Controlling

Basic Components of the Control Process

>Includes assessing and regulating performance in
A. Establishment of Standards, Objectives & Methods
accordance with the plans that have been adopted, the
for Measuring Performance
instructions issued, and the principles established
Types of performance standards:
>It provides information about how well processes &
>1. Structure Standards - focus on the
people function so they can be motivated to perform
structure or management system used
better in the future
by the agency to deliver care
Reasons For Conducting Evaluation
> 2. Process standards - action of the nurse
1. Ensures that quality nursing care is provided.
relative to the nursing process
2. Allows for the setting of sensible objectives and
> 3. Outcome standards- designed to measure the
ensures compliance with them.
results of care provided.
3. Provides standards for establishing
Purpose of objectives:
comparisons.
>To provide clear direction & communication of
4. Promotes visibility and a means for employees
expected levels of achievement
to monitor their own performance.
Methods for measuring nursing care:
5. Highlights problems related to quality care and
> Task Analysis
determines the areas that require priority
> Quality Control
attention.
B. Measuring Actual Performance
6. Provides an indication of the costs of poor
> An ongoing, repetitive process with
quality.
the actual frequency dependent on
7. Justifies the use of resources.
the type of activity being measured
8. Provides feedback for improvement.
> Maybe scheduled in advance/maybe
Principles of Evaluation
done at periodic but unannounced
1. Must be based on the behavioral standards of
intervals
performance.
C. Comparing Results of Performance
2. There should be enough time to observe
with Standards & Objectives
employee’s behavior.
> Performance should match with
3. Employee should be given a copy of the job
standards & objectives
description, performance standards &
D. Reinforcing Strengths & Taking
evaluation form.
Corrective Action
4. Performance appraisal should include
>Corrective actions are applied to
satisfactory & unsatisfactory results
improve performance
5. . Areas needing improvement must be
prioritized Performance Appraisal
6. 6.Evaluation conference should be scheduled > Employee’s performance is evaluated against
and conducted at a convenient time for the standards
rater and employee >Reflects how well the nursing personnel have
7. 7.Evaluation report and conference should be performed during a specific period of time.
structured Purposes of Performance Appraisal
> Determine salary standards
Characteristics of an Evaluation Tool >Select qualified individuals for promotion
>Objectivity - tool is free from bias. >Identify unsatisfactory employees for
>Reliability - tool is accurate demotion
>Validity - tool is relevant > Make inventories of talents
>Sensitivity - tool can measure fine > Determine training needs of employees
lines of differences among > Improve the performance of work groups
the criteria being measured > Improve communication
Con’t 2. Forced checklist
>Establish standards of supervisory – requires the supervisor to select an
performance undesirable and a desirable behavior for each
>Discover the aspirations of employees employee.
>Provide “employee recognition” for 3. Simple checklist
accomplishments – composed of numerous words or phrases
> Inform employees “where they stand.” describing various employee behaviors or traits. The
rater will check all those that describe the employee on
Factors Influencing Effective Performance Appraisal each checklist.
> Appraisal should be based on a standard “Rating Scale”
> Employee should have input into the >Includes a series of items representing the different
development of the standard. tasks or activities in the nurse’s job description or the
>Employee must know the standard in advance absence or presence of desired behaviors and the
>Employee must know the sources of data gathered for extent to which these are possessed.
the appraisal. “Forced-Choice Comparison”
>Appraiser should be someone who has observed >The evaluator will choose the statement
employee’s work. that best/least describes the nurse being
>Appraiser should be someone whom the employee evaluated
trusts and respects. >The items are grouped that the evaluator
is forced to choose from favorable as well
Methods of Measuring Performance as unfavorable statements.
Informal appraisal “Anecdotal Recording”
> May consist of “incidental observation” of >Describes the nurse’s experience with a group or a
performance while the worker is engaged in performing person, or in validating technical skills and interpersonal
nursing care relationships.
Formal appraisal “Peer Review”
>Accomplished regularly and methodically > May be done by peers (employees of the same
by collecting objective facts that can profession, rank and setting) evaluating another’s job
demonstrate the difference between what performance against accepted standards.
is expected and what was done.
Common Pitfalls of Performance Appraisal
Performance Appraisal Tools Halo Effect
“Essay” > when the appraiser lets one or two positive aspects of
>Referred to as the free-form review the behavior of the employee influence all other
>The appraiser describes in narrative form an aspects of the employees’ performance.
employee’s strengths & areas where improvement is Horns Effect
needed > when the appraiser allows some negative aspects of
“Ranking” the employee’s performance influence the assessment
>The appraiser ranks the employees to such extent that other levels of job performance are
according to how he fared with co- not accurately recorded.
workers with respect to qualifications. Central tendency trap
“Checklists” >The appraiser is hesitant to risk true assessment and
>A compilation of all nursing performances expected therefore rates all employees as average.
of a worker.
Quality Assurance
Types:
>Process of evaluation that is applied to the health care
1. Weighted scale
system and the provision of health care services by
– composed of many behavioral statements that
health workers.
represent desirable job behaviors.
Quality Improvement Program Discipline
> A continuous on-going measurement and evaluation
> A constructive and effective means by which
process that includes structure, process, and outcome
employees take personal responsibility for their own
Benchmarking
performance and behavior .
> Process of measuring products and services against
Factors That Influence Self-discipline:
those of best-performing organizations.
1. A strong commitment to the vision, philosophy,
Quality of care
goals and objectives of the institution.
- the degree to which health services for individuals &
2. Laws that govern the practice of professionals
population increase the likelihood of desired health
and their respective Codes of conduct .
outcomes
3. Understanding the rules and regulations of the
Nursing Audit
agency
- Documentation of the quality of nursing
4. An atmosphere of mutual trust and confidence
care in relation to the standards
5. Pressure from peers and organization.
established by the nursing department
Disciplinary Approach:
A sound disciplinary program must be tailored to the
Methods of Quality Assurance objectives of the institution.
❖ Patient Care Audits Should include the following:
Concurrent > Set of disciplinary policies and procedures
>Patient care is observed and evaluated. >A uniform application of the rules
Patients charts are reviewed while the patients >Disciplinary committee
are still confined in the hospital >Orientation program for all new employees
Retrospective Characteristics of a Successful Implementation of a
> Patient care is evaluated thru review of discharged disciplinary action:
patient’s chart & questionnaires sent to or interviews > Promptness
on discharged patients > Fairness
❖ Peer Review > Impartiality
>A collegial evaluation of the performance > Nonpunitiveness
done to promote excellence in practice > Advance warning
❖ Quality Circles > Follow-through
> Group of workers doing similar work who meet
regularly, voluntarily on normal working time under the
leadership of their supervisor.
Disciplinary Action
❖ Structure Audit 1.Counseling and Oral Warning
Monitors the structure or setting in which patient care > The employee is counseled regarding
occurs such as the finances, nursing service structure, expectations of improved performance,
medical records, and environmental structure. ways of correcting the problem and a warning
❖ Process audit that a repetition of the same offense may
> Measure how nursing care is provided or warrant further disciplinary action.
how the care was carried out 2. Written Warning
>Used to provide a tool to assess deviations from >This includes the statement of the problem,
accepted best practice process standards
identification of the rule which was violated,
❖ Outcome Audit
consequences of continued deviant behavior, and
>Determines what results if any, occurred
as a result of specific nursing intervention the employee’s commitment to take corrective
for patients action, and any follow-up action to be taken.
>Considered to be the most valid indicators 3. Suspension
of quality care > Suspension over a minor violation is given after
an evidence of oral and written warnings
> Suspension rather than dismissal is applied when Legal Aspects of Nursing
management feels that the employee can still be Philippine Constitution
rehabilitated. Constitution is the supreme law of the land
4. Dismissal ◼ Ensures order
> Invoked only when all disciplinary efforts have ◼ Protects individuals
failed ◼ Resolves disputes
> The Disciplinary Committee should be very sure ◼ Promotes the general welfare of the people
that the cause for dismissal conforms with the Branches
criteria of a major discipline violation as contained ◼ Executive: Charged to implement law (President)
in the policy manual ◼ Legislative: Charged to create law (Congress)
◼ Judicial: Charged to interpret law (Supreme
Court)
◼ Laws are rules of conduct that are authored,
enforced and hold people accountable for
compliance
Division of Law
◼ Administrative Law: legislative branch delegates
authority to government agencies to create laws
◼ Civil Law: enforces rights of individuals
◼ Criminal Law: protects society
Differences in Criminal Offenses
Felony
◼ Penalty is a term of more than one year in
prison
◼ Murder, robbery, rape, possession with intent
to distribute
Misdemeanor
◼ Penalty is prison term of one year or less
◼ Simple assault, minor theft, possession
Tort Law
◼ A civil wrong arising from an act or failure to
act, independently of any contract, for which an
action for personal injury or property damages
may be brought
◼ 2 types:
➢ Unintentional
➢ Intentional

Legal Risks in Nursing Practice

A. Unintentional Tort
◼ Malpractice: greatest legal concern
◼ Negligence—failure to act as a reasonably prudent
person would have acted in similar circumstances
◼ Commission = doing something that should not
have been done
◼ Omission = failing to do things that should have
been done
◼ Central question in any charge of malpractice
 ◼ “Was the prevailing standard of care met?” 4. Wrong medicine, wrong concentration, wrong
◼ In malpractice claim, evidences should be route, and wrong dose.
presented to the court to determine if elements of 5. Defects in the equipment such as stretchers and
liability are present. wheel chairs may lead to falls thus injuring the
patient.
Consider:
6. Errors due to family assistance.
◼ Prevailing standards of care: what another
7. Administration of medicine without a doctor’s
prudent nurse would have done
prescription.
◼ Expert witness testimony
◼ Standards of nursing practice DOCTRINE OF RES IPSA LOQUITOR
◼ Patient record ◼ “The thing speaks for itself”
◼ Direct testimony of patient, nurse, and others ◼ Three conditions are required to establish a
Prerequisite of a Malpractice Action defendant’s negligence without proving specific
◼ Nurse (defendant) has specialized skills & conduct:
knowledge, & through practice causes the patient 1. that the injury was of such nature that it would
(plaintiff) injury not normally occur unless there was a negligent
◼ Patient proves nurse is liable with all following act on the part of someone
elements 2. that the injury was caused by an agency within
1. Nurse has assumed duty of care control of the defendant; and
(responsibility for pt’s care) 3. that the plaintiff himself did not engage in any
2. Nurse breached duty of care by failing to manner that would tend to bring about the
meet standards of care injury.
3. Failure of nurse to meet standards of care Examples of Res Ipsa Loquitor
was proximate cause of the injury 1. A patient came in walking to the out-patient
4. Injury is proved clinic for injection. Upon administering the
◼ Monetary damages are awarded when plaintiff injection to his buttocks, the patient experienced
prevails extreme pain. His leg felt weak and he was
◼ In past, doctors or hospital paid damages subsequently paralyzed.
◼ Nurse liability has risen due to increased expertise, 2. The presence of sponges in the patient’s
autonomy and authority abdomen after an operation.
3. Fracture on a newly-delivered baby born by
Common Acts of Negligence
breech presentation.
◼ Burns resulting from hot water bags, heat
lamps, vaporizers, sitz bath Doctrine of Respondeat Superior
◼ Objects left inside the patient’s body such as ◼ “Let the master answer for the acts of the
sponges, suction tips, loose dentures lodged in subordinate”
the patient’s trachea ◼ This doctrine is also known as “master-servant”
◼ Falls of the elderly, confused, unconscious, rule
sedated patients, or those who are not fully ◼ The liability is expanded to include the master
recovered from anesthesia as well as the employee.
◼ Falls of children whose side rails were not ◼ This doctrine applies only to those actions
pulled up and locked; and performed by the employee within the scope of
◼ Failure to observe and take appropriate action his employment.
as needed ◼ Respondeat superior is a type of vicarious
SPECIFIC EXAMPLES OF NEGLIGENCE: liability, which allows a third party to be held
1. Failure to report observations to attending liable for a defendant’s negligence, even if the
physicians. third party wasn’t there when the injury
2. Failure to exercise the degree of diligence, occurred.
which the circumstances of the particular case Doctrine of Force Majeure
demand.
3. Mistaken identity
 ◼ The term “force majeure” means an irresistible Intravenous Therapy and Legal
force, one that is unforeseen or inevitable
Implications
◼ These clauses excuse a party from liability if
◼ Nurses’ legal right to give intravenous injection is
some unforseen event beyond the control of
based on the Philippine Nursing Act of 1991
that party prevents it from performing its
Section 28, which states that “in the
obligations under the contract.
administration of intravenous injections, special
◼ Force majeure clauses cover natural disasters or
training shall be required according to protocol
other "Acts of God” such as floods, fire,
established.”
earthquakes or war
◼ Nurses who fail to render service during these Scope of Duties and Responsibilities in
circumstances are not held negligent Intravenous Therapy
◼ Force majeure clauses are intended to excuse a 1. Interpretation of the doctor’s orders for
party only if the failure to perform could not be intravenous therapy
avoided by the exercise of due care by that 2. Performance of venipuncture, insertion of
party. needles, cannulas except TPN and cutdown
3. Preparation, administration, monitoring and
LIABILITY OF NURSES FOR THE WORK OF NURSING termination of intravenous solution such as
AIDES additives, intravenous medications, and
◼ Nursing aides perform selected nursing intravenous push
activities under the direct supervision of nurses 4. Administration of blood/blood products as
◼ Their responsibilities usually pertain to the ordered by physicians
routine care of chronically ill patients 5. Recognition of solution and medicine
LIABILITY FOR THE WORK OF NURSING STUDENTS incompatibilities
◼ Nursing students do not perform professional 6. Maintenance and replacement of sites, tubing’s,
nursing duties but are to be supervised by their dressings, in accordance with established
Clinical Instructors. procedures
◼ To avoid and/or minimized errors, the following 7. Establishment of flow rates of solutions,
measures should be taken: medicines, blood and blood components
1. Nursing students should always be under the 8. Nursing management of Total Parenteral
supervision of their CIs. Nutrition, out-patient intravenous care
2. They should be given assignments that are at 9. Maintenance of established infection control and
their level of training, experience, and aseptic nursing interventions
competency. 10. Maintenance of appropriate documentation,
3. They should be advised to seek guidance associated with the preparation, administration
especially if they are performing a procedure for and termination of all forms of intravenous
the first time. therapy.
4. They should be oriented to the policies of the
nursing unit where they are assigned. CONSENT TO MEDICAL AND SURGICAL
5. Their performance should be assessed PROCEDURES
frequently to determine their strengths and ◼ The very essence of informed consent is to make
weaknesses. the patient understand what will happen to
6. Frequent conferences with the students will him/her after a certain treatment or procedure
reveal their problems which they may want to is made upon his/her body.
bring to the attention of their instructors or vice ◼ It is the patient who must decide whether or not
versa. a certain treatment or procedure must be
performed upon his/her body.
The Basic Elements of Informed Consent:
1. The consent must be voluntary
2. The patient has legal capacity to give consent
 3. The patient has sufficient understanding of the 3. The nurse should sign the name of physician per
situation her own and note the time the order was
4. The patient must make an enlightened decision. received.
Consent may be either: Medical records
◼ Express consent can be obtained either by ◼ The value of medical records is both scientific
having and requiring a patient to sign a written and legal
statement, whether in his/her own statement or ◼ Nurses must remember the rule, “If it was not
in a prescribed legal document, or though an charted, it was not observed or done.”
oral agreement. ◼ In the performance of their duties, nurses are
◼ Implied consent may arise by implication to expected to record fully, accurately, legibly, and
certain circumstances. Nurses or even medical promptly their observations from admission to
practitioners need a witness with regard to the the time of the patient’s discharge
implied consent of the patient. ◼ Charting Done By Nursing Students. When a
◼ Informed consent must include: nurse or a clinical instructor countersigns the
1. the diagnosis and explanation of the condition; charting of a nursing student, he/she attests
2. a fair explanation of the procedures to be done that he/she has personal knowledge of
and used and the consequences; information and that such is accurate and
3. a description of alternative treatments or authentic.
procedures; Legal Guidelines in Documentation
4. a description of the benefits to be expected; 1. Write legibly or print neatly
5. material rights if any; ◼ Illegible entries can cause
6. the prognosis, if the recommended care, misunderstanding leading to errors
procedure, is refused. 2. Use permanent ink
◼ Who Must Consent. Ordinarily, the patient is 3. Write entries in consecutive and chronological
the one who gives the consent in his behalf. order as soon as care has been provided
However, if he is incompetent (such as in the ◼ Be factual and specific
case of minors or the mentally ill) or physically 4. Give the date and time of every entry; sign the
unable and is not an emergency case, consent entry with full signature and position/title
must be taken from another who is authorized ◼ The signature clarifies who is
to give it in his behalf. responsible for the care
◼ Consent of Minors. Parents or someone 5. Describe the care provided and the patient’s
standing in their behalf, gives the consent to response
medical or surgical treatment of a minor. 6. Promptly document any change in the patient’s
Parenteral consent is not needed however, if condition and the actions taken based on that
the minor is married or otherwise emancipated. change
Telephone Orders 7. Chart only for yourself and do not chart in
◼ There are legal risks in telephone orders since advance as patient’s condition may change
these may be misunderstood or misinterpreted anytime
by the receiving nurse 8. Correct errors promptly as these may lead to
◼ Only in extreme emergency situation and when errors in treatment
no other resident or intern is available should a What to avoid in documenting?
nurse receive telephone orders 1. Relying on memory
What to do with telephone orders? ◼ Facts may be forgotten or distorted
1. The nurse should read back such order to the with the passage of time
physician to make certain the order has been ◼ Chart all information before going on a
correctly written. break
2. Such order should be signed by the physician on 2. Making retaliatory remarks or critical
his/her next visit within 24 hours comments regarding the patient or any member
of the health team
 3. Erasing or applying correction fluid or crossing ◼ Discussing with others involved in patient
out word beyond recognition. care, quality assurance, legal mandates,
4. Leaving gaps or blanks spaces on narrative third party payers
notes between entries and signatures. ◼ Privileged communication: lawyers, clergy
5. Using abbreviation except where they are clear ◼ Duty to report: child abuse, gunshot
and appear on the hospital’s list of accepted wounds, threats to another, vulnerable
abbreviations adult abuse, certain communicable
6. Using generalized empty phrases such as diseases
“status unchanged” or “patient had a good False Imprisonment or Illegal Detention
day.” ◼ Unjustifiable detention of a person without a
Intentional Torts legal warrant within boundaries fixed by the
defendant by an act or violation of duty
◼ A willful act that violates another person’s
intended to result in such confinement.
rights or property
◼ If the patient has a communicable disease,
◼ Differs from malpractice in that the nurse must
however, the hospital cannot be charged for
1. intend to bring about the consequences of the
false imprisonment if it compels the patient to
act;
stay in the hospital
2. nurse’s act must be intended to interfere with
◼ Patients insisting on leaving the hospital cannot
the client or his property;
be detained, instead, a competent doctor or
3. the act must be substantial factor in bringing
medical staff must explain the probable
about the injury or consequences
consequences of their actions.

Assault & Battery Invasion of Privacy

◼ Assault: threat or attempt to make bodily ◼ The right to privacy is the right to be left alone,
contact without another person’s consent; the right to be free from unwarranted publicity
causes fear that battery about to occur and exposure to public view as well as the right
◼ Example: Threat to give patient vitamin to live one’s life without having anyone’s name,
injection if does not eat picture or private affairs made public against
◼ Battery: assault carried out, impermissible one’s will
touching; actual harm may or may not occur ◼ Nurses may become liable for invasion of right
◼ Example: Giving pt. vitamin injection to privacy if they divulge information from a
against their will patient’s chart to improper sources or
◼ Patients have the right to refuse treatment, unauthorized persons.
meds, etc. Defamation
Confidentiality ◼ Character assassination, be it written or spoken,
◼ Code of Ethics for nurses constitutes defamation
◼ “the nurse has a duty to maintain ◼ Slander is oral defamation of a person by
confidentiality of all patient information.” speaking unprivileged or false words by which
◼ There is breach of confidentiality if a client’s his reputation is damaged
trust and confidence are violated by public ◼ Libel is defamation by written words, cartoons
revelation of confidential of privileged or such representations that cause a person to
communication without the client’s consent be avoided, ridiculed or held in contempt or
◼ Privileged client information can be disclosed tend to injure him in his work
only upon authorization by the client Patient’s Responsibilities
◼ Disclosure of information to family members is 1. Providing accurate information
not acceptable unless authority is given by the 2. Complying with instructions
client. 3. Informing the physician of refusal of treatment
◼ Exceptions: 4. Paying hospital charges
 5. Following hospital rules and regulations
6. Showing respect and consideration
Prevent Legal Problems
◼ Communicate with providers, patient, family
◼ Document accurately, in timely
manner, and concisely
◼ Rapport with patient & family can be
protection from lawsuits
◼ Meet the standards of care in facility, trends in
area of practice
◼ Practice in a safe setting
◼ Employ appropriate number, skill, and
mix of personnel
◼ Policies and rules that promotes quality
improvement (Risk management)
◼ Keep equipment in good working order
◼ Provide orientation and continuing
education

Positive Interpersonal Relationships is Important

◼ Prevent disgruntled patients; key is positive
relationship with patient/family
◼ Provide personalized care; include in planning;
show compassion & caring
◼ Avoid criticizing or blaming health care
providers
◼ Maintain a concerned and non-defensive
manner
7 Legal Tips
1. Administer medication properly
2. Monitor for & report deterioration
3. Communicate effectively
4. Delegate responsibly
5. Document accurately & timely
6. Know & follow facility policies & procedures
7. Use equipment properly
Austin,S.(2008). Seven legal tips for safe nursing
practice. Nursing2008. March 2008, p 34-40.
Contract and Wills machinations of one of the contracting
parties.
Contract
5. There must be no conflict between what
◼ It is a meeting of minds between two persons
is declared and what is intended.
whereby one binds himself, with respect to the
Persons who are not Qualified to Enter into a Contract
other, to give something or render services.
1. Unemancipated minors are those who have not
◼ The contract must bind both contracting parties
reach the age of 18 years.
and contract should contain some stipulation in
2. Insane or demented persons unless they acted
favor of a third person, he may demand its
during lucid interval. Contracts entered under
fulfillment provided he communicated his
this condition are valid.
acceptance to the obligator before its
3. Deaf – mutes who do not know how to write.
revocation.
4. Those who are in the state of drunkenness or
Consent of Contracting Parties
during hypnotic spell.
◼ Consent is manifested by the meeting of the
Requisites of the Object of Contract
offer and the acceptance upon the thing and
1. All things which are in the commerce of men,
the cause which are to constitute the contract.
including future things.
◼ Offer is a proposal made by one party to
2. It must be transmissible or transferrable from
another into a contract. The offer must be
one person to another.
certain and the acceptance absolute.
3. Not contrary to law, morals, good customs,
◼ Acceptance is the manifestation of the offense
public order or public policy.
of his assent to the terms of the offerer. A
4. Only physically, legally and possible things are
qualified acceptance constitutes a counter-
the subject of the contract.
offer. Acceptance maybe made by letter or
telegram does not bind the offerer except from
the time it came to his knowledge.
Cause of Contract
Requisites of Contract
◼ The cause is understood to be, for each
1. There must be two or more parties.
contracting party the prestation or promise of a
2. The parties must be of legal capacity to enter a
thing or service by the other. If the cause of
contract. Each party must be of legal age; of
contract is remuneratory ones, the service or
sound mind; not suffering physical disability
benefit is remunerated; and in contracts of pure
(mental incompetence); and not under the
beneficence, the mere liberality of the
influence of drugs.
benefactor is stated.
3. There is no vitiation of consent. Vitiation of
Forms of Contract
consent maybe caused through:
Contracts shall be obligatory, in whatever form they
1. Mistake as to identity or qualifications of
may have been entered into, provided all the essential
one of the parties only when it is the
requisites for their validity are present. The following
principal cause of contract.
must appear in a public document:
2. Violence as to serious or irresistible force
1. Acts and contracts which have for their object
is employed to wrest the contract.
the creation, transmission, modification or
3. Intimidation as when one of the
extinguishment of real rights over immovable
contracting parties is compelled by a
property; sales of real property or of an interest
reasonable and well grounded fear of an
therein
imminent and grave evil upon his person
2. The cession, repudiation or renunciation of
or property
hereditary rights or of those of the conjugal
4. Undue influence or fraud. There is undue
partnership of gains.
influence when a person takes improper
3. The power to administer property, or any other
advantage of his power over the will of
power which has for its object an act appearing
another, depriving the latter of
or which should appear in a public document, or
reasonable freedom of choice. There is
should prejudice a third person.
fraud when, through insidious words or
 4. The cession of actions or rights proceeding from Succession and Wills
an act appearing in a public document.
◼ Succession is a mode of acquisition by virtue of
Kinds of Contract
which the property, rights and obligations to
◼ Informal contracts are those which maybe
the extent of the values of the inheritance, of a
entered into in whatever from provided that all
person are transmitted through his death to
requisites are present for validity. These may be
another or others either by his will or by
oral or written.
operation of law.
◼ Formal contracts are those which require
◼ Decendent is the general term applies to the
special formalities or a certain specified form. It
person whose property is transmitted through
may also contain the perfected form of consent,
succession, whether or not he left a will.
subject matter and cause.
◼ Inheritance includes all the property, rights and
◼ Implied contract is a contract that is concluded
obligations of a person which are not
as the result of acts of parties to which there is
extinguished by his death.
an objective intention to enter into a contract.
Kinds of Succession
◼ Expressed contract is one which conditions of
◼ Testamentary succession is the one that which
the contract are expressed through writing or
results from the designation of an heir, made in
orally by both parties.
a will executed in the form prescribed by law.
◼ Void contracts are those that do not have effect
◼ Legal or Intestate succession occurs when a
at all or invalid due to fictitious content; the
person did not make a will before his death, if
cause of object do not exist at the time of
his will is void; the law vests the inheritance to
transaction; object of the contract cannot be
the proper persons such as the legitimate or
ascertained; and object of the contract is
illegitimate relatives of the deceased.
contrary to the law.
◼ Mixed succession is that partly affected, partly
◼ Illegal contract are those that are contrary to
by will, and partly by operation of law.
the law because of consent obtained through
Will
fraud; threatened violence to get consent; and
◼ Will is an act whereby a person is permitted,
consent taken through material
with the formalities prescribed by law, to
misrepresentation.
control to a certain degree the disposition of
this estate, to take effect after his death.
◼ Living will, also called a directive to physicians,
is a document that lets people state their
wishes for end-of-life medical care, in case they
become unable to communicate their decisions
◼ Testator is the one making the will
◼ Devisees and Legatees are persons to who gifts
of real and personal property are respectively
given by virtue of a will.
Forms of Wills
Ordinary or Natural Will
◼ Every will must be in writing and executed in a
language or dialect known to the testator.
◼ Every will, other then a holographic will, must
be subscribed at the end thereof by the testator
himself or by the testator’s name written by
some other person in his presence, and by his
express direction.
Holographic Wills
◼ The dispositions of the testator written below
his signature must be dated and signed by him
 in order to make them valid as testamentary Laws Relevant to Nursing Practice
dispositions.
Statury law
◼ When a number of dispositions appearing in a
The legal guidelines that nurses follow come from
holographic will are signed without being dated
statutory law, regulatory law, and common law. Elected
and the last dispositions has a signature and a
legislative bodies such as state legislatures and the U.S.
date, such dates validates the dispositions
Congress create statutory law. An example of state
preceding it, whatever be the time of prior
statutes are the Nurse Practice Acts
dispositions.
Persons Qualified to Make a Will
What is the Philippine nursing Law?
1. All persons who are not expressly prohibited by
Title. - This Act shall be known as the "Philippine
law may make a will.
Nursing Act of 2002." Section 2. ... The State hereby
2. The testator is of sound mind at the time of its
guarantees the delivery of quality basic health services
execution. To be of sound mind, it is necessary
through an adequate nursing personnel system
that the testator be in full possession of all his
throughout the country.
reasoning faculties, or that his mind be wholly
Republic Act No. 9173
unbroken, unimpaired by disease, injury or
AN ACT PROVIDING FOR A MORE RESPONSIVE NURSING
other cause.
PROFESSION,
3. A married woman may make a will without
REPEALING FOR THE PURPOSE REPUBLIC ACT NO. 7164,
consent of her husband, and without authority
OTHERWISE
of the court.
KNOWN AS "THE PHILIPPINE NURSING ACT OF 1991"
4. Persons of either sex above eighteen years of
AND FOR OTHER
age.
PURPOSES
Witnesses to Wills
Be it enacted by the Senate and the House of
The following are qualified to be a witness to a will:
Representatives of the Philippines
1. Any person of sound mind
in Congress assembled:
2. Age of eighteen years or more
ARTICLE I Title Section 1. Title. - This Act shall be known
3. Not blind, deaf or dumb
as the "Philippine Nursing Act of 2002." ARTICLE II
4. Able to read and write
Declaration of Policy Section 2. Declaration of Policy. – It
The following are disqualified from being witnesses to a
is hereby declared the policy of the State to assume
will:
responsibility for the protection and improvement of
1. Any person not domiciled in the Philippines
the nursing profession by instituting measures that will
2. Those who have been convicted of falsification
result in relevant nursing education, humane working
of a document, perjury, or false testimony.
conditions, better career prospects and a dignified
existence for our nurses. The State hereby guarantees
the delivery of quality basic health services through an
adequate nursing personnel system throughout the
country.
ARTICLE II Declaration of Policy
Section 2. Declaration of Policy. – It is hereby declared
the policy of the State to
assume responsibility for the protection and
improvement of the nursing
profession by instituting measures that will result in
relevant nursing education,
humane working conditions, better career prospects
and a dignified existence for
our nurses.
The State hereby guarantees the delivery of quality
basic health services through
an adequate nursing personnel system throughout the of the members of the Board shall be holders of a
country master's degree in
ARTICLE III nursing: Provided, further, That the Chairperson shall be
Organization of the Board of Nursing a holder of a
Section 3. Creation and Composition of the Board. - master's degree in nursing;
There shall be created a What laws protect nurses?
Professional Regulatory Board of Nursing, hereinafter Nurses have the right to a work environment that is safe
referred to as the Board, to for themselves and their patients. The federal
be composed of a Chairperson and six (6) members. Occupational Safety and Health Act of 1970 requires
They shall be appointed by that an employer provide a workplace free from
the president of the Republic of the Philippines from recognized hazards that could cause harm or death to
among two (2) employees.
recommendees, per vacancy, of the Professional Why the laws in nursing are important in our nursing
Regulation Commission, profession?
hereinafter referred to as the Commission, chosen and The reality is that law is now fundamental to the study
ranked from a list of three of nursing and underpins your relationship with the
(3) nominees, per vacancy, of the accredited profession and with your patients. The law informs
professional organization of nurses nursing at every stage and it is essential that you
in the Philippines who possess the qualifications understand and are able to critically reflect on the legal
prescribed in Section 4 of this issues relevant to nursing practice
Act.
(d) Have at least ten (10) years of continuous practice of
the profession
prior to appointment: Provided, however, That the last
five (5) years of
which shall be in the Philippines; and
(e) Not have been convicted of any offense involving
moral turpitude;
Provided, That the membership to the Board shall
represent the three (3)
areas of nursing, namely: nursing education, nursing
service and
community health nursing.
Section 4. Qualifications of the Chairperson and
Members of the Board. - The
Chairperson and Members of the Board shall, at the
time of their appointment,
possess the following qualifications:
(a) Be a natural born citizen and resident of the
Philippines;
(b) Be a member of good standing of the accredited
professional
organization of nurses;
(c) Be a registered nurse and holder of a master's
degree in nursing,
education or other allied medical profession conferred
by a college or
university duly recognized by the Government:
Provided, That the majority