Scope

• What is the legal basis for the scope of nursing practice in the Philippines?

  Article VI, Section 28 of Republic Act 9173 (R.A. 9173)
• What are the key components of the scope of nursing practice as defined in R.A. 9173?

  • Provides nursing services to individuals, families, and communities
  • Initiates and performs nursing services collaboratively or independently
  • Cares for individuals across the lifespan (conception, labor, delivery, infancy, childhood, adulthood, and old age)
  • Duties include:
  • Providing nursing care
  • Performing internal examinations
  • Establishing linkages with community resources
  • Coordinating with the health team
  • Providing health education
• What is the main goal of the WHO standards for improving the quality of maternal and newborn care in health facilities?

  Ensure that every pregnant woman and newborn receives high-quality care throughout pregnancy, childbirth, and the postnatal period.
• According to WHO’s MCN Standard 1, what should every woman and newborn receive?

  Routine, evidence-based care and management of complications during labor, childbirth, and the early postnatal period, according to WHO guidelines.
• What is the purpose of WHO’s MCN Standard 2?

  To enable use of data to ensure early, appropriate action to improve the care of every woman and newborn.
• What should be done for every woman and newborn with conditions that cannot be managed effectively with available resources?

  They should be appropriately referred.
• What does WHO’s MCN Standard 4 emphasize?

  Effective communication with women and their families that responds to their needs and preferences.
• What is the focus of WHO’s MCN Standard 5?

  Providing care with respect and preservation of the dignity of women and newborns.
• What is the main objective of WHO’s MCN Standard 6?

  To provide emotional support sensitive to their needs and strengthen the woman’s capability.
• What does WHO’s MCN Standard 7 state?

  Competent, motivated staff are consistently available to provide routine care and manage complications for every woman and newborn.
• What is required of the health facility according to WHO’s MCN Standard 8?

  An appropriate physical environment with adequate water, sanitation, energy, medicines, supplies, and equipment.
• What is the difference between legal and ethical standards?

  • Legal Standards:
  • Set forth in governmental laws
  • Help people know what they cannot do
  • Enforceable by authorities
  • Ethical Standards:
  • Based on human principles of right and wrong
  • Do not necessarily have a legal basis
• What does Section 12 recognize and protect regarding family life?

  It recognizes the sanctity of family life, protects and strengthens the family as a basic autonomous social institution, protects the life of the mother and the unborn from conception, and supports parents in rearing their children for civic efficiency and moral character.
• What rights does the State defend in relation to marriage and the family?

  • Right of spouses to found a family in accordance with their religious convictions and responsible parenthood
  • Right of children to assistance, including proper care and nutrition, and special protection from neglect, abuse, exploitation, etc.
  • Right of the family to a family living wage and income
  • Right of families or family associations to participate in policy planning and implementation
• List some Public Health Laws that affect Maternal and Child Care (MCN) in the Philippines.

  • Responsible Parenthood and Health Law of 2012
  • Rooming-in and Breastfeeding Act of 2018
  • Violence Against Women
  • Save the Children
  • Mandatory Infants and Children Health Immunization Act of 2018
  • Children Safety on Motorcycle Act of 2015
  • Children’s Emergency Relief and Protection Act of 2016
  • Child and Youth Welfare Code of the Philippines
• What is autonomy in the context of maternal-child practices?

  • Involves self-determination
  • Freedom to choose and implement decisions
  • Free from deceit, duress, constraint, or coercion
• What is the obligation of veracity in healthcare?

  • Patients are responsible to provide accurate and complete information about their complaints and relevant health matters.
  • Physicians tell patients and families their diagnosis, plan of care, treatment, risks, length of treatment, possible expenses, and other options.
• What does beneficence mean in the healthcare setting?

  The obligation to do good, promoting acts of kindness and mercy that directly benefit the patient.
• What is nonmaleficence in healthcare?

  To prevent harm, not to do harm.
• What does the principle of justice in healthcare entail?

  Treating everyone fairly by providing comparative and equitable treatment.
• What does fidelity mean in healthcare ethics?

  Telling the truth and keeping actual and implicit promises; devotion to duties and obligations; faithfulness.
• List other bioethical principles that affect Maternal and Child Care (MCN).

  • Stewardship
  • Totality
  • Double effect
  • Cooperation
  • Solidarity
• What does stewardship imply in the context of human life?

  Our life and everything on this earth are gifts we have dominion over.
• What characterizes an action with the double effect?

  The act has both good and bad effects.
• What does the principle of totality state?

  Wholeness; a part may only be sacrificed for the good or better function of the whole.
• What is cooperation in bioethics?

  The process of working or acting together, achieved intentionally or non-intentionally.
• What is solidarity in the nursing profession?

  Being one with others; nurses acting as patient advocates.
• What is confidentiality of information in healthcare?

  Privileged communication given based on trust.
• When can confidential information be revealed?

  • With the patient's permission (e.g., for claims)
  • In medico-legal cases (e.g., suicide, gunshot wounds)
  • When public safety may be jeopardized
  • When information is relevant to healthcare among health team members
• Under what conditions may confidential information be revealed as per the Law?

  Upon lawful order of the court or when public safety and order require otherwise.
• What is an ethical dilemma in perinatal nursing?

  • A choice that has the potential to violate ethical principles
  • Often based on the nurse’s commitment to advocacy
  • Advocacy involves two individuals: the woman and the fetus
• What are some ethical issues and challenges in maternal and child health nursing?

  • Balancing maternal and fetal well-being
  • Managing pregnancy complications and severe disabilities
  • Dealing with parental substance abuse and neglect
  • Making decisions on borderline viability and resuscitation
  • Addressing ethical aspects of genetic technologies
  • Ensuring confidentiality of patient information
• List advances in genetics and genetic technology relevant to maternal and child health.

  • Expanded carrier screening panels
  • Non-invasive cell-free fetal DNA-based screening
  • Chromosomal microarray analysis (CMA)
  • Whole-exome sequencing (WES)
  • Tandem mass spectrometry (MS/MS)
  • Carrier screening programs for Tay-Sachs Disease (TSD)
  • Prenatal screening for aneuploidy and neural tube defects
  • Identification of two main mutations in the hemochromatosis gene (C282Y and H63D)
  • Recognition of Factor V Leiden (FVL) associated with increased risk of thrombosis
  • Massively parallel sequencing (MPS)
• What does fidelity involve?

  Truthfulness, keeping actual and implicit promises, and faithfulness to duties.
• Why is having competent and motivated staff important for maternal and newborn care?

  Because they can provide routine care and manage complications effectively.
• What are some common reproductive health concerns for women?

  • Endometriosis
  • Uterine Fibroids
  • Gynecologic Cancer
  • HIV/AIDS
  • Interstitial Cystitis
  • Polycystic Ovary Syndrome (PCOS)
  • Sexually Transmitted Diseases (STDs)
  • Sexual Violence
• What are the key objectives and initiatives under the National Safe Motherhood Program (NSMP)?

  Key Objectives:

  • Reduce maternal and neonatal mortality
  • Enhance maternal and newborn care quality

  
  

  Initiatives:

  • Implementing Health Reforms (Administrative Order 2008-0029)
  • Paying training fees for Basic Emergency Obstetric and Newborn Care skills (Department Order 2009-0084)
  • Establishing Basic Emergency Obstetric and Newborn Care Training Centers (Administrative Order 2011-0011)
  • Administering life-saving drugs during maternal care emergencies (Administrative Order 2015-0020)
  • Guidelines on providing quality antenatal care (Administrative Order 2016-0035)
  • National Policy on the Prevention of Illegal and Unsafe Abortion (Administrative Order 2018-0003)
• What are some existing DOH Programs on Maternal and Child Care?

  • Partnership for Maternal, Newborn, and Child Health: Launched on Sept 12, 2005
  • Global Consensus for Maternal, Newborn, and Child Health: Aims to save 10 million lives by 2015
  • Integrated Maternal, Neonatal, and Child-Health and Nutrition Strategy: Places mothers and children at the center of health sector reform
  • Women’s Health and Safe Motherhood Project: Flagship program under F1 to reduce maternal mortality ratio (MMR)
• What programs promote maternal and child health under the Existing DOH Programs on Maternal and Child Care?

  • Promotion of Breastfeeding program / Mother and Baby Friendly Hospital Initiative: Aims to fully protect, promote, and support breastfeeding and rooming-in practices
  • Legal mandates: RA 7600 (Rooming-In and Breastfeeding Act of 1992) and Executive Order 51 of 1986 (The Milk Code)
  • Food Fortification program: Addresses micronutrient malnutrition
  • Expanded Program on Immunization: Reduces susceptibility to common childhood diseases
• What is the scope of nursing practice in the Philippines according to R.A. 9173?

  Nursing services to individuals, families, and communities