



R.A. 9173/The Philippine Nursing

Act of 2002, Article VI NursingPractice, SEC.28.Scope of Nursing(a) Provide nursing care through theutilization of the nursing process.Nursing care includes, but not limitedto…

administration of written presentationfor treatment, therapies, oral, topicaland parenteral medications…



That in the practice of nursingin all settings, the nurse is

duty-bound to observe theCode of Ethics for nurses anduphold the standards of safe

nursing practice.



ETHICAL ISSUES



CODE OF ETHICS FORNURSES IN THE

PHILIPPINES



ETHICS according to Webster Dictionary, is the study of thestandards of conduct and moral

judgment.

Therefore..NURSING ETHICS is concerned

with the principles of right conduct

as they apply to the nursingprofession.



NURSES AND PEOPLE

• Values, customs and spiritual beliefs

held by individuals are to be respected.

• Nurses hold in strict confidence personal

information acquired in the process of

giving nursing care.



NURSES AND PRACTICES

• Nurses are accountable for their own

nursing practice.

• Nurses maintain or modify standards of

practice within the reality of any given

situation.



• Nurses are the advocates of the

patients.

• Nurses are aware that their actions have professional, ethical,

moral and legal dimensions.



NURSES AND CO-WORKERS

• Nurses maintain collaborative working

relationships with their co-workers and other

members of the health team.• They recognize their capabilities and

limitations in accepting responsibilities and

those of their co-workers when delegatingresponsibilities to them.



NURSES AND SOCIETY

• Nurses are contributing members of

society. They assume responsibilities

inherent in being members and citizensof the community/society in which they

live/work.



• Nurses recognize the need for

change and initiate, participate,

and support activities to meet the

health and social needs of the

people.



NURSES AND THEPROFESSION

• Nurses are expected to be

members of professional

organizations of nurses.• Nurses help to determine and

implement desirable standards of

nursing practice and nursing

education.



• Nurses should initiate and involve

themselves in structured and non-structured research activities within

their existing milieu.

• Nurses should assert theimplementation of labor standards

and lobby for favorable legislations to

improve existing socio-economic

conditions of nurses.



CODE OF ETHICS

The Nursing ServiceAdministrators of the

Philippines



MISSION

Provision of efficient and effective

nursing services.

Promote quality health care for peopleas a basic human right.

Be responsible for planning, organizing,

directing and controlling the programs

and activities of the Nursing Service

towards optimum quality nursing care.



ARTICLE II

THE ANSAP CREED; CORE VALUES& BELIEFS

1. The nursing profession is acommitment to God and people;

2. The nursing service is responsible

and accountable for quality nursingcare;



3. The nursing service is a major

function in any health care deliverysystem and deserves a

corresponding importance in the

organizational structure;

4. A high level of self-discipline and

committed leadership are essentialfactors in the effective management

of health care services;



5. The nursing services is most

important asset, aside from itsclients, are its caring, competent and

productive personnel;

6. Competence enhances the public’s

assurance of quality nursing care,

therefore, nursing personnel must beselected and appointed to positions

consistent with their qualifications;

7 The client is the reason for the



7. The client is the reason for theexistence of the nursing profession;

all efforts should be directed to hiscare and should consider hisuniqueness, personal worth, dignity,

and socio-cultural values;8. The implementation and

maintenance of approved standards

of nursing practice and nursingadministration are bases for effectiveand efficient nursing service;

9 N i i i i t l i th



9. Nursing service is integral in the

quality of education of students; and

10. A unified stand is vital in achievingtheir objectives through membership

in professional organizations, such

as the Philippine Nurses Association

(PNA), the Association of Nursing

Service Administrators of thePhilippines (ANSAP), and other

specialty groups in nursing.



ARTICLE III

NORMS OF PROFESSIONALCONDUCT

SECTION 1. Dedication to God andpeople.

SECTION 2. Responsibility and

accountability for quality nursingservice.



SECTION 3. Leadership and Technical

Competence.

SECTION 4. Responsibility and

Accountability for Nursing Practice.SECTION 5. Commitment to the

Nursing Profession.



ARTICLE IV

GENERAL PROVISIONSSection 1. Creation of Ethics

Committee that shall be responsible

to adjudicate violations against the

NSA Code of Ethics and adopt such

rules and sanctions as the associationis authorized to do.



SECTION 2. Legal Force.

SECTION 3. Moral Force.

SECTION 4. Dissemination.



SECTION 5. Sanctions.

SECTION 6. Amendment.

SECTION 7. Effectivity



CODE OF GOOD

GOVERNANCE FORTHE PROFESSIONS IN

THE PHILIPPINES



• E.O. No. 220 - Directing theadoption of the Code of Good

Governance for the Professions inthe Philippines on June 23, 2003.



General Principle of

Professional ConductProfessionals are required not

only to have an ethicalcommitment, a personal resolve

to act ethically, but also have both

ethical awareness and ethicalcompetency.



Specific Principles of Professional Conduct

1. Service to Others

2. Integrity and Objectivity

3. Professional Competence

4. Solidarity and Teamwork



5. Social and Civic Responsibility

6. Global Competitiveness

7. Equality of All Professions



PROFESSIONALVALUES



CARING

is the locus of all attributes used todescribe NURSING. It is not only the

main value of NURSING but the

Essence. It is not only a nursing actbecause to care is human and to be

human is caring.



5 Cs of Caring

Compassionate – Concern

– CaringCommitted – Willingness to

perform her

responsibilities

Confident – Assertive

– SmartConscientious – Honest

Competent

– Knowledgeable – Effective/

Efficient



Wholistic

ApproachNurse Practitioner

I.V. Nurse Therapist

Quality

careEthico – legalEthico – legal

Responsibility – AccountabilityResponsibility – Accountability

InIn

Varied Health SettingVaried Health Setting

Industrial

Setting-Company

Clinics-Occupation

Health

Units

Community

Setting

Health Center

Rural HealthUnits

Periculture

Centers

Hospital and

Institutional

Setting

Lying- inHospice Center

Day Care Center

Educational

Setting-Colleges

of NursingUniversities-Other

colleges &

Schools

Home Care

Setting-Independent

Practitioners-Self

employed

Impact to

Health Care

Delivery sites



RELATED LAW OFFENSES



LEGAL ASPECTS AND THE



LEGAL ASPECTS AND THENURSE

The Republic Act 9173 or the

Philippine Nursing Act of 2002 is

the best guide the nurse canutilize as it defines the scope of

nursing practice.



Negligence

Commission or omission of an act,

pursuant to a duty, that a

reasonably prudent person in thesame or similar circumstance

would or would not do.



The Doctrine of Res IpsaLoquitur

Three conditions are required toestablish a defendant’s negligence

without proving specific conduct:

1. That the injury was of such naturethat it would not normally occur

unless there was a negligent act on

the part of someone;



2. That the injury was caused by an

agency within control of defendant;

3. That the plaintiff himself did notengage in any manner that would

tend to bring about the injury.



Example:

A patient came in walking to the out-patient clinic for injection. Upon

administering the injection to his

buttocks, the patient experiencedextreme pain. His leg felt weak and

he was subsequently paralyzed.



Malpractice

Refers to a negligent act committed

in the course of professional

performance.

Example is the giving of anesthesia

by a nurse or prescribingmedicines.



Incompetence

The lack of ability, legal qualifications

or fitness to discharge the required

duty.

Example:

Although a nurse is registered, if she’s notyet an IV therapists, she is not allowed to

give IV medications or do the IV insertion.



Assault and Battery

Assault is the imminent threat of

harmful or offensive bodily

contact.Battery is an intentional, un

consented touching of another

person.



It is, therefore, important thatbefore a patient can be touched,

examined, treated or subjected tomedical/surgical procedures, hemust have given a consent to this

effect.

Example: If a patient refuses an

injection and the nurse gives itanyway, the latter can be chargedfor battery.



LEGAL

TERMINOLOGIESTHAT ALSO APPLY

IN IV THERAPY



• CIVIL ACTION

a non-criminal action whereby one seeks

to protect, enforce, or declare a right or

address a civil wrong close to him or her.When the harm occurs, the guilty party

may be required to pay damages to the

injured person.



• CRIMINAL ACTION

an action brought about by a state or

federal law enforcement agency or by an

official agency on behalf of an individual,to protect one’s person or property or to

protect society in general. Punishment

includes imprisonment, fine or both.



• DEPOSITION

a discovery procedure which is an oral

question and answer proceeding, under oath

and recorded, wherein the attorneys seek tofind out what testimony and evidence will be

confronting them in a lawsuit. It is an informal

proceeding with lawyers of all parties present.



• INTERROGATORY

another discovery procedure which is the written

equivalent of a deposition.

• RULE OF PERSONAL LIABILITY

every person is liable for his own wrongdoing.

No one can bypass this rule with personal

assurance.



• STATUTE OF LIMITATIONS

the time limit set by each state legislature in

which civil or criminal action can be brought.

• TORT

a private wrong by act or omission, which canresult in a civil action by the harmed person.

• SUBPOENA



the process or "paper command" by which theperson served must appear at a certain time andgive testimony to the court. It is an order under the seal of the court for which one can be held for contempt of court for ignoring the subpoena.

• SUMMONSnotification served upon defendant to

appear before the court.



NURSING

LIABILITIES ANDPREVENTIVE

MEASURES

Points to Observe in Order to



Points to Observe in Order toAvoid Criminal Liability

1. Be very familiar with thePhilippine Nursing Law.

2. Beware of laws that affect

nursing practice.3. At the start of employment, get a

copy of your job description, the

agency’s rules, regulations and

policies.



4. Upgrade your skills and competence.

5. Accept only such responsibility thatis within the scope of your

employment and your job description.

6. Do not delegate your responsibility to

others.



7. Develop good interpersonal

relationships with your co-workers,whether they be your supervisors,

peers or subordinates.

8. Consult your superiors for problemsthat may be too big for you to handle.

9. Verify Doctors prescriptions that are

not clear to you or those that seem tobe erroneous.



10. The doctors should be informedabout the patient’s conditions.

11. Keep in mind the value and

necessity of keeping complete andaccurate recording.

12. Patients are entitled to an informed

consent.



STANDARDS OF

NURSING INFUSIONCARE



REQUIREMENTS TO

BECOME AN IVTHERAPIST

Structure Criteria (NOT



Structure Criteria (NOTINCLUDED)

1. Entrance Requirements

Level of academic preparation:

A BSN graduate, RN, with acurrent license from the PRC.

Behavioral characteristics :

Honesty, reliability, initiative,flexibility and judgment.



Demonstrates communication

and technical skills.

2. Completion Requirements 3 days Basic IV Therapy Training

Program must have successfully

participated.



3. Renewal/Revalidation of an IV

Therapy Card

The IV Therapy Card isrenewable every three (3) years.

Attendance to IV related Updatesequivalent to 24 CEU.



4. Loss of The IV Therapy Nurse

Card Presenting an affidavit of loss.

Submitting Certificate of Training. Photocopy of the official list of

participants of the IV therapy

training attended.



5. Cancellation of the IV Card

PRC License is not renewed. Any violation of Nursing Law

9173. IV Card is not renewed for more

than 3 years.

Violations in the Standards of IV

Therapy practice.

Process Criteria(NOT



Process Criteria(NOTINCLUDED)

The IV Therapy Program consistsof discussions of concepts in IVtherapy and demonstration of skills in access-related situations.It has a twenty-four (24)-hour didactic lecture and a practicumwith the following evaluationmethods:



1. Written examinations: pre and

post tests2. Completion of the required

number of actual cases for each

of the following competencies:

Initiating and maintaining

peripheral IV infusion (3 cases). Administering IV drugs (3 cases)



Administering and maintaining

blood and blood components(2 cases).

The participants will be rated as

follows: (a) Didactic – 50%; and

(b) Practicum – 50%.



REFERENCES• Association of Nursing Service Administrators of

the Philippines, Inc. (ANSAP). 2000. Nursing

Standards on Intravenous Practice 7th EDITION.

• Atty. Rustico T. De Belen, BA, BSN, LLB, MNSA,

PhD and Donna Vivian V. De Belen, BSN, RN,CCRN, CRNA, MS Anesthesia. Nursing Law,

Jurisprudence & Professional Ethics 1st

EDITION.



• Lesnik, M.J. and Anderson, B. Nursing

Practice and the Law. 2nd EDITION withrevisions. Philadelphia: J.B. Lippincott .

• Pallock: Torts, 14th EDITION .

• Philippine Nursing Act of 1991, Republic Act No.7169 Sec.28.

• Philippine Nursing Law, Republic Act No.

9173 Section 28 (a), (e).• Prescer: Torts, 3rd EDITION .

PRIMER CODE OF ETHICS THE



• PRIMER CODE OF ETHICS THE NURSING SERVICE ADMINISTRATORS

OF THE PHILIPPINES.• Professional Regulation Commission,

Board of Nursing Resolution No. 8.

• Professional Regulation CommissionBoard of Nursing Souvenir Program Oathtaking as Professionals of the Successful Examinees June 6 & 7, 2004 Nurse

Licensure Examination.



• Venzon, Lydia M. R.N., M.A., FPCHA.

2003. Professional Nursing in the

Philippines 9th EDITION .• Webster’s New World Dictionary of the

American Language. Cleveland and New

York: World Publishing Co.

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