THE FUTURE OF THE FUTURE OF NURSING SERVICE NURSING SERVICE

REGULATION REGULATION

CARMENCITA MATIASCARMENCITA MATIAS--ABAQUIN, RN. PhDABAQUIN, RN. PhDChairperson, Board of Nursing Chairperson, Board of Nursing

Professional Regulation Commission , Professional Regulation Commission , PhilippinesPhilippines

ObjectivesObjectivesDescribe the overview of the mandated Describe the overview of the mandated functions of the Board of Nursingfunctions of the Board of NursingDiscuss the current issues and challenges Discuss the current issues and challenges faced by the nursing professionfaced by the nursing professionDescribe the significant initiatives Describe the significant initiatives undertaken to address the challenges in undertaken to address the challenges in the nursing professionthe nursing profession

Overview of Overview of Mandated Functions Mandated Functions

of the BONof the BON

REPUBLIC ACT NO.8981 REPUBLIC ACT NO.8981 ““THE PRC MODERNIZATION ACT OF 2000THE PRC MODERNIZATION ACT OF 2000””

REPUBLIC ACT NO. 9173 REPUBLIC ACT NO. 9173 ““NURSING ACT 2002NURSING ACT 2002””

REPUBLIC ACT 7722“HIGHER EDUCATION ACT OF 1994”

THE PROFESSIONAL REGULATION COMMISSION

Regulatory Boards

QUASI- LEGISLATIVE(Rule-Making)Function

QUASI- JUDICIAL(Investigatory, Determination, Hearing, and Decision of Cases) Function

EXECUTIVE(Promulgating) Function

Republic Act No.8981 ““The PRC Modernization Act of 2000”

The Professional Regulation Commission

BOARD OF NURSINGQUASI- LEGISLATIV E

QUASI- JUDICIAL

EXECUTIVE

BON BON --

QuasiQuasi--Judicial FunctionsJudicial Functions

Conduct hearings and investigations to Conduct hearings and investigations to resolve complaints on nurseresolve complaints on nurse--practitioners for practitioners for unethical and unprofessional conduct and unethical and unprofessional conduct and violations of the Nursing Law or its Rules violations of the Nursing Law or its Rules and Regulationsand RegulationsAfter due process, suspend, revoke, or re-issue, re-instate Certificate of Registration or License for causes provided by law.

BON BON --

QuasiQuasi--Legislative Functions Legislative Functions

Prescribe, adopt, and promulgate Prescribe, adopt, and promulgate guidelines, regulations, measures and guidelines, regulations, measures and decisions necessary for the decisions necessary for the improvement of nursing practice, improvement of nursing practice, advancement of the profession and advancement of the profession and proper and full enforcement of the proper and full enforcement of the Nursing Act.Nursing Act.

BON BON --

Executive Functions:Executive Functions:Ensure quality of Nursing Education in the Ensure quality of Nursing Education in the PhilippinesPhilippinesConduct (honest and credible) licensure Conduct (honest and credible) licensure examinations for nursesexaminations for nursesRecognize Nursing Specialties in the PhilippinesRecognize Nursing Specialties in the PhilippinesMonitor and enforce quality standards of nursing Monitor and enforce quality standards of nursing practice in the Philippines and practice in the Philippines and Exercise the powers necessary to ensure the Exercise the powers necessary to ensure the maintenance of efficient, ethical, and technical, maintenance of efficient, ethical, and technical, moral and professional standards in the practice moral and professional standards in the practice of nursing taking into account the health needs of of nursing taking into account the health needs of the nationthe nation

THE BOARD OF NURSINGTHE BOARD OF NURSING

1

NURSING

EDUCATION

2

NURSING SERVICE/ PRACTICE

3

LICENSURE

AND

OATHTAKING

4

ETHICS,

LEGAL

CONCERNS, AND

LEGISLATION

5LOCAL

ANDINTERNATIONAL

LINKAGES

and its

5 PILLARS

• CPE• Credentialing• Monitoring

Standards • Code of Ethics• Laws and

Legislation• IRR• Legal Matters

• N.E. Standards• Requirements

for RLE• Accreditation of

N.E. Programs• Review Centers

BON Chairman

Local:

PNA, ADPCN, ANSAP, Various Specialty & Interest Groups, DOH, LGUs, NBI, DOLE, POEA, DFA, AIMInternational:

Regulatory Boards, ICN, WHO, ASEAN

NURSING ISSUES AND CONCERNS

Nursing Issues & ConcernsNursing Issues & Concerns

NURSING PROFESSION

Deteriorating Quality of Nursing Supply

Unethical Practices Of Hospitals/ Institutions

Lack of Integrated National Data Base on Nursing Human

Resource

Weak Link with Policy Making Body

Poor Representation in

International Agreements

Deteriorating Quality of Nurses

in Service

Threatened Autonomy of

Regulatory Bodies

Leakage In The Nurse Licensure

Examination June 2006

Unmanaged Migration of Nurses

DEVELOPMENTS IN NURSING :

1) Common Core Competencies

SIGNIFICANCE OF CORE SIGNIFICANCE OF CORE COMPETENCY STANDARDSCOMPETENCY STANDARDS

Guide is developing curriculum in nursingGuide is developing curriculum in nursingFramework in developing test syllabus for Framework in developing test syllabus for entrants to the nursing professionentrants to the nursing professionTool for performance evaluation among nursesTool for performance evaluation among nursesBasis for advanced practice and specializationBasis for advanced practice and specializationFramework for developing a training curriculum Framework for developing a training curriculum for nurses for nurses Protect the public from incompetent practitionersProtect the public from incompetent practitionersYardstick for unethical and unprofessional Yardstick for unethical and unprofessional practice of nursingpractice of nursing

Key Areas of ResponsibilitiesKey Areas of ResponsibilitiesPatient Care Patient Care CompetenciesCompetencies

Safe and quality nursing careSafe and quality nursing careCommunicationCommunicationCollaboration and teamworkCollaboration and teamworkHealth EducationHealth Education

EmpoweringEmpowering Legal responsibilityLegal responsibilityEthicoEthico--moral responsibilitymoral responsibilityPersonal and professional developmentPersonal and professional development

EnhancingEnhancing Record managementRecord managementManagement of resources and environmentManagement of resources and environment

EnablingEnabling Quality ImprovementQuality ImprovementResearchResearch

Core CompetencyCore Competency IndicatorsIndicators1: Demonstrates knowledge 1: Demonstrates knowledge base on the health /illness base on the health /illness status of individual / groupsstatus of individual / groups

••Identifies the health needs of the patients / Identifies the health needs of the patients / groupsgroups•• Explains the health status of the patients /Explains the health status of the patients /

groupsgroups2. Provides sound decision 2. Provides sound decision making in the care of making in the care of individuals / groups individuals / groups considering their beliefs and considering their beliefs and valuesvalues

••Identifies the problemIdentifies the problem••Gathers data related to the problemGathers data related to the problem••Analyzes the data gatheredAnalyzes the data gathered••Selects appropriate actionSelects appropriate action••Monitors the progress of the action takenMonitors the progress of the action taken

3. Promotes safety and 3. Promotes safety and comfort of patientscomfort of patients

••Performs agePerforms age--specific safety measures in specific safety measures in all aspects of patient careall aspects of patient care••Performs agePerforms age--specific comfort measures inspecific comfort measures in

all aspects of patient careall aspects of patient care

Patient Care Competencies Patient Care Competencies

A. Safe And Quality Nursing CareA. Safe And Quality Nursing Care

Patient Care Competencies Patient Care Competencies

A. Safe And Quality Nursing Care Cont. A. Safe And Quality Nursing Care Cont.

4.4. Sets priorities in nursing Sets priorities in nursing care based on patientscare based on patients’’ needsneeds

••

Identifies the priority needs of patientsIdentifies the priority needs of patients••

Analyzes the needs of patients Analyzes the needs of patients

••

Determines appropriate nursing care to be Determines appropriate nursing care to be providedprovided

5. Ensures continuity of 5. Ensures continuity of carecare

••

Refers identified problem to appropriate Refers identified problem to appropriate individuals / agenciesindividuals / agencies

••

Establishes means of providing Establishes means of providing continuous patient carecontinuous patient care

6. Administers 6. Administers medications and other medications and other health therapeuticshealth therapeutics

••

Conforms to the 10 golden rules in Conforms to the 10 golden rules in medication administration and health medication administration and health therapeuticstherapeutics

Core CompetencyCore Competency IndicatorsIndicators

Patient Care Competencies Patient Care Competencies

A. Safe And Quality Nursing Care Cont. A. Safe And Quality Nursing Care Cont.

7. Utilizes the nursing 7. Utilizes the nursing process as framework process as framework for nursingfor nursing7.1 Performs 7.1 Performs comprehensive and comprehensive and systematic nursingsystematic nursing assessmentassessment

••

Obtains consentObtains consent••

Completes appropriate assessment formsCompletes appropriate assessment forms

••

Performs effective assessment techniquesPerforms effective assessment techniques••

Obtains comprehensive client informationObtains comprehensive client information

••

Maintains privacy and confidentialityMaintains privacy and confidentiality••

Identifies health needs Identifies health needs

7.2 Formulates a plan of7.2 Formulates a plan ofcare in collaborationcare in collaborationwith patients and otherwith patients and othermembers of the healthmembers of the healthteamteam

•• Includes patient and his family in care planningIncludes patient and his family in care planning••States expected outcomes of nursing States expected outcomes of nursing

interventionintervention••Develops comprehensive patient care planDevelops comprehensive patient care plan••Accomplishes patient centered discharge planAccomplishes patient centered discharge plan

Core CompetencyCore Competency IndicatorsIndicators

Patient Care Competencies Patient Care Competencies

A. Safe And Quality Nursing Care Cont. A. Safe And Quality Nursing Care Cont. 7.3 Implements planned7.3 Implements planned

nursing care tonursing care toachieve identifiedachieve identifiedoutcomesoutcomes

••Explains interventions to patients and his family Explains interventions to patients and his family before carrying them outbefore carrying them out

•• Implements nursing intervention that is safe Implements nursing intervention that is safe and comfortableand comfortable

••Acts according to clientsActs according to clients’’ health condition and health condition and needsneeds

••Performs nursing activities effectively and in a Performs nursing activities effectively and in a timely mannertimely manner

7.4 Evaluates progress7.4 Evaluates progresstoward expectedtoward expectedoutcomesoutcomes

••

Monitors effectiveness of nursing Monitors effectiveness of nursing interventionsinterventions

••

Revises care plan when necessaryRevises care plan when necessary8. Responds to the 8. Responds to the

urgency of the patienturgency of the patient’’s s conditioncondition

••

Identifies sudden changes in the patientIdentifies sudden changes in the patient’’s s health conditionshealth conditions

••

Implements immediate and appropriate Implements immediate and appropriate interventionintervention

Patient Care CompetenciesPatient Care Competencies

B. COMMUNICATIONB. COMMUNICATION1. Establishes rapport with 1. Establishes rapport with

patients, significant others patients, significant others and members of the health and members of the health teamteam

••

Creates trust and confidenceCreates trust and confidence••

Listens attentively to clientListens attentively to client’’s queries and s queries and requestsrequests

••

Spends time with the client to facilitate Spends time with the client to facilitate conversation that allows client to express conversation that allows client to express concernsconcerns

2. Identifies verbal and non2. Identifies verbal and non-- verbal cuesverbal cues

••

Interprets and validates clientInterprets and validates client’’s body s body language and facial expressionslanguage and facial expressions

3. Utilizes formal and informal 3. Utilizes formal and informal channels channels

••

Makes use of available visual aids Makes use of available visual aids

Patient Care Competencies Patient Care Competencies

B. COMMUNICATION Cont. B. COMMUNICATION Cont. 4. Responds to needs of 4. Responds to needs of

individuals, family, group individuals, family, group and community and community

••

Provides reassurance through Provides reassurance through therapeutic, touch, warmth and therapeutic, touch, warmth and comforting words of encouragement comforting words of encouragement

••

Readily smilesReadily smiles

5. Uses appropriate 5. Uses appropriate information technology to information technology to facilitate communicationfacilitate communication

••

Utilizes telephone, mobile phone, email Utilizes telephone, mobile phone, email and internet, and informatics and internet, and informatics

••

Identifies significant others so that Identifies significant others so that follow up care can be obtainedfollow up care can be obtained

••

Provides Provides ““ HoldingHolding”” or emergency or emergency numbers for servicesnumbers for services

Patient Care Competencies Patient Care Competencies

C. COLLABORATION AND TEAMWORKC. COLLABORATION AND TEAMWORK1. Establishes 1. Establishes

collaborative collaborative relationship with relationship with colleagues and colleagues and other members of other members of the health teamthe health team

••

Contributes to decision making regarding Contributes to decision making regarding patientspatients’’ needs and concernsneeds and concerns

••

Participates actively in patient care Participates actively in patient care management including auditmanagement including audit

••

Recommends appropriate intervention to Recommends appropriate intervention to improve patient careimprove patient care

••

Respect the role of other members of the Respect the role of other members of the health teamhealth team

••

Maintains good interpersonal relationship with Maintains good interpersonal relationship with patients, colleagues and other members of the patients, colleagues and other members of the health teamhealth team

2. Collaborates plan 2. Collaborates plan of care with other of care with other members of the members of the health teamhealth team

••

Refers patients to allied health team partnersRefers patients to allied health team partners••

Acts as liaison / advocate of the patientActs as liaison / advocate of the patient

••

Prepares accurate documentation for efficient Prepares accurate documentation for efficient communication of services communication of services

Patient Care Competencies Patient Care Competencies

D. HEALTH EDUCATIOND. HEALTH EDUCATION1. Assesses the learning 1. Assesses the learning

needs of the patient and needs of the patient and familyfamily

••

Obtains learning information through interview, Obtains learning information through interview, observation and validationobservation and validation

••

Defines relevant informationDefines relevant information••

Completes assessment records appropriatelyCompletes assessment records appropriately••

Identifies priority needsIdentifies priority needs

2. Develops health 2. Develops health education plan based education plan based on assessed and on assessed and anticipated needsanticipated needs

••

Considers nature of learner in relation to: social, Considers nature of learner in relation to: social, cultural, political, economic, educational and cultural, political, economic, educational and religious factors.religious factors.

3. Develops learning 3. Develops learning materials for health materials for health educationeducation

••

Involves the patient, family, significant others Involves the patient, family, significant others and other resourcesand other resources

••

Formulates a comprehensive health education Formulates a comprehensive health education plan with the following components: objectives, plan with the following components: objectives, content, time allotment, teachingcontent, time allotment, teaching--learning learning resources and evaluation parametersresources and evaluation parameters

••

Provides for feedback to finalize the planProvides for feedback to finalize the plan

Patient Care Competencies Patient Care Competencies

D. HEALTH EDUCATION ContD. HEALTH EDUCATION Cont..4. Implements the health 4. Implements the health

education planeducation plan••

Provides for a conducive learning Provides for a conducive learning situation in terms of time and placesituation in terms of time and place

••

Considers client and familyConsiders client and family’’s s preparednesspreparedness

••

Utilizes appropriate strategies Utilizes appropriate strategies ••

Provides reassuring presence through Provides reassuring presence through active listening, touch, facial expression active listening, touch, facial expression and gesturesand gestures

••

Monitors client and familyMonitors client and family’’s responses s responses to health educationto health education

5. Evaluates the outcome 5. Evaluates the outcome of health educationof health education

••

Utilizes evaluation parametersUtilizes evaluation parameters••

Documents outcome of careDocuments outcome of care

••

Revises health education plan when Revises health education plan when necessarynecessary

Empowering Empowering

E. LEGAL RESPONSIBILITYE. LEGAL RESPONSIBILITY1. Adheres to practices in 1. Adheres to practices in

accordance with the accordance with the nursing law and other nursing law and other relevant legislation relevant legislation including contracts, including contracts, informed consent.informed consent.

••

Fulfills legal requirements in nursing practiceFulfills legal requirements in nursing practice••

Holds current professional licenseHolds current professional license••

Acts in accordance with the terms of contract of employment Acts in accordance with the terms of contract of employment and other rules and regulationsand other rules and regulations

••

Complies with required continuing professional educationComplies with required continuing professional education••

Confirms information given by the doctor for informed consentConfirms information given by the doctor for informed consent••

Secures waiver of responsibility for refusal to undergo Secures waiver of responsibility for refusal to undergo treatment or proceduretreatment or procedure

••

Checks the completeness of informed consent and other legalChecks the completeness of informed consent and other legal formsforms

2. Adheres to organizational 2. Adheres to organizational policies and procedures, policies and procedures, local and nationallocal and national

••

Articulates the vision, mission of the institution where one Articulates the vision, mission of the institution where one belongsbelongs

••

Acts in accordance with the established norms of conduct of Acts in accordance with the established norms of conduct of the institution / organizationthe institution / organization

3. Documents care 3. Documents care rendered to patientsrendered to patients

••

Utilizes appropriate patient care records and reports.Utilizes appropriate patient care records and reports.••

Accomplishes accurate documentation in all matters Accomplishes accurate documentation in all matters concerning patient care in accordance to the standards of concerning patient care in accordance to the standards of nursing practice.nursing practice.

Empowering Empowering

F. ETHICOF. ETHICO--MORAL RESPONSIBILITYMORAL RESPONSIBILITY1. Respects the rights of 1. Respects the rights of

individual / groupsindividual / groups••

Renders nursing care consistent with the Renders nursing care consistent with the patientpatient’’s bill of rights: (i.e. confidentiality s bill of rights: (i.e. confidentiality of information, privacy, etc.)of information, privacy, etc.)

2. Accepts responsibility and 2. Accepts responsibility and accountability for own accountability for own decision and actionsdecision and actions

••

Meets nursing accountability Meets nursing accountability requirements as embodied in the job requirements as embodied in the job descriptiondescription

••

Justifies basis for nursing actions and Justifies basis for nursing actions and judgmentjudgment

••

Projects a positive image of the Projects a positive image of the professionprofession

3. Adheres to the national and 3. Adheres to the national and international code of ethics international code of ethics for nursesfor nurses

••

Adheres to the Code of Ethics for Nurses Adheres to the Code of Ethics for Nurses and abides by its provisionand abides by its provision

••

Reports unethical and immoral incidents Reports unethical and immoral incidents to proper authoritiesto proper authorities

Empowering Empowering

G. PERSONAL & PROFESSIONAL DEVELOPMENTG. PERSONAL & PROFESSIONAL DEVELOPMENT

1.1. Identifies own learning Identifies own learning needsneeds

••

Verbalizes strengths, weaknesses, limitationsVerbalizes strengths, weaknesses, limitations••

Determines personal and professional goals Determines personal and professional goals and aspirations and aspirations

2.2. Pursues continuing Pursues continuing educationeducation

••

Participates in formal and nonParticipates in formal and non--formal formal educationeducation

••

Applies learned information for the Applies learned information for the improvement of care improvement of care

3.3. Gets involved in Gets involved in professional professional organizations and civic organizations and civic activitiesactivities

••

Participates actively in professional, social, Participates actively in professional, social, civic, and religious activitiescivic, and religious activities

••

Maintains membership to professional Maintains membership to professional organizationsorganizations

••

Support activities related to nursing and Support activities related to nursing and health issueshealth issues

EmpoweringEmpowering

G. PERSONAL & PROFESSIONAL DEVELOPMENTG. PERSONAL & PROFESSIONAL DEVELOPMENT

4. Projects a professional 4. Projects a professional image of the nurseimage of the nurse

••

Demonstrates good manners and right conduct at Demonstrates good manners and right conduct at all timesall times

••

Dresses appropriatelyDresses appropriately••

Demonstrates congruence of words and actionDemonstrates congruence of words and action••

Behaves appropriately at all timesBehaves appropriately at all times5.5. Possesses positive Possesses positive

attitude towards attitude towards change and criticismchange and criticism

••

Listens to suggestions and recommendationsListens to suggestions and recommendations••

Tries new strategies or approaches Tries new strategies or approaches ••

Adapts to changes willinglyAdapts to changes willingly

6. Performs function 6. Performs function according to according to professional standardsprofessional standards

••

Assesses own performance against standards of Assesses own performance against standards of practicepractice

••

Sets attainable objectives to enhance nursing Sets attainable objectives to enhance nursing knowledge and skillsknowledge and skills

••

Explains current nursing practices, when situations Explains current nursing practices, when situations call for it call for it

EnhancingEnhancing

H. RECORDS MANAGEMENTH. RECORDS MANAGEMENT1. Maintains accurate and 1. Maintains accurate and

updated documentation updated documentation of patient care of patient care

••

Completes updated documentation of Completes updated documentation of patient care.patient care.

2. Records outcome of 2. Records outcome of patient carepatient care

••

Utilizes a records system ex. Kardex Utilizes a records system ex. Kardex or Hospital Information System (HIS)or Hospital Information System (HIS)

3. Observes legal 3. Observes legal imperatives in record imperatives in record keepingkeeping

••

Observes confidentially and privacy of Observes confidentially and privacy of the patientthe patient’’s records.s records.

••

Maintains an organized system of filing Maintains an organized system of filing and keeping patientsand keeping patients’’ records in a records in a designated area.designated area.

••

Refrains from releasing records and Refrains from releasing records and other information without proper other information without proper authority.authority.

Enhancing Enhancing

I. Management Of Resources And EnvironmentI. Management Of Resources And Environment

1. Organizes work load to 1. Organizes work load to facilitate patient carefacilitate patient care

••

Identifies tasks or activities that need to be Identifies tasks or activities that need to be accomplishedaccomplished

••

Plans the performance of tasks or activities Plans the performance of tasks or activities based on prioritiesbased on priorities

••

Finishes work assignment on timeFinishes work assignment on time2. Utilizes resources to 2. Utilizes resources to

support patient caresupport patient care••

Determines the resources needed to deliver Determines the resources needed to deliver patient carepatient care

••

Controls the use of supplies and equipmentControls the use of supplies and equipment

3. Ensures functioning of 3. Ensures functioning of resourcesresources

••

Checks proper functioning of equipment Checks proper functioning of equipment ••

Refers malfunctioning equipment to Refers malfunctioning equipment to appropriate unitappropriate unit

Enhancing Enhancing

I. Management Of Resources And Environment I. Management Of Resources And Environment Cont. Cont.

4: Checks proper 4: Checks proper functioning of functioning of equipmentequipment

••

Determines tasks and procedures that can be Determines tasks and procedures that can be safely assigned to other member of the team.safely assigned to other member of the team.

••

Verifies the competency of the staff prior to Verifies the competency of the staff prior to delegating tasksdelegating tasks

5: Maintains a safe 5: Maintains a safe environmentenvironment

••

Observes proper disposal of wastesObserves proper disposal of wastes••

Adheres to policies, procedures and protocols Adheres to policies, procedures and protocols on prevention and control of infectionon prevention and control of infection

••

Defines steps to follow in case of fire, Defines steps to follow in case of fire, earthquake and other emergency situations.earthquake and other emergency situations.

EnablingEnabling

J. QUALITY IMPROVEMENTJ. QUALITY IMPROVEMENT1. Gathers data for 1. Gathers data for

quality quality improvementimprovement

••

Demonstrate knowledge of method appropriate for the clinical Demonstrate knowledge of method appropriate for the clinical problems identifiedproblems identified

••

Detects variation in the vital signs of the patient from day to Detects variation in the vital signs of the patient from day to dayday••

Reports necessary elements at the bedside to improve patient Reports necessary elements at the bedside to improve patient stay at hospitalstay at hospital

••

Solicits feedback from patient and significant others regarding Solicits feedback from patient and significant others regarding care renderedcare rendered

2. Participates in 2. Participates in nursing audits nursing audits and roundsand rounds

••

Contributes relevant information about patient condition as wellContributes relevant information about patient condition as well as unit condition and patient current reactionsas unit condition and patient current reactions

••

Shares with the team current information regarding particular Shares with the team current information regarding particular patients conditionpatients condition

••

Encourage the patient to speak about what is relevant to his Encourage the patient to speak about what is relevant to his conditioncondition

••

Documents and records all nursing care and actionsDocuments and records all nursing care and actions••

Performs daily check of patients records / conditionPerforms daily check of patients records / condition••

Completes patients recordsCompletes patients records••

Actively contributes relevant information of patients during Actively contributes relevant information of patients during rounds thru readings and sharing with others rounds thru readings and sharing with others

EnablingEnabling

J. QUALITY IMPROVEMENT Cont.J. QUALITY IMPROVEMENT Cont.3. Identifies and reports 3. Identifies and reports

variancesvariances••

Documents observed variance regarding patient Documents observed variance regarding patient care and submits to appropriate group within 24 care and submits to appropriate group within 24 hourshours

••

Identifies actual and potential variance to patient Identifies actual and potential variance to patient carecare

••

Reports actual and potential variance to patient Reports actual and potential variance to patient care care

••

Submits reports to appropriate groups within 24 Submits reports to appropriate groups within 24 hourshours

4. Recommends 4. Recommends solutions to identified solutions to identified problemsproblems

••

Gives appropriate suggestions on corrective and Gives appropriate suggestions on corrective and preventive measurespreventive measures

••

Communicates and discusses with appropriate Communicates and discusses with appropriate groups.groups.

••

Gives an objective and accurate report on what Gives an objective and accurate report on what was observed rather than an interpretation of the was observed rather than an interpretation of the event. event.

Enabling Enabling

K. RESEARCHK. RESEARCH1. Gather data using 1. Gather data using

different different methodologiesmethodologies

••

Able to identify researchable problems regarding patient Able to identify researchable problems regarding patient care and community healthcare and community health

••

Identify appropriate methods of research for a particular Identify appropriate methods of research for a particular patient / community problempatient / community problem

••

Combines quantitative and qualitative nursing design thru Combines quantitative and qualitative nursing design thru simple explanation on the phenomena observedsimple explanation on the phenomena observed

••

Analyzes data gatheredAnalyzes data gathered

2. Recommends actions 2. Recommends actions for implementationfor implementation

•• Based on the analysis of data gathered, recommends Based on the analysis of data gathered, recommends practical solutions appropriate for the problempractical solutions appropriate for the problem

3. Disseminates results 3. Disseminates results of research findingsof research findings

••

Able to talk about the results of findings to colleagues / Able to talk about the results of findings to colleagues / patients / family and to otherspatients / family and to others

••

Endeavors to publish researchEndeavors to publish research••

Submits research findings to own agencies and others as Submits research findings to own agencies and others as appropriateappropriate

4. Applies research 4. Applies research findings in nursing findings in nursing practicepractice

••

Utilizes findings in research in the provision of nursing Utilizes findings in research in the provision of nursing care to individuals / groups / communitiescare to individuals / groups / communities

••

Makes use of evidenceMakes use of evidence--based nursing to ameliorate based nursing to ameliorate nursing practice.nursing practice.

DEVELOPMENTS IN DEVELOPMENTS IN NURSING NURSING

2. Nursing Profession 2. Nursing Profession Core Values Core Values

LOVE OF

GOD

CARING THE CORE OF NURSING

LOVE OF PEOPLE

LOVE OF COUNTRY

Compassion, Conscience, Competence, Confidence, Commitment,

Professionalism

Respect For The Dignity Of Each Person Regardless Of Race, Creed, Color, Gender,

Political Affiliation

Patriotism

Preservation & Enrichment of the Environment &

Cultural HeritageCORE VALUE

S

NURSING NURSING SERVICESSERVICES

HOSPITAL NURSING SERVICESHOSPITAL NURSING SERVICESCore ValuesCore ValuesCode Of EthicsCode Of EthicsStandards Of Hospital Nursing Service Standards Of Hospital Nursing Service StatusStatusPresented to panel of experts Presented to panel of experts Presented in public consultationPresented in public consultationPilot studyPilot studyPromulgationPromulgationPrinting and disseminationPrinting and disseminationHospital Nursing Service Accreditation Hospital Nursing Service Accreditation

HOSPITAL NURSING HOSPITAL NURSING SERVICE CONT.SERVICE CONT.

Content of Standards for Hospital Nursing Content of Standards for Hospital Nursing ServicesServices

I. Clinical ServiceI. Clinical ServiceStandards on Assessment of CareStandards on Assessment of CareStandards on Care of PatientStandards on Care of PatientStandards on Patient and Family EducationStandards on Patient and Family EducationStandards on Access and Continuity of CareStandards on Access and Continuity of CareStandards on Nursing DocumentationStandards on Nursing Documentation

HOSPITAL NURSING HOSPITAL NURSING SERVICE CONT.SERVICE CONT.

II. Administration and ManagementII. Administration and ManagementStandards on Governance and DirectionStandards on Governance and DirectionStandards on Human Resource Standards on Human Resource ManagementManagementStandards on Facility Management and Standards on Facility Management and Environment SafetyEnvironment SafetyStandards on Communication Standards on Communication ManagementManagementStandards on Quality ImprovementStandards on Quality Improvement

NURSING SERVICE CONT.NURSING SERVICE CONT.Standards of nursing services in clinics, health Standards of nursing services in clinics, health centers to be reviewed and harmonized centers to be reviewed and harmonized Formation of Committee Formation of Committee -- review of existing standards review of existing standards locally and internationallylocally and internationallyPresented to experts Presented to experts Presented in public consultationPresented in public consultationPilot studyPilot studyPromulgationPromulgationPrinting and disseminationPrinting and disseminationHospital Nursing Service Accreditation Hospital Nursing Service Accreditation

CONTINUING CONTINUING PROFESSIONAL PROFESSIONAL

EDUCATIONEDUCATION

CONTINUING PROFESSIONAL CONTINUING PROFESSIONAL EDUCATIONEDUCATION

PRC Guidelines ReviewedPRC Guidelines ReviewedOathtaking of CPE Council For Nursing Oathtaking of CPE Council For Nursing Finalization of guidelines pertinent to Finalization of guidelines pertinent to nursing: nursing: for presentation for presentation dissemination and dissemination and implementationimplementationevaluationevaluation

Remember the three PRemember the three P’’s that are s that are emphasized in our profession:emphasized in our profession:

Professionalism Professionalism –– Commit yourselves to a very high level of Commit yourselves to a very high level of professionalism. Commit to serve with responsibility and ethicsprofessionalism. Commit to serve with responsibility and ethicsPatriotism Patriotism –– love your country. Again we are asking you to love your country. Again we are asking you to serve the Filipinos first. Develop your competencies and serve the Filipinos first. Develop your competencies and confidence to prepare you for the challenges of global nursing. confidence to prepare you for the challenges of global nursing. We sincerely hope that a mechanism will be in place to ensure We sincerely hope that a mechanism will be in place to ensure a continuous supply of nursing human resource for our country. a continuous supply of nursing human resource for our country. to ensure improved health care delivery systemto ensure improved health care delivery systemPersonal governance Personal governance –– Commitment to Personal governance Commitment to Personal governance ––have a wholistic and a balance perspective. This will not only have a wholistic and a balance perspective. This will not only put quality into your life as a nurse but also as a person.put quality into your life as a nurse but also as a person.

NURSING SPECIALTY NURSING SPECIALTY CERTIFICATION CERTIFICATION

PROGRAM PROGRAM

PHILIPPINE NURSING PHILIPPINE NURSING CERTIFICATION PROGRAM CERTIFICATION PROGRAM Historical PerspectiveHistorical PerspectiveDevelopment of Guidelines and Development of Guidelines and Mechanics Mechanics Nursing CouncilNursing CouncilPublic Consultation Public Consultation PromulgationPromulgationDisseminationDisseminationImplementationImplementationEvaluationEvaluation

Nursing Profession Roadmap SynchronizationNursing Profession Roadmap Synchronization

PROUD TO BE FILIPINO NUJRSE

6. The Filipino5. The EconomyGrowth & Productivity

4.Infrastructu re

3. Internal Capacity

2. Institutions

1. Values

PERSPECTI VES

1. Meet with: PNA, DOH, Various Specialty Nursing Organizations and

former/original NSCC members and assess situation;

2. Arrive at agreements on directions to take to realize the setting up of a NEW National Nursing Specialty Certification Program

TARGETS AND MEASURES

Strengthen driversOf change

DoH: Identifies beneficiaries for Specialty Training Programs

Constantly review new NNSCC Program and Provide Amendments to upgrade Program

1.

Push for the Organization of Specialty Boards (to include Nursing Education Administration and Nursing Service Administration

2.

Continue with Training Programs and updating of Specialty Registry3.

Connect with Congress for incorporation of amendments (at the proper time)

1. Able to build pool of respectable NURSE CLINICIANS, NURSE EDUCATORS, and NURSE ADMINISTRATORS;

2. Filipino Nurse-Clinicians, Educators, and Administrators able to serve local health needs and recognized globally for skills and expertise;

3. NEW NNSCC Program enshrined perfectly in the Nursing Law

1.

Jointly prepare NNSCC Program with the DoH2.

Present New NNSCC Program to PCS and PAGCOR for funding

Contribute towards GOOD GOVERNANCE

CREATE AN ADHOC NNSCC

BoN: Promulgates Directions of the Specialty Program in the Philippines

Constantly update statute instruments in preparation for essential amendments to the Nursing Law

And now the nursing specialty council must And now the nursing specialty council must look beyond credentialing processeslook beyond credentialing processes……

it should exert advanced efforts to institute it should exert advanced efforts to institute mechanisms in engaging nursing specialty mechanisms in engaging nursing specialty

groups towards organizational development groups towards organizational development in the following perspectives:in the following perspectives:

1. Learning and Growth Perspective 2. Internal Processes 3. Customer Perspective 4. Financial Perspective

Measures

Targets

VisionMissionValues

Initiatives

Strategic Objectives

Secure Charter

Specify Strategy

Define Measures

Set Targets

Plan Initiatives

POLICYACCOUNTABILITY

MONITORING

Ensure Consistency

Ensure Consistency

Actual vs. Target

Report on Outcomes

6. THE NURSING PROFESSION

ROADMAP ON GOOD GOVERNANCE

Executive Order 25(Governance Advisory Council)

Good Governance for the Professions in the Philippines Mandated by

Executive Order 220

Creation of the Coordinating Body on Good Governance for

the Nursing Profession

ISA

BON

PNA

ADPCN

ANSAP

BON

Measures

Targets

VisionMissionValues

Initiatives

Strategic Objectives

Secure Charter

Specify Strategy

Define Measures

Set Targets

Plan Initiatives

POLICY ACCOUNTABILITY

MONITORING

Ensure Consistency

Ensure Consistency

Actual vs. Target

Report on Outcomes

MECHANICS OF TASKING FOR MECHANICS OF TASKING FOR STRATEGIC PLANNINGSTRATEGIC PLANNING

VisionVision--MissionMission--Objectives (VMO 2030)Objectives (VMO 2030)

SECRETARIAT

BONPNA

ANSAPADPCN

Coordination Monitoring Evaluation

TH E

CORE

• Strategic Objectives

• Measures• Targets• Initiatives• Milestones

Technical Working Groups

(TWGs)

Nurse Members from participating

Nursing Organizations

CBGGNPCBGGNP

TWGTWG

TWGTWGTWGTWG

TWGTWG

BONBONPNAPNAANSAPANSAPADPCNADPCNCNGPCNGPRENAPRENAPCCNAPICCNAPIORNAPORNAPOHNAPOHNAPPHICNAPHICNAPONAPONA

NLGNNLGNAPDNPAPDNPADNEPADNEPMCNAPMCNAPMNAPMNAPSCVNPPSCVNPPGNCFGNCFPSECNPSECNEtc.Etc.

TECHNICAL WORKING GROUPS

TECHNICAL WORKING GROUPS

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030

6. The Filipino

5. The Economy

4.Infrastructu re

3. Internal Capacity

2. Institutions

1. Values

PERSPECTIV ES

100% integration of citizenship and ethics in the curriculum100% of filed complaints resolved

TARGETS AND MEASURES

100% integrity of professional registry100% compliance with regulatory laws100% compliance with CPE requirements90% passing rate in NLE per school100% compliance to standard rules on passing rate of licensure examinationFull modernization of NLE

100% institutionalized SRPs in all organizations100% compliance with global ethical and professional standards

Minimum 700 trees planted and maintained by nursing organizations per year100% of nursing organizations and health institutions implement effective waste

management programs

100% of nursing progessional organizations involved in continuous upgrading of employment, labor, income standards

↑

contribution to GDP; ↑

contribution to GNP (non-monetary)

With other country bilateral/multilateral agreements

VISIONVISIONBy 2030, the Philippines shall be the lead By 2030, the Philippines shall be the lead in promoting PROFESSIONAL NURSING in promoting PROFESSIONAL NURSING in the Asia Pacific Region.in the Asia Pacific Region.

By 2030, Philippine Nursing shall be a top By 2030, Philippine Nursing shall be a top provider of a world class, EXCELLENT provider of a world class, EXCELLENT CARING, significantly contributing to the CARING, significantly contributing to the wellbeing of Filipinos, and people of the wellbeing of Filipinos, and people of the worldworld

MISSIONMISSION

We, the Filipino nurses, are committed to We, the Filipino nurses, are committed to provide society with professional nursing provide society with professional nursing service through innovations in education service through innovations in education and training, research and management and training, research and management that will improve the wellthat will improve the well--being and quality being and quality of life.of life.

STRATEGIC OBJECTIVESSTRATEGIC OBJECTIVESShall persevere to uphold excellence in Shall persevere to uphold excellence in ““Philippine Philippine NursingNursing”” for the wellbeing of the Filipino people by :for the wellbeing of the Filipino people by :

providing dynamic leadership for the achievement of Nursing providing dynamic leadership for the achievement of Nursing Profession RoadmapProfession Roadmapaadhering to professional, ethical and legal standards for the dhering to professional, ethical and legal standards for the health and safety of the public health and safety of the public practicing good governance to sustain collaborative efforts practicing good governance to sustain collaborative efforts among nurses and nursing organizations among nurses and nursing organizations maintaining linkages with domestic and international maintaining linkages with domestic and international stakeholders stakeholders Sustain growth and productivity that improve the quality of lifeSustain growth and productivity that improve the quality of life of of nurses, the Filipinos and the people of the worldnurses, the Filipinos and the people of the world

LOVE OF

GOD

CARING THE CORE OF

NURSING

LOVE OF PEOPLE

LOVE OF COUNTRY

Compassion, Conscience, Competence, Confidence, Commitment,

Communication

Respect For The Dignity Of Each Person Regardless Of

Race, Creed, Color & Gender

Patriotism

Preservation & Enrichment of the Environment &

Cultural HeritageCORE VALUE

S

THROUGH NETWORK ORGANIZATION TOWARDS NURSING 2030 THROUGH NETWORK ORGANIZATION TOWARDS NURSING 2030

TURNING OUR VISION INTO REALITY TURNING OUR VISION INTO REALITY

ORGANIZATIONALMAINSTREAMING

ANSAP ADPCN CNGP ANSAP ADPCN CNGP NLGN APDNP MNAP NLGN APDNP MNAP GNCFI NCFPI GNCFI NCFPI Other Nursing GroupsOther Nursing Groups

OrganizationalStructure

LEVELI

LEVELII

CLUSTER AAPO

CLUSTER BINTEREST GROUPS

CLUSTER CSPECIALTY

NURSING GROUP

LEVEL III

PNA REGIONS AND CHAPTERS

NURSING ORGANIZATIONS DEVELOPMENT IN PROGRESSNURSING ORGANIZATIONS DEVELOPMENT IN PROGRESS

RENAP CCNAPI ORNAP RENAP CCNAPI ORNAP OHNAP PHICNA PONAOHNAP PHICNA PONAMCNAP SCVNPP PSECN MCNAP SCVNPP PSECN ADNEP PNEA ADNEP PNEA Other Nursing Specialty GroupsOther Nursing Specialty Groups

PNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHICNA PONA PHICNA PONA NLGN APDNP ADNEP MCNAP MNAP SCVNPP NLGN APDNP ADNEP MCNAP MNAP SCVNPP GNCF PSECN GNCF PSECN NCFPI Other Nursing GroupsNCFPI Other Nursing Groups

LEARNING AND GROWTHPerspective

PNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHPNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHICNA PONA NLGN ICNA PONA NLGN APDNP ADNEP MCNAP MNAP SCVNPP APDNP ADNEP MCNAP MNAP SCVNPP GNCF PSECN NCFPI GNCF PSECN NCFPI

Other Nursing GroupsOther Nursing Groups

INTERNAL PROCESSESPERSPECTIVE

PNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHPNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHICNA PONA ICNA PONA NLGN APDNP ADNEP MCNAP MNAP SCVNPP NLGN APDNP ADNEP MCNAP MNAP SCVNPP GNCF PSECN GNCF PSECN NCFPI NCFPI Other Nursing GroupsOther Nursing Groups

CUSTOMERPERSPECTIVE

Produce/Service Attributes Relationship Image

PNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHPNA ANSAP ADPCN CNGP RENAP CCNAPI ORNAP OHNAP PHICNA PONA ICNA PONA NLGN APDNP ADNEP MCNAP MNAP SCVNPP NLGN APDNP ADNEP MCNAP MNAP SCVNPP GNCF PSECN GNCF PSECN NCFPI Other Nursing GroupsNCFPI Other Nursing Groups

FINANCIALPERSPECTIVE

Productivity Strategy

Growth Strategy

Relationship IMAGE

Measures

Targets

VisionMissionValues

Initiatives

Strategic Objectives

Secure Charter

Specify Strategy

Define Measures

Set Targets

Plan Initiatives

POLICY ACCOUNTABILITY

MONITORING

Ensure Consistency

Ensure Consistency

Actual vs. Target

Report on Outcomes

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030

Perspectives Objectives Measures Targets InitiativesFinancial Perspectives

Customer Perspectives

Internal Process Perspectives Learning and Growth Perspectives

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030Strategic Goal 1. Providing dynamic leadership for the achievement of the Nursing

Profession RoadmapStrategic Theme Dynamic Leadership

Perspectives Objectives Financial Perspectives

4. FINANCIAL AND FISCAL PERSPECTIVES 4.1 Growth Strategy

4.1.1 To be recognized as an expert in nursing by the public. 4.1.2 To institutionalize a system that compensates nurses based on career

path both in public and private institutions 4.2 Productivity Strategy - To sustain viability of independent nursing practice /

entrepreneural nursing.

Customer Perspectives

3. CUSTOMER PERSPECTIVES 3.1 Product/ service attributes - To implement evidence- based studies on costing

of nursing services3.2 Relationship - To institutionalize partnerships with other professionals 3.3 Image - To project a positive image of a competent, excellent caring nurse

imbued with the core values of the profession.

Internal Process Perspectives

2. INTERNAL PERSPECTIVES: 2.1 Customer Management -

To provide opportunities to meet the needs of nurses as provided by regulatory laws.

2.2 Operation Management -

To establish rational management of production, deployment, distribution and turnover of nurses to ensure continuity of care.

2.3 Innovation -

To support and create opportunities for advance nursing practice (eg. Home care, nursing clinics, nursing entrepreneurship).

2.4 Regulatory and Social 2.4.1 To strengthen the implementation of standards

in the provision of quality nursing practice, education and service.

2.4.2 To enhance competency of nurses on decision making, advocacy and policy-

making.

Strategic Goal Cont.

1. Providing dynamic leadership for the achievement of the Nursing Profession Roadmap

Strategic Theme Dynamic Leadership

Perspectives Objectives

Learning and Growth Perspectives

1. LEARNING & GROWTH1.1. Human Capital:

1.1.1. Education and Training -

To Implement fully competency based curriculum.

1.1.2 Professional growth -

To advance the profession of nursing through formal and informal education

1.1.3 Research and development 1.1.3.1. To develop evidence-based nursing practice technology 1.1.3.2 To continuously create new knowledge thru research and

pursue publication of evidence-

based practices. 1.1.4 Career advancement

1.1.4.1. To develop tracking and career paths for nurses utilizing the core competencies.

1.1.4.2. Maintain the established nursing

specialty program .1.1.4.3. Establish a nurse-led clinic for nurse specialty practitioners

(Cardio, Diabetes, Maternal and Child, Infectious, Geriatric ) 1.1.4.4. Ensure that a nursing leadership program is in place

1.2.Informational Capital -

To establish an effective and efficient nursing information system.

1.3.Organizational Capital -

To strengthen international as well as local partnerships and collaboration between institutions and among nursing organizations.

STRATEGIC GOAL

2. Adhering to professional, ethical and legal standards for the

health and safety of the public

Perspectives Objectives

Financial Perspectives

4. FINANCIAL & FISCAL PERSPECTIVES -

To recognize nursing service as an income generating center.

Customer Perspectives

3. CUSTOMER PERSPECTIVES

3.1. To support activities in promoting health and safety of the public. (C)

3.2. To promote occupational health and environmental safety. (CInternal Process Perspectives

2. INTERNAL PERSPECTIVES

2.1.To implement the scope of nursing practice standards.

2.2. To implement regulations, policies, and procedures for licensure including re-entry into practice.

2.3. To respond logically and swiftly to current and emerging issues and trends on education, practice, and ethics

2.4. To provide mechanisms for continuous quality improvement on all aspects of professional practice : ethics, legal, and practice standards

Nursing Profession Roadmap 2030

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030STRATEGIC GOAL 2. Adhering to professional, ethical and legal standards for the

health and safety of the public

STRATEGIC THEME EXCELLENCE IN SERVICE/ QUALITY PATIENT CAREPerspectives Objectives

Learning and Growth Perspectives

1.

LEARNING AND GROWTH

1.1.To fully utilize nursing informatics support system

1.2.To implement fully the developed educational programs in all fields of nursing.

1.3.To implement a national credentialing body of nursing specialties program

1.4. To fully utilize nursing informatics support system

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030STRATEGIC GOAL

3. Practicing good governance to sustain collaborative efforts among nurses and nursing organizations

STRATEGIC THEME OPERATIONAL EXCELLENCE

Perspectives ObjectivesFinancial Perspectives

4. FINANCIAL AND FISCAL PERSPECTIVES

4.1.Establish linkages with government and non-government funding agencies to support Roadmap 2030

4.2. Manage funds equitably to sustain the implementation of the Roadmap 2030

4.3. Adhere to acceptable financial and fiscal policies Customer Perspectives

3. CUSTOMER PERSPECTIVES

3.1.Adhere to principles of shared governance among nursing organizations in support of the Nursing Roadmap 2030 (I & C)

3.2. Institutionalize the Nursing Roadmap 2030 for national and international recognition and certification (I and C)

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030STRATEGIC GOAL

3. Practicing good governance to sustain collaborative efforts among nurses and nursing organizations

STRATEGIC THEME OPERATIONAL EXCELLENCE

Perspectives Objectives

Internal Process Perspectives

2. INTERNAL PERSPECTIVES

2.1.Evaluate regularly the implementation of standards of Nursing Practice (I).

2.2. Develop a governance policy model to implement the VMOV of the Nursing Profession (I)

Learning and Growth Perspectives

1. LEARNING AND GROWTH

1.1. Commit to a culture of excellence in nursing practice (L)

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030Strategic Goal 4. Maintaining linkages with domestic and international stakeholdersStrategic Theme STRATEGIC PARTNERSHIPSPerspectives ObjectivesFinancial Perspectives Customer Perspectives Internal Process Perspectives

2. Enhance existing linkages among national and international Stakeholders

2.1.National:

2.1.1.Participate actively in the implementation of a health human resource network

2.1.2.Align programs according to the millennium goals

2.2.International - Participate in the development of Health Trade Services Learning and Growth Perspectives

Nursing Profession Roadmap 2030Nursing Profession Roadmap 2030STRATEGIC GOAL

5. To promote equity, access and justice towards the improvement

of the quality of life of the Filipino and people of the world.

STRATEGIC THEME

Professional Social Responsibility

Perspectives Objectives

Financial Perspectives

Customer Perspectives

Internal Process Perspectives

2. Take the lead in socio-civic activities

Learning and Growth Perspectives

1. Promote respect for diversity and pluralism and freedom of expression through role modeling, education and training.

STRATEGIC PLANS

BUSINESS PLANSTranslate

With all these initiatives by the Philippine With all these initiatives by the Philippine Nursing Professional Organizations Nursing Professional Organizations –– we will be able to provide professional we will be able to provide professional

nursing service that will improve quality nursing service that will improve quality of life and wellbeing of Filipino Nurses, of life and wellbeing of Filipino Nurses,

Filipinos and people of the worldFilipinos and people of the world

I’m

Proud to be a

Filipino Nurse

THANK

YOU 80

I’m

Proud to be a

Filipino Nurse

MABUHAY !!

CARMENCITA MATIAS-ABAQUIN,RN, PhDChairperson, BON, Philippines

mengabaquin@yahoo.comwww.bonphilippines.org