Divine Mercy Medical Center Iloilo City, Philippines 2009

* DIVINE MERCY MEDICAL CENTER *
DIVINE MERCY MEDICAL CENTER

* ILOILO CITY, PHILIPPINES
* 2009
Benigno Aquino
Avenue, *
Mandurriao, Iloilo City
Nursing Services Division
Description
The Nursing Service, as an integral part of the Divine Mercy Medical
Center, accepts that its primary functions are focused on service to the
community; participation in the education of students and practitioners of
nursing, medicine and other health disciplines; promotion of research to
increase knowledge and improve patient care.
The role our nurses play in the success of your treatment, and in your
entire healing process, can never be underestimated.
Our professional nurses and their assistants are at the frontline of patient
care, and we at recognize this and act accordingly. By taking care of our
nurses, we are able to provide you with exceptional patient care.
We value the contribution of our nurses to our successand reward
them. We start off by choosing the right people from the thousands of nursing
graduates who apply to train with us. We only hire nurses from the outstanding
and high performing schools. We then inspire them with the innovative vision
of outstanding patient care first envisioned by the celebrated 19th century
British nurse Florence Nightingale.
As we know that meritocracy encourages hard work and efficiency, we let
all our nurses undergo a competency-based trainingand their job description
and appraisal system is also clearly competency-based, serving to motivate
and encourage them.
This rigorous training is also meant to break up their old way of thinking
and help them shift into a distinct nursing paradigm that combines an equal
measure of quick wits, a compassionate heart and hard manual work.
Because we recognize that the main part of the responsibility to create
and maintain a safe and healing environment for patients falls on our nurses,
our training does not only teach them to be clinically proficient. Instead, we
train our nurses to be leadersto have the authority and autonomy to make
decisions that could save lives.

* 2009
Benigno Aquino
Avenue, *
VISION
The Department of Nursing Vision Statement: NURSE
It is dedicated to promote Nursing professional development and Utilization of
patient-centered care practice with Research-based and innovations, Safety
initiatives and Excellent caring service globally through collaborative
relationships.
MISSION
Nursing Service Department is committed to

provide the highest quality patient-centered
care through evidence-based practice,
advancement in professional nursing practice,
research, innovations, education and continued pursuit of nursing quality for

global excellence.
These are guided by the Nursing as Caring theory.

* 2009
Benigno Aquino
Avenue, *
CORE VALUES
The Department of Nursing Values Statement
PATIENT-CENTERED CARE
While the quality of care is uniform and improved and as a health care professional who are
competent, care may be modified according to patients needs, choices, preferences and values.
AUTONOMY
The patient has a significant role in determining the course of his or her care. Health professionals
should communicate effectively, ensuring that patients have adequate information to make informed
decisions and encourage shared decision making, participation and sovereignty.
TEAMWORK
Cooperation among health care professionals is one of the priorities. Acknowledging the
contributions of all but requires sacrifice through sharing ideas and responsibilities in an
environment of mutual respect for the benefit of the patient so as to enhance the health and works to
achieve our aspirations and goals.
INNOVATIONS AND EVIDENCE-BASED CARE

Decisions regarding in providing the best care are based on the best available scientific acceptable
standardized knowledge, evidence practice and innovations through research and theory which
undergone systematic and scientific process with the aid of our advanced, state of the art and high
technological facilities and equipments.
EXCELLENCE
We are committed to provide our patients with excellent standards of service, medical care and
satisfaction through client and family partnerships, participation and collaboration among health
care professionals in order to exceed the community's expectations of excellence. Health
professionals should provide care and be responsive at all times.
NURTURE AND CONTINUUM OF CARE

Patients needs should be anticipated whenever possible. Health professionals should do their best
to anticipate patient needs through patient collaboration, partnership and interpersonal relationship
and their representatives to ensure patients satisfaction, continuity of high quality care and their
conditions are at the best state.
6

* 2009
Benigno Aquino
Avenue, *
TRUST, RESPECT and COMPASSION

Health professionals should deliver care with respect and compassion with an environment of trust,
openness and cooperation. We are committed to provide patients and the community the highest
standards of respect, compassion and clinical excellence. We are exceptional professionals called to
do exceptional duty.
SAFETY AND STANDARDS

Patient safety is a top priority at all times. Health professionals should strive to enhance safety by
continuously paying close attention to procedural and operational systems and by following policies
and procedures that help prevent and mitigate errors.
Figure 1. Paradigm or framework showing the vision, mission and core values of Nursing Service
Department.

* 2009
Benigno Aquino
Avenue, *
Nursing Philosophy
We believe that Nursing is united by:
A personal commitment to caring
A dynamic search for professional excellence through innovation
A team spirit of trust, compassion and respect in our interaction with mankind
The Key Components of Our Practice:
1. Caring and Compassionate Environment
2. Professional excellence
3. Continuum of Care
4. Respect, trust and compassionate approach to Health and Wellness
5. Evidence-based Practice and innovation
6. Sensitivity for Customer Service, Outcomes and Cost
7. Advocacy
8. Collaboration across disciplines
9. Autonomy
Goal:
Optimal Patient Care Experience for every patient and family member through service excellence,
patient-centered care practice, innovations, partnership, communication, and corporate values.
Figure 2. Paradigm or framework showing the goal and its core component of the Nursing Service
Department.
6

* 2009
Benigno Aquino
Avenue, *
OBJECTIVES
General:
Nursing Service is committed to promote holistic and excellent quality patient care and service
to meet patients expectations, needs, and preferences.
Specific:
Nursing service specifically aimed:
To provide excellence inpatient care that is comprehensive and sensitive to their social,
emotional, cultural and physical needs.
To recruit, retain and develop nursing staff in a progressive environment that provides
challenges and fosters creativity, personal/professional growth and displays performance of
service standards.
To ensure optimal quality of patient care through objective, systematic monitoring using
established standards and criteria-based evaluations.
To measure the effectiveness of nursing research through ongoing investigation and

implementation of concepts and theories designed to improve patient care.
To provide care to patients with acute and chronic illness, patient education, illness
prevention, health maintenance, discharge planning and palliative care.
CORE COMPETENCIES
Our nurses are trained in 12 areas of competence:
1. Safe and quality nursing
2. Management of environment and resources
3. Health and education
4. Legal responsibility
5. Ethico-moral responsibility
6. Personal and professional development
7. Quality improvement
6

* 2009
Benigno Aquino
Avenue, *
8. Research
9. Records management
10.
Communication
11.
Collaboration and teamwork
12.
Customer service
Our nursing services training curriculum is meant to develop these 12 core

competencies. These competencies also serve as the:
practical tool for evaluation performance of nurses
basis for advanced practice and specialization
means to protect the public from incompetent practitioners
yardstick for unethical and unprofessional practice
Finally, by empowering them to be leaders in their respective units, and

providing them with an attractive career path of both clinical and managerial
positions, we ensure that they are motivated to stay with us through the years.
Because of this, we can guarantee that at a time when most nurses have
imbibed the impersonal values of the industrialized worldour nurses are some
of the worlds best, still embodying the care and compassion of older days.
As proof to our claim, Nursing Services has consistently rated high in the
patient satisfaction index through the years.
PHILOSOPHY
We, at the Nursing Service Division of the Divine Mercy Medical Center believes
that nursing is an individualized process of caring for and supporting patients
as they progress through the changing level of health.
Our nursing staff believes:

* 2009
Benigno Aquino
Avenue, *
1. That its major contribution to society is the provision of professional nursing
care that is a direct personal service toward individuals and families with
problems of health-illness nature.
Nursing Care involves among others the process of identification of patient
problems through systematic assessment and meeting of client needs
through careful planning and evaluation. It believes further that the practice
of nursing like other health disciplines, demands professional responsibility,
commitment and "oughtness" from those who engage in its practice.
2. In the intrinsic worth and dignity of individual, thereby recognizing the
client's needs, goals, potentialities, individuality and integrity.
Likewise, it believes that the client lives within a society whose culture
affects his ways of doing things and therefore, in the process of planning
and carrying out his nursing care, these factors are taken into consideration.
3. That everyone should be treated with dignity, courtesy and compassion;

that quality of care should be unaffected by race, culture and religious
belief. The rights of patients must be respected and their physical,
psychological and spiritual health must be valued.
4. That it shall foster a climate conducive to continued professional and
intellectual growth of the nursing personnel to further develop their
potentialities and capabilities so that they may be able to initiate changes in
terms of desirable goals of society as well as conserve the desirable aspects
of the Filipino cultural heritage.
5. In the support of research in nursing and participation in investigations for

the improvement of client care.

* 2009
Benigno Aquino
Avenue, *
Ways to achieve exceptional nursing care
We realize that excellence in nursing care is only assured when we
continuously and regularly:
1. Recognize that the scope of their work extends throughout all areas of
operation, encompassing clinical skills, caring, customer relations and
even financial and logistics planning.
2. Nurture our nurses
education, research.
and
cultivate
their
skills
through
continuing
3. Empower them to make decisions.

4. Grant them a clear and attractive career path.
5. Evaluate our nursing services, and modify work protocols, nursing
policies and procedures to place them in line with ever-increasing global
standards.
The Nursing Services Division has the following units:
Standard Nursing Units
Critical Care and Intensive Care,
Operative Services,
Emergency / Outpatient Services
Professional Development and Training
We also have special training for pain management, oncology and

cardiovascular, peritoneal and hemodialysis training and the triage nursing
training.
BALANCE SCORECARD
6

* 2009
Benigno Aquino
Avenue, *
1. Sustain high standards

of healthcare ethics.
2. Develop a culture of
patient safety.
3. Create and sustain a
Culture of excellence
defined by
standards of care.
1. Develop a
culture of
teamwork.
2. Develop a
work of
3. culture
Create of
a culture
customer service
excellence.
4. Recruit and retain a
team
of highly skilled patient
focused professionals.
1. Patient- centered care.

2. Be a resource for health
education and support.
P
S
It is dedicated to promote
Nursing professional
development and Utilization of
patient-centered care practice
with Research- based and
innovations, Safety initiatives
and Excellent caring service
globally through collaborative
relationships.
3. Build and
empower a team of
exceptional patient
advocates.
4. Identify,
prioritize and
deliver valueadded services.
1. Grow revenue
from existing and
potential markets.
2. Increase annual
operating margin
percent.
3. Capture new
revenue.
NURSING
Nursing is an art of applying scientific principles in an intelligent humanitarian
way to the care of people experiencing potentially maladaptive stress
A professional service that has sound knowledge base gleaned from
both social and physical sciences.
THE UNIQUE FUNCTION OF NURSING

* 2009
Benigno Aquino
Avenue, *
The unique function of the nurse is to assist the individual, sick or well, in the
performance of the activities contributing to health or his recovery (or to a
peaceful death) that he would do unaided if he had the necessary strength, will
or knowledge, and to do this in such a way as to help him gain independence as
rapidly as possible. This aspect of her work, she initiates and controls, of this she
is mater.
CONCEPTS OF NURSING ETHICS
Nursing ethics is that aspect of moral philosophy which serves as guide in
ones judgment or appraisal of the goodness or badness of acts relative to the
practice of nursing. Nursing ethics is often times associated or considered
synonymous with nursing etiquette. In a larger sense, however, nursing ethics is
concerned not only with etiquette but with moral principles or moral conduct.
The practice of nursing is a profession predicated on the ideals of service.
It is a vocation premised on personal sacrifices and devotion to duty for the
benefit of the people while the profession is a means of livelihood and a
professional nurse has an inherent right to earn a living and secure for herself
the necessities and comforts of life, so as to enable her to perform her work well
and place herself in proper estimation in the community in which she lives, she
should not however forget that as a practitioner her primary object is not to
amass financial gains but to render satisfactory professional service.
THE ICN CODE OF ETHICS FOR NURSES

PREAMBLE
Nurses have four fundamental responsibilities: to promote health, to prevent
illness, to restore health and to alleviate suffering. The need for nursing is
universal.
Inherent in nursing is respect for human rights, including cultural rights, the right
to life and choice, to dignity and to be treated with respect. Nursing care is
respectful of and unrestricted by considerations of age, color, creed, culture,
disability or illness, gender, sexual orientation, nationality, politics, race or social
status.
Nurses render health services to the individual, the family and the community
and co-ordinate their services with those of related groups.
6

* 2009
Benigno Aquino
Avenue, *
ELEMENTS OF THE CODE

I. NURSES AND PEOPLE
The nurses primary professional responsibility is to people requiring nursing
care. In providing care, the nurse promotes an environment in which the
human rights, values, customs and spiritual beliefs of the individual, family
and community are respected.
The nurse ensures that the individual receives sufficient information on which
to base consent for care and related treatment.
The nurse holds in confidence personal information and uses judgment in
sharing this information.
The nurse shares with society the responsibility for initiating and supporting
action to meet the health and social needs of the public, in particular those of
vulnerable populations.
The nurse also shares responsibility to sustain and protect the natural
environment from depletion, pollution, degradation and destruction.
II. NURSES AND PRACTICE
The nurse carries personal responsibility and accountability for nursing
practice, and for maintaining competence by continual learning.
The nurse maintains a standard of personal health such that the ability to
provide care is not compromised.
The nurse uses judgment regarding individual competence when accepting
and delegating responsibility.
The nurse at all times maintains standards of personal conduct which reflect
well on the profession and enhance public confidence.
The nurse, in providing care, ensures that use of technology and scientific
advances are compatible with the safety, dignity and rights of people.
III.NURSES AND THE PROFESSION
The nurse assumes the major role in determining and implementing
acceptable standards of clinical nursing practice, management, research and
education.
6

* 2009
Benigno Aquino
Avenue, *
The nurse is active in developing a core of research-based professional
knowledge.
The nurse, acting through the professional organization, participates in
creating and maintaining safe, equitable social and economic working
conditions in nursing.
IV. NURSES AND CO-WORKERS
The nurse sustains a co-operative relationship with co-workers in nursing and
other fields.
The nurse takes appropriate action to safeguard individuals, families and
communities when their health is endangered by a coworker or any other
person.
USE OF THE CODE OF ETHICS FOR NURSES
The Code of Ethics for Nurses is a guide for action based on social values and
needs. It will have meaning only as a living document if applied to the realities of
nursing and health care in a changing society.
To achieve its purpose the Code must be understood, internalized and used by
nurses in all aspects of their work. It must be available to students and nurses
throughout their study and work lives.
APPLYING THE ELEMENTS OF THE CODE OF ETHICS FOR NURSES
The four elements of the ICN Code of Ethics for Nurses: nurses and people,
nurses and practice, nurses and the profession, and nurses and co-workers, give
a framework for the standards of conduct. The following chart will assist nurses
to translate the standards into action. Nurses and nursing students can
therefore:
Study the standards under each element of the Code.
Reflect on what each standard means to you. Think about how you can
apply ethics in your nursing domain: practice, education, research or
management.
Discuss the Code with co-workers and others.

* 2009
Benigno Aquino
Avenue, *
Use a specific example from experience to identify ethical dilemmas and

standards of conduct as outlined in the Code. Identify how you would
resolve the dilemmas.
Work in groups to clarify ethical decision making and reach a consensus on

standards of ethical conduct.
Collaborate with your national nurses association, co-workers, and others

in the continuous application of ethical standards in nursing practice,
education, management and research.
Element of the Code # 1: NURSES AND PEOPLE

Practitioners and
Managers
Educators and
Researchers
Provide care that respects

human rights and is
sensitive
to the values, customs
and beliefs of all people.
In curriculum include
references to human rights,
equity, justice, solidarity as
the basis for access to care.
Develop position statements

and guidelines that support
human rights and ethical
standards.
Provide continuing
education in ethical
issues.
Provide teaching and

learning opportunities for
ethical issues and decision
making.
Lobby for involvement of

nurses in ethics review
committees.
Provide teaching/learning
Opportunities related to
Informed consent.
Provide guidelines, position

statements and continuing
education related to informed
consent.
Introduce into curriculum

concepts of privacy and
confidentiality.
Incorporate issues of
confidentiality and privacy into
a national code of ethics for
nurses.
Sensitize students to the

importance of social action
in current concerns.
Advocate for safe and healthy

environment.
Provide sufficient
information to permit
informed consent and the
right to choose or refuse
treatment.
Use recording and
information management
systems that ensure
confidentiality.
Develop and monitor
environmental safety in
the workplace.
National Nurses
Associations
Element of the Code # 2: NURSES AND PRACTICE

6

* 2009
Benigno Aquino
Avenue, *
Practitioners and
Managers
Educators and
Researchers
Establish standards of care

and a work setting that
promotes safety and
quality care.
Establish systems for
professional appraisal,
continuing education and
systematic renewal of
licensure to practice.
Monitor and promote the
personal health of nursing
staff in relation to their
competence for practice.
opportunities that foster
lifelong learning and
competence for practice.
Conduct and disseminate
research that shows links
between continual
learning and competence
to practice.
Promote the importance
of personal health and
illustrate its relation to
other values.
National Nurses
Associations
Provide access to continuing
education, through journals,
conferences, distance
education, etc.
Lobby to ensure continuing
education opportunities and
quality care standards.
Promote healthy lifestyles for
nursing professionals. Lobby
for healthy work places and
services for nurses.
Element of the Code # 3: NURSES AND THE PROFESSION

Practitioners and
Managers
Set standards for nursing
practice, research,
education and
management.
Foster workplace support
of the conduct,
dissemination and
utilization of research
related to nursing and
health.
Promote participation in
national nurses
associations so as to
create favorable socioeconomic conditions for
nurses.
Educators and
Researchers
National Nurses
Associations
opportunities in setting
standards for nursing
practice, research,
education and
management.
Collaborate with others to set

standards for nursing
education, practice, research
and management.
Conduct, disseminate and

utilize research to
advance the nursing
profession.
Develop position statements,

guidelines and standards
related to nursing research.
Sensitize learners to the

importance of
professional nursing
associations.
Lobby for fair social and

economic working conditions in
nursing. Develop position
statements and guidelines in
workplace issues.

* 2009
Benigno Aquino
Avenue, *
Element of the Code #4: NURSES AND CO-WORKERS
Practitioners and
Managers
Educators and
Researchers
National Nurses
Associations
Create awareness of specific

and overlapping functions
and the potential for
interdisciplinary tensions.
Develop understanding
of the roles of other
workers.
Stimulate co-operation with

other related disciplines.
Develop workplace systems

that support common
professional ethical values
and behavior.
Communicate nursing
ethics to other
professions.
Develop awareness of ethical

issues of other professions.
Develop mechanisms to
safeguard the individual,
family or community when
their care is endangered by
health care personnel.
Instill in learners the

need to safeguard the
individual, family or
community when care
is endangered by health
care personnel.
Provide guidelines, position

statements and discussion fora
related to safeguarding people
when their care is endangered
by health care personnel.
NSO ORGANIZATIONAL STRUCTURE

CHIEF EXECUTIVE OFFICER
NURSING DIRECTOR
ASSISTANT NURSING DIRECTOR
NURSE SUPERVISOR
(OPD, ER)
NURSE SUPERVISOR
(CLINICAL AREA)
NURSE SUPERVISOR
(OR, RR, DR, NICU)
NURSE SUPERVISOR
(INSTRUCTOR)
HEAD NURSE
HEAD NURSE
HEAD NURSE
NURSE INSTRUCTOR

* 2009
Benigno Aquino
Avenue, *
STAFF NURSES
STAFF NURSES
STAFF NURSES
NURSING
ATTENDANTS
NURSING
ATTENDANTS
MIDWIVES
INSTITUTIONAL
WORKERS
INSTITUTIONAL
WORKERS
NURSING
ATTENDANTS
TRAINEES
INSTITUTIONAL
WORKERS
ORGANIZATIONAL CHART
This is a pyramidal or vertical type of an organizational chart. It shows
the nursing director having the highest form of authority in the unit. The solid
vertical lines show that the authority flows from the Director of Nursing to the
nurse supervisor then to the head nurse and to the front line nurses, nursing
attendants and institutional workers. The authority from the head nurse flows
down to the staff nurses representing the different units. The relationship of the
head nurse to the senior nurses and their corresponding staff nurses becomes
more effective and it suggests better coordination and effective
communication. The solid horizontal lines do not convey any authority rather
suggests equal placement and authority in the line of organization.
The organizational structure has a top down flow of authority and
communication. Even though staff nurses have no direct authority to their head
nurse, staff nurses could have an upward communication with regards to
schedule requests, reports and other responsibilities. The chain of command
does not suggest direct authority by the staff nurse to the nursing attendants
and institutional workers. Nursing attendants and institutional workers report
for duty to the head nurse. The staff nurses and the nurse attendants do not
have any direct form of authoritarian relationship with each other.
Centrality in the organizational structure indicates the location of a
position where frequent communication occurs. Staff nurses have shorter
organizational distance than nursing attendants have and it means that staff
6

* 2009
Benigno Aquino
Avenue, *
nurses are able to get broader bits of information from the top authority than
nursing attendants. The type of organization utilizes a narrow span of control.
The organization of the staff nurses for each unit is lead by the senior nurses
who have stayed in the hospital and in the unit for quite some time though not
directly specified in the chart. Senior nurses act as leaders only in the
implementation of the directives received from the head nurse but have no
direct authority in the management of staff performance and prescribed job.
Senior nurses only aid the head nurse in the operational management of the
units of the complex. The members are given the opportunity to enhance their
skills and expand their knowledge in different areas of nursing. In every change
of schedule, the mix of nursing personnel also changes. Nurses, nursing
attendants and institutional workers rotate among each units of the hospital as
stipulated in the staffing modality of the hospital.
NURSING ADMINISTRATION
It is the process through which the full latent capacity of nurses and of
related professionals and supporting personnel, of facilities and environment,
and of social action are developed in a systematic way to improve the health of
the people.
Nursing Service Office
The Nursing Service Office shall be headed by a Director of Nursing. The
Director of Nursing is responsible for the design of the entire program of the
administration and supervision in relation to nursing service.
Functions and Duties:
1. Plans, organizes and supervises the nursing service in order to provide
nursing care to patients.
2. Responsible for the assignment of duties and schedule of personnel in the
nursing department.

* 2009
Benigno Aquino
Avenue, *
3. Coordinates all activities of the nursing service department with other
department.
4. Participates in the preparation of nursing service budget to provide
adequate personnel,, supplies, equipment, and physical facilities.
5. Observes and evaluates the performance of personnel as well as analyses
and evaluates nursing activities to determine whether they are meeting
desired standards.
6. Interviews and screens all applicants for the nursing service, and evaluates
their qualifications and experiences and recommends them to the
Selection and Promotions Board.
The Nursing Service is concerned with the practice of professional nursing
which according to law shall for a fee, salary or other reward or compensation, or
even without the same, perform professional services such as:
1. Undertaking responsible nursing care with supervision of medical,
communicable, mental health, psychiatric patients, surgical, orthopedic,
eye-ear-nose and throat, emergency, urologic and gynecologic, pediatric
and obstetric patients involving the whole management of care, requiring
the application of principles based upon the biologic, the physical and
social sciences.
2. The observation of symptoms of physical and mental conditions and needs
requiring evaluation or application of principles based upon the biologic,
the physical and social sciences.
3. The accurate reporting and recording of facts including evaluation of the
whole care.
4. The supervision of others contributing to the nursing care of patients.
5. The execution of nursing procedures and techniques.
6. The application and execution of legal orders concerning treatments and
medications with an understanding of causes and effects.
7. Formulates and recommends policies for the improvement of patient care.
8. Participates in planning of personnel policies and interprets the needs and
interests of nursing personnel.
9. Promotes individual growth and development by maintaining a program of
staff education and research.
10.
Promotes and maintains cordial relationship with patients, their
families and the community and provides opportunities for nursing staff to
work with other groups so that the aims of the hospital can be achieved
through good interpersonal and interdepartmental relationship.

* 2009
Benigno Aquino
Avenue, *
11.
Participates in professional meetings as the representative of the
nursing service personnel.
12.
Provides for healthful living conditions of nursing personnel and
prepares and submits nursing service reports as needed.
JOB DESCRIPTION
Job Title: Director of Nursing (Nurse V)
Job Summary:
A registered nurse with masters degree who is responsible for the whole
nursing division of the hospital. The Director of Nursing reports to the immediate
supervisor, which is the Hospital Administrator and coordinates with the Medical
Director, College of Nursing and other heads of Offices of the hospital.
Qualification Requirement
a. Competence in the field in which the individual has specialized particularly
on administrative and supervisory skills including ability to give good
nursing care and to cooperate with members of the nursing staff as well as
to coordinate her part of the program with theirs.
b. Acceptable personality and professional qualities essential for leadership.
c. Integrity of mind and character, ability to grow and adjust with others.
d. Good mental and physical health.
e. Participation in community activities.
f. Must be above average of her professional group in intelligence, uses her
mind and knowledge effectively in improving her nursing practice.
g.
h.
i.
j.
Must be a registered nurse in the Philippines

Have at least two (2) years experience as a staff nurse.
Have at least three (3) years in clinical managerial position
Have at least five (5) years experience in a supervisory or managerial
position in nursing
k. Have atleast two (2) years in Chief Managerial Position
l. Possess a degree of Bachelor of Science in Nursing, with a degree of
Master of Arts in Nursing Major in Nursing Service Administration and
Health Services Administration.
m. Be a member of good standing of the accredited professional organization
of nurses.
n. Be a holder of masters degree major in Nursing, or its equivalent.
o. Must have BLS training in any institution in the country.
p. Must be a licensed IV therapy preceptor.
6

* 2009
Benigno Aquino
Avenue, *
Duties and Responsibilities

Trainings, seminars and workshops attended
Training needs
Basic Nursing Programs, Decentralized Programs,

Specialty Program, Progressive Clinical Nursing
Program, Postgraduate Courses programs,
National Association of Directors of Nursing

Administration in Long Term Care program
certification, Behavioral Health Case Management
Planning
Prepares strategic and operational plan in congruence with the objectives
of the organization.
Established nursing standards (Structure, criteria standards), policies and
procedures of the organization. The Director of Nursing also developed, in
congruence with the policies, the nursing service policies and manual that
each nursing department will used for uniformity in practice.
Approved and developed scheduling programs for each nursing
department, and prepares the budget in line with the strategic and
operational plan the organization ensues.
Coordinates with the top management, for organizational plan and
changes that the top management wants to pursue, and coordinates
accordingly for forecasting purposes in response and preparation for future
accreditations, in cooperation with the Quality Control Team.
Organizing
Conforms and coordinates with the hospital director and the Management
is setting up the Organizational Structure for the organization.
Determines staffing needs for each unit in coordination with the clinical
supervisors of each nursing unit. Organize nursing schedules in
collaboration with the clinical supervisors.
Directing
Delegates specific duties and responsibilities to clinical supervisors and the
nurses alike in the performance of their duties and responsibilities.
Directs the nursing care assignment.
Supervise the Nursing Service Office.
Prepares and directs necessary communication for all nursing units in
accordance with the goals of the organization.
Coordinates and reports directly to the medical director, and coordinates
with the ancilliary services, administrative services, medical records,
medical social services, and other institutions in directing the nursing
service office.
6

* 2009
Benigno Aquino
Avenue, *
Responsible for staff development of each nurses, may it be in-service
trainings and the like.
Responsible in directing and solving conflict management, and sentinel
events within the organization in collaboration with the sentinel event
analysis team.
Controlling
Conducts evaluation and Performance Appraisals every 3 months.
Established standards for nursing performance.
Maintains quality assurance within the organization, in coordination with
the CQI Director.
Conducts Nursing Audit every month.
Plays an active role in employee discipline.
JOB DESCRIPTION
Job Title: Assistant Director of Nursing (Nurse IV)
Job Summary:
A registered nurse who assists the Nursing Director in managing the whole
nursing personnel workforce in the hospital. The Assistant Director of Nursing is
also the Continuous Quality Assurance Nurse. He/She reports to the immediate
supervisor, which is the Nursing Director or the Medical Director.
Qualifications:
a. Competence in the field in which the individual has specialized particularly
on administrative and supervisory skills including ability to give good
nursing care and to cooperate with members of the nursing staff as well as
to coordinate her part of the program with theirs.
b. Acceptable personality and professional qualities essential for leadership.
c. Integrity of mind and character, ability to grow and adjust with others.
d. Good mental and physical health.
e. Participation in community activities.
f. Must be above average of her professional group in intelligence, uses her
mind and knowledge effectively in improving her nursing practice.
g. Must be a registered nurse in the Philippines
h. Have at least two (2) years experience as a staff nurse.
i. Have at least three (3) years in clinical managerial position
j. Have at least five (5) years experience in a supervisory or managerial
position in nursing

* 2009
Benigno Aquino
Avenue, *
k. Possess a degree of Bachelor of Science in Nursing and a degree of Master
of Arts in Nursing Major in Nursing Service Administration.
l. Be a member of good standing of the accredited professional organization
Basic Nursing Programs, decentralized Programs,
Specialty Program, Progressive Clinical Nursing
Program, Leadership Training, Communication And
Critical Thinking,
Training needs
Postgraduate Courses programs, National
Association of Directors of Nursing Administration
in Long Term Care program certification,
Behavioral Health Case Management
of nurses.
m. Must have BLS training in any institution in the country.
n. Must be a licensed IV therapy preceptor.
1. Plans, organizes and supervises the nursing service in order to provide
adequate nursing care to patients.
2. Collates and reviews report and recommendation submitted to the office.
3. Guides the nursing service personnel in the investigation of issues,
problems and concern which may exist in the clinical area.
4. Participates in meetings as the representative of the v personnel and
provides for healthful living condition of nursing personnel.
5. Daily purposeful ward rounds to give insight to the problems and needs as
presented by the patient and the family, nurses and other members of the
health team.
6. Assists the Director of Nursing in the annual programming.
7. Assumes the functions of the Director of Nursing delegated by the Medical
Director and CQI Director in the absence of the latter.
8. Plans and implements the nursing service, nursing audit or quality
assurance.
9. Serves as a Consultant in all Nursing Service Committee such as Quality
Assurance, Grievance and Complaints Committee, Continuing Education
Committee, and other related committees.
10.
Recommends to the Director of Nursing policies for the
implementation of nursing care to provide quality, safe and relevant care.
11.
Helps maintain proper decorum among nursing personnel.
12.
Assess the training and in-service and continuing education needs of
the nursing staff.
13.
Performs other duties as may be required by the Medical Director.
JOB DESCRIPTION
Job Title: Supervisor (Nurse III)
6

* 2009
Benigno Aquino
Avenue, *
Job Summary:
A mature registered nurse who is responsible for the coordination,
supervision and delivery of quality nursing care of the whole hospital on the
particular shift.He/She is accountable to the Director of Nursing for the
management of the units under care.
Qualifications:
a. Must be a graduate of an accredited school or College of Nursing
b. Must be currently licensed in the Philippines.
c. Possess a degree of Bachelor of Science in Nursing with at least CAR in
Master of Arts in Nursing.
d. Must have at least 2 years as staff nurse, 5 years as clinical managerial
position experience, 1 year of which had been in the supervisory position
Training needs
Basic Nursing Programs, decentralized Programs,

Specialty Program, Leadership Training,
Communication And Critical Thinking,
Progressive Clinical Nursing Program,

Postgraduate Courses programs
in a general service in which administrative ability has been demonstrated.

e. Must possess above average knowledge and skills in her area of specialty,
as well as in general nursing.
f. Be a member of good standing of the accredited professional organization
of nurses.
g. Must be in good physical and mental health.
h. Must possess excellent leadership qualities and the capacity to
communicate effectively in both oral and written form.
i. Must be discreet and fair at all times.
j. Must know the principles of management and administration and be able to
apply them accordingly.
k. Must have BLS training in any institution in the country.
l. Must be a licensed IV therapy preceptor.
Assumes responsibility in the management of nursing care and services in
the different areas of the hospital.
1. Assess, plans, implements and evaluates in cooperation with the
headnurse, the various nursing activities and requirements in a unit.
2. Make s regular rounds in the area of assignment, taking note of the needs
and problems; offers advice and suggests solutions to such problems.
3. Maintain a collaborative relationship with other supervisors to make sure
that the nursing service runs smoothly.
6

* 2009
Benigno Aquino
Avenue, *
4. Makes the schedule of designated nursing personnel.
5. Assumes the role of Director of Nursing when requested or in the absence
of the latter.
6. Ensures an effective endorsement of all duties and required information
during shift change.
7. Maintains a personal contact with all patients through ward rounds,
conversation and teaching sessions.
8. Monitors the standard of cleanliness in the ward areas, acts as liaison with
the headnurse regarding cleaning problems and schedules.
9. Reports any sickness or absenteeism to the Director of Nursing according
to the appropriate procedure.
10.
Participates in the in service program of the nursing department;
and keeps himself up to date on professional matters by attending
lectures and reading appropriate journals.
11.
Undertakes the orientation of the new employees.
12.
Promotes and maintains good interpersonal and interdepartmental
relationships.
13.
Monitors staffing levels in each ward; recommends duty changes
accordingly.
14.
Acts as counselor to the nursing staff.
15.
Assists the headnurse in planning assignment of duties to nursing
and auxiliary personnel.
16.
Recommends to the Director of Nursing deserving personnel for
promotion as well as demotion, and helps in the performance evaluation of
the nursing staff.
17.
Attends unit meetings and general nursing staff meetings
18.
Undertakes any other duties which may be required by the Director
of Nursing or Director of the Hospital.
19.
Supervision of Patient Care
Checks the Head Nurse plans for patient care and sees to it that they are
properly executed.
Keeps herself informed of patients needs and problems.
Serves as consultant and adviser to the Senior Nurse in developing,
devising and adopting work techniques and methods for the solution
of problems related to patient care.
20.
Personnel Management
Interprets standard operating and new procedures and policies, reviews
work performance of personnel to determine if it conforms to recognize
standards.
Plans the programs and work of all the nursing personnel of the unit.
Directs arrangements of schedule of work hours, off-duties, vacation
leaves, etc., of all nursing person assigned in the unit.
Evaluates work accomplished by each nursing employee in the ward.
6

* 2009
Benigno Aquino
Avenue, *
Prepares the plans for counseling of co-workers; this is done individually
especially to personnel with problems Example: Habitual absenteeism
and alcoholism
Renders harmonious relationships and self-discipline among nursing
personnel under her supervision.
Helps in providing an adequate and safe environment by guiding and
helping Head Nurses in providing and maintaining a safe, orderly and
clean environment for patient and personnel.
21.
Ensure in providing adequate supplies and equipment by:
Determining the needs for supplies and equipment based upon past
experience and future plans for programs of patient care;
Making proper representation to the administration of the needs of the
department;
Coordinating with the specially department (maintenance and property)
to meet the needs for supplies and equipment for the department.
EMERGENCY ROOM NURSE SUPERVISOR
1. Supervision of patient care
a. Check the Head Nurse schedule of operations.
b. Ensures that the care/assistance given to the patients and doctors are
executed properly and correctly.
Keeps self informed of patients and doctors needs and problems
Reinforces instructions given to patients and their families as
needed.
Verifies doctors order, requests and referrals to assure safe and
effective care.
Serves as consultant to the ER Head Nurse in developing, devising
and adopting work techniques and methods for the solutions to
the problems related to patient care.
2. Personnel Management
a. Interprets standards policies and procedures that governs operations of
the area.
b. Plans the programs and work of all the nursing personnel of the unit.
c. Directs the arrangements of the schedule of works hours off-duties,
vacation leaves, etc of all nursing personnel assigned in the ER.
d. Conducts the evaluation of the work performance of each nursing
personnel in the units.
e. Prepares the counseling sessions of the personnel especially with
personal or interpersonal problems.
6

* 2009
Benigno Aquino
Avenue, *
f. Provides a harmonious working relationships and self-discipline among
nursing personnel under his supervision.
3. Assists Head Nurse in providing and maintaining a safe, orderly and clean
environment for patient and personnel.
4. Ensures the provision of adequate supplies and equipment through:
a. Anticipating the supplies and equipment needed for patient care.
b. Communicates to the administration the needs of the unit.
c. Coordinates with other areas to meet the needs for supplies and
equipments of the area.
5. Takes responsibility for personal and professional growth
a. Strives towards higher level of educational attainment.
b. Attends seminars/conferences related to the profession.
c. Encourages staff attendance in professional meetings.
d. Devices programs to enhance staff expertise.
e. Joins the recognized and accredited organizations of the profession.
f. Participates in researches related to the profession
OPERATING ROOM NURSE SUPERVISOR
needed.
effective care.
Serves as consultant to the OR Head Nurse in developing, devising
and adopting work techniques and methods for the solutions to
the problems related to patient care.
the area.
vacation leaves, etc of all nursing personnel assigned in the OR.
6

* 2009
Benigno Aquino
Avenue, *
f. Participates in researches related to the profession.
DR/ NURSERY SUPERVISOR
a. Check the Head Nurse schedule of deliveries.
needed.
effective care.
Serves as consultant to the DR/Nursery Head Nurse in developing,
devising and adopting work techniques and methods for the
solutions to the problems related to patient care.
6

* 2009
Benigno Aquino
Avenue, *
a. Interprets standards policies and procedures that govern operations of
the area.
vacation leaves, etc of all nursing personnel assigned in the DR/Nursery.
6. Coordinator Newborn Screening
a. Follow-up results and informs parents for any abnormalities.
b. Request NBS filters.
c. Facilitate payments for NBS.
ICU NURSE SUPERVISOR
Keeps self informed of patients and doctors needs and problems.
6

* 2009
Benigno Aquino
Avenue, *

needed.
effective care.
Serves as consultant to the ICU Head Nurse in developing,
devising and adopting work techniques and methods for the
solutions to the problems related to patient care.
the area.
vacation leaves, etc of all nursing personnel assigned in the ICU.
JOB DESCRIPTION
Job Title: Head Nurse (Nurse II)
Job Summary:
6

* 2009
Benigno Aquino
Avenue, *
A registered nurse who is responsible for the organization, management,
Training needs
Basic Nursing Programs, Decentralized

Programs, Specialty Program
Leadership Training, Communication And
Critical Thinking,
Progressive Clinical Nursing Program
and implementation of a program of nursing care for each patient in a unit or a

special area. She is responsible for the unit on a 24-hour basis. The head nurse is
accountable to the supervisor.
Qualifications
a. A graduate of an accredited school of College of Nursing.
b. Currently a registered Nurse in the Philippines
c. Possess a degree of Bachelor of Science in Nursing with at least 18 units in
Master of Arts in Nursing.
d. Must have at least 2 years as staff nurse, 3 years as clinical managerial
position experience in a general service in which administrative ability has
been demonstrated.
e. Must be a member of accredited national organization for nurses.
f. Must have good leadership traits, as well as good interpersonal
relationship with co-workers.
g. Must have the ability to apply sound judgment and put to practice
principles of administration.
h. Must be mentally and physically fit.
i. Must have the ability to communicate effectively in oral and written form.
j. Must have above average knowledge and skills in her area of nursing
specialty as well as general nursing.
k. Must have BLS training in any institution in the country.
l. Must be a licensed IV therapy preceptor.
1. Manages and supervises all nursing care given to patients in the unit.
2. Guides, teaches and evaluates staff nurses, nursing attendants and
orderlies.
3. Makes regular rounds to all patients assessing and evaluating their case
as required.
4. Makes schedule of the nursing staff in the unit and submits it to the
supervisor and the Nursing Director for approval.
5. Assists with coordination of tasks between the medical, nursing staff,
patients and relatives.
6. Is fully conversant with policies, SOPs guidelines of the hospital and nursing
service.
6

* 2009
Benigno Aquino
Avenue, *
7. Applies knowledge of nursing principles and skills and exercises judgment
in the delegation of tasks to the members of the nursing team.
8. Acts as supervisor when designated.
9. Assists in the orientation of new personnel in the area.
10.
Collaborates with the other nurses to make certain that patient care
runs smoothly.
11.
Gives direct nursing care in certain situations as well as in the
absence of the staff nurse.
12.
Transcribes doctors orders in the patients record file and sees to it
that they are promptly carried out.
13.
Acts as a nursing consultant and counselor to her staff.
14.
Is responsible for requesting for and maintaining equipment and
supplies in the ward.
15.
Makes rounds with doctors whenever free from her managerial role.
16.
Undertakes the performance evaluation of her nursing staff every
month.
17.
Receives proper endorsement from outgoing staffs/ incoming staffs.
18.
Bedside rounds after endorsement and thereafter.
19.
Interacting with folks and patients by giving health advice and
concerns.
20.
Answer code calls.
21.
Answer / responds to calls of Resident/s or other personnel that the
staff cannot response soon.
22.
Reminds staffs/orderly of oxygen standby at beside to pull-out and
charge after.
23.
Counter check the completeness of patients charts.
24.
Monitor the Admission/ Discharge/ Absences patient/s at the unit.
25.
Check the completeness of discharge patient chart before forwarding
to Record Station.
26.
Reminds staff to start soon the availablemeds of patient/s especially
the anti-biotic drugs.
JOB DESCRIPTION
Job Title: Staff Nurse (Nurse I)
Job Summary
A registered nurse who assists the head nurse in planning, directing, and
coordinating the nursing care of the patients in a unit.Undertakes direct nursing
care to patients with the assistance of other members of the health team.
Qualifications
6

* 2009
Benigno Aquino
Avenue, *
Name
Academic
Qualification
Nurse A
Position:
Staff
Nurse
Registered
Nurse
Have 9 units in
Master of Arts in
Nursing Major in
Nursing Service
Administration
Nurse B
Position:
Staff
Nurse
Nurse C
Position:
Staff
Nurse
Registered
Nurse
Registered
Nurse
Work
experiences
2 years and 5
months staff
nurse
1 year and 5
months staff
nurse
1 year and 5
months staff
nurse
Trainings,
seminars and
workshops
attended
Training needs
Basic Nursing
Programs,
Decentralized
Programs,
Specialty Program,
Leadership
Training,
Communication
And Critical
Thinking,
Progressive Clinical
Nursing Program
Basic Nursing
Programs,
Decentralized
Programs,
Specialty Program,
Leadership
Training,
Communication
And Critical
Thinking,
Nursing Program
Basic Nursing
Programs,
Decentralized
Programs,
Specialty Program,
Leadership
Training,
Communication
And Critical
Thinking,
Nursing Program

1. Prepares, administers, and charts accurately medications and treatments
given to patients at the patients record file.
2. Plans and gives direct nursing care to patients and evaluates their care.
3. Encodes truthful information about the patients status on the patients
record file and on patients accounts.
4. Supervises nursing aides as they assists in the care of the patients.
5. Assists the head nurse in planning for the care of the patients.
6. Acts as charge nurse when designated.
7. Attends meetings and conferences.

* 2009
Benigno Aquino
Avenue, *
8. Is fully conversant with the hospital policies and regulations, SOPs and
keeps up-to-date with such matters.
9. Observes and ensures that nursing care is carried out in accordance with
Doctors instructions.
10.
Observes records and reports to head nurse and/or doctor the
patients conditions, reaction to drugs and treatment as well as other
significant incidents.
11.
Brings to the attention of the head nurse the shortage of supplies and
the existence of potentially hazardous or faulty equipment.
12.
Charts accurately nursing observations and changes in patients
condition.
13.
Regularly attends and actively participates in the in-service program
of the nursing department
14.
Prepares patient and equipment required; assists in the examination
of patients.
15.
Safeguards hospital equipment and ensures the economical use of
supplies.
16.
Applies knowledge of nursing principles and skills, exercises
judgment in the delegation of duties to the other members of the health
team.
17.
Gives health teachings to patient and family.
18.
Knows each patient in the ward his diagnosis, treatment, condition
and other social problems.
19.
Helps patients and their families with their problems by referrals,
advice or sympathetic listening.
20.
Assists the head nurse in evaluating the performance of other staff.
21.
Establishes and maintains good interpersonal and intradepartmental
relationships.
22.
Forwards to the billing section the oxygen meter readings and other
charges incurred by the patient.
23.
Sends charts of patients with discharge orders to the billing section
for assessment of the hospital bill.
24.
Forwards charts of discharged patients to the record section and after
having checked the chart as to its completeness and chart arrangements.
25.
Discharges patient.
26.
Performs post mortem care.
OPERATING ROOM STAFF NURSE

1. Nursing
6

* 2009
Benigno Aquino
Avenue, *
a. Prepares operating room for surgery.
b. Identifies and assess patients condition.
c. Assists and circulates in operations and procedures.
2. Reporting and recording
a. Writes the account of procedure, treatments and medications given to
the patient accurately.
b. Makes accurate report/record of the instruments, sponges and needles
used to the patient.
c. Accomplishes inventories of equipment, instruments and linen supplies.
d. Updates administrative and clinical records.
e. Accounts for all linens and gowns during her shift and endorses them to
the next shift.
3. Scrub nurse
a. Prepares instruments, supplies, equipment to be used in a particular
operation or procedure.
b. Prepares the drapes, opens the sterile packs and arranges them
accordingly.
c. Assists the surgeons during the operation from draping of the patient to
the handling of instruments and supplies and final care of the patient.
d. Maintains sterility of the instruments and supplies of the operative field.
e. Performs after care of the operating room and the instruments.
f. Collaborates with the circulating nurse in the accurate counting of
instruments, sponges and needles.
g. Preserves and labels specimen for laboratory examination and legal
purposes correctly.
4. Circulating nurse
a. Receives patient from ward room, takes vital signs, name of patient,
name of operation, intravenous fluid(s), medications administered and
doctors orders.
b. Prepares operative area by sterilization of the skin and draping.
c. Positions patient for the desired operation.
d. Observes the progress if surgery, providing additional instruments,
supplies and other items needed.
e. Performs accurate counting of instruments, sponges and needles before
the start of operation and before closure of incision.
f. Makes a complete assessment and care of the patients recovery.
g. Assist and collaborates with the anesthesiologist in providing medication
to the patient during the stay in the operating room.
5. Special procedure nurse
6

* 2009
Benigno Aquino
Avenue, *
a. Acts as a regular operating room nurse with similar responsibilities.
Furthermore, he/she is required to assist/scrub or circulate in special
procedure like laparoscopy or arthroscopy.
b. He/she is in charge with the safe keeping of instruments of special
procedures and can seek assistance from other OR nurses or OR
technician.
c. He/she is in charge with the after care of the laparoscopic instruments
and machines.
d. Make reports of any damage to laparoscopic hand instruments (this
includes trocars, fiber optic cables and scopes) or machine.
e. Responsible for completeness of supplies or needed materials before the
said operation.
RECOVERY ROOM STAFF NURSE
1. Make the following initial observations:
a. Time of arrival to the unit.
b. Responsiveness (to what the patient responds and how he/she responds)
c. Vital signs and other initial vital parameters as indicated in the
monitoring sheet.
Temperature
Pulse
Respiration
Blood pressure
CVP
MIOs etc
d. Skin
Color
Temperature (warmth or coolness)
Condition (dryness or moisture)
e. Dressing
Clean, dry and intact
f. Look and feel under patient to detect pooling of blood
g. Presence of an intravenous infusion
Type of solution
Amount left in the bottle
Drip rate
h. Presence of urinary bladder catheter
Clamped or unclamped
Connected to drainage bag or bottle
6

* 2009
Benigno Aquino
Avenue, *
Freely draining
Characteristics and amount of urine
i. Presence of other drainage tubes
Clamped or unclamped
Attach appropriately to bottle or suction
Tubes not kinked or under patient
Characteristics and amount of drainage
j. Safety and comfort
Presence of pain, nausea or vomiting
Position appropriately for surgical procedure
Side rails up, bed in low position and call light within reach
2. Check the chart for the following information (some of which may have
been included in the report from the OR nurse)
a. Surgical procedure or length of surgery
b. Postoperative diagnosis
c. Anesthetic agents or length of anesthesia
d. Estimated blood loss
e. Blood or fluid replacement given during surgery and RR stay
f. Type and location of drains
g. Vital signs when patient left RR (for use as baseline)
h. Medication administered in the RR:
Time
Type
Amount
Response of the patient
i. Output
Urine
Other drainage
Vomitus
j. Physicians orders
Frequency of vital signs
Diet
Activity
Intravenous orders
Medication (amount and frequency of pain and other medication
used)
Laboratory or respiratory therapy orders
Other specific to type of surgery and other problems of patients
NEONATAL ICU STAFF NURSE
6

* 2009
Benigno Aquino
Avenue, *
1. Patient care management
The staff nurse shall initiate and perform nursing care services to meet the
needs of born well and sick infants in NICU utilizing the nursing process.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
Directs patient care provided by support personnel for a specific shift.

Identifies changes in patients physiological condition.
Coordinates patients status to multidisciplinary team members.
Communicates directly with patients family about nursing care.
Provides clinical intervention to meet the patients needs.
Routine newborn care on admission
Cord dressing
Giving eye prophylaxis
Giving vitamin K and hepatitis B immunization to the newborn
Getting the anthropometric measurement such as the head,
chest, and abdominal circumferences, the birth weight and length
Taking the vital signs.
Monitoring the patients intake and output
Giving medications (IV, oral, IM)
Feeding the patients orally by cup/dropper and tube
(nasopharyngeal and oropharyngeal)
Suctioning when necessary
Turning the patient every two hours especially those on
phototherapy exposure with eye and gonadal shields
Initiating access (with IV therapy nurse)
Assess in the laboratory works (e.g. drawing blood for CRP and
ABGs)
Performs ambubagging/thumb bagging with mechanical ventilator
apparatus (CPAP)
Monitoring glucose level of the patient
Documents nursing process.
Assimilates information from multiple sources and implements
appropriate action plan to provide safe quality care.
Assures safety and security of the patients.
Conducts discharge planning with patients family.
Implements strict breastfeeding regulation through encouraging
mothers to breastfeed/room-in their babies.
Facilitate in taking newborn screening test.
2. Hospital and nursing service policies and regulation.

6

* 2009
Benigno Aquino
Avenue, *
a. Observe hospital and nursing service rules, regulations and policies.
3. Professional responsibilities
a. Takes initiative and responsibility for memberships in professional
organization and participates actively in their programs and activities.
b. Keeps self professionally update through continuing education.
c. Updates professional license.
EMERGENCY ROOM STAFF NURSE
1. Assess and Admits out or in patient.
2. Performs routine assessment such as vital signs (BP, PR, RR, Temp) and
fetal heartbeat (FHB).
3. Carry out physicians order.
4. Monitor Patients Progress.
5. Assist physician during internal examination, and other Procedure needed.
6. Assist/carry out laboratory works and other Diagnostic Tests.
7. Administer medications (per orem, sublingual, subcutaneous, IM and IV) as
ordered.
8. Perform proper documentation (e.g. nurses notes, intake and output, carry
out physicians order, etc)
9. Transfer out patient to their room of choice with doctors order.
10.
Endorsed properly to the ward/ ICU/ OR/ DR/ LR nurse.
TRAUMA CASES
1. Assist patient in position.
2. Perform preparation needed for procedure.
3. Assist the doctor in gowning.
4. Perform responsibilities of a circulating nurse such as providing materials
or equipment needed by the physician.
5. Assist the patient during procedure if with permission of the physician.
6. Documenting important information.
7. Administer medications (e.g. IM and IV) as ordered.
8. Performs assessment such as vital signs (BP, PR, RR, Temp) Assist patient
in transferring to the stretcher and bring to Room of choice.
1. Check uterus if well contracted and massage as needed.
2. Check episiotomy site and diaper for excessive blood discharges and refer
accordingly.
4. Transfer out patient to their room of choice with doctors order.
5. Endorsed properly to the ward nurse.
6

* 2009
Benigno Aquino
Avenue, *
DR/NURSERY STAFF NURSE
PREPARTUM
11.
Admits prepartum patients in the labor.
12.
Performs routine assessment such as vital signs (BP, PR, RR, Temp)
and fetal heartbeat (FHB).
13.
Carry out physicians order.
14.
Monitor progress of labor.
15.
Assist physician during internal examination, artificial rupture of
membrane, catheterization, IV insertion, induction of epidural anesthesia
16.
Do perineal shaving and flushing prior to delivery.
17.
Assist/carry out laboratory works (e.g. CBC, bloodtyping, HBsAg
screening, urinalysis, etc)
18.
Administer medications (per orem, sublingual, subcutaneous, IM and
IV) as ordered.
19.
Give health teachings regarding breastfeeding and room-in policy of
the hospital.
ANTEPARTUM
9. Assist patient in lithotomy position.
10.
Perform perineal preparation and perineal shaving if not yet done in
the labor room.
11.
Assist the doctor and midwife in gowning.
12.
Perform responsibilities of a circulating nurse such as providing
materials or equipment needed by the physician.
13.
Assist the patient during delivery such as coaching her to bear down
or doing fundal push if with permission of the physician.
14.
Documenting important information such as time of delivery, time of
placenta expulsion and time of episiotomy.
15.
Administer medications (e.g. IM and IV) as ordered.
16.
Check blood pressure right after the placenta was expelled
completely.
17.
Provide ice pack over hypogastrium and massage for a firm and well
contracted uterus.
18.
Clean the patients nipples for latching on the baby.
19.
Performs final perineal flushing.
20.
Provide diapers.
21.
Assist patient in supine position.
22.
Assist patient in transferring to the stretcher and bring to labor room
for postpartum monitoring.
POSTPARTUM
6

* 2009
Benigno Aquino
Avenue, *
6. Performs assessment such as vital signs (BP, PR, RR, Temp) usually every
15 minutes for two hours until stable or depending on the doctors order.
7. Check uterus if well contracted and massage as needed.
8. Check episiotomy site and diaper for excessive blood discharges and refer
accordingly.
10.
Transfer out patient to their room of choice with doctors order.
11.
Endorsed properly to the ward nurse.
ICU STAFF NURSE
1. Receives the written orders from the Emergency Room and/or Operating
Room and special instructions about patients care and caries them out
accurately.
2. Explain set-up, ICU care and post-operative care (monitoring, intubations,
lines, catheter, dressing and drains) and expected possible outcomes.
3. Evaluate, note, observe, ascertain specified documentation of patients
clinical manifestation including temperature, pulse, depth of respiration,
quality of breathing, blood pressure, state of consciousness, eye opening,
verbal response and ability to follow commands, essential to assess
whether the patients condition is improving, worsening or unchanged, and
report immediately any condition and deviation in the neurologic function.
4. Provide comfort and maintain safety. Providing the patient a quiet,
comfortable and planned periods of rest is possible.
5. When the patient is fully awake, encourage deep breathing exercises to
prevent pneumonia.
6. Facilitate frequent turning and repositioning as necessary to prevent
contractures, decubitus ulcers, urinary stasis, atelectasis, pneumonia, and
other pulmonary complications.
7. Maintain accurate intake and output record and be aware of the
significance of any alarming and peculiar signs and symptoms and report
at once.
8. Administer medication and carry out treatment and procedures and note
down the reactions.
9. Inspects dressing from time to time to detect signs of undue hemorrhage
of frank bleeding.
10.
Perform external cardiac massage (CPR) in case the patient goes on
cardiac or respiratory arrest and administer drugs as directed.
11.
Provide continued assessment of the patients level of
consciousness/responsiveness by maintaining a neurologic observation
record.
6

* 2009
Benigno Aquino
Avenue, *
12.
Observe, evaluate and carry out repeated clinical examinations to
determine hour-to-hour changes in patients status.
13.
Do hemodynamic monitoring for clinically ill patients like CVP
reading, ECG tracing and cardiac monitoring, etc.
14.
Frequently observe and evaluate the patient for any sign that may
indicate the onset of complications like evaluation in temperature, blood
pressure, swelling and bleeding.
15.
Explain to the folks and family the reason for hospitalization,
diagnostic test and other therapies to be administered.
16.
Give NGT feeding if the patient is unable to swallow and prevent
aspiration and ensure adequate respiratory ventilation.
17.
Go with the doctors rounds without fail to clarify and carry out
orders accurately.
18.
Attach any drainage apparatus when drainage is to be collected in
a bottle from cholecystectomy tube, indwelling catheters and chest
tubes.
19.
Give tracheostomy, colostomy care and change dressing if
necessary.
20.
Suction tracheostomy and endotracheal tube to remove secretions
that have accumulated in the tracheobronchial tree and do correct
back/chest tapping procedure.
21.
Assist the physician in endotracheal intubation and other related
ventilator procedures like administer oxygen, ambubagging, VR, T-piece.
22.
Check IV site for leakage and tissue infiltration and change
site/dressing if necessary.
23.
Provide adequate psychological support for the patient.
JOB DESCRIPTION
Job Title: Midwife
Job Summary
A certified midwife who provides basic patient care under direction of a
DR/Nursery head nurse. She also works closely with nurses and medical staff to
ensure that a patient is provided basic care on a daily basis. Perform duties,
such as feed, bathe, dress, groom, or move patients, or change linens.
Qualifications
a. A graduate of an accredited or certified midwifery schools.
b. Must have at least 2 years experience in general wards.
c. Physically and mentally healthy.
d. Neat and clean in appearance, with pleasing personality.
6

* 2009
Benigno Aquino
Avenue, *
e. Possessing thorough knowledge of nursing principles and procedure;
committed to quality care.
f. Able to work well with medical and paramedical personnel.
g. Possessing leadership skills and good communication skills.
h. Diligent, resourceful, and loyal; able to hold matters pertaining to
patients and co-workers personal affairs in strict confidentiality.
PREPARTUM
1. Monitor the progress of uterine contractions, its interval, duration and
frequency.
2. Assist the doctor and patient when performing internal examination.
3. Monitor patients vital signs.
4. Assist in normal spontaneous delivery.
5. Responsible for cleaning up the Delivery Room after delivery and making
sure the proper disposal of blood and placenta.
6. Change beddings at the labor room and dispersing soiled linens in the
delivery room and labor room to the laundry department.
7. Encoding all charges of the patient.
8. Follow up replacement from CSR and pharmacy (medicines, supplies used
by the patient).
ROUTINE RESPONSIBILITIES
1. Inventory of OB pack, baby care set, instruments, supplies and taking into
consideration its expiration date.
2. Packing of used instruments and sending them to the central sterile room
for autoclaving.
3. Check the availability of instruments at DR.
4. Refill respective canisters with gauze, cherries, cotton balls, and gloves.
5. Cleaning and mopping every shift if no attendant is on duty.
6. Inventory of linens in the delivery room.
7. Helps the nurses in taking care of babies in the nursery if there is no
prepartum.
8. Assist mothers while breastfeeding by giving more encouragement and
instruction on how to do proper positioning of baby and proper
techniques.
JOB DESCRIPTION
Job Title: Nursing Aide
Job Summary

* 2009
Benigno Aquino
Avenue, *
A certified nurse aide who provides basic patient care under direction of a
head nurse. A certified nurse aid also works closely with nurses and medical
staff to ensure that a patient is provided basic care on a daily basis. Perform
duties, such as feed, bathe, dress, groom, or move patients, or change linens.
Qualifications
Name
Health aid A
Position:
Nursing
Attendant
Health aid B
Position:
Nursing
Attendant
Health aid C
Position:
Nursing
Attendant
Academic
Qualification
Certified Nursing
Assistants
(CNAs)
Certified
Medication
Assistant (CMA)
Certified Nursing
Assistants
(CNAs)
Certified
Medication
Assistant (CMA)
Certified Nursing
Assistants
(CNAs)
Work
experiences
2 year
experience unit
assigned.
1 year
experience unit
assigned.
1 year
experience unit
assigned.
Trainings, seminars and

workshops attended
Basic Cardiac Life
Support- Healthcare
Provider (BCLS-HCP),
Basic computer
orientation and
simulation
Basic Cardiac Life
Support- Healthcare
Provider (BCLS-HCP)
Basic Cardiac Life

Support- Healthcare
Provider (BCLS-HCP)
Training needs
Interpersonal
Communication Skills
Program
Interpersonal
Program,
Basic Computer
orientation and
simulation
Interpersonal
Program
Basic Computer
orientation and
simulation

1. Turn and re-position bedridden patients, alone or with assistance, to
prevent bedsores.
2. Answer patients' call signals.
3. Feed patients who are unable to feed themselves.
4. Observe patients' conditions, measuring and recording food and liquid
intake and output and vital signs, and report changes to professional staff.
5. Provide patient care by supplying and emptying bed pans, applying
dressings and supervising exercise routines.
6. Provide patients with help walking, exercising, and moving in and out of
bed.

* 2009
Benigno Aquino
Avenue, *
7. Bathe, groom, shave, dress, and/or drape patients to prepare them for
surgery, treatment, or examination.
8. Collect specimens such as urine, feces, or sputum.
9. Prepare, serve, and collect food trays.
10.
Clean rooms and change linens.
11.
Transport patients to treatment units, using a wheelchair or
stretcher.
12.
Deliver messages, documents and specimens.
13.
Answer phones and direct visitors.
14.
Administer medications and treatments, such as catheterizations,
suppositories, irrigations, enemas, massages, and douches, as directed by
a physician or nurse.
15.
Restrain patients if necessary.
16.
Maintain inventory by storing, preparing, sterilizing, and issuing
supplies such as dressing packs and treatment trays.
17.
Explain medical instructions to patients and family members.
18.
Perform clerical duties such as processing documents and
scheduling appointments.
19.
Work as part of a medical team that examines and treats clinic
outpatients.
20.
Set up equipment such as oxygen tents, portable x-ray machines,
and overhead irrigation bottles.
21.
Collects urine and fecal specimen and takes them to the laboratory.
22.
Keeps an accurate record of patients intake and output.
23.
Answers call bells and relays messages
24.
Assists staff nurse in the care of the confused and unmanageable
patients.
25.
Gives, empties, and keeps clean bedpans, and urinals.
26.
Obtains necessary supplies and equipments from the Central Supply
and exercises responsibility over them
27.
Safeguards equipment of the unit and assists in their inventory.
28.
Performs simple nursing care and treatment for patients like enema,
skin prep, and sponge bath.
29.
Helps in maintaining order and cleanliness in the nurses station,
treatment and utility room
30.
Assists in post mortem care and transport of dead body to the
morgue
31.
Does janitorial duties when necessary.
JOB DESCRIPTION
Job Title: Orderly
6

* 2009
Benigno Aquino
Avenue, *
Job Summary
An auxiliary worker who works under the supervision of the head nurse
and the supervisor. He performs various cleaning and janitorial chores in areas
assigned to him.
Qualifications
a.
b.
c.
d.
e.
Completion of the high school course.

Ability to read, write, and interpret verbal or written instructions.
Physically and mentally fit.
Diligent, courteous, and trustworthy.
Able to adjust well to changes in areas of assignment.

1. Escorts newly admitted patients to the room or ward. Assist the patient to
his/her bed.
2. Transports patients from one area to another by wheelchair or stretcher.
3. Reports any defective equipment to head nurse or supervisor.
4. Furnishes patients with oxygen tank, gauge and regulator.
5. Records and charge oxygen consumed by the patient.
6. Ensures that the oxygen cylinder stock level is maintained in the ward at
all times.
7. Does janitorial job when necessary.
JOB DESCRIPTION
Job Title: Utility worker
Job Summary
An auxiliary worker who works under the supervision of the head nurse
and the supervisor. He performs various cleaning and janitorial chores in areas
assigned to him.
Qualifications
a.
b.
c.
d.
e.
Completion of the high school course.

Ability to read, write, and interpret verbal or written instructions.
Physically and mentally fit.
Diligent, courteous, and trustworthy.
Able to adjust well to changes in areas of assignment.
6

* 2009
Benigno Aquino
Avenue, *
1. Perform any combination of light and heavy cleaning duties to maintain
the hospital in a clean and orderly manner.
2. Does janitorial job.
3. Cleans and disinfect room, hallways, lobbies, lounges, restrooms,
corridors, elevators, stairways, locker room, and other work areas so that
health standards are met.
4. Empty trash and waste to disposal areas.
5. Segregate and dispose waste properly.
6. Reports any defective equipment to head nurse or supervisor.
STAFFING
(*Adopted from the Hospital Nursing Service Administration Manual of the
Department of Health)
This is a one hundred (100) bed capacity tertiary hospital. 30% of
patients need minimal care, 45% of patients need moderate care, 15% of
patients need intensive care, and 10% of patients need highly specialized care.
Percentage of Patients in Various Levels of Care
(100 Bed Capacity)
Type of Care
Percentage of
Patients (%)
Number of Patients
Minimal Care
30
105
Moderate Care
45
157.5
Intensive Care
15
52.5
Highly Specialized Care
10
35
STAFFING FORMULA

* 2009
Benigno Aquino
Avenue, *
Find the number of nursing personnel needed for 350 patients in Divine Mercy
Medical Center.
1. Categorize the patients according to levels of care needed.
100 x 0.30 = 30 patients needing minimal care
100 x 0.45 = 45 patients needing moderate care
100 x 0.15 = 15 patients needing intensive care
100 x 0.10 = 10 patients needing highly specialized care
2. Find the number of Nursing Care Hours (NCH) needed by patients at each
level of care per day
30
45
15
10
pts
pts
pts
pts
x 1.5 (NCH needed at Level I) = 45 NCH/day

x 3 (NCH needed at Level II) = 135 NCH/day
x 4.5 (NCH needed at Level III) = 67.5 NCH/day
x 6 (NCH needed at Level IV) = 60 NCH/day
TOTAL = 307.5 NCH/day
3. Find the total NCH needed by 100 patients per year.

307.5 NCH/day x 365 (days/year) = 112,237.5 NCH/year
4. Find the actual working hours rendered by each nursing personnel per year.
8 (hrs/day) x 213 (working days/year) = 1, 704 working hours/year
5. Find the total of nursing personnel needed.
a. Total NCH per year divided by the working hours per year
112,237.5 NCH/year 1, 704 working hours/year = 66 nursing
personnel
b. Relief x total nursing personnel
66 nursing personnel x 0.15 = 10 relievers
c. Total nursing personnel needed
66 nursing personnel + 10 relievers = 76 total nursing
personnel
6. Categorize to professional and non-professional personnel. Ratio of
professionals to non-professionals in a special tertiary hospital is 70:30.
266 total nursing personnel x 0.65 (percentage of RN) = 49
Registered Nurses
266 total nursing personnel x 0.35 (percentage of NA) = 27 Nursing
Attendants
7. Distribute by shifts. (The distribution usually followed is 45% for the morning
shift, 37% for the afternoon shift and 18% for the night shift.)
For Registered Nurses:
A.M. shift: 49 nurses x 0.45 = 22 nurses
6

* 2009
Benigno Aquino
Avenue, *
P.M. shift: 49 nurses x 0.37 = 18 nurses
NOC shift: 49 nurses x 0.18 = 9 nurses
TOTAL = 49 Registered Nurses
For Nursing Attendants:
A.M. shift: 27 nurses x 0.45 = 12 nursing attendants
P.M. shift: 27 nurses x 0.37= 10 nursing attendants
NOC shift: 27 nurses x 0.18 = 5 nursing attendants
TOTAL = 27 Nursing Attendants
This is the schedule of employees at the Divine Mercy Medical Center.
The hospital is composed of 49 nurses and 27 nursing attendants. Of the 49
nurses, 22 are tasked for the morning shift, 18 for the afternoon shift, and 9 for
the night shift. There are 27 nursing attendants to help the nurses. 12 are
assigned in the morning, 10 in the afternoon, and 5 during nighttime. This
staffing modality was adopted from the Hospital Nursing Service Administration
Manual of the Department of Health. We used the 8 nursing care hours (NCH)
per patient per day and a 65:35 professional to nonprofessional ratio that is
applicable in a tertiary hospital.
All of our staff nurses are registered nurses, thus they have all equal
chances of success in the different units of the medical center. We used the
decentralized type of scheduling which means that the head nurse of the unit
is responsible in making the schedule. The staff nurses are responsible for
choosing their off days also for their convenience. The schedule is good for only
30 days long and repeats thereon like a cycle.
In our 30 days or 1 month schedule, nurses and attendants report for
duty 5 days a week with the head nurse choice of shift. Only 2 days off are
allowed per week and these are distributed over a week where the unit has no
heavy needs. After 30 days, the schedule changes. Since not all of the staff
could have a change in their shift after 30 days, an open communication
between the head nurse and the subordinates is encouraged. Night shift nurses
should take a 2 days off before reporting for the morning shift after 30 days.
6

* 2009
Benigno Aquino
Avenue, *
The head nurse and other senior nurses are encouraged to take the morning
shift duty where the bulk of the units work is happening.
Morning shift has more number of nursing personnel because most of the
nursing procedures are done during this time. Since doctors rounds are also
happening more during afternoon shift, there are also enough nursing
personnel to man the unit. Night time is a shift to rest so the nursing personnel
are also decreased but more enough to cover the other needs of the critical
care patients. Furthermore, the unit assignment of the nursing personnel
between the different units is identified during the change of shift. It is during
this time where the number of mix personnel is distributed depending on the
number of patients admitted and the load of the work for that day and shift.
The Divine Mercy Medical Center also has 25 institutional workers (15
orderlies and 10 utilities) to aid in the physical operation and maintenance of
the units. Everyday 5 orderlies and 3 utilities report for duty per shift. They also
are given 2 off days per week and follow the same cyclical schedule as
identified for the nursing personnel.
STAFFING PERSONNEL COMPUTATION FOR OPERATING ROOM

TWO (2) OPERATING ROOM BEDS = 8 HOUR SHIFT
NURSE / PATIENT RATIO = 2 : 1
SHIFT
SCRUB
CIRCULATOR
6
TOTAL

* 2009
Benigno Aquino
Avenue, *
AM
PM
NOC
2
10
OFF DUTY STAFF = (10 X 110) / 262 = 4.19 ~ 4 Off-duty Nurse

Where 110 is constant
262 = 8hrs total working days/yr
TOTAL OPERATING ROOM PERSONNEL:
10 + 4 = 14
+ 1
+ 1
+ 4
20
TOTAL STAFF TO FUNCTION:
AM
PM
NOC
OFF
TOTAL
4
2
4
14
(Regular Staff)
(Endoscopy Nurse)
(Head Nurse)
(Relievers)
STAFFING PERSONNEL COMPUTATION FOR DELIVERY ROOM

TWO (2) DELIVERY ROOM = 8 HOUR SHIFT
SHIFT
ASSIST
BABY CARE
6
TOTAL

* 2009
Benigno Aquino
Avenue, *
AM
PM
NOC
2
10

10 + 4 = 14
+ 1
+ 4
AM
(Regular Staff)
PM
NOC
OFF
TOTAL
4
2
4
14
(Head Nurse)
(Relievers)
19
STAFFING PERSONNEL COMPUTATION FOR EMERGENCY ROOM

FIVE (7) EMERGENCY ROOM BEDS = 8 HOUR SHIFT
SHIFT
MEDICINE
SURGERY
OB/GYN
6
PEDIA
TOTAL

* 2009
Benigno Aquino
Avenue, *
AM
PM
NOC
3
10

10 + 4 = 14
+ 1
+ 4
19
AM
PM
NOC
OFF
TOTAL
3
3
4
14
(Regular Staff)
(Head Nurse)
(Relievers)
STAFFING PERSONNEL COMPUTATION FOR INTENSIVE CARE UNIT

SEVEN (7) BED = 8 HOUR SHIFT
2 MICU, 1CCU, 2 SICU, 2 PICU
SHIFT
ICU
CCU
SICU
6
PICU
TOTAL

* 2009
Benigno Aquino
Avenue, *
AM
PM
NOC
3
10

10 + 4 = 14
+ 1
+ 4
AM
(Regular Staff)
PM
NOC
OFF
TOTAL
3
3
4
14
(Head Nurse)
(Relievers)
19
NURSING SERVICE POLICIES

When does the institution hire employees?
When there is a need to cover the vacant jobs for the smooth-sailing
operation of the hospital and the different units. Usually a new employee is
selected or appointed within six (6) months after a certain vacant item has been
posted.
Documents to be submitted
Application letter addressed to the Chief Nurse

6

* 2009
Benigno Aquino
Avenue, *
Comprehensive resume with 1 pc. 2x2 ID picture with white background

Authenticated copy of college diploma
Authenticated copy of transcript of records
NBI Clearance
Police Clearance
Certificate of Passing/Board Certificate (from PRC)
Professional ID card (PRC licenses for all professionals)
Updated IV Therapy ID (for all nurses)
Updated PNA card (for all nurses)
Certification letter from the Dean
Certificates earned for the past 3 years which should include their latest
(current year):
o BLS Training Certificate (for all nurses)
o ACLS Certificate (for nurses) for special area
o Other training and seminar certificates
NURSING SERVICE POLICIES

A. Employment Policy
1. An applicant shall be required to write a letter of application which shall be
supported by a bio data, transcript of records, Diploma, Board Rating
result, and NBI Clearance. They also need to pass their latest IV Therapy,
Basic Computer Training, BLS and ACLS certificate (if any) and their PRC ID.
2. An initial interview shall be scheduled and conducted by the hospital
Selection and Promotions Committee which composes personnel from the
Human Resource Department and the Nursing Service Office.
3. The Hospital Selection and Promotions Committee shall rank the applicants
and shall make recommendations to the Nursing Service Director.
4. All new employees shall undergo a period of probation varying from one
month to a maximum of 5 months depending upon the discretion of the
Nursing Service Director.
5. All new employees shall undergo complete medical examination (CBC,
HBsAg, Chest x-ray, drug test, urine and stool exam). Physical examination
shall be done by the hospital resident physician.
6. Recommendations for promotion shall be made by the Nursing Service
Director whenever there is vacancy in the department and the applicant is
qualified for the position. Performance rating shall be submitted by the
immediate supervisors.
7. Appointments shall be signed by the Nursing Service Director with the
approval of the Hospital Director.
6

* 2009
Benigno Aquino
Avenue, *
B. Orientation
1. Orientation shall consist of briefing of the following:
a. Hospitals policies, history, services and facilities
b. Fringe benefits of employees
c. Different department chairpersons of the hospital.
d. Nursing service policies
2. A guided tour shall be conducted by the in-service coordinator or the
training supervisor, the Nursing Service Director, or her authorized
representative.
3. Orientation to the job specification shall last for 14 working days.
C. Uniforms for Employees
1. Nurses:
a A standard uniform will be used by nurses. It is provided by the hospital
for free. Each staff nurses will be given 2 pairs of rubber/duty shoes and
3 pairs of duty white uniform. For special areas, 3 pairs for each color of
scrub suits will be provided for each nurse. For the actual nurses
uniform. Please refer to Page 48.
a. Only uniforms that are provided by the hospital should be worn within
duty hours inside the hospital premises.
b. All female nurses are required to wear nurses caps within the hospital
premises except those assigned in special areas.
c. All nurses should have their school pin, hospital pin, and IDs for
identification purposes.
d. For men, hair shall not touch the scrubs collar.
e. For women, hair shall be short and secured with a hairnet in order not
to touch the collar.
f. Facial make up for women shall not be too heavy.
g. Only small inconspicuous pierced earrings shall be allowed for female
nurses assigned in the ward.
h. Only graduation and wedding rings shall be allowed. Those assigned in
the Operating Room shall not wear any jewelry.
i. Wrist watch with second hand should be worn.
j. Uniforms shall always be neat and clean.
2. Nursing Attendants
a. A standard uniform will be used by nursing attendants.It is provided by
the hospital for free. Each nursing attendant will be given 2 pairs of
white duty shoes, and 3 pairs of scrub suits.(For the actual nurses
uniform please refer to Page 50.)
b. Only uniforms that are provided by the hospital should be worn within
duty hours inside the hospital premises.
c. IDs should be worn at all times for identification purposes.
6

* 2009
Benigno Aquino
Avenue, *
d. Hair shall be short and secured with a hairnet in order not to touch the
collar.
e. No heavy make-up.
f. Only small inconspicuous pierced earrings shall be allowed.
k. Only graduation and wedding rings shall be allowed. Those assigned in
the Operating Room shall not wear any jewelry.
g. Wrist watch with second hand should be worn.
h. Uniforms shall always be neat and clean.
3. Utility Workers/Orderlies
a. Standard uniform for the utility workers will be provided by the hospital.
. It is provided by the hospital for free. Each nursing attendant will be
given 2 pairs of white duty shoes, and 3 pairs of scrub suits. (For the
actual nurses uniform please refer to Page 51.)
b. Hair shall not touch the scrubs collar.
c. IDs should be worn at all times for identification purposes.
NURSES UNIFORMS

* 2009
Benigno Aquino
Avenue, *
This is our nurses. Like all nurses,

they are wearing white tops and
white pants with white duty shoes.
This is the standard uniform of the
hospital.
(SPECIAL AREA) NURSES UNIFORMS

* 2009
Benigno Aquino
Avenue, *
These are the 3 different pairs of

scrub suits that staff nurses
assigned in special areas must
wear while on duty.
NURSING ATTENDANTS UNIFORMS

* 2009
Benigno Aquino
Avenue, *
This is the uniform of our nursing attendant.
UTILITY WORKERS UNIFORMS

* 2009
Benigno Aquino
Avenue, *
This is the uniform of our utility workers and orderlies.
D. Communications
1. The NSO encourages a two way flow of communication, from the NSO to
personnel and personnel to NSO.
2. Communications shall be done through proper channeling.
3. All requisitions shall be done by heads of the units for supplies, equipment,
etc., and shall be submitted to the NSO for endorsement to the
administrative officer.
4. Request for job orders shall be accomplished by the head nurse and shall
be countersigned by the chief nurse or by the supervisor on duty.
E. Vacation Leave
1. Vacation leaves shall be approved by the nursing director taking into
consideration hospital operation and the desire of the employees.
2. Application for vacation leave shall be submitted to the NSO fourteen (14)
days before effective date of leave to give allowance for NSO to look for
relievers. (The application shall be approved by administration prior to
scheduled date).
3. Regular employees are entitled to 15 days vacation leave with pay for
every year of continuous service. Vacation leave may be availed of for
other purposes as sick leave or maternity leave provided prior approval has
been secured from the nursing director.
6

* 2009
Benigno Aquino
Avenue, *
4. All personnel on vacation leave are expected to check with their head nurse
their respective schedule of duty, the day before returning to duty.
5. All employees have a compulsory 5 day vacation leave per year.
F.
Sick Leave
1. Regular employees shall be entitled to 15 working days of sick leave with
pay for every year of continuous service.
2. Sick leaves shall be granted only in cases of illness or injury.
3. Employees who are sick and unable to report for duty shall notify the NSO
or Nurse Supervisor according to the following:
A.M. Shift notify the NSO at 6 pm the night before
P.M. shift notify the NSO on or before 8:00 am of the day of duty
Night shift notify the NSO on or before 4:00 pm of the day of duty
Failure to do so at the specified time shall be considered unauthorized
absence.
If ever sickness occurs after the above specified times, the personnel is
expected to come to the hospital for consultation.
4. All sick leave exceeding 3 days shall be supported by a medical certificate.
Consultation must be done in the hospital. Failure to submit such certificate
means absence without pay.
5. All sick leaves which are unused are convertible to cash.
G. Maternity Leave
1. a. Regular employees who have rendered two or more years of continuous
service shall be entitled to 60 days with full pay.
2. Regular employees who have rendered less than two years of continuous
service shall be entitled to 60 days with half pay.
H. Absences
1. Three unauthorized absences are considered first offense on the part of the
employees. Disciplinary measures for unauthorized absence shall be taken
according to the following procedures:
First offense verbal admonition by the nurse supervisor or nursing
director
Second Offense written warning from the NSO
Third Offense recommendation to Disciplinary Board for appropriate
action
2. Three consecutive absences without notice will be considered Absence
Without Official Leave (AWOL).
I. Tardiness
6

* 2009
Benigno Aquino
Avenue, *
1. All employees shall be considered tardy if he arrives at his place of work
after the expected time regardless of the number of minutes.
2. Any employee shall be considered habitually tardy if he incurs tardiness,
regardless of the number of minutes, the (10) times a month for at least
two (2) months in a 6 month-period or at least two (2) consecutive months
during the year.
3. If the employee has been tardy 10tines for at least two (2) months in a 6
month-period or at least two (2) consecutive months during the year, a
recommendation to the Disciplinary Board for appropriate action will be
submitted by the supervisor or nursing director.
J. Performance Evaluation
1. Performance evaluation of all nursing service personnel shall be made
every four months and shall be collated and summarized. Evaluation is
done every April, August and December.
K. Incident Reports
1. An incident report shall be made upon the requirement of the headnurse,
supervisor or NSO on all incidents that may adversely affect the
organization especially in rendering nursing care to patients.
2. Written incident report shall be submitted not later than 24 hours after the
incident.
3. The head nurse must be notified immediately of all incident reports. Written
reports shall be submitted to the Director of Nursing.
4. The deliberation of the incident reports are in front of the Disciplinary Board
for appropriate action.
L. Request for Transfer of Personnel from One Nursing Unit to Another
The following are pre-conditions for transfer:
1. The employee who desires to transfer shall write an application to the NSO
for transfer.
2. A vacancy or new position should exist in the department to which he
desires to transfer.
3. He must be qualified for the job to which he desires to transfer.
M. Staffing Pattern
1. Since the hospital operates on a 24 hour basis, the Nursing Service
department provides staffing pattern in a 3-shift rotational plan:
A.M. Shift
7:00a.m. 3:00p.m.
P.M. Shift
Night Shift
3:00p.m. 11:00p.m. 11:00p.m. 7:00a.m.

* 2009
Benigno Aquino
Avenue, *
All personnel are required to report to their respective area 15 minutes
before the time, to receive endorsements.
2. All personnel on full time status shall be required to work on different
shifts.
3. The NSO reserves the right to change schedules made to accommodate
hospital needs as well as needs of the personnel.
4. Such personnel shall have at least 8 hours and preferably 12 hours
between the time of completing one shift and beginning the next shift
except in cases of emergency.
5. Rotation schedule made by headnurses shall be submitted to the NSO 2
weeks prior to scheduled effective date and will be posted 5 days before.
6. A block system of scheduling shall be followed for nurses and nursing
attendant. Utility workers shall be divided into 3 groups to cover 3 shifts.
7. The NSO reserves the right to transfer personnel from one assigned unit to
another when the demand for nursing service is great.
8. Since we are committed to patient service, all personnel shall be requested
to render service needed.
N. Exchange of Duties
1. All requests for exchange of duties shall be submitted to the supervisor the
chief nurse for approval before their scheduled duty with the conforme
signed by the reliever.
2. The one who makes the request shall be responsible for submitting the
request to the supervisor or to the chief nurse for approval.
3. Anybody who shall go on duty in place of another without the approval of
the nursing service will be marked absent and shall be subject to
disciplinary action.
STANDARD OPERATING PROCEDURE

I.
SCHEDULE
All Nursing Departments shall be manned by nurses for 24 hours. Duty
hours shall be 8 hours per shift.
Staff Nurses and Head Nurse
A.M. Shift
7:00a.m. 3:00p.m.
P.M. Shift
Night Shift
3:00p.m. 11:00p.m. 11:00p.m. 7:00a.m.

Supervisors
A.M. Shift
7:00a.m. 3:00p.m.
P.M. Shift
Night Shift
3:00p.m. 11:00p.m. 11:00p.m. 7:00a.m.

6

* 2009
Benigno Aquino
Avenue, *
II.
ENDORSEMENT
A. The outgoing nurses shall endorse to the incoming nurses.
B. Endorsement shall be done at the beginning of each shift. All charts
shall be accounted before endorsement.
C. The outgoing nurses shall endorse to the incoming nurses.
D. Endorsement shall be done at the beginning of each shift. All charts
shall be accounted before endorsement.
E. Endorsement shall include:
1. Total census
2. Name/room of patient and other pertinent patients information
3. Number of admissions
4. Number of discharges
5. Seriously ill patients
6. Pre operative patients
7. Procedures to be done
a.
Pre operative
b.
Surgical
c.
Laboratory
d.
X-ray
8. Medications due for the next shift (this will include the last time PRN
mediation was given)
9. Doctors order to be carried out
10.
Equipment which belong to the ward
F. Endorsement of Nursing Aides shall include procedures still to be done,
status of stocks, supplies, equipments and forms, patients with special
attention needed, intake and output monitoring.
G. Endorsement (orderly and utility) rooms for disinfections, patients for
transport, set-up traction, oxygen tanks on standby.
III.
CHARTING
A. Traditional charting shall be done by the nurse on duty on the computer
on each of the patients record file and must be signed using biometrics
wherein she will just put her right thumb at the pad connected to the
computer. After which, her name will appear on the computer with her
signature after her nurses notes. The charting will then be grayed out
after the signature has appeared and thus, it cannot be edited
anymore.
B. Charting shall include:
1. Date and time patient was received from the previous shift which is
automatically generated after the outgoing nurse has signed her
charting.
2. Condition of the patient whether:
6

* 2009
Benigno Aquino
Avenue, *
a. On respirator
b. With CVP
c. With indwelling catheter
d. With cystoclysis
e. On continuous low pressure suction
f. With endotracheal tube attached to oxygen catheter
g. With tracheostomy
h. With continuous oxygen therapy via prongs / catheter
3. IV infusing, amount, rate and IV site
4. Type of diet and whether the diet was tolerated or not by patient
5.
6.
7.
8.
a. NPO
b. Full
c. Soft
d. Liquid
e. Special Diet
f. Osteorized Tube Feeding (OTF)
Procedures done during nurses tour of duty.
End of shift summary of patients condition
The word endorsed and the nurses signature shall appear after
each nurses notes.
All charting should be in black ink.
a.
b.
c.
d.
IV.
V.
VITAL SIGNS
A. Vital signs shall be taken by the nurse on duty
B. Vital signs, Neuro Vital Signs shall be recorded and graphed at the
patients record file. Recording must be done by the nurse.
C. The nurse shall chart the fluid intake and output on the patients
record file.
e.
MEDICATIONS
A. Hospital Standard Timing for Medication:
f.
ORDER
g.
h.
Once a day / OD or
QD
j.
Two times a day /
BID
l.
Three times a day /
TID
n.
Four times a day / o.
QID
p.
Every other day /
STANDARD TIME
i.
8:00am
k.
8:00am 6:00pm
m.
8:00am 1:00pm 6:00pm

8:00am 12:00nn 4:00pm
8:00pm
QOD
r.
Before meals / AC
t.
After meals / PC
v.
Every 4 hours
x.
Every 6 hours
q.
8:00am
s.
u.
w.
30 minutes before meals

30 minutes before meals
Every 4 hours from the initial
dose
y.
62
z.
Every 8 hours
ab.
Every 12 hours
dose
aa. Every 8 hours from the initial
dose
ac.
dose
ad. At bedtime / HS
ae. 8:00pm
af. Color Code of Medication Card:
ag.
White
Oral medications
ah.
Green
IV medications
ai.
Yellow
therapeutics
aj.
Pink blood transfusion/blood products
ak.
Blue
special endorsement
al.
B. Preparation and Administration
1. The hospital enforces a close pharmacy policy to ensure that the
drugs given to the patients are of quality and genuine.
2. The medications are prepared by the pharmacist after the order
has been relayed to them by the nurses through the centralized
computer system. The pharmacist will then put a bar code to
drugs prepared specific for the patient. The medications are then
sent to the nurses station through pneumatic tube. It will be
stores at the area intended for storage of the medications near the
station.
3. Administration of drugs follows a series of steps to ensure that no
medication errors will occur. Before giving the drug, it will then be
scanned through a censor at the patients bracelet to ensure that
the drug is really intended for the patient. An alarm sound will be
produced and a message will be flashed on the screen NOT
COMPATIBLE by the bracelet if the drug is not for the patient. If
the drug is really for the patient, a sound will be produced and the
message COMPATIBLE will be displayed.
4. After the drug has been given. It will automatically appear on the
patients record file and the nurse just need to scan her right
thumb mark again to sign the administration of the drug.
am.
C. Night duty nurses shall issue prescriptions for medicines to cover
medication for 24 hours. It will then be scanned and the pharmacist
will just send all the medications to the station through the
pneumatic tube.
D. The nurse shall request for supplies when needed. These supplies are
for free of charge. It is included already in their accommodation fees.
an.
VI.
LINEN
62
A. The nurse attendant shall request for and return linen to the Linen
Department.
1. Linen shall be provided to all patients.
2. Nurse Attendant shall do the bed making.
ao.
VII.
LABORATORY
A. All laboratories are just charged to the patients account. The order of
the doctor for the laboratory tests or diagnostics is encoded by the
doctor in the patients record file and then relayed by the nurse to the
concerned department through the centralized computer system. It
will then appear on the computer of the department that will do the
procedure.
B. After the information is received by the laboratory, the personnel will
be the one to go to the patients suite and get the specimen.
C. Blood requests follow the same procedure. It is charged to the
patients account and the hospital will be the one to look for the
compatible blood in our own blood bank and then will do all the tests
before certifying that the blood is now ready for transfusion.
D. Once there is already the order to transfuse the blood and the
baseline vital signs is taken, the nurse will then get the blood in the
laboratory where the tests has been done and then bring the blood to
the unit and ready the blood for transfusion.
VIII. X-RAY / ULTRASOUND
A. Upon the physicians order for an x-ray procedure, the nurse shall
then sends the information to the department and then schedule the
patient for the procedure. After confirmation of schedule and time,
the patient will then be wheeled to that department by the orderly at
the time scheduled.
B. The patient shall be properly informed and instructed about the
preparation required for the procedure. For example NPO post midnight, drinking 6-8 glasses of water and holding the sensation to void
before ultrasound procedure, clamping of Foley catheter prior to
ultrasound.
IX. PULMONARY CENTER
A. Upon the physicians order for ABG, Incentive Spirometry, Peak Flow,
T-Piece, the nurse on duty relays the order to the Pulmonary Center
through the central computer system. The pulmonary technician will
be responsible for procedure charging on the patients account. On
the scheduled time, they will go to the patients suite and do the
procedure.
X.
CARDIOVASCULAR CENTER
A. Upon the physicians order for 2D Echo, the nurse on duty relays the
order to the Cardiovascular Center through the central computer
system. The cardio technician will be responsible for procedure
62
XI.
XII.
charging on the patients account. On the scheduled time, they will

go to the patients suite and do the procedure.
OXYGEN
A. Full oxygen tanks shall be taken by the orderly from the Central
Supply upon request of the nurse. The Central Supply personnel are
then responsible for charging the oxygen for the patient upon the
report of the orderly as to the total number of lbs. consumed by the
patient.
ap.
DIETARY
A. Diet shall be served by the Dietary personnel between:
aq.
ar.
at.
MEAL
as.
Breakfast
av.
Lunch
ax.
Supper
au.
aw.
ay.
TIME SERVED
7:00am 8:00am
11:30am 12:30pm
4:00pm 5:00pm
B. The diet list of the patient is also encoded in the central computer
system by the night duty nurse. This will reflect the following data:
1. Name of Patient
2. Age of Patient
3. Room/Ward
4. Diet Specification
5. Attending Physician
6. Signature of nurse on duty who filled out the diet list (done through
the use of biometrics)
7. Isolation patients should be indicated by red colored texts.
az.
C. In cases that patient is admitted after the diet lists have been encoded
but before the meal trays are served, the nurse duty shall encode the
information in the central computer system and at the same time call
the dietary department for the recent admission.
D. Change of diet after the diet list have encoded maybe done through
calling the dietary department about such change.
E. Tube feeding shall be endorsed by Dietary personnel to the nurse on
duty at 9:00am and 4:00pm.
1. The nurse on duty shall check the contents and volume of the tube
feeding endorsed.
2. The Dietary department shall not be responsible for any spoilage
after the endorsement.
ba.
XIII. PRE-OPERATIVE PROCEDURES
62
A. The staff nurses shall inform the operating room of the schedule (for
booking) and will fill up the Request for Operation Form indicating
whether the patient is for cardiac monitoring. Surgery for approval
shall be sent to OR together with the request form.
B. The senior nurse shall approve and sign for STAT operations after office
hours.
C. The staff nurse shall accomplish the pre-operative checklist.
D. The staff nurse shall prepare the consent for operation and give it to
the surgeon who will explain the procedure. The surgeon will then have
the patient, folks, or immediate family members sign the consent.
Consent for operation shall be updated on the day of the scheduled
OR.
E. The nursing attendant shall prepare or shave the operative site (with
written order from the physician) and shall give the patient bath before
sending the patient to the Operating Room.
F. The staff nurse shall endorse the patient to the Operating Room 30
minutes before the scheduled time.
bb.
bc.
***For on call operations, the OR NOD shall inform the staff NOD
when to give the pre-op, medications and when to bring the patient to OR.
XIV. REFERRALS
A. Referrals shall be done thru proper channeling.
1. The nurse shall refer to the resident in charge.
2. The resident in charge shall refer to the consultant.
B. The nurse may refer directly to the attending physician in case the
junior consultant is not available.
bd.
XV.
ORDER SHEET
A. The consultants and residents are the only people who can encode on
the physician order sheet. Before they encode their order, they are
required to enter their license number and their name for identification
purpose. Only when these information are accurately filled out will they
be allowed to encode their orders on the patients record file.
B. No telephone orders are allowed. Everything needs to be encoded.
C. A verbal order during physicians rounds and emergency situations
needs to be encoded in the file within 2 hours after they were made.
D. The staff nurse has the duty to verify with the doctor in cases of
doubtful or erroneous orders.
be.
XVI. INTERPRETATION OF SKIN TEST
A. Skin test shall be performed by the staff nurse on duty.
B. Skin test needs to be interpreted 30 minutes after the procedure
regardless of time, night or day.
C. Skin test shall be interpreted by resident physician.
62
D. A repeat skin test with control shall be ordered by the doctor if the first
skin test is doubtful.
bf.
XVII. ADMISSION OF PATIENT IN THE CCC
A. The staff nurse and the nursing attendant shall prepare the patients
suite for the new admission and check the following:
1. Patients bed with fresh clean linen
2. Bedside table with pitcher and drinking glass
3. Bedpan and urinal
4. Light
5. IV stand
6. O2 tank with gauge
7. cardiac monitor
8. Sofa chairs
9. Suction machine
B. The staff nurse shall receive the patient from ER and shall accompany
him/her to their suite.
C. The nurse shall evaluate the patients physical and mental status.
D. The nurse shall receive endorsement from the ER nurse. Endorsement
shall include:
1. Name, age, status
2. Chief complaints, vital signs, weight
3. Attending physician
4. Medication and treatment indicate whether stat meds were given
or initial doses were started.
5. IV fluids
6. Oxygen
7. Special endorsement like special procedures to be done.
E. The nurse shall check for the patency of the following contraptions, if
there is any.
62

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
F.
G.
H.
XVIII.
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
1. IVF
2. NGT
3. Oxygen inhalation
4. Catheters
The nurse shall retrieve the doctors orders and encoding them in the central
computer system. The nurse must relay pertinent information for specific
departments concerned.
The nurse shall record in the nurses notes:
1. Time the patient was received which is automatically generated after the
nurse from the ER signed her nurses notes.
2. The condition of patient.
3. How the patient was transported.
4. Contraptions attached to the patient.
The staff nurse shall inform the members of the unit especially the resident on
duty of the admission.
5.
DISCHARGE OF PATIENT
The consultant first needs to make his discharge orders and may go home
instructions. The doctor is then required by the computer to enter his professional
fee before he can check the may go home and for discharge tag on the screen.
The staff nurse shall carry out the order for the discharge of patient.
The staff nurse then encodes this information in the central computer system.
The nurse is also tasked to encode the professional fee as indicated on the file.
Upon receiving the information, personnel in the business office will sum up all
the charges of patients hospitalization. He is also task to prepare the hard copy
of the detailed charges in the clients account.
Thirty minutes after the information is encoded, the patients folks may now
settle the bill at the business office.
The nursing attendant shall issue a linen clearance duly noted by the staff nurse
to the patient when all the linens are accounted.
The nurse shall give the patient his going home instructions and home
medications prescribed by the physician.
The nurse shall check the central computer system if the bill has been settled
and if the client has the linen clearance already.
The nurse shall sign the discharge slip and instruct the patient to give the
discharge slip to the guard on duty.
The nurse shall request the orderly to transport the patient from his suite to the
front exit of the hospital and assist the patient until the patient gets into his car.
The nurse, if available, may accompany the patient.
The nurse shall indicate on the patients file discharged in the nurses notes. It
should be indicated whether the patient went home:
1. Ambulatory
2. Per wheelchair
3. Per stretcher
MAN: NURSING SERVICE ADMINISTRATION

73

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
M. The nurse shall sign the accomplished discharge checklist on the patients record
file. The file should be tagged as discharged and this will be counterchecked
and countersigned by the head nurse during her duty hours. After the head nurse
had signed the document, it will then be forwarded to the medical records
department.
6.
XIX. TRANSFER OF PATIENTS
A. Transfer of Consultants Service
1. If the patient or relative expresses the desire to change consultant, the nurse
shall notify the resident on duty.
2. The nurse shall confer with the patient and his relative, the reason for transfer.
3. The resident shall inform the consultant of the request for transfer.
4. The nurse shall request for the consultants bill and shall inform the billing
clerk.
5. The resident shall inform the new consultant of his new patient.
6. The resident shall indicate on the Physician order sheet Transfer of service of
(name of consultant).
7.
B. Transfer to Another Hospital
1. The attending physician shall order for transfer of patient to another hospital
in the physician order page.
2. The doctor is then required by the computer to enter his professional fee
before he can countersign the transfer to another hospital order.
3. The staff nurse shall carry out the order for transfer of hospital.
4. The staff nurse then encodes this information in the central computer system.
5. Upon receiving the information, personnel in the business office will sum up all
the charges of patients hospitalization. He is also task to prepare the hard
copy of the detailed charges in the clients account.
6. Thirty minutes after the information is encoded, the patients folks may now
7. The nursing attendant shall issue a linen clearance duly noted by the staff
nurse to the patient when all the linens are accounted.
8. The nurse shall check the central computer system if the bill has been settled
9. The patient shall be conducted by a resident physician with an accomplished
referral slip.
10.
The nurse shall request the orderly to transport the patient from his
suite to the front exit of the hospital and assist the patient until the patient
gets into the hospitals ambulance car.
11.
The nurse shall document the transfer in her nurses notes:
a. Time of transfer
b. Condition of patient
c. Accompanied by resident physician
74

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
XX.
d. Name of hospital the patient was transferred to.

12.
The nurse needs to sign the nurses notes and have the head nurse
counter sign it during her duty hours before forwarding the file to medical
records department.
8.
GOING HOME AGAINST MEDICAL ADVICE
A. The Going Home Against Medical Advice order shall made by the attending
physician with their professional fee.
B. The nurse shall accomplish the Leaving Hospital Against Medical Advice form and
shall request the patient/folks to sign in the prescribed page using biometrics
which will encode the patients signature or folks signature.
C. The staff nurse then encodes this information in the central computer system.
D. Upon receiving the information, personnel in the business office will sum up all
the charges of patients hospitalization. He is also task to prepare the hard copy
of the detailed charges in the clients account.
E. Thirty minutes after the information is encoded, the patients folks may now
F. The nursing attendant shall issue a linen clearance duly noted by the staff nurse
to the patient when all the linens are accounted.
G. The nurse shall check the central computer system if the bill has been settled
H. The nurse shall instruct the patient regarding home medications.
I. The nurse shall indicate discharge against medical advice in the nurses notes
as her closing entry.
9.
XXI. PROCEDURE IN CASE OF DEATH

A. The attending physician/resident shall pronounce the patient dead.
B. After the pronouncement of death, the nurse shall:
1. Assist the relatives with their spiritual, emotional, and physical needs.
2. Request the nursing aide to do post mortem care.
3. Credit memo all supplies and medicines not used.
4. Encodes the charges for:
a. Oxygen
b. Emergency Stock Replacement
c. Rent of equipment used
5. Request the consultant to sign the death certificate. If the doctor is not
available, the nurse shall forward the death certificate to the medical records
department together with the patients record file.
6. Encodes charges on the patients account. If the business office is closed, the
nurse shall instruct the folks to return during office hours.
7. Contact the funeral parlor preferred by folks when requested.
8. Request orderly to transport the body to the morgue.
75

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
9. Record in the nurses notes the tie the patient expired, post mortem
procedure, and the time the body was brought to the morgue.
10.
XXII. REQUISITION OF SUPPLIES FOR UNIT USE
A. Hospital forms except death, birth and medical certificates shall be requested
from Central Supply.
B. Cotton balls, isopropyl alcohol 70%, anti-bacterial liquid soap, and some sterile
supplies such as dressing materials shall be requested form the Central Supply.
C. Office Supplies used in the unit shall be requested from the supply room every
week. Request for supplies shall be submitted to the supply room on Tuesday
and shall be available on Wednesday.
D. Housekeeping supplies shall be requested by the Nursing Service Office from the
Supply Officer every week. Theutility shall request housekeeping supplies for
unit use from the NSO.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.

24.
25.
26.
27.
28.
29.
30.
31.

76

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
32.
33.
34.
35.
36.
37.
38.
We create a friendly, welcoming atmosphere for our clients,
significant others and as well as our new employees staff, offering
structured working schedules. The Divine Mercy Medical Centerhas a
busy and challenging hospital care environment with a rapid
throughput of patients.
39.
40.
41.
42.
43.
PHILOSOPHY OF CARE
44.
45.
Each individual is a
holistic beingwith
physiological, cognitive,
psychological, and
spiritual needs. The family
considered to be part of
health, healing, and
flexible visiting hours for
care delivery system used is
pathways for specific patient
system
is
our realm of care and integral to the
recovery of the patient. We offer
our families and visitors. The nursing
primary nursing utilizing critical
populations.

77

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
Patients and Families First. We support this
philosophy by providing compassionate care. We pride
ourselves in ongoing patient education, making sure that
our patients and families understand their plan of care and
participate in that plan as much as possible. This
improves the patient and family outcomes
and eases anxiety at the time of
discharge.
46.
47.
48.
49.
50.
51.
NURSES STATIONS
52.
54.
53.
Medical Intensive Care
Unit Nurses Station
55.
56.
57.
58.
Surgical Intensive Care
Unit Nurses Station
59.
60.

78

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
61.
62.
63.
64.
Wards Nurses
Station
65.
66.
67.
68.
These are the nurses station of the Divine Mercy Medical Center.
Each of these stations faces their area of responsibilities. New technology was
incorporated into the design to offer the latest in patient monitoring and care.
Routinely the ratio is one nurse to one patient, however if the dependency allows
one nurse may look after two patients.
69.
For patients with life threatening conditions, the Divine
Mercy Medical Center offers a high ratio of staffing in a setting that

features a variety of modern monitoring and treatment equipment,
close at hand. Both nursing and physician care are provided 24 hours
a day.
70.
MEDICAL INTENSIVE CARE UNIT

79

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
71.
The
72.
Medical
Intensive
Care
Unit (MICU) is a adult critical care
73.
unit providing comprehensive care
74.
for critically ill medical patients with
75.
a vast variety of diagnoses. The
76.
MICU has a well-trained team of

intensivists
77.
(staff
nurses)
and
physicians to provide expert care to
78.
patients with medical problems. The
79.
MICU performs intense monitoring of
80.
patients and provides care for those

requiring high-frequency ventilation
81.
and continuous renal replacement
82.
therapy.
83.
The MICU also works with the
84.
rapid response team (RRT), providing
85.
a nurse to assist with diagnosis and
86.
treatment of patients that are not

currently
87.
in
critical
care
environment.
88.
As teaching and research are
89.
highly valued within Divine Mercy
90.
Medical
91.
SURGICAL
INTENSIVE CARE
Center, special
rounds are done on a weekly basis.

The multidisciplinary team shares
UNIT
92.
80
teaching

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
93.
The SICU is a fast-paced, high94.
acuity, multi-specialty unit. Our most
95.
common
patient
population
includes
96.
patients
97.
procedures: major vascular and peripheral
undergoing
the
following
surgery, AFBs, renal revascularization, GI
98.
surgical
99.
surgical
100.
care
procedures,
procedures
monitoring,
and
oncological
requiring
intensive
liver/pancreas/renal
101. ECMO, and CRRT.

transplant surgery,
The Cardiovascular Intensive Care
102.
In the SICU, patients benefit from the
Unit (CICU) provides care to patients with a
coordination of
multi-specialty103.medical
variety of illnesses and other critical
care that is commonly delivered
by
104.
medical issues.
specialty teams to critically ill patient.
All
105.
thespecialized
services and professionals necessary to
The nursing staff receives
106.
treat
a withpatient
in
trauma
are
training in the care of patients
107.
brought
with the common mission
arrhythmias, chest pain, heart
failure,together
and
108. residents
of providing
excellent care to the
other critical medical conditions.
They
ofTraining
Iloilo City.
should have Basic Life Support
and
an ACLS licensed nurse.
Providing
109.
exemplary
110.
collaborative
care
for critically ill patients,111.
conducting
They use state-of-the-art
technology
of cutting-edge
the patient research related
112.to critical
care, providing
population.
New
technology
was evidence-based education,
113.
and
training
tomorrow's leaders in the field
incorporated into the design to offer the
to
meet
the
needs
114.
CARDIOVASCULAR INTENSIVE CARE UNIT
latest in patient monitoring and care. Plans
of care are discussed during patient rounds 115.

and reviewed by the interdisciplinary team 116.
daily in order to provide the most
comprehensive services to patients.
81

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
117.
118.
119.
120.
121.
122.
123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
SUITE ROOMS
138. The hospital contains an increasing variety and complexity of

technical equipment and can be quite noisy and active, especially in emergency
situations. Since patients are very sensitive to noise disturbance (especially

82

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
patients), the design of the suite rooms are made in a way that it will
contain/absorb noise in the complex.
139. Each patients suite room is provided with visual and acoustical
privacy from activities in adjacent rooms. A sitting area is provided to encourage
patients to get out of bed as soon as possible (if not contraindicated).
140. Lighting system is designed to provide for adequate nursing care yet
maintain optimum patient comfort. Dimmers are also used because patients can
be quite sensitive to intense levels of lighting. Night time lighting must
facilitate patient sleeping while maintaining nurse patient observation.
141. Divine Mercy Medical Center wants patients to be at least aware of
time and day (day/night orientation) and weather conditions. Natural lighting is
provided to help maintain circadian cycles. All patients suites provide exterior
views to provide patients with an alternative to a very technical environment
and to provide relief to staff working in the units. The ability to see vegetation
and activity is very much desired by the hospital for the patients that is why
windows are made to offer natural ventilation and have low sills to afford views
to prone patients.
142. The patients suite rooms are all of the same sizes and are closed
with sliding glass doors at the corridor and between rooms to allow for maximum
accessibility and observation. Room finishes and furnishings are selected in way
that they will create bright, cheerful, positive environment for patients
undergoing a high degree of stress. A clothes closet plus shelves for personal
use are provided. There is also space provided for a supply cart in each room.
143. Intrinsic Louvre blinds built into double gazed windows and walls
are provided to provide visual privacy between each adjacent patients suites
and the corridor.
144.
All patient bed areas are provided with generous space at
the sides, head and end of the bed to accommodate life support and monitoring
equipment and often a large number of staff, and to allow access around the
around the patient in an emergency. Rooms are also provided with computers for
bedside computer charting.
145.
146.
147.
SUITE ROOMS
148.

83

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
149. Patients in the
Divine Mercy Medical Center
enjoy huge windows that
provide a view of the outdoors
and help them feel less
isolated. Sliding glass doors on
inpatient and treatment rooms
ensure staff can observe
patients while giving them
some privacy. Spacious corridors, attractive dcor and comfortable furniture
soften the 'high tech' clinical environment.
150.
151. The unit is a high care environment with a higher ratio of nurses to
patients than on a general ward. There is monitoring equipment above each bed.
This is normal for this kind of unit and enables nursing staff to constantly
monitor heart rhythms and
other important
signs, such as blood pressure
and
oxygen levels. Information is

sent to a central monitor so
staff can still see this even
when not at the bedside.
There are alarms on the
equipment that may sound
from
time to time - they do not

always indicate a problem so try not to worry.
152.
153.
84

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
154.
PATIENTS FOLKS WAITING AREA AND SUITE

ROOMS
155.
156.
157.
158.
159.
160.
161.
162.
163.
For family members of patients, Divine Mercy Medical Center provides lounge
area just outside the complex, sleepover suite rooms, washrooms, and waiting areas to make family
164.
members more comfortable.

These suites have king-size bed and provide a spacious living area with a large
working desk. Each suite is elegantly designed with high quality and comfortable couch and built in
32 inch plasma television and each suite has an average space of 56 m. They are also provided with
free internet access. Accommodation in these rooms is charged to patients accounts.
165.
166.
167.
168.
169.
170.
CONFERENCE
ROOMS
171.

85

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
172.
173.
174.
These rooms
are utilized for the meetings

in the complex and also by
the physician to discuss
some important matters
regarding patients
problems.
175.
176.
177.
178. This is the place where case
presentations
are conducted. These conference

rooms are located in the far
end of the complex. It is located
there so that patient wont be
disturbed during conferences
or meetings.
179.
180.
181.
EQUIPMENTS, DEVICES AND MACHINES
182.

86

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
183. The Divine Mercy Medical Center has state of the art equipment as
shown in the pictures on this page to provide patients with specialized care and
treatment in hemodynamic monitoring, respiratory support, acute unstable
hemodialysis (multi system failure patients only), administration of vasoactive and
cardioactive drugs, anesthesia and pain management, responding to arrest
situations with the component, surgical post operative
care. All of theseequipmentsare essential in patient
monitoring, life support and emergency resuscitation
devices, and diagnostic devices.
184.
Since
these
equipmentsare
used
continuously on patients, it is essential that equipments

be properly maintained, particularly those devices used
for life support and resuscitation. Staff Nurses performs
daily checks on equipment and inform biomedical
engineering staff when equipment needs maintenance,
repair, or replacement.
For
mechanically
complex
devices, service and preventive maintenance contracts are

available from the manufacturer or third-party servicing
companies.
185.
186.
187.
191.
188.
189.
190.
EQUIPMENTS, DEVICES AND MACHINES
192.

87

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
193.
The Divine Mercy Medical194.
195.
Center is equipped with state of the
art technological equipment which
are intended to increase clients 200.
201.
comfort and increase accuracy of 202.
196.
197.
198.
199.
203. EQUIPMENTS,
monitoring and treatment.
We have the Spacelabs Monitoring,

Puritan Bennett ventilators, the latest
DEVICES
Datascopeintra-aortic balloon pumps,
AND
specialist intensive care
beds,Hypo/hyperthermia machine
and EKG machine

88
MACHINES
204.

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
205. Cardiac and vascular ultrasound machine, vascular Doppler,
infusion pump, syringe pumps, heart / lung
bypass machine, stress
tests
system, external
defibrillators, enteral
feeding pumps, intra
balloon pumps,
pulse oximeter, and the intubation
206.
207.
208.
209.
210.
211.
EQUIPMENTS,
DEVICES AND
212.
MACHINES
213.
214.

89
set.
aortic

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
215. We also have the intercom system, call light system, the centralized
computer system for our documentation, LCD Screens at the nurses
station which shows patients status at the bedside and built in
cameras are also provided in each room to help the nurse
keep an eye to the patient
busy in her works at the
are also equipped with stress
even she is
station. We
test
system, most advanced

wheelchair for each patient,
stretchers, IV stands, and an
Emergency cart which as a self
disinfection mechanism.
216.
217.
218.
219.
220.
221. RIGHTS TO CONFIDENTIALITY

222. CONFIDENTIAL information is also termed as privileged
communication because it is given based on trusts. Patients and/or their
relatives are expected to give the necessary information so that proper
treatment could be made.
223.
diagnosis
and
1. The patient and his/her family are entitled to know information or facts within the limits determined
by the physician.
2. If client insists on knowing what his/her diagnosis, the nurse may only repeat what the doctor wishes
to disclose.
3. Any information gathered by the nurse during the course of caring for the client should always be
treated confidential. This duty extends even after the patients death.
4. Confidential information may be revealed only when:
a. The patient himself/herself permits such revelations as in the case of claims for hospitalization,
insurance benefits, among others;
b. The case is medico-legal such as attempted suicide, gunshot wounds which have to be reported
to the local police or NBI.
c. Given to members of the health team if information is relevant to his care.
224.

90

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
225. Confidential information as provided for the law in Article IV, Section 4 (1) of the New Constitution,
which states that:
226.
227.
The privacy of communication and correspondence shall be inviolable except upon lawful
order of the court or when public safety and order require otherwise.
228.
229.
230. PATIENT BILL OF RIGHTS

1
2
The patient has the right to considerate and respectful care.

The patient has the right to obtain from his/her physician complete current information concerning
his/her diagnosis, treatment and prognosis in terms the patient can be reasonably expected to
understand.
3 The patient has the right to receive from his/her physician information necessary to give informed
consent prior to the start of any procedure and/or treatment.
4 The patient has the right to refuse treatment to the extent permitted by law, and to be informed of the
medical consequences of his/her action.
5 The patient has the right to every consideration of his privacy concerning his/her own medical care
program.
6 The patient has the right to expect that all communications and records pertaining to his/her care
should be treated as confidential.
7 The patient has the right to expect that within its capacity a hospital must make reasonable response to
the request of a patient.
8 The patient has the right to obtain information as to any relationship of his/her hospital to other health
care and educational institutions insofar as his/her care is concerned.
9 The patient has the right to be advised if the hospital proposes to engage in or perform human
experimentation affecting his/her care or treatment.
10 The patient has the right to expect reasonable continuity of care.
11 The patient has the right to examine and receive an explanation of his/her bill regardless of source of
payment.
231.
232.
233.
234. PATIENTS' RESPONSIBILITIES
1 To give complete and accurate information about your condition and care.
2 To follow doctor's orders and instructions and the staff's instructions. This responsibility
includes the keeping of appointments
3 To let a doctor or nurse know if your condition changes.
4 To bring an updated Living Will or Durable Power of Attorney for Healthcare to be
placed in the medical record as soon as possible.
5 To accept what happens if you refuse treatment.
6 To consider the needs and desires of other patients by following all hospital rules and
regulations, especially those concerning smoking, noise, visitors, and general conduct.
7 To accept financial obligations caused by receiving care.
8 If not happy with your care, to tell an employee of the facility.
91

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
9 To treat staff members with respect.
235.
236.
237.
238.
239.
240.
241.
242.
243.
244.
245.
246.
247.
248.
249.
250. APPENCIES
251.
252.
GANNT CHART
253.EMERGENCY ROOM AND INTENSIVE CARE UNIT 2016
254.

92

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
1.
T
3.
4.
14.
5.
6.
7.
16.17. 18.
19.
29.30. 31.
8.
9.
10.
11.
20.21.22.
23.
24.
25.
32.
33.34. 35.
36.
37.
38.
42.43. 44.
45.
46.47. 48.
49.
50.
51.
55.56. 57.
58.
59.60. 61.
62.
63.
64.
68.69. 70.
71.
72.73. 74.
75.
76.
77.
81.82. 83.
84.
85.86. 87.
88.
89.
90.
92.
94.96. 97.
98.
99.100.101.
102. 103.
104.
93.
95.
113.
114.115.
116. 117.
118.
2.
12.
T
15.
13.
O
26.
G
27.
28.
39.
O
40.
41.
52.
B
53.
54.
65.
T
66.
67.
78.
P
79.
80.
91.
U
105.
U
106.
Jan 25-
108.
110.111. 112.
1 week
109.
107.
PM only
93 Apr

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
256.
T
257.
START
258. 259. 260. 261. 262. 263. 264.
266.
265.
267.
P
268.
Jun 6-
269. 270. 271. 272.

273.
274. 275. 276.
277.
278.
A
279.
Jul 4-8
280.
Oct 10-
282.
283.
285. 287. 288.
289.290. 291.
292.293.
284.
286.
294.
281.
Dec
295.
Tr
296.
July
297.
298.
299. 300. 301. 302. 303. 304.
305.
306.
O
307.
July
308.
309.
310. 311. 312. 313. 314. 315.
316.
317.
V
318.
Aug 8-
319. 320.
321.322. 323. 324. 325. 326.
327.
328.
329.
333.
334.
START
330.
T
331.
332.

94
337.
336.
338. 339. 340. 341. 342.
343.

2009
*
Diversion*Road,
Mandurriao,
Iloilo City
344.
M
345.
Oct 10-
347. 348.
351.352.
353.354.
346.
Nov 7357.
A
358.
July
360.
361.
362. 363. 364. 365. 366.
367.368.
369.
359.
Dec
370.
C
371.
All
372. 373. 374. 375. 376. 377. 378.
379.
380.
R
381.
Every
382. 383. 384. 385. 386. 387. 388.
389.
390.
391.
392.
393.
394.
395.
396.

95

Divine Mercy Medical Center Iloilo City, Philippines 2009

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Divine Mercy Medical Center Iloilo City, Philippines 2009

Uploaded by

Copyright:

Available Formats

* DIVINE MERCY MEDICAL CENTER *