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90th Foundation Anniversary 55th Nurses Week Celebration, 2012 National Annual Convention Inspiring The Filipino Nursing Workforce Towards Equity and Access to health Care
OUTLINE
I. Vision II. Background To The Competitiveness Roadmap III. Competitiveness Assessment Current Nursing Scenarios Nursing Issues and Concerns Criteria And Measurable Indicators Of Professional Competitiveness IV. Action Agenda V. Summary and Recommendation
I. VISION
PRBON VISION Under the guidance of the Almighty, the PRBON will be the ULTIMATE AUTHORITY in regulating the nursing profession in collaboration with PRC NURSING PROFESSION VISION Philippine Professional Nursing Care will be the BEST for the Filipino and the CHOICE of the World
Executive Order 25 (Governance Advisory Council) Good Governance for the Professions in the Philippines Mandated by Executive Order 220
Creation of the Coordinating Body for Good Governance of the Nursing Profession
Social Impact
Vision 2030
Philippine Professional Nursing Care: the BEST for the Filipino and the CHOICE of the World by 2030
(13) Empowered clients to maintain the highest level of wellness and well-being
Profession as a recognized leader in primary health care & the Choice of the World (12) To adopt local and global best practices in the management of resources
Competency Linkages/ The Filipino Collaborative Service Nurse Partnerships Excellence Enhancement Networking
Mission
We, the Filipino nurses, responding to the needs of society, are engaged in providing humane and globally competent nursing care.
(9) To institutionalize a sustainable and effective continuing professional education and development for individual nurses and institutions
(7) To institutionalize sustainable organizational support structure for nursing career progression
Core Values
Love of God Caring Integrity Excellence Nationalism
(3) To advocate collegiality and mutual respect that cut across all health disciplines
(5) To engage stakeholders and make them co-owners of nursing issues and concerns
(4) To actively participate in the critical socio-economic and political issues of the country
(1) To live the core values and to manifest the desired qualities of a Filipino Nurse
Measures
2030
Targets
2020 90% 2015 80% 2011 100%
Initiatives
40% A. NURSE WATCH INITIATIVE: (Organize a Nursing Education Watch) B. NURSING CAREER PROGRESSION PROGRAM INITIATIVE: C. FUNCTIONAL INTEGRATION INITIATIVE: (Strengthen organized training programs for nursing faculty ; Develop transformative leadership programs for nurses in leadership positions ) D. NURSING LAW AMENDMENT INITIATIVE: (Amend the Nursing law to strengthen regulation of nursing schools ) E. CORE VALUES INITIVATIVE: (Institutionalize a mechanism of self-regulation of nursing schools that embody a professional code of ethics that translate into action (2012))
% of nursing schools for undergraduate and graduate levels that are compliant with Commission on Higher Education Policies, Standards and Guidelines (CHED-PSG)
2.1 Primary Health Care 2.2 Independent Nursing Practice 5. Center for Nursing Governance
5.1 Fully Functional OSM 5.2 Nursing Organizations Roadmap and Scorecard Alignment 5.3 Resource Generation for Philippine Nursing Development
Development & Management 3.1Competency Enhancement for Education and Service 3.2 Functional Integration between Education and Service 3.3 National Career Progression Plan 3.4 Nursing Management Information System (NMIS) 3.5 Nursing Deployment Programs
4. Nursing Regulation
4.1 Nursing Law Amendments 4.2 Nursing Practice Standards 4.3. Strengthening Nursing Regulation
Nursing Roadmap Developments 1. A multi-sectoral governance coalition has been formed referred to as Philippine Nursing Profession Roadmap Coalition to manage the implementation of Nursing Roadmap 2030 2. Complete the Balanced Scorecard (BSC) 3. Increase awareness of Nursing Roadmap 2030 as the Nursing Professions transformation initiative and capacitate members towards organizational alignment and implementation of the Nursing Roadmap
3. Education, Training, and Development of Filipino Nurses which includes issues and initiatives in Competency Development and Technology Transfer, Reintegration Program For Nurse Returnees
Work-Setting Scenarios: Demographic Profile Health Picture Socio-EconomicPolitical- Cultural Context Bases for Selecting Learning Experiences
Professional Roles Required Professional Responsibilities Professional Tasks SKA Analysis Professional Competencies Student Competencies
Entry Competencies
Intermediate Competencies
Terminal Competencies
Competency-Based BSN Curriculum A Model Revised Edition College of Nursing Faculty, University of the Philippines Manila
FAMILY
POPULATION GROUPS
NURSE
COMMUNITY
31 3 2
1. Demonstrates management and leadership skills to provide safe and quality care. 2. Demonstrates accountability for safe nursing practice. 3. Demonstrates management and leadership skills to deliver health programs and services effectively to specific client groups in the community setting 4. Manages a community/village based health facility component of a health program or a nursing service 5. Demonstrates ability to lead and supervise nursing support staff. 6. Utilizes appropriate mechanisms of networking, linkage building and referrals.
4 4 2 7 8 4
IMPLEMENTATION PHASE GOAL To effectively and efficiently Implement the 2012 National Nursing Core Competencies in all work settings.
TARGET
FULL IMPLEMENTATION NURSING SERVICE (Hospital and Community) NURSING EDUCATION NURSE LICENSURE EXAMINATION
2014
CHED TCNE
ADPCN
PNA
WHOCC
INTEREST GROUPS
COMMITTEES
1. 2. 3. 4. 5. 6. Steering and Oversight Committee Selection Committee Resource Generation Committee Logistics Committee Training Committee Information, Communications, and Media Relations Committee 7. Continuous Quality Improvement Committee 8. Curricular Change Committee 9. Research Committee
4. Development of the National Nursing Career Progression Program (NNCPP) and CNARS
General Nursing Practice, Nursing Leadership and Governance, Nursing Specialty /Independent Nursing Practice And Nursing Education.
With the NNCPP, nurses can pursue the pathway that best embodies their areas of career development.
Head Nurse
Supervisor
Director of Nursing
Dean
At every level there should be an appropriate program prescribed, qualified trainers and training facilities for the rigorous job of progressive nurse-human resource development.
4. Development of the National Nursing Career Progression Program and the CNARS
ON GOING ACTIVITIES Development of the Competencies per Track and level Official recognition of the CNARS Council Presentation of the Competencies Training of Trainors for the Implementation of the NNCPP Implementation Phase Evaluation Phase
The revisions seeks to initiate reforms in Nursing Practice to further protect and develop the nursing profession to make nurses responsive to the needs of the clients and the public and private health systems locally and globally.
PHILIPPINE NURSING CARE: THE BEST FOR THE FILIPINO AND THE CHOICE OF THE WORLD
Phil Development Plan 2011-2016 * Serves as a guide in formulating policies and implementing development programs for the next six years. It enables the government, in partnership with the private sector and the civil society, to work systematically to give the Filipino people a better chance to find their way out of poverty, inequality and the poor state of human development
Exchange of Information
Facilitate Mobility
Registration through AJCCs
Capacity Building
Compilation
Visits
Conferences
Standardised Procedures
AJCC Roles
Better understanding of Domestic Regulations to develop strategy for Implementing the MRAs Standardise Procedures /Mechanism Exchange information towards harmonisation in accordance with international standards Develop mechanism for continued exchange of information
Exchange of Information
Qualifications (technical, ethical & legal) Domestic Laws and regulations Core Competencies Code of Professional Conduct CPD (Continuing Professional Development) Best Practices
Standardised Procedures
Facilitate Mobility
Professional Regulatory Authority
Evaluate qualifications and experience of nominated foreign professionals Register and grant recognition to nominated foreign professionals Monitor their practice Take necessary action for any violation to ensure high standard of practice
Conferences/ Forums
Capacity Building
Visits to healthcare facilities /institutions Attachments programmes Countries with developed system assist the less developed countries through various programmes Countries in need for capacity building can arrange local seminars, inviting resource persons from more developed AMS
ROADMAP FOR IMPLEMENTATION OF ASEAN MRA ON NURSING SERVICES MRA Objective and Detailed Activities
1. Exchange information and expertise in order to promote adoption of best practices on standards and qualifications A. Compilation of required information: 1 Recognised Basic Qualifications (local &foreign) 2 List of Recognised Institutions (local &foreign) 3 Domestic Laws and Regulations pertaining to Registration 4 Requirements for Post Basic Nursing Practice 5 Requirements for Credentialing for Specialisation in Host Country 6 Code of Ethics & Professional Conduct and Nursing Practice Safety Guidelines 7 CPD (Continuing Professional Development) requirements in Host Country 8 Registration Policy and Procedures in Host Country
Roadmap for Implementation of ASEAN MRA on Nursing Services MRA Objective and Detailed Activities
3 Provide opportunities for capacity building and training of Registered Nurses a. Conferences/ Forums 1. List of Relevant Websites in Host Country 2. Websites announcing Regular Conferences/ Forums of Registered Nurses b. Visits to healthcare facilities /institutions 1. List of facilities/Institutions made available in the website
Roadmap for Implementation of ASEAN MRA on Nursing Services MRA Objective and Detailed Activities
c. Attachments programmes List of Institutions offering attachments programmes made available in the website d. Exchange of Resources among AMS Mechanism of exchange of resources (e.g. experts, students) to facilitate capacity building and training among AMS. PRA of the Host Country provide temporary license upon request List of experts and their areas of expertise made available in the website List of possible funding agencies/institutions e. Malpractice Insurance (to be reviewed)
From 2001 to 2011, the number of nurse enrollees reached 2.6M with 487,491 graduating or 18.5% of the total enrollees.
No. of Enrollees
No. of Graduates
49,995 92,106 178,626 295,752 393,386 459,173 420,015 409,793 341,367 N.A.
5,425 8,596 14,383 34,589 57,698 79,304 94,688 103,361 89,447 N.A.
Annually, an average
16.2% of nurse enrollees graduate
Total
Source of data: CHED, PRC
2,640,213
487,491
478
33.92% 45.69%.
Between 2001-2011 the number of nurse board examinees accumulated to 975,956 with 421,468 passing the exams or 43.2% of total examinees. Average annual passing rate of 45.1% observed for the period
Year
No. of Examinees
No. of Passers
2001-2002 2002-2003 2003-2004 2004-2005 2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 2010-2011 Total
9,449 15,625 25,325 50,287 82,153 146,311 153,108 173,183 175,285 145,230 975,956
4,228 7,528 12,581 25,951 37,030 69,650 67,220 69,617 67,390 60,273 421,468
5,221 8,097 12,744 24,336 45,123 76,661 85,888 103,566 107,895 84,957 554,488 N.A. 199,902
199,902
Dentist Midwives Nurses Optometrists Pharmacists Physicians Physical therapists Occupational therapists
For TESDA, figures indicate 214,192 certified workers in the health, social and other community development services (as of Dec. 2011)
Note: Figures from PRC are cumulative total of registered professionals as of Dec 2011 Source of data: NSO-LFS ; PRC; TESDA
272 26 81
336 7 0 0 702
397 113 85
465 70 4 2 1,136
A total of 702 government hospitals and other health facilities with a capacity of 42,559 beds as of 2005 (DoH) Any significant additions over the last 5 years? 1,136 private hospitals and other health facilities with a capacity of 43,397 beds as of 2005 (DoH). Any significant expansions over the last 5 years? A total of 16,191 barangay health stations nationwide A total of 60-70,000 RN Positions ONLY are available
Employment Situation
Total employed nurses for overseas covering the period 2001 2011 accounted to 132,943 Employed nurses locally is estimated at 67,202 for 2011 The number of nurses employed both locally and abroad is 200,145 Using the board passers (421,468) as supply data, less the employed nurses local and overseas (200,145), the estimated unemployed/ underemployed nurses from 2001 2011 totaled 221,323
Employment Situation
Phil. Hospitals dont have enough nurses. Nurse/patient ratio are high. To meet the nursing care needs of hospital, some have resorted to exploitative practices e.g Nurses are hired on a contractual basis; nurse volunteers in hospitals round the clock.
Percent Share of Deployed Nurses by Top Ten Destinations, New Hires: 2010
POEA
COMPETITIVENESS ASSESSMENT
COMPETITIVENESS ASSESSMENT
COMPETITIVENESS ASSESSMENT
COMPETITIVENESS ASSESSMENT
COMPETITIVENESS ASSESSMENT
CRITERION 3. QUALITY ASSURANCE Cont. The PRBON has undertaken two collaborative researches. The 2nd is entitled An Analytical Study of the NLE Performance of Graduates of Colleges of Nursing In the Philippines (NLE Dec. 2006-Dec 2011) A 3rd collaborative research is currently being done to determine compliance of nurses in hospital nursing services with standards. PRBON fully supports the Good Governance thrust of PRC
COMPETITIVENESS ASSESSMENT
COMPETITIVENESS ASSESSMENT
CRITERION 5 LANGUAGE SKILLS AND PERSONAL ATTRIBUTES Medium of Instruction in our educational system is in English Communication specifically recording and reporting in most health institutions is in English Positive employer feedback related to caring and compassionate attitude of Filipino nurses.
ACTION AGENDA
MAJOR AREAS OF CONCERN 1. Regulation of Nursing Schools ISSUANCE OF PERMIT STRATEGIES
Strict implementation of CHED Policies Standards and Guidelines in nursing education . Strict Adherence to Moratorium on the Opening of Nursing Schools/Nursing Programs Regular monitoring of compliance Apply sanctions as prescribed Closure of Poor Performing Nursing Schools Based on NLE Results Pursue mandatory accreditation
ACTION AGENDA
MAJOR AREA OF CONCERN 2. Regulation of students entry to nursing schools
ADMISSION POLICY PROMOTION /RETENTION AND DISMISSAL POLICIES
STRATEGIES
Pursue National Nursing Admission Test In the proposed revision of the Nursing Law. Strict Implementation Of PSG On Admission , Promotion, Retention And Dismissal Policies
ACTION AGENDA
MAJOR AREA OF CONCERNS STRATEGIES
Include in the Revision of the Nursing Law the 3. Licensure Examination System following: INCREASING NUMBER OF NLE REPEATERS VIS A VIZ THE FIRST TIMERS National Admission Policy for Nursing Education (NNAT) Adoption of a policy to put a cap on the number of repeating the NLE
ACTION AGENDA
STRATEGIES
Strict compliance to the correct implementation of the curriculum e,g, Competency Appraisal 1 And 2 In CMO 14 Series Of 2009 PRC, BON, CHED and other Agencies to recommend appropriate policy/ guidelines and/or possible legislation on the regulation of nursing review center Hold collaborative meeting of stakeholders to recommend body that will regulate review centers
ACTION AGENDA
MAJOR AREA OF CONCERN 5. Continuing Professional Education
ALIGNMENT OF CPE WITH NNCPP
STRATEGIES
Explore innovative ways of conducting CPE, aligned with National Nursing Career Progression Program . Apply competency -based evaluation Explore creative methods to improve monitoring and evaluation of CPE program
ACTION AGENDA
MAJORN AREA OF CONCERN 6 Standards Of Nursing Practice (Institutional And Community)
No updated general standards of nursing practice
STRATEGIES
Promulgate standards of nursing service (institutional and community) in: General/basic Specialty Advanced practice Implement nursing standards Evaluate nursing standards for continuous improvement Align credentialing program with NNCPP taking into considerations competency standards
ACTION AGENDA
MAJOR AREA OF CONCERN 6 Standards Of Nursing Practice (Institutional And Community) Cont.
NON ALIGNMENT OF CIVIL SERVICE RULES WITH THE NURSING LAW REGARDING QUALIFICATIONS OF NURSING ADMINISTRATORS
STRATEGIES Strict implementation of the provisions of the Nursing Law Have regular meetings with other government regulatory agencies e.g. DOH, PhilHealth, DILG, CSC to discuss pertinent issues Make information more accessible in the PRC and BON websites.
ACTION AGENDA
MAJOR AREA OF CONCERN 7. Evidence Based Practice STRATEGIES
Develop research agenda Organize a research team equipped with appropriate infrastructure Conduct research studies for improvement of nursing profession In collaboration with PRC establish a system to publish all PRBON initiated research studies
ACTION AGENDA
MAJOR AREA OF CONCERN 8. The lack of accurate and reliable data about nurses Nursing Management Information System (NMIS) STRATEGIES Design the Nursing Management Information System which includes collaborative activities with stakeholders Organize the NMIS team Implement a NMIS with the support of PRC Evaluate effectiveness of the NMIS
ACTION AGENDA
MAJOR AREA OF CONCERN 9 FULLY FUNCTIONAL OFFICE OF THE STRATEGY MANAGEMENT (OSM) FOR THE NURSING PROFESSION ROADMAP STRATEGIES
Finalize roles, functions and responsibilities of the Philippine Nursing Profession Roadmap Coalition Organize the Measurement, Core and Leadership Team of The Office of Strategy Management Execute Nursing Profession Roadmap Towards Good Governance
) )
RECOMMENDATIONS
Review Human Resource for Health Master Plan Fill Up Plantilla Positions For RNs Upgrade Nurse: Patient Ratio based on WHO Standards VOLUNTEERISM Recommend to DOH Issuance of FOR A FEE / NURSES Appropriate Guidelines and an increase AS SERVICE in the plantilla positions for nurses
CONTRACTUAL
ACTION AGENDA
MAJOR AREA OF CONCERN 11. Deployment And Migration of RNs STRATEGIES
Continue to explore potentials job market opportunities Pursue ethical recruitment in the deployment and migration of RNs Expand market links Pursue Implementation of ASEAN MRA
SUMMARY
Issues and concerns as well as strategies have been identified The various criterion for competitiveness assessment have been taken into consideration as we reviewed our accomplishments that were mentioned in the background of activities Based on our assessment and the feedback given by Miss Jane Brokman the nursing profession is competitive in 3 criterion but for 1st Criterion on market conditions and trends medium term unemployment /underemployment crisis despite huge and urgent community needs..
SUMMARY
A weakness on the 5th Criterion on Salary- Fee level expectation. (Traditional focus on migration rather than trade which has contributed to high salary expectation) We are trying our best to maintain our competitive standard despite the challenges that the nursing profession is currently experiencing. There are issues that are beyond our capability and control but may have policy implications.
RECOMMENDATIONS
The Philippine Professional Nursing Roadmap on Good Governance milestones, targets and initiatives the need to be reviewed and once we have a fully functional OSM we will be moving towards institutionalization phase of the PGS system. A Gantt chart of the strategies, measures and targets is being finalized. The targets for the initiatives being undertaken by the PRBON and partners like the National Nursing Core Competency Standards, National Nursing Career Progression Program, Revision of the Nursing Law, Collaborative Nursing Research among others need to be incorporated in the Competitiveness Roadmap Gant Chart
Recommendations
Fast track the Implementation Plan for the ASEAN Nursing Roadmap by finalizing mechanics to facilitate the mobility of Registered Nurses in ASEAN Continue to conduct information awareness regarding the various initiatives of the nursing profession.
We as a profession are determined and committed to achieve our vision to have PHILIPPINE PROFESSIONAL NURSING CARE TO BE THE BEST FOR THE FILIPINO AND THE CHOICE OF THE WORLD.