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PolicyandLegalAspectsof PrivatePracticeinNursing

Fely MarilynE.LorenzoRN,DrPH Professor NationalInstitutesofHealthIO UniversityofthePhilippines,Manila

PresentationOutline
WhyPromotePrivatePracticeinNursing EvolvingTrendsofNursingPractice RoleofPolicyinAdvancingPrivatePracticeinNursing FocusonAdvancedPracticeNursing CurrentandProposedPolicyandLegalFoundations providingforAPN ProjectedOutcomesofMeaningfulPrivatePractice inNursing

WhyPrivatePracticeinNursing?
ProvidemoreACCESS topatientswhoneed caremost; AllowmoreFLEXIBILITY forwomenwhoare havedualcareersmothersandnurses; PromotedirectACCOUNTABILITY fornursing careoutcomes; EncourageindividualRESPONSIBILITY over participationinthepursuitofcareerladders

OVERSUPPLY OF NURSES
Lorenzo, Fely Marilyn , et al.(2003). Analysis of Policy Options Affecting Nursing Surplus. The UP Manila Journal. 1

Estimated Percent of Nurses Employed and Unemployed/ Underemployed

Estimated Number of Employed Filipino Nurses by Work Setting Unemployed/ Underemployed Nurses (Surplus) (42%) Employed in different health settings, locally and internationally (58%) WorkSetting Number 29,467 Percentage

I.Local/National
A.Service

15.25%

1.Government Agencies 2.PrivateAgencies B.Education

19,052 8,173 2,241 163,758 193,223

9.86% 4.23% 1.16%

Stock of Nurses: 497,285 (PRC, Aug. 2008) Estimated Surplus: 208, 860
VMManila, 2009

II.International
Total

84.75%
100.00% 4

NARROW CAREER PATH


Department of Budget and Management, 2007; Institute of Health Policy and Development Studies, National Institutes of Health, 2

Position/ Title

Salary Grade

Teaching/ Training, Tertiary Hospitals 400 bed 300 bed

SecondaryHospital 200 bed 150 bed 100 bed

NI NII NIII NIV NV NVI NVII

10 14 16 18 20 22 24

106 226 31 18 4 2 1

83 176 39 1 2 2 1
VMManila, 2009

55 137 12 2 1 1

36 116 7 0 1 0

48 74 5 0 1 0
5

EvolvingTrendsofNursingPractice
IndependentNursingathome CommunityNursing Institutional/HospitalNursing IndependentMultisettingAdvancePractice Nursing

RoleofPolicyinAdvancingPrivatePractice inNursing
Policy SHAPESBEHAVIORby
Providingincentives, Creatingtheenvironmentthatnurturesthe behavior Providingforrulesofconduct Specifyingthescopeandlimitsofallowable practice

ENSURESORDER

FocusonAdvancedPracticeNursing
Producespositivehealthoutcomes Cost effectivewithhighpatientsatisfaction Advancedknowledgeandskillofnurses Providescareerladdersfornurseswith avenuesforincreasedcompensationand remuneration

STIPULATIONS IN THE NURSING LAW Apersonshallbedeemedtobepracticing nursinge.)Undertakenursingandhealth humanresourcedevelopmenttrainingand researchwhichshallinclude,butnotlimited to,thedevelopmentofadvancenursing practice(ArticleVISec.28,RANo.9173

RESOLUTIONS BY THE BON


NursingSpecialtyCertificationProgram (NSCP)
BON9914 BON99 24 BON2002 118 Tocertifyandpromotepracticethatoptimally contributetodesiredpatientoutcomes

ProposedLegislationRevisions
TostrengthenIncentivesandFurtherEnable Environment: RedefinitionoftheScopeofNursingpractice; Provide thepolicyinstrumentsthatwill promoteAdvancedPractice

Redefining ScopeofNursingPractice
Apersonpracticesnursingwhens/hesinglyor incollaborationwithanotherinitiatesand performsnursingCARE toindividuals,families, POPULATIONGROUPSandcommunitiesinany healthcaresetting; Asmembersofthehealthteam.In PERFORMINGINDEPENDENTOR COLLABORATIVEFUNCTIONSSINGLYOR JOINTLY

PolicyInstrumentsthatPromote AdvancedPractice Provideadvancednursingcarethrough SPECIALIZEDANDEXPANDEDROLES within: ThePROTOCOL ofAdvancedNursing Practice; CERTIFICATION byanaccredited certificationbody

ProjectedOutcomesofMeaningful PrivatePracticeinNursing
IncreasedpatientACCESS tonursesinmany settings; NurseswillvalueRELEVANCE inpractice; IncreasednumberofprofessionallyFULFILLED NURSES; MoreEMPOWEREDNURSES;thatallleadto

ProjectedOutcomesofMeaningful PrivatePracticeinNursing
MoreCommittedandHappyNursesinPractice! MoreSatisfiedandHappyFilipinosovertheir healthcare! IncreasedProductivityofFilipinos translatesto MOREPROGRESSIVEANDHAPPIERFILIPINOS! (GNHvs GNP)

Maraming Salamat Po!


MABUHAYANG FILIPINONARS! (LALO NASA PILIPINAS)