Patient's Bill of Right

Title 111: Declaration of Rights

Sec. 4. The Rights of Patients. - The following
rights of the patient shall berespected by all
those involved in his care:
(1) Right to Appropriate Medical Care and
Humane Treatment. - Every person has a right to
health and medical care corresponding to his
state of health,without any discrimination and
within the limits of the resources, manpower and
competence available for health and medical
care at the relevant time.The patient has the right
to appropriate health and medical care of good
quality.In the course of such care, his human
dignity, convictions, integrity, individual needs
and culture shall be respected.If any person
cannot immediately be given treatment that is
medically necessary he shall, depending on his
state of health, either be directed to wait for care,
or be referred or sent for treatment elsewhere,
where the appropriate care can be provided. If
the patient has to wait for care, he shall be
informed of the reason for the delay.Patients in
emergency shall be extended immediate medical
care and treatment without any deposit, pledge,
mortgage or any form of advance payment for
treatment.
(2) Right to Informed Consent. - The patient has
a right to a clear, truthful and substantial
explanation, in a manner and language
understandable to the patient, of all proposed
procedures, whether diagnostic, preventive,
curative, rehabilitative or therapeutic, wherein the
person who will perform the said procedure shall
provide his name and credentials to the patient,
possibilities of any risk of mortality or serious side
effects, problems related to recuperation, and
probability of success and reasonable risks
involved: Provided, That, the patient will not be
subjected to any procedure without his written
informed consent, except in the following cases:
a. in emergency cases, when the patient is at
imminent risk of physical injury,decline or death if
treatment is withheld or postponed. In such
cases, the physician can perform any diagnostic
or treatment procedure as good practice of
medicine dictates without such consent;
b. when the health of the population is dependent
on the adoption of a mass health program to
control epidemic;
c. when the law makes it compulsory for
everyone to submit to a procedure;
d. when the patient is either a minor, or legally
incompetent, in which case, a third party consent
is required;
e. when disclosure of material information to
patient will jeopardize the success of treatment,
in which case, third party disclosure and consent
shall be in order;
f. when the patient waives his right in writing.
Informed consent shall be obtained from a
patient concerned if he is of legal age and of
sound mind. In case the patient is incapable of
giving consent and a third party consent is
required, the following persons, in the order of
priority stated here under, may give consent:
i.spouse;
ii.son or daughter of legal age;
iii.either parent;
iv.brother or sister of legal age,
or v.guardian

If a patient is a minor, consent shall be obtained
from his parents or legal guardian. If next of kin,
parents or legal guardians refuse to give consent
to a medical or surgical procedure necessary to
save the life or 1imb of a minor or a
patientincapable of giving consent, courts, upon
the petition of the physician or any person
interested in the welfare of the patient, in a
summary proceeding, mayissue an order giving
consent.
(3) Right To Privacy and Confidentiality. - The
privacy of the patients must be assured at all
stages of his treatment. The patient has the right
to be free from unwarranted public exposure,
except in the following cases:
a) when his mental or physical condition is in
controversy and the appropriate court, in its
discretion, orders him to submit to a physical or
mental examination by a physician;
b) when the public health and safety so demand;
and c) when the patient waives this right.
The patient has the right to demand that all
information, communication and records
pertaining to his care be treated as confidential.
Any health care provider or practitioner involved
in the treatment of a patient and all those who
have legitimate access to the patient's record is
not authorized to divulge any information to a
third party who has no concern with the care and
welfare of the patient without his consent, except:
a) when such disclosure will benefit public health
and safety;
b) when it is in the interest of justice and upon
the order of a competent court;
and c) when the patients waives in writing the
confidential nature of such information;
d) when it is needed for continued medical
treatment or advancement of medical science
subject to de-identification of patient and shared
medical confidentiality for those who have access
to the information.Informing the spouse or the
family to the first degree of the patients medical
condition may be allowed; Provided, That the
patient of legal age shall have the right to choose
on whom to inform. In case the patient is not of
legal age or is mentally incapacitated, such
information shall be given to the parents, legal
guardian or his next of kin.
4) Right to Information. - In the course of his/her
treatment and hospital care,the patient or his/her
legal guardian has a right to be informed of the
result of the evaluation of the nature and extent
of his/her disease, any other additional or further
contemplated medical treatment on surgical
procedure or procedures,including any other
additional medicines to be administered and their
generic counterpart including the possible
complications and other pertinent facts,statistics
or studies, regarding his/her illness, any change
in the plan of care before the change is made,
the persons participation in the plan of care and
necessary changes before its implementation,
the extent to which payment may be expected
from Philhealth or any pay or and any charges for
which the patient maybe liable, the disciplines of
health care practitioners who will furnish the care
and the frequency of services that are proposed
to be furnished.The patient or his legal guardian
has the right to examine and be given an
itemized bill of the hospital and medical services
rendered in the facility or by his/her physician
and other health care providers, regardless of the
manner and source of payment. He is entitled to
a thorough explanation of such bill.The patient or
his/her legal guardian has the right to be
informed by the physician or his/her delegate of
his/her continuing health care requirements
following discharge, including instructions about
home medications, diet, physical activity and all
other pertinent information to promote health and
well-being. At the end of his/her confinement, the
patient is entitled to a brief, written summary of
the course of his/her illness which shall include at
least the history, physical examination, diagnosis,
medications, surgical procedure, ancillary and
laboratory procedures, and the plan of further
treatment, and which shall be provided by the
attending physician. He/she is likewise entitled to
the explanation of, and to view, the contents of
the medical record of his/her confinement but
with the presence of his/her attending physician
or in the absence of the attending physician, the
hospitals representative. Notwithstanding that
he/she may not be able to settle his accounts by
reason of financial incapacity, he/she is entitled
to reproduction, at his/her expense, the pertinent
part or parts of the medical record the purpose or
purposes of which he shall indicate in his/her
written request for reproduction. The patient shall
likewise be entitled to medical certificate, free of
charge, with respect to his/her previous
confinement.The patient has likewise the right
not to be informed, at his/her explicit request.
(5) The Right To Choose Health Care Provider
and Facility. - The patient is free to choose the
health care provider to serve him as well as the
facility except when he is under the care of a
service facility or when public health and safety
so demands or when the patient expressly or
impliedly waives this right. The patient has the
right to discuss his condition with a consultant
specialist, atthe patients request and expense.
He also has the right to seek for a secondopinion
and subsequent opinions, if appropriate, from
another health care provider/practitioner.
(6) Right to Self-Determination. - The patient has
the right to avail himself/herself of any
recommended diagnostic and treatment
procedures. Any person of legal age and of
sound mind may make an advance written
directive for physicians to administer terminal
care when he/she suffers from the terminal
phase of a terminal illness: Provided, That a) he
is informed of the medical consequences of his
choice; b) he releases those involved in his care
from any obligation relative to the consequences
of his decision; c) his decision will not prejudice
public health and safety.
(7) Right to Religious Belief. - The patient has the
right to refuse medical treatment or procedures
which may be contrary to his religious beliefs,
subject to the limitations described in the
preceding subsection: Provided, That such a
right shall not be imposed by parents upon their
children who have not reached the legal age in a
life threatening situation as determined by the
attending physician or the medical director of the
facility.
(8) Right to Medical Records. - The patient is
entitled to a summary of his medical history and
condition, He has the right to view the contents of
his medical records, except psychiatric notes and
other incriminatory information obtained about
third parties, with the attending physician
explaining contents thereof. At his expense and
upon discharge of the patient, he may obtain
from the health care institution a reproduction of
the same record whether or not he has fully
settled his financial obligation with the physician
or institution concerned.The health care
institution shall safeguard the confidentiality of
the medical records and to likewise ensure the
integrity and authenticity of the medical records
and shall keep the same within a reasonable time
as may be determined by the Department of
Health.The health care institution shall issue a
medical certificate to the patient upon request.
Any other document that the patient may require
for insurance claims shall also be made available
to him within a reasonable period of time.
(9 ) Right to Leave . - The patient has the right to
leave a hospital or any other health care
institution regardless of his physical condition:
Provided, That
a) he/she is informed of the medical
consequences of his/her decision;
b) he/she releases those involved in his/her care
from any obligation relative to the consequences
of his decision;
c) his/her decision will not prejudice public health
and safety

No patient shall be detained against his/her will in
any health care institution on the sole basis of his
failure to fully settle is financial obligations.
However, he/she shall only be allowed to leave
the hospital provided appropriate arrangements
have been made to settle the unpaid bills:
Provided, farther, that unpaid bills of patients
shall be considered as lost income by the
hospital and health care provider/practitioner and
shall be deducted from gross income as income
loss for that particular year.
(10) Right to Refuse Participation in Medical
Research. - The patient has the right to be
advised if the health care provider plans to
involve him in medical research, including but not
limited to human experimentation which may be
performed only with the written informed consent
of the patient. Provided, further, That, an
institutional review board or ethical review board
in accordance with the guidelines set in the
Declaration of Helsinki be established for
research involving human experimentation:
Provided, finally, That the Department of Health
shall safeguard the continuing training and
education of future health care
provider/practitioner to ensure the development
of the health care delivery in the country.
(11) Right to Correspondence and to Receive
Visitors - The patient has the rightto
communicate with relatives and other persons
and to receive visitors subject toreasonable limits
prescribed by the rules and regulations of the
health careinstitution.
(12) Right to Express Grievances. - The patient
has the right to express complaints and
grievances about the care and services received
without fear of discrimination or reprisal and to
know about the disposition of such
complaints.The Secretary of Health, in
consultation with health care providers,
consumer groups and other concerned agencies
shall establish a grievance system wherein
patients may seek redress of their grievances.
Such a system shall afford all parties concerned
with the opportunity to settle amicably all
grievances.
(13) Right to be Informed of His Rights and
Obligations as a Patient. Every person has the
right to be informed of his rights and obligations
as a patient. The Department of Health, in
coordination with health care providers,
professional and civic groups, the media, health
insurance corporations, peoples organizations,
local government organizations, shall launch and
sustain a nationwide information and education
campaign to make known to people their rights
as patients, as declared in this Act. Such rights
&d obligations of patients shall be posted in a
bulletin board conspicuously placed in a health
care institution.It shall be the duty of health care
institutions to inform patients of their rights as
well as the institution's rules and regulations that
apply to the conduct of the patient while in the
care of such institution.
Posted by Rubeth San Diego
Labels: 11 Core Competency
Monday, October 3, 2011
Nursing leadership and
management
Effective management leadership in nursing is
not a career that is suitable for everyone or for
every nurse. Leadership positions not only
require additional sacrifices on your behalf but it
also requires someone who is a critical thinker, in
other words, somebody who can work effectively
under pressure and who is able to resolve
problems within the workplace quickly and

efficiently and without conflict. Nurses who
assume leadership and management roles also
need to be creative thinkers. Not only is their
work demanding of them, but they too have to
oversee that everyone else is fulfilling their duties
and that patient care is of the best. Within a
position of leadership, one should be a role
model and a positive influence on the nurses
within the hospital as well as on the image of the
hospital as a whole. Therefore, effective
management leadership in nursing does not
mean just barely surviving the job, it actually
means taking it full force and making it flourish!

A nurse leader may be a nurse manager,
responsible for one nursing unit, or a nurse
executive, responsible for all in-patient nursing
units. Rather than choosing just one leadership
style, an outstanding nurse leader typically uses
multiple styles depending on the situations she's
facing.
Posted by Rubeth San Diego
Labels: 11 Core Competency
Sunday, September 13, 2009
SAFE AND QUALITY
NURSING CARE
I. SAFE AND QUALITY NURSING CARE


CORE COMPETENCY 1:
Demonstrate knowledge based on health/illness
status of individual/ groups

Indicators :
Identifies health needs of patients/groups
Explains patient/group status

CORE COMPETENCY 2:
Provides sound decision making in care of
individual/groups considering their beliefs, values

Indicators :
Problem identification
Data gathering related to problem
Data analysis
Selection appropriate action
Monitor progress of action taken

CORE COMPETENCY 3:
Promotes patient safety and comfort

Indicators :
Performs age-specific safety measures and
comfort measure in all aspects of patient care

CORE COMPETENCY 4:
Priority setting in nursing care based on patients
needs

Indicators :
Identifies priority needs of patients
Analysis of patients needs
Determine appropriate nursing care to be
provided

CORE COMPETENCY 5:
Ensures continuity of care

Indicators :
Refers identified problems to appropriate
individuals/ agencies
Establish means of providing continuous
patient care

CORE COMPETENCY 6:
Administers medications and other health
therapeutics

Indicators :
Conforms to the 10 golden rules in medication
administration and health therapeutics

CORE COMPETENCY 7:
Utilizes nursing process as framework for
nursing. Performs comprehensive, systematic
nursing assessment

Indicators :
Obtains consent
Complete appropriate assessment forms
Performs effective assessment techniques
Obtains comprehensive client information
Maintains privacy and confidentiality
Identifies health needs

CORE COMPETENCY 8:
Formulates care plan in collaboration with
patients, other health team members

Indicators :
Includes patients, family in care planning
States expected outcomes in nursing
interventions
Develops comprehensive patient care plan
Accomplishes patient centered discharge plan


CORE COMPETENCY 9:
Implements NCP to achieve identified outcomes

Indicators :
Explain interventions to patient, family before
carrying them out
Implement safe, comfortable nursing
interventions
Acts according to clients health conditions,
needs
Performs nursing interventions effectively and
in timely manner

CORE COMPETENCY 10:
Implements NCP progress toward expected
outcomes

Indicators :
Monitors effectiveness of nursing interventions
Revises care plan PRN

CORE COMPETENCY 11:
Responds to urgency of patients condition

Indicators :
Identifies sudden changes in patients health
conditions
Implements immediate, appropriate
interventions
Posted by Rubeth San Diego
Labels: 11 Core Competency
MANAGEMENT OF
RESOURCES AND
ENVIRONMENT
II. MANAGEMENT OF RESOURCES AND
ENVIRONMENT


CORE COMPETENCY 1:
Organizes workload to facilitate patient care

Indicators:
Identifies task or activities that need to be
accomplished
Plans the performance of task or activities
based on priority
Finishes work assignment on time

CORE COMPETENCY 2:
Utilizes resources to support patient care

Indicators:
Determines the resources needed to deliver
patient care
Control the use of equipment

CORE COMPETENCY 3:
Ensures the functioning of resources

Indicators:
Check proper functioning of the equipment
Refers Malfunctioning equipment to
appropriate unit

CORE COMPETENCY 4:
Check the Proper functioning of the Equipment

Indicators:
Determines the task and procedures that can
be safely assigned to the other members of the
team
Verifies the competence of the staff prior to
delegating tasks

CORE COMPETENCY 5:
Maintains safe Environment

Indicators:
Observe proper disposal of waste
Adheres to policies, procedures and protocols
on prevention and control of infection
Defines steps to follow incase of fire ,
earthquake and other emergency situation
Posted by Rubeth San Diego
Labels: 11 Core Competency
HEALTH EDUCATION
III. HEALTH EDUCATION


CORE COMPETENCY 1:
Assesses the learning needs of the patient and
the family

Indicators:
Obtains learning information through interview,
observation and validation
Defines relevant information
Completes assessment records appropriately
Identify priority needs

CORE COMPETENCY 2:
Develops Health Education plan based on
assessed and anticipated needs.

Indicators:
Considers nature of the learner in relation to
social, cultural, political, economic, educational,


and religious factor

CORE COMPETENCY 3:
Develops learning material for health education

Indicators:
Involves the patient, family and significant
others and other resources
Formulates a comprehensive health
educational plan with the following components ,
objectives, content and time allotment
Teaching-learning resources and evaluation
parameters
Provides for feedback to finalize plan

CORE COMPETENCY 4:
Implements the health Education Plan

Indicators:
Provides for conducive learning situation in
terms of timer and place
Considers client and family preparedness
Utilize appropriate strategies
Provides reassuring presence through active
listening, touch and facial expression and
gestures
Monitors client and familys responses to health
education

CORE COMPETENCY 5:
Evaluates the outcome of health Education

Indicators:
Utilizes evaluation parameters
Documents outcome of care
Revises health education plan when necessary
Posted by Rubeth San Diego
Labels: 11 Core Competency
ETHICO-MORAL
RESPONSIBILITY
IV. ETHICO-MORAL RESPONSIBILITY


CORE COMPETENCY 1:
Respects the rights of individual/ groups

Indicator:
Renders nursing care consistent with the
patients bill of rights (ie. confidentiality of
information, privacy, etc.)

CORE COMPETENCY 2
Accepts responsibility & accountability for own
decisions and actions

Indicators:
Meets nursing accountability requirements as
embodied in the job description
Justifies basis for nursing actions and judgment
Protects a positive image of the profession

CORE COMPETENCY 3
Adheres to the national and international code of
ethics for nurses

Indicators:
Adheres to the Code of Ethics for Nurses and
abides by its provisions
Reports unethical and immoral incidents to
proper authorities
Posted by Rubeth San Diego
Labels: 11 Core Competency
LEGAL RESPONSIBILITY
V. LEGAL RESPONSIBILITY


CORE COMPETENCY 1:
Adheres to practices in accordance with the
nursing law and other relevant legislation
including contract and informed consent.

Indicators:
Fulfill legal requirements in Nursing Practice
Holds current professional license
Acts in accordance with the terms of contract of
employment and other rules and regulation
Complies with the required CPE
Confirms information given by the doctor for
informed consent
Secures waiver of responsibility for refusal to
undergo treatment or procedures
Check the completeness of informed consent
and other legal forms

CORE COMPETENCY 2:
Adheres to organizational policies and
procedures, local and national

Indicators:
Articulates the vision and mission of the
institution where one belongs
Acts in accordance with the established norms
and conduct of the institution/ organization

CORE COMPETENCY 3:
Document care rendered to patients.



Indicators:
Utilizes appropriate patient care records and
reports
Accomplish accurate documentation in all
matters concerning patient care in accordance
with the standard of nursing practice.
Posted by Rubeth San Diego
Labels: 11 Core Competency
PERSONAL &
PROFESSIONAL
DEVELOPMENT
VI. PERSONAL & PROFESSIONAL
DEVELOPMENT


CORE COMPETENCY 1
Identifies own learning needs

Indicators:
Verbalizes strengths, weaknesses, limitations.
Determines personal and professional goals
and aspirations.

CORE COMPETENCY 2
Pursues continuing education

Indicators:
Participates in formal and non-formal
education.
Applies learned information for the
improvement of care.

CORE COMPETENCY 3
Gets involved in professional organizations and
civic activities

Indicators:
Participates actively in professional, social,
civic and religious activities
Maintain membership to professional
organizations
Support activities related to nursing and health
issues

CORE COMPETENCY 4
Projects a professional image of nurse

Indicators:
Demonstrate good manners and right conduct
at all times.
Dresses appropriately.
Demonstrates congruence of words and
actions.
Behaves appropriately at all times.

CORE COMPETENCY 5
Possesses positive attitude towards change and
criticism
Indicators:
Listens to suggestions and recommendations.
Tries new strategies or approaches.
Adapts to changes willingly.

CORE COMPETENCY 6
Performs function according to professional
standards

Indicators:
Assesses own performance against standards
of practice.
Sets attainable objectives to enhance nursing
knowledge and skills.
Explains current nursing practices, when
situations call for it.
Posted by Rubeth San Diego
Labels: 11 Core Competency
RESEARCH
VII. RESEARCH


CORE COMPETENCY 1:
Gathers data using different methodologies

Indicators:
Identifies researchable problems regarding
patient care and community health
Identifies appropriate methods of research for a
particular patient/community problem
Combines quantitative and qualitative nursing
design thru simple explanation on the
phenomena observed
Analyzes data gathered

CORE COMPETENCY 2:
Recommends actions for implementation

Indicator:
Based on the analysis of data gathered,
recommends practical solutions appropriate for
the problem

CORE COMPETENCY 3:
Disseminates results of research findings

Indicators:
Communicates results of findings to
colleagues/patients/family and to others


Endeavors to publish research
Submits research findings to own agencies and
others as appropriate

CORE COMPETENCY 4:
Applies research findings in nursing practice

Indicators:
Utilizes and findings in research in the provision
of nursing care to individuals/groups/communities
Makes use of evidence-based nursing to
ameliorate nursing practice
Posted by Rubeth San Diego
Labels: 11 Core Competency
RECORDS MANAGEMENT
VIII. RECORDS MANAGEMENT


CORE COMPETENCY 1:
Maintains accurate and updated documentation
of patient care

Indicator:
Completes updated documentation of patient
care

CORE COMPETENCY 2:
Records outcome of patient care

Indicator:
Utilizes a record system

CORE COMPETENCY 3:
Observes legal imperatives in recording keeping

Indicators:
Observes confidentially and privacy of patients
records
Maintains an organized system of filing and
keeping patients records in a designated area
Refrains from releasing records and other
information without proper authority
Posted by Rubeth San Diego
Labels: 11 Core Competency
COMMUNICATION
IX. COMMUNICATION


CORE COMPETENCY 1:
Establishes rapport with patients, significant
others and members of the health team.

Indicators:
Creates trust and confidence
Listens attentively to clients queries and
requests
Spends time with the client to facilitate
conversation that allows client to express
concern.

CORE COMPETENCY 2:
Identifies verbal and non-verbal cues

Indicator:
Interprets and validates clients body language
and facial expression

CORE COMPETENCY 3:
Utilizes formal and informal channels

Indicator:
Makes use of available visual aids

CORE COMPETENCY 4:
Responds to needs of individuals, family, group
and community

Indicator:
Provides re- assurance through therapeutic,
touch, warmth and comforting words of
encouragement
Readily smiles

CORE COMPETENCY 5:
Uses appropriate information technology to
facilitate communication

Indicator:
Utilizes telephone, mobile phone, email and
internet, and informatics
Identifies a significant other so that follow up
care can be obtained
Provides holding or emergency numbers of
services
Posted by Rubeth San Diego
Labels: 11 Core Competency
COLLABORATION and
TEAMWORK
X. COLLABORATION and TEAMWORK

CORE COMPETENCY 1:
Establishes collaborative relationship with
colleagues and other members of the health
team

Indicators:



Contributes to decision making regarding
patients needs and concerns
Participates actively in patients care
management including audit
Recommends appropriate intervention to
improve patient care
Respects the role of the other members of the
health team
Maintains good interpersonal relationships with
patients, colleagues and other members of the
health team

CORE COMPETENCY 2:
Collaborates plan of care with other members of
the health team

Indicator:
Refers patients to allied health team partners
Acts liaison / advocate of the patients
Prepares accurate documentation of efficient
communication of services
Posted by Rubeth San Diego
Labels: 11 Core Competency
QUALITY IMPROVEMENT
XI. QUALITY IMPROVEMENT


CORE COMPETENCY 1:
Gathers data for quality improvement

Indicators:
Demonstrates knowledge of method appropriate
for the clinical problems identified
Detects variation in the vital signs of the patient
from day to day
Reports necessary elements at the bedside to
improve patient stay at hospital
Solicits feedback from patient and significant
others regarding care rendered

CORE COMPETENCY 2:
Participates in nursing audits and rounds

Indicators:
Contributes relevant information about patient
condition as well as unit condition and patient
current reactions
Shares with the team current information
regarding particular patients condition
Encourages the patient to speak about what is
relevant to his condition
Documents and records all nursing care and
actions
Performs daily check of patient records/condition
Completes patients records
Actively contributes relevant information of
patients during rounds thru readings and sharing
with others

CORE COMPETENCY 3:
Identifies and reports variances

Indicators:
Documents observed variance regarding patient
care and submits to appropriate group within 24
hours
Identifies actual and potential variance to patient
care
Reports actual and potential variance to patient
care
Submits report to appropriate groups within 24
hours

CORE COMPETENCY 4:
Recommends solutions to identified problems

Indicators:
Gives appropriate suggestions on corrective and
preventive measures
Communicates and discusses with appropriate
groups
Gives and objective and accurate reporton what
was observed rather than an interpretation of the
event.