STANDARDS AND LEGAL

ASPECTS OF INTRAVENOUS
THERAPY

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

DUTIES AND RESPONSIBILITIES
OF IV THERAPISTS
1. Interpret and carry out the physicians
prescriptions for IV therapy.
2. Prepare, initiate and terminate IV therapy
based on physicians written
prescription.
3. Perform peripheral venipuncture (all types
of needles and cannulas) excluding the
insertion of subclavian and cut down
catheter.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
4. Determine solution and medication
incompatibilities.
5. Administer computed medications,
chemotherapeutic drugs, flow rates of
solutions, compatible blood/blood
components and parenteral nutrition as
prescribed by the physician.
6. Assess all adverse reactions related to IV
therapy and initiate appropriate nursing
interventions.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

7.Establish nursing care plan related to IV
Therapy.
8.Adhere to established infection control
practices.
9. Maintain proper care of IV equipments.
10. Document relevant data in the
preparation, administration and
termination of all forms of IV therapy.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 IV THERAPY AND LEGAL
IMPLICATIONS
R.A. 7164 The Philippine Nursing Act of
1991 Section 28 states that in
administration of IV injections, special
training shall be required.

IV Nursing Standards of Practice

developed by the ANSAP should be used.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 In giving IV injections, nurses should
follow the policies of their agencies.

Board of Nursing Resolution No.8 Sec.30

(c) Art.VII or administratively under Sec.21
Art.III states that any registered nurse
without training and who administers IV
injections to patients shall be held liable,
either criminally, administratively or both.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 R.A. 9173/The Philippine Nursing Act of
2002, Article VI Nursing Practice,
SEC.28.Scope of Nursing (a) Provide
nursing care through the utilization of the
nursing process. Nursing care includes,
but not limited to
administration of written presentation for
treatment, therapies, oral, topical and
parenteral medications
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
That in the practice of nursing in all
settings, the nurse is duty-bound
to observe the Code of Ethics for
nurses and uphold the standards
of safe nursing practice.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

CODE OF ETHICS FOR NURSES
IN THE PHILIPPINES
ETHICS according to Webster
Dictionary, is the study of the standards
of conduct and moral judgment.
Therefore..
NURSING ETHICS is concerned with the
principles of right conduct as they apply
to the nursing profession.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 NURSES AND PEOPLE
Values, customs and spiritual beliefs
held by individuals are to be
respected.
Nurses hold in strict confidence
personal information acquired in the
process of giving nursing care.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 NURSES AND PRACTICES
Nurses are accountable for their own
nursing practice.
Nurses maintain or modify standards of
practice within the reality of any given
situation.
Nurses are the advocates of the patients.
Nurses are aware that their actions have
professional, ethical, moral and legal
dimensions.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
 NURSES AND CO-WORKERS
Nurses maintain collaborative working
relationships with their co-workers and
other members of the health team.
They recognize their capabilities and
limitations in accepting responsibilities
and those of their co-workers when
delegating responsibilities to them.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 NURSES AND SOCIETY
Nurses are contributing members of
society. They assume responsibilities
inherent in being members and citizens
of the community/society in which they
live/work.
Nurses recognize the need for change
and initiate, participate, and support
activities to meet the health and social
needs of the people.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
NURSES & THE PROFESSION
Nurses are expected to be members of
professional organizations of nurses.
Nurses help to determine and implement
desirable standards of nursing practice
and nursing education.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

NURSES & THE PROFESSION
Nurses should initiate and involve
themselves in structured and non-
structured research activities within their
existing milieu.
Nurses should assert the
implementation of labor standards and
lobby for favorable legislations to
improve existing socio-economic
conditions of nurses.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
 CODE OF GOOD GOVERNANCE
FOR THE PROFESSIONS IN THE
PHILIPPINES
E.O. No. 220 - Directing the
adoption of the Code of Good
Governance for the Professions in
the Philippines on June 23, 2003.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

General Principle of Professional
Conduct

Professionals are required not only

to have an ethical commitment, a
personal resolve to act ethically, but
also have both ethical awareness
and ethical competency.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

Specific Principles of Professional
Conduct
1. Service to Others
2. Integrity and Objectivity
3. Professional Competence
4. Solidarity and Teamwork
5. Social and Civic Responsibility
6. Global Competitiveness
7. Equality of All Professions

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 PROFESSIONAL VALUES
CARING
is the locus of all attributes used to
describe NURSING. It is not only the
main value of NURSING but the
Essence. It is not only a nursing act
because to care is human and to be
human is caring.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 5 Cs of Caring
Compassionate Conscientious
Concern Honest
Caring Competent
Committed Knowledgeable
Willingness to perform Effective/ Efficient
her responsibilities
Confident
Assertive
Smart

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

Wholistic Nurse Practitioner Quality
Approach I.V. Nurse Therapist care

Ethico legal Impact to

Responsibility Accountability Health Care
Delivery sites
In Varied Health Setting

Industrial Community Hospital and Educational Home Care

Setting Setting Institutional Setting Setting
-Company Health Center Setting -Colleges -Independent
of Nursing Practitioners
Clinics Rural Health Lying- in
-Self
-Occupation Units Hospice Center Universities employed
Health Periculture Day Care Center -Other
Units Centers colleges &
Schools
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
 RELATED LAW OFFENSES
LEGAL ASPECTS AND THE NURSE
The Republic Act 9173 or the Philippine
Nursing Act of 2002 is the best guide the
nurse can utilize as it defines the scope of
nursing practice.

Negligence
Commission or omission of an act, pursuant
to a duty, that a reasonably prudent person
in the same or similar circumstance would or
would not do.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
 RELATED LAW OFFENSES
The Doctrine of Res Ipsa Loquitur
1. Commission or omission of an act,
pursuant to a duty, that a reasonably
prudent person in the same or similar
circumstance would or would not do.
2. That the injury was caused by an
agency within control of defendant;
3. That the plaintiff himself did not engage
in any manner that would tend to bring
about the injury.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

Example:
A patient came in walking to the out-
patient clinic for injection. Upon
administering the injection to his
buttocks, the patient experienced
extreme pain. His leg felt weak and he
was subsequently paralyzed.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 RELATED LAW OFFENSES
Malpractice
Refers to a negligent act committed
in the course of professional performance.

Example:
Giving of anaesthesia by a nurse or
prescribing medicines.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 RELATED LAW OFFENSES
Incompetence
The lack of ability, legal qualifications
or fitness to discharge the required duty.
Example:
Although a nurse is registered, if shes
not yet an IV therapists, she is not
allowed to give IV medications or do the
IV insertion.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
 RELATED LAW OFFENSES
Assault and Battery
Assault is the imminent threat of harmful
or offensive bodily contact.
Battery is an intentional, un consented
touching

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 It is, therefore, important that before a
patient can be touched, examined,
treated or subjected to medical/surgical
procedures, he must have given a
consent to this effect.
Example: If a patient refuses an injection
and the nurse gives it anyway, the latter
can be charged for battery.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 LEGAL
TERMINOLOGIES
THAT ALSO APPLY IN
IV THERAPY

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

CIVIL ACTION
a non-criminal action whereby one
seeks to protect, enforce, or declare
a right or address a civil wrong
close to him or her.
When the harm occurs, the guilty
party may be required to pay
damages to the injured person.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

CRIMINAL ACTION
an action brought about by a state
or federal law enforcement agency
or by an official agency on behalf of
an individual, to protect ones
person or property or to protect
society in general.
Punishment includes imprisonment,
fine or both.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
DEPOSITION
a discovery procedure which is an
oral question and answer proceeding,
under oath and recorded, wherein the
attorneys seek to find out what
testimony and evidence will be
confronting them in a lawsuit.
It is an informal proceeding with
lawyers of all parties present.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
INTERROGATORY
another discovery procedure which
is the written equivalent of a
deposition.
RULE OF PERSONAL LIABILITY
every person is liable for his own
wrongdoing. No one can bypass
this rule with personal assurance.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
STATUTE OF LIMITATIONS
the time limit set by each state
legislature in which civil or criminal
action can be brought.

TORT
every person is liable for his own
wrongdoing. No one can bypass
this rule with personal assurance.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
SUBPOENA
the process or "paper command" by
which the person served must
appear at a certain time and give
testimony to the court. It is an order
under the seal of the court for which
one can be held for contempt of
court for ignoring the subpoena.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

SUMMONS
notification served upon defendant
to appear before the court.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 NURSING LIABILITIES
AND PREVENTIVE
MEASURES

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 Points to Observe in Order to
Avoid Criminal Liability
1. Be very familiar with the Philippine Nursing
Law.
2. Beware of laws that affect nursing practice.
3. At the start of employment, get a copy of
your job description, the agencys rules,
regulations and policies.
4. Upgrade your skills and competence.
5. Do not delegate your responsibility to
others.
PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH
 Points to Observe in Order to
Avoid Criminal Liability
6. Accept only such responsibility that is
within the scope of your employment
and your job description.
7. Develop good interpersonal relationships
with your co-workers, whether they be
your supervisors, peers or subordinates.
8. Consult your superiors for problems that
may be too big for you to handle.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 Points to Observe in Order to
Avoid Criminal Liability
9. Verify Doctors prescriptions that are not
clear to you or those that seem to be
erroneous.
10. The doctors should be informed about
the patients conditions.
11. Keep in mind the value and necessity of
keeping complete and accurate
recording.
12. Patients are entitled to an informed
consent.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 REFERENCES
Association of Nursing Service Administrators of the Philippines,
Inc. (ANSAP). 2000. Nursing Standards on Intravenous Practice
7th EDITION.
Atty. Rustico T. De Belen, BA, BSN, LLB, MNSA, PhD and
Donna Vivian V. De Belen, BSN, RN, CCRN, CRNA, MS
Anesthesia. Nursing Law, Jurisprudence & Professional Ethics
1st EDITION.
Lesnik, M.J. and Anderson, B. Nursing Practice and the Law. 2nd
EDITION with revisions. Philadelphia: J.B. Lippincott.
Pallock: Torts, 14th EDITION.
Philippine Nursing Act of 1991, Republic Act No.7169 Sec.28.
Philippine Nursing Law, Republic Act No. 9173 Section 28 (a),
(e).
Prescer: Torts, 3rd EDITION.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH

 REFERENCES
PRIMER CODE OF ETHICS THE NURSING SERVICE
ADMINISTRATORS OF THE PHILIPPINES.
Professional Regulation Commission Board of Nursing Souvenir
Program Oath taking as Professionals of the Successful
Examinees June 6 & 7, 2004 Nurse Licensure Examination.
Professional Regulation Commission, Board of Nursing
Resolution No. 8.
Venzon, Lydia M. R.N., M.A., FPCHA. 2003. Professional
Nursing in the Philippines 9th EDITION .
Websters New World Dictionary of the American Language.
Cleveland and New York: World Publishing Co.

PHILIPPINE HEART CENTER DIVISION OF NURSING EDUCATION & RESEARCH