This document outlines policies and standards for Bachelor of Science in Nursing (BSN) programs in the Philippines. It establishes that BSN programs must be at least 4 years and consist of general education and professional nursing courses. It defines 11 key areas of responsibility that BSN graduates must demonstrate competence in, including safe nursing care, management, health education, legal/ethical responsibilities, and professional development. It also specifies requirements for institutions to offer BSN programs and competency standards for new nurses.
This document outlines policies and standards for Bachelor of Science in Nursing (BSN) programs in the Philippines. It establishes that BSN programs must be at least 4 years and consist of general education and professional nursing courses. It defines 11 key areas of responsibility that BSN graduates must demonstrate competence in, including safe nursing care, management, health education, legal/ethical responsibilities, and professional development. It also specifies requirements for institutions to offer BSN programs and competency standards for new nurses.
This document outlines policies and standards for Bachelor of Science in Nursing (BSN) programs in the Philippines. It establishes that BSN programs must be at least 4 years and consist of general education and professional nursing courses. It defines 11 key areas of responsibility that BSN graduates must demonstrate competence in, including safe nursing care, management, health education, legal/ethical responsibilities, and professional development. It also specifies requirements for institutions to offer BSN programs and competency standards for new nurses.
This document outlines policies and standards for Bachelor of Science in Nursing (BSN) programs in the Philippines. It establishes that BSN programs must be at least 4 years and consist of general education and professional nursing courses. It defines 11 key areas of responsibility that BSN graduates must demonstrate competence in, including safe nursing care, management, health education, legal/ethical responsibilities, and professional development. It also specifies requirements for institutions to offer BSN programs and competency standards for new nurses.
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Republic of the Philippines
OFFICE OF THE PRESIDENT
COMMISSION ON HIGHER EDUCATION
CHED MEMORANDUM ORDER (CMO) No. 14 Series of 2009
SUBJECT: POLICIES AND STANDARDS FOR BACHELOR OF SCIENCE IN NURSING (BSN) PROGRAM
In accordance with pertinent provisions of Republic Act (RA) No. 7722, otherwise known as the Higher Education Act of 1994 and pursuant to Commission en Banc Resolution No. 170 dated April 19, 2009, and for the purpose of rationalizing Nursing Education in the country to provide relevant and quality health services locally and internationally, the following policies and standards for Bachelor of Science in Nursing (BSN) program are hereby adopted and promulgated by the Commission.
ARTICLE I INTRODUCTION
Section 1. A person is a unique bio-psycho-socio-cultural and spiritual being who is always in constant interaction with the environment. These interactions affect individuals, families, population groups and societal health status.
The nurse assumes the caring role in the promotion and restoration of health, prevention of diseases, alleviation of suffering and, when recovery is not possible, in assisting patients towards a peaceful death. The nurse also collaborates with other members of the health team and other sectors to achieve quality healthcare. Moreover, the nurse works with individuals, families, population groups, communities and society, as a whole, in ensuring active participation in the delivery of holistic healthcare.
Within the context of Philippine society, nursing education, with caring as its foundation, subscribes to the following core values which are vital components in the development of a professional nurse and are therefore emphasized in the BSN program:
1.1 Love of God 1.2 Caring as the core of nursing a. Compassion b. Competence c. Confidence e. Conscience f. Commitment (commitment to a culture of excellence, discipline, integrity and professionalism) 1.3 Love of People
1 a. Respect for the dignity of each person regardless of creed, color, gender and political affiliation. 1.4 Love of Country .a Patriotism (Civic duty, social responsibility and good governance) .b Preservation and enrichment of the environment and culture heritage
A strong liberal arts and sciences education with a transdisciplinary approach, enhances this core values. The BSN program therefore, aims to prepare a nurse, who, upon completion of the program, demonstrates beginning professional competencies and shall continue to assume responsibility for professional development and utilizes research findings in the practice of the profession. The following are the Key Areas of Responsibility for which a nurse should demonstrate competence in:
1. Safe and quality nursing care 2. Management of resources and environment 3. Health education 4. Legal responsibility 5. Ethico-moral responsibility 6. Personal and professional development 7. Quality improvement 8. Research 9. Record Management 10. Communication 11. Collaboration and teamwork
ARTICLE II AUTHORITY TO OPERATE
Section 2. All private higher education institutions (PHEIs) intending to offer the Bachelor of Science in Nursing program must first secure proper authority from the Commission in accordance with existing rules and regulations. State universities and colleges (SUCs) and local colleges and universities (LCUs) should strictly adhere to the provisions of these policies and standards.
The BSN program shall be offered by HEIs with strong liberal arts education, offering at least six (6) baccalaureate programs, preferably in a university-based setting. In the case of colleges and universities with less than six (6) baccalaureate program offerings, a Memorandum of Agreement [MOA] shall be entered between and among higher education institutions with strong liberal arts education [e.g. AB Psychology, BS Biology, AB English, BS Engineering, BS Math, BS Economics] or hire qualified faculty to teach the General Education courses.
ARTICLE III PROGRAM SPECIFICATIONS
2
Section 3. Degree Name.
The degree name shall be Bachelor of Science in Nursing (BSN). To ensure the quality of the nursing graduate, the degree is conferred upon completion of at least four- year BSN program offered by a college or university duly recognized by the Commission on Higher Education.
Section 4. Program Description.
The BSN is a four-year program consisting of general education and professional courses. Professional courses begin in the first year and threads through the development of competencies up to the fourth year level. The BSN program provides an intensive nursing practicum that will refine clinical skills from the first year level to ensure basic clinical competencies required of a beginning nurse practitioner.
4.1 Objective: The BSN program aims to produce a fully functioning nurse who is able to perform the competencies under each of the Key Areas of Responsibility as enumerated in Article IV Section 5 herein.
4.2 Specific Careers/Professions/Occupations. Graduates of this program as beginning nurse practitioner may pursue the following career paths but not limited to:
a. Clinical Nursing b. Community Health Nursing c. Private-duty Nursing d. Occupational Health Nursing e. School Nursing f. Military Nursing g. Health Education h. Research i. Entrepreneurship
4.3 Allied Programs. The BSN program is allied to the following health related programs:
a. Medicine b. Dentistry c. Optometry d. Physical Therapy/Occupational Therapy e. Pharmacy f. Public Health g. Medical Technology h. Radiologic Technology i. Respiratory Therapy j. Nutrition and Dietetics k. Midwifery l. Speech Pathology
ARTICLE IV
3 COMPETENCY STANDARDS
Section 5. Graduates of Bachelor of Science in Nursing program must be able to apply analytical and critical thinking in the nursing practice. The nurse must be competent in the following Key Areas of Responsibility and its respective core competency standards and indicators:
Key Areas of Responsibility Core Competency Indicators A. Safe and Core Competency 1: - Identifies the health
Quality Demonstrates
needs of the clients (individuals, families,
Nursing knowledge based on
population groups and/or communities)
Care the health /illness
- Explains the health
status of individual /
status of the clients/ groups
groups
Core Competency 2: - Identifies wellness
Provides sound
potential and/or health problem of clients
decision making in the
- Gathers data related to
care of individuals /
the health condition
families/groups
- Analyzes the data
considering their
gathered
beliefs and values
- Selects appropriate
action to support/enhance wellness response; manage the health problem - Monitors the progress of the action taken Core Competency 3: - Performs age-specific
Promotes safety and
safety measures in all aspects of client care
comfort and privacy of
- Performs age-specific
clients
comfort measures in all aspects of client care
- Performs age-specific measures to ensure privacy in all aspects of client care Core Competency 4: - Identifies the priority
Sets priorities in
needs of clients
nursing care based on
- Analyzes the needs of
clients needs
clients
- Determines appropriate nursing care to address priority needs/problems Core Competency 5: - Refers identified problem
Ensures continuity of
to appropriate individuals / agencies
care
- Establishes means of
providing continuous client care Core Competency 6: - Conforms to the 10 golden
4 Administers rules in medication administration and medications and other health therapeutics health therapeutics Core Competency 7: - Obtains informed consent
Utilizes the nursing
- Completes appropriate
process as framework
assessment forms
for nursing
- Performs appropriate
7.1 Performs assessment techniques
- Obtains comprehensive
comprehensive and
client information
systematic nursing
- Maintains privacy and
assessment
confidentiality
- Identifies health needs 7.2 Formulates a - Includes client and family
plan of care in
in care planning
collaboration with
- Collaborates with other
clients and other
members of the health team
members of the
- States expected
health team
outcomes of nursing intervention maximizing
clients competencies - Develops comprehensive client care plan maximizing opportunities for prevention of problems and/or enhancing wellness response - Accomplishes client- centered discharge plan 7.3 Implements - Explains interventions to
planned nursing care
client and family before carrying them out to
to achieve identified
achieve identified outcomes
outcomes
- Implements nursing
intervention that is safe and comfortable - Acts to improve clients health condition or human response - Performs nursing activities effectively and in a timely manner - Uses the participatory approach to enhance client-partners empowering potential for healthy life style/wellness 7.4 Evaluates - Monitors effectiveness of
progress toward
nursing interventions
expected outcomes
- Revises care plan based
on expected outcomes B. Manage - Core Competency 1: - Identifies tasks or
ment of Organizes work load
activities that need to be accomplished
Resources to facilitate client care
- Plans the performance of
and
tasks or activities based on priorities
5 Environment - Verifies the competencies
of the staff prior to delegating tasks - Determines tasks and procedures that can be safely assigned to other members of the team - Finishes work assignment on time Core Competency 2: - Identifies the cost-
Utilizes financial
effectiveness in the utilization of resources
resources to support
- Develops budget
client care
considering existing resources for nursing
care Core Competency 3: - Plans for preventive
Establishes
maintenance program
mechanism to ensure
- Checks proper
proper functioning of
functioning of equipment considering the:
equipment
- intended use
- cost -benefit - infection control - safety - waste creation and disposal storage - Refers malfunctioning equipment to appropriate unit Core Competency 4: - Complies with standards
Maintains a safe
and safety codes prescribed by law
environment
- Adheres to policies,
From Competency 5 procedures and protocols on prevention and
control of infection
- Observes protocols on pollution-control (water, air and noise) - Observes proper disposal of wastes - Defines steps to follow in case of fire, earthquake and other emergency situations. Core Competency 1: - Obtains learning
C. Health Assesses the learning
information through interview, observation
Education needs of the clients/
and validation
partner/s
- Analyzes relevant
information - Completes assessment records appropriately - Identifies priority needs Core Competency 2: - Considers nature of
Develops health
learner in relation to: social, cultural, political,
education plan based
economic, educational and religious factors.
6 on assessed and - Involves the client, family,
anticipated needs
significant others and other resources in identifying learning needs on behavior change for wellness, healthy lifestyle or management of health problems - Formulates a comprehensive health education plan with the following components: objectives, content, time allotment, teaching-learning resources and evaluation parameters - Provides for feedback to finalize the plan Core Competency 3: - Develops information
Develops learning
education materials appropriate to the level of
materials for health
the client
education
Applies health education
-
principles in the development of information education materials Core Competency 4: - Provides for a conducive
Implements the health
learning situation in terms of time and place
education plan
- Considers client and
familys preparedness - Utilizes appropriate strategies that maximize opportunities for behavior change for wellness/healthy life style Provides reassuring
- presence through active listening, touch, facial expression and gestures - Monitors client and familys responses to health education Core Competency 5: - Utilizes evaluation
Evaluates the
parameters
outcome of health
Documents outcome of
-
education
care
- Revises health education plan based on client response/outcome/s Core Competency 1: - Fulfills legal requirements
D. Legal Adheres to practices
in nursing practice
Responsibility in accordance with
- Holds current
the nursing law and
professional license
other relevant
- Acts in accordance with
legislation including
the terms of contract of employment and
contracts, informed
other rules and regulations
consent.
- Complies with required
continuing professional education
7 - Confirms information
given by the doctor for informed consent
- Secures waiver of
responsibility for refusal to undergo
treatment or procedure
- Checks the completeness of informed
consent and other legal forms
Core Competency 2: - Articulates the vision,
Adheres to
mission of the institution where one belongs
organizational policies
- Acts in accordance with
and procedures, local
the established norms of conduct of the
and national
institution / organization/legal and regulatory
requirements
Core Competency 3: - Utilizes appropriate client
Documents care
care records and reports.
rendered to clients
- Accomplishes accurate
documentation in all matters concerning
client care in accordance to the standards of
nursing practice.
E. Ethico-moral Core Competency 1: - Renders nursing care consistent with the
Responsibility Respects the rights of
clients bill of rights: (i.e. confidentiality of
individual / groups
information, privacy, etc.)
Core Competency 2: - Meets nursing
Accepts responsibility
accountability requirements as embodied in
and accountability for
the job description
own decision and
- Justifies basis for nursing
actions
actions and judgment
- Projects a positive image
of the profession
Core Competency 3: - Adheres to the Code of
Adheres to the
Ethics for Nurses and abides by its
national and
provisions
international codes of
- Reports unethical and
ethics for nurses
immoral incidents to proper authorities
F. Personal Core Competency 1: - Identifies ones strengths,
and Identifies own
weaknesses and limitations
Professional learning needs
- Determines personal and
Development
professional goals and aspirations
Core Competency 2: - Participates in formal and
Pursues continuing
non-formal education
education
- Applies learned
information for the improvement of care
Core Competency 3: - Participates actively in
Gets involved in
professional, social, civic, and religious
professional
activities
8 organizations and - Maintains membership to
civic activities
professional organizations
- Support activities related to nursing and health issues Core Competency 4: - Demonstrates good
Projects a
manners and right conduct at all times
professional image of
- Dresses appropriately
the nurse
- Demonstrates
congruence of words and actions - Behaves appropriately at all times Core Competency 5: - Listens to suggestions
Possesses positive
and recommendations
attitude towards
- Tries new strategies or
change and criticism
approaches
Adapts to changes
- willingly Core Competency 6: - Assesses own
Performs functions
performance against standards of practice
according to
- Sets attainable objectives
professional
to enhance nursing knowledge and skills
standards
- Explains current nursing
practices, as the situation arises G. Quality Core Competency 1: - Identifies appropriate
Improvement Gathers data for
quality improvement methodologies for
quality improvement
clinical problems
- Detects variations in specific parameters i.e vital signs of the client from day to day - Reports significant changes in clients condition/environment to improve stay in the hospital - Solicits feedback from clients and significant others regarding care rendered Core Competency 2: - Shares with the team
Participates in nursing
relevant information regarding clients
audits and rounds
condition and significant changes in clients environment Encourages the client to
- verbalize relevant changes in his/her condition Performs daily check of
- clients records / condition - Documents and records all nursing care and actions implemented 9 Core Competency 3: - Reports to appropriate person/s significant
Identifies and reports
variances/changes/occurrences immediately
variances
- Documents and reports observed
variances regarding client care Core Competency 4: - Gives an objective and
Recommends
accurate report on what was observed
solutions to identified
rather than an interpretation of the event
problems
- Provides appropriate
suggestions on corrective and preventive measures - Communicates solutions to appropriate groups Core Competency 1: - Specifies researchable
H. Research Gathers data using
problems regarding client care and
different
community health
methodologies
- Identifies appropriate
methods of research for a particular client / community problem - Combines quantitative and qualitative nursing design through simple explanation on the phenomena observed Core Competency 2: - Analyzes data gathered using appropriate
- Endeavors to publish research - Submits research findings to own agency and others as appropriate Core Competency 5: - Utilizes findings in
Applies research
research in the provision of nursing care for
findings in nursing
individuals / groups / communities
practice
- Makes use of evidence-based nursing to
enhance nursing practice Core Competency 1: - Completes updated
I. Records Maintains accurate
documentation of client care
Management and updated
- Applies principles of
documentation of
record management
client care
- Monitors and improves
10 accuracy, completeness and reliability of relevant data - Makes record readily accessible to facilitate client care
Core Competency 2: - Utilizes records system
Records outcome of
ex. Kardex or Hospital Information System
client care
(HIS)
- Uses data in decision and policy making activities
Core Competency 3: - Maintains integrity,
safety, access and security of records
Observes legal
- Documents/monitors
imperatives in record
proper record storage, retention and disposal
keeping
- Observes confidentially
and privacy of the clients records - Maintains an organized system of filing and keeping clients records in a designated area - Follows protocol in releasing records and other information
Core Competency 1: - Creates trust and confidence
Establishes rapport
- Spends time with the client/significant others
J. with clients, significant
and members of the health team to facilitate
Communicatio others and members
interaction
n of the health team
- Listens actively to clients concerns/significant
others and members of the health team
Core Competency 2: - Interprets and validates
Identifies verbal and
clients body language and facial expressions
non-verbal cues
Core Competency 3: - Makes use of available
Utilizes formal and
visual aids
informal channels
- Utilizes effective channels of
communication relevant to client care management
Core Competency 4: - Provides reassurance
Responds to needs of
through therapeutic touch, warmth and
individuals, families,
comforting words of encouragement
groups and
- Provides therapeutic bio-
communities
behavioral interventions to meet the needs
of clients
11 Core Competency 5: - Utilizes telephone, mobile
Uses appropriate
phone, electronic media
information
- Utilizes informatics to
technology to facilitate
support the delivery of healthcare
communication
Core Competency 1: - Contributes to decision
K. Establishes
making regarding clients needs and
Collaboration collaborative
concerns
and relationships with
- Participates actively in client
Teamwork colleagues and other
care management including audit
members of the
- Recommends appropriate
health team
interventions to improve client care
- Respects the role of other members of the health team - Maintains good interpersonal relationships with clients, colleagues and other members of the health team Core Competency 2: - Refers clients to allied health
Collaborates plan of
team partners
care with other
- Acts as liaison / advocate of
members of the
the client
health team
- Prepares accurate
documentation for efficient communication of services
ARTICLE V CURRICULUM
Section 6. Curriculum. Higher education institutions offering the Bachelor of Science in Nursing program must conform to the standard curriculum embodied in this CMO, provided that program innovations shall be subject to prior review by the Commission.
Section 7. Level Objectives. The student shall be given opportunities to be exposed to the various levels of health care (health promotion, disease prevention, risk reduction, curative and restoration of health) with various client groups (individual, family, population groups and community) in various settings (hospital, community). These opportunities shall be given in graduated experiences to ensure that the competencies per course, per level and for the whole program are developed.
Before graduation, the student shall approximate the competencies of a professional nurse as they assume the various roles and responsibilities. For each year level, the following objectives should be achieved:
7.1 At the end of the first year, the students shall have acquired an understanding and awareness of themselves as an individual and as a member of the family, the
12 community, and the world with emphasis on personal, societal and professional values responsibilities, rights, and an awareness of physical, social and cultural milieu.
The student shall have an awareness of the competency -based approach in the curriculum and the core competencies under the 11 key areas of responsibility: safe and quality nursing care, communication, collaboration and teamwork, health education, legal responsibility, ethico-moral responsibility, personal and professional development, quality improvement, research, management of resources and environment, and record management.
Specifically, the student shall:
a. develop a deeper understanding of himself/herself and the multi-factorial dimensions of the individual which can affect health and well being; b. recognize his/her duty in improving the quality of life not only for himself/herself but for others as well; c. develop a deeper awareness of his/her rights, duties and responsibilities to God, country and the world; d. demonstrate beginning skills in the use of the nursing process in caring for healthy individuals; e. explain the theoretical foundation of nursing with the four meta-paradigms as guide to his/her nursing practice; f. apply the scientific method to his activities wherever possible; g. imbibe the values cherished by the nursing profession such as teamwork, respect, love of God, integrity and caring; h. discuss the competency based BSN program and the core competencies under the 11 key areas of responsibility; and i. demonstrate critical thinking skills in relating with self and others.
7.2 At the end of the second year, the student shall have acquired the holistic understanding of the human person as a bio-psycho-cultural being focusing on the concept of health and illness as it is related to the care of the mother and child in varied settings. The student shall be able to demonstrate the competencies in the following key areas of responsibility such as safe and quality nursing care, communication, collaboration and teamwork, health education, legal responsibility, ethico-moral responsibility, personal and professional development, quality improvement, research, management of resources and environment, and records management.
Specifically, the student shall:
a. describe the health care delivery system and the role of the nurse in it; b. demonstrate ethico-moral, legal responsibilities in the care of individual family and community; c. demonstrate the beginning skills in the provision of independent and collaborative nursing functions; d. relate the stages of growth and development in the care of clients; e. demonstrate beginning skills in the preparation of healthy and therapeutic diets in varied client cases;
13 f. explain the dynamics of the disease process caused by microbes and parasites and the environment; g. imbibe the core values cherished by the nursing profession such as love of God, country and people, and caring; h. design a plan that will focus on health promotion and risk reduction to clients; and i. utilize the nursing process in the care of the high risk mother and child in the family.
7.3 At the end of the third year, given actual clients/situations with various physiologic and psychosocial alterations, the student shall be able to demonstrate the competencies in the following key areas of responsibility such as safe and quality nursing care, communication, collaboration and teamwork, health education, legal responsibility, ethico -moral responsibility, personal and professional development, quality improvement, research, management of resources and environment, and records management.
Specifically the student shall:
a. utilize the nursing process in caring for clients across the lifespan with problems in oxygenation, fluid and electrolyte balance, metabolism and endocrine functioning, inflammatory and immunologic reactions, perception coordination and maladaptive patterns of behavior; b. apply the research process in addressing nursing/health problems to improve quality of care; c. integrate the role of culture and history in the plan of care; d. apply principles of good governance in the effective delivery of quality health care; e. observe the core values cherished by the nursing profession such as love of God, country and people, and caring and the bioethical principles in the care of clients; f. apply a nursing theory in the management of care of a client for case study; and, g. discuss the roles of economics as it impacts on health and illness;
7.4 At the end of the 4th year, given actual clients/situations the student shall be able to demonstrate competencies in all the key areas of responsibility such as safe and quality nursing care, communication, collaboration and teamwork, health education, legal responsibility, ethico-moral responsibility, personal and professional development, quality improvement, research, management of resources and environment, and records management.
Specifically, the student shall:
a. utilize the nursing care process in caring for clients across the lifespan with problems in cellular aberrations and acute biologic crisis, disaster/emergency situations; b. apply a nursing theory in the management of care of a client for case study; c. observe the core values cherished by the nursing profession such as love of
14 God, country, people and caring, and the bioethical principles and legal dimensions in the care of clients; and, d. demonstrate leadership and management skills in the care of a group of clients in the community and hospital setting utilizing research findings.
Section 8. Curriculum Outline A. Outline of Total Units of General Education (GE) Courses: 87 Units Courses Units Language and Humanities 21 English 1 & 2 (Communication Skills) 6 English 3 (Speech and Communication) 3 Filipino 1 & 2 6 Philosophy of Man 3 Logic and Critical Thinking 3 Mathematics, Natural Sciences & Information Technology 22 Mathematics (College Algebra) 3 Biostatistics 3 General Chemistry 3/2 5 Biochemistry 3/2 5 Physics 2/1 3 Informatics 2/1 3 Health Sciences 9 Anatomy & Physiology 3/2 5 Microbiology & Parasitology 3/1 4 Social Sciences 15 General Psychology 3 Sociology/Anthropology 3 Humanities [ World Civilization & Literature] 3 Economics with Taxation & Land Reform 3 Bioethics 3 Mandated Subjects 20 Life, Works and Writings of Rizal 3 Philippine History, Government & Constitution 3 PE 1 to 4 [2 units each] 8 National Service Training Program 1& 2 6 B. Outline and Units of Professional Courses 115 Units Theoretical Foundations in Nursing 3 Health Assessment (2/1*) 3 Community Health Nursing (3/2*) 5 Nutrition and Diet Therapy (3/1) 4 Health Education 3 Pharmacology 3 Nursing Research I (2/1) 3
15 Nursing Research II 2 Competency Appraisal I 3 Competency Appraisal II 3 Elective I** 2 Elective II** 2 NCM 100 Fundamentals of Nursing Practice (3/2*) 5 NCM 101 -- Care of Mother, Child and Family (4/4*) 8 NCM 102 Care of Mother, Child, Family and Population Group At-risk or With Problems (5/6*) 11 NCM 103 Care of Clients with Problems in Oxygenation, Fluid & Electrolyte Balance, Metabolism and Endocrine (8/6*) 14 NCM 104 Care of Clients with Problems in Inflammatory and Immunologic Response, Perception and Coordination (5/4*) 9 NCM 105 Care of Clients with Maladaptive Patterns of Behavior (4/2*) 6 NCM 106 Care of Clients with Problems in Cellular Aberrations, Acute Biologic Crisis including Emergency and Disaster Nursing (6/5*) 11 NCM 107 Nursing Leadership and Management (4/3*) 7 Intensive Nursing Practicum (8*) 8 *Related Learning Experience Grand Total Number of Units = 202 At the end of the B. S. Nursing program, the total number of related learning experiences, skills laboratory/clinicals shall include the following:
RLE Contact Hours
Courses Skills Lab Clinical (1 credit unit =51
hours)
Health Assessment 1 0 51
Community Health Nursing 0.5 1.5 102
Nursing Research I 1 0 51
Nursing Research II 2 0 102
Nursing Care Management 100 2 0 102
Nursing Care Management 101 1 3 204
Nursing Care Management 102 1 5 306
Nursing Care Management 103 1 5 306
Nursing Care Management 104 1 3 204
Nursing Care Management 105 0 2 102
Nursing Care Management 106 2 3 255
Nursing Care Management 107-B 0 3 153
Intensive Nursing Practicum 0 8 408
Total 12.5 33.5 2,346 hours
46 RLE Units
At the end of the B. S. Nursing program, the total number of laboratory units/hours shall comprise the following courses: Courses Laboratory Units Laboratory Hours
1 unit lab=54 hours
General Chemistry 2 108
Anatomy & Physiology 2 108
Biochemistry 2 108
Physics 1 54
16 Microbiology & Parasitology 1 54 Nutrition with Diet Therapy 1 54 Informatics 1 54 TOTAL 10 units 540 hours
Section 9. Program of Study
BACHELOR OF SCIENCE IN NURSING Prototype 4-Year Curriculum
FIRST YEAR First Semester Course Lec Lab RLE Units Code Course Name SL C English 1 Communication Skills I 3 0 0 0 3 Filipino 1 Komunikasyon sa Akademikong 3 0 0 0 3 Filipino Chem 1 General Chemistry (Organic & Inorganic) 3 2 0 0 5 TFN Theoretical Foundations in Nursing 3 0 0 0 3 Math 1 College Algebra 3 0 0 0 3 Psych General Psychology 3 0 0 0 3 PE 1 Physical Education 1 2 0 0 0 2 NSTP 1 National Service Training Program 3 0 0 0 3 Total 23 2 0 0 25 Second Semester Course Lec Lab RLE Units Code Course Name SL C English 2 Communication Skills II 3 0 0 0 3 Filipino 2 Pagbasa at Pagsulat Tungo sa 3 0 0 0 3 Pananaliksik Ana/Physio Anatomy and Physiology 3 2 0 0 5 NCM 100 Fundamentals of Nursing Practice 3 0 2 0 5 Chem 2 Biochemistry 3 2 0 0 5 PE 2 Physical Education 2 2 0 0 0 2 NSTP 2 National Service Training Program 3 0 0 0 3 Total 20 4 2 0 26 SUMMER Course Le La RLE Units Code Course Name c b SL C Physics Physics 2 1 0 0 3 Logic Logic and Critical Thinking 3 0 0 0 3 HA Health Assessment 2 0 1 0 3
17 7 1 1 0 9
SECOND YEAR
First Semester Lec Lab RLE Units Course Code Course Name
SL CL
NCM 101 Care of Mother, Child and Family 4 0 1 3 8
CHN Community Health Nursing 3 0 0.5 1.5 5
Micro/Para Microbiology and Parasitology 3 1 0 0 4
Philo Philosophy of Man 3 0 0 0 3
Bioethics Bioethics 3 0 0 0 3
PE 3 Physical Education 3 2 0 0 0 2
Total 18 1 1.5 4.5 25
Second Semester Lec Lab RLE
Units
Course Code Course Name
SL C
Care of Mother, Child, Family and L
NCM 102 Population Group At-risk or With 5 0 1 5 11
Problems
NuDiet Nutrition and Diet Therapy 3 1 0 0 4
Pharma Pharmacology 3 0 0 0 3
Socio/Anthro Sociology with Anthropology 3 0 0 0 3
Second Semester Course Course Name Lec Lab RLE Units Code SL C INP Intensive Nursing Practicum 0 0 0 8 8 CA 2 Competency Appraisal 2 3 0 0 0 3 NCM 107-B Nursing Leadership and Management 0 0 0 3 3 (RLE) Total 3 0 0 11 14 SL - Skills Laboratory C - Clinicals
ARTICLE VI
20 OTHER REQUIREMENTS
Section 10. Program Administration:
10.1 The College shall be administered by a full-time dean with the following qualifications:
o. Filipino citizen; |. Registered Nurse in the Philippines with current and valid PRC ID; _. Holder of Masters degree in Nursing (MAN, MN, MSN) conferred by a college or university duly recognized by the Commission on Higher Education; o. Has at least one (1) year experience of clinical practice and a total of at least five (5) years experience in teaching, administration and supervision of nursing education; c. Physically and mentally fit; |. Of good moral character; . Has no other teaching assignments or administrative functions in other public/private institutions or higher education institutions; q. Member of accredited professional nursing organization of good standing; i. Upon appointment, he/she must be an active member of good standing of the Association of Deans of Philippine College of Nursing (ADPCN); and, . Upon appointment, he/she should have a duly notarized employment contract of at least one (1) academic year renewable annually. The contract should specify the academic rank.
10.2 The Dean shall have the following functions and responsibilities:
a. Prepares short term and long term plans; b. Initiates curriculum development programs; c. Plans a rational faculty, academic and non-academic load; d. Leads in the faculty and staff development programs; e. Manages human, financial and physical resources; f. Manages student development programs; g. Manages department/college office operations; h. Leads development and utilization of instructional resource materials; i. Pursues personal and professional development; j. Collaborates with the health services, affiliation agencies and other academic units in the implementation of instructional programs; k. Monitors proper implementation of the programs; l. Initiates research and community extension projects/programs; m. Establishes internal and external linkages; n. Obtains recognition/accreditation of the nursing program; and o. Evaluates the performance results of the nursing program.
21 10.3 The Dean shall have a teaching load not exceeding a total of six (6) units of lecture in a semester.
Section 11. Faculty Qualifications/Requirements:
11.1 The faculty shall have academic preparation appropriate to his/her teaching assignment. In addition to being a Filipino citizen and having good moral character, the following qualifications must be observed:
For faculty members teaching professional courses:
a. Registered Nurse in the Philippines with current/valid PRC ID b. Holder of Masters degree in Nursing (MAN, MN, MSN), Education or other allied medical and health sciences conferred by a college or university duly recognized by the Commission on Higher Education; c. At least one (1) year of clinical practice d. A member of accredited professional nursing organization of good standing
For faculty members teaching other courses:
e. At least a masters degree holder of other allied medical and health sciences as specified under Section 4.3 of this CMO for those teaching health science courses; f. At least a masters degree holder in their area of specialization for faculty members teaching general education courses and should only teach courses in their area of specialization;
11.2 When vacancies occur in the teaching force of the college during the school year, substitute or replacement with similar or higher qualifications shall be employed.
11.3 The following conditions for employment must be observed:
a. The salary of faculty shall be commensurate to his/her academic rank.
b. Full time faculty member who teaches professional courses shall be responsible for both classroom and Related Learning Experiences (RLEs).
11.4 Upon appointment, a faculty member should have a duly notarized employment contract of at least one (1) academic year, renewable annually specifying academic rank in accordance with his academic training and clinical expertise. The recognized ranks are: instructor, assistant professor, associate professor and professor.
11.5 For the initial operation of the BSN program with two (2) sections of not more than 50 students per section, a minimum of four (4) qualified faculty members teaching professional and health science courses, two (2) of whom must be at least holders of a masters degree in nursing, shall be employed.
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11.6 The College of Nursing shall have an updated five-year faculty development program (FDP). The FDP consists of written activities and programs toward the development of the faculty for intellectual, personal, and professional as well as moral and spiritual growth. The program may be in the form of:
a. graduate studies b. scholarship and research grants c. in-service and continuing training programs d. clinical skills enhancement on official basis for at least two weeks per year
11.7. Teaching Load. The teaching load of faculty members should be as follows:
a. Full-time faculty members may carry a combined RLE and teaching load of not more than thirty-six (36) units per semester which include consultation hours and other activities related to RLE instruction, research and extension services. One hour of RLE supervision is equivalent to one (1) unit credit.
b. Nurses who are employed in government and private institutions and at the same time who serve as part time faculty or clinical instructors must secure permit from the employer/s to be given a maximum teaching load of nine (9) units, provided they will render services after office hours. Moreover, the Chief Nurse/Training Coordinator/Supervisor/Head Nurse should not assume any administrative and clinical supervisory function in any nursing school.
11.8. The college of nursing must have a faculty manual containing information and policies on all matters pertaining to the faculty.
11.9. There must be a faculty clinical orientation on policies, standards, guidelines and expectations on the course of affiliating agencies. Likewise, nurses from affiliating agencies employed as preceptors or clinical instructors must be oriented on the BSN Curriculum and the expectations on the course.
Section 12. Library
12.1. Policy. Library services shall provide the instructional and research needs of the staff and students making it one of the most important service units within a higher education institution. It is for this reason that libraries should be given special attention by the administrators of the institution. Libraries should be maintained it with a wide and up- to-date collection, qualified staff, communications and connectivity portals.
12.2 Library Staff. The Head librarian should be:
a) A registered librarian; b) Masters degree holder in Library Science; and, c) Posses appropriate professional training.
23 The library should be staffed with one full time registered librarian for every 1,000 students and a ratio of 1 librarian to 2 staff/clerks.
12.3. Library Holdings. Library holdings should conform to existing requirements for libraries. There should be five (5) book titles per professional subject found in the curriculum at a ratio of one (1) volume per fifteen (15) students enrolled in the program. Book titles must be of recent edition, published within the last five (5) years. The Higher education institutions [HEI] are encouraged to maintain periodicals and other non -print materials relevant to the nursing program to aid the faculty and students in their academic works. CD-ROMs may complement a librarys book collection but should not be considered a replacement for the same.
a. Opening of new BSN program shall have at least 3,000 total number of books accessioned, 30% of which shall consist of professional books. Ten percent (10%) of the total professional book collection shall be of Filipiniana collection.
b. The library collection during the recognition of the BS Nursing program shall double the book collection specified in 12.3.a.
12.4. Journals. For the opening of new BS nursing program, the HEI shall have a regular and updated subscription to at least seven (7) professional foreign nursing journals and at least two (2) local journals in the following areas:
a. Maternal and Child Nursing b. General Nursing c. Nursing Research d. Psychiatric Nursing e. Nursing Management/Leadership f. Pediatric Nursing g. Medical-Surgical Nursing
For the recognition of the BS nursing program, the subscription of foreign nursing journals should be regularly updated and maintained. The number of copies of these journals shall be increased depending upon the student population.
In addition to the core book collection, a core periodical collection of current and relevant titles (local and foreign) shall also be provided. Periodicals shall include serials, magazines and newspapers. A minimum of five (5) titles are required. The recommended number of periodicals based on enrollment is as follows:
No. of copies of Enrollment Periodicals For every 250 students 5 copies per title
24 12.5. Regular weeding out program shall be undertaken to keep the collections relevant and up-to-date within the last five (5) years. Archived collections shall not be more than 30% of the total collections.
12.6. Stamping of Library Collections. For purposes of identification, the library collection including general education books, professional books, reference materials, journals and similar other collections shall be stamped with the name of college/university and the campus where the institution is located.
12.7. Internet Access. Internet access is encouraged but should not be made a substitute for book holdings.
12.8. Space Requirements. The following are the minimum requirements for the library: a. At least 126 square meters or approximately two (2) classrooms shall be required for the library.
b. At any one time, a library space should accommodate at least five per cent (5%) of the total enrollment.
c. It should include space for collections, shelving areas, stockroom, reading area and office space or lounge for staff. The facilities shall be designed to attract and provide safety and promote operational efficiency and effectiveness of use. In addition, provision for future expansion should be made.
12.9. Finance. All library fees should be used exclusively for library operations and procurement for collections, furniture and fixtures, equipment and facilities, maintenance and staff development.
12.10. Networking. School libraries shall participate in inter-institutional activities and cooperative programs whereby resource sharing is encouraged.
12.11. Accessibility. The library should be accessible to all and should be open to serve the needs of users even beyond class hours. Users include members of the faculty, students and employees of the institution.
Section 13. Facilities and Equipment
13.1. Laboratory Requirements:
Laboratories should conform to existing requirements as specified in RA 6541, The National Building Code of the Philippines and Presidential Decree 856, Code of Sanitation of the Philippines. List of required and recommended equipment are listed in each course requirement.
A system for identification of laboratory equipment, supplies and models should be observed.
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13.2. Classroom Requirements:
a. For regular lecture class, the class size shall have a maximum of 50 students. b. For science laboratory class, the class size shall have a maximum of 25 students c. For special lectures, a class size of more than 45 students may be allowed as long as the required facilities are provided.
The classroom area shall have at least 7 meters x 9 meters or 63 square meters.
13.3. Nursing Skills Laboratory:
The nursing skills laboratory must be well-lighted and well-ventilated. Its demonstration room and practice area for return demonstration must have an area of at least 8m. x 14m. or 112 sq.m. The nursing skills laboratory simulates major areas in hospital setting and equipped with basic instruments, equipment and supplies, to aid in the development of the competencies in performing nursing procedures. Specifically, the nursing skills laboratory shall have:
a. An amphitheater-style demonstration room that can accommodate a maximum of 50 students at one time with lavatory and running water; c. Ratio of bed to practicing students is 1:2 or a practice area for return demonstration where there is one (1) bed to two (2) students at any given time; d. At least two (2) doors which will serve as an entrance and exit; e. At least one (1) fire extinguisher placed outside the door in each science laboratory/nursing skills laboratory. The fire extinguisher must have a record of refill and expiry date attached to the unit; f. Basic demonstration models namely:
1. Birthing model 2. Newborn Model 3. Adult bisexual model with the following contraptions for: 3.1 basic life support 3.2. tracheostomy care 3.2. colostomy care 3.3 catheterization 3.4 enema 3.5. parenteral/intravenous (IV) g. Equipment 1. Electrocardiogram (ECG) monitoring demonstration 2. Suction apparatus
h. Ratio of demonstration models to practicing students is 1:10, to facilitate learning.
13.4. Clinical Facilities and Resources:
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Related Learning Experiences (RLEs) are teaching-learning opportunities designed to develop the competencies of students utilizing processes in various health situations. These could be sourced from, but not limited to: lying-in clinics, schools, industrial establishments, community, out-patient clinics and general and specialty hospitals.
Base Hospital. The base hospital is a health facility utilized by a higher education institution with nursing program offering as a source of basic or primary related learning experiences. The hospital maybe independent or owned or operated by the institution or utilized by the institution in accordance with an effective and duly notarized Memorandum of Agreement between the institution and the base hospital which clearly specifies the responsibilities of each party.
The base hospital of a nursing school should meet the following requirements:
a. Has current accreditation by the DOH-Bureau of Licensing and Regulation as Level IV Hospital (Tertiary Care/Teaching/Training Hospital). However, Level III Hospitals (Secondary Care Hospitals) may be considered provided that the hospital can provide the following:
a.1 adequate case load for the number of students enrolled as stipulated in Article VII, Section 15-e. 9.
a.2 adequate facilities for the teaching and learning needs of the students.
b. Has minimum capacity of 100 beds with general services and minimum bed occupancy of eighty percent (80%);
c. Should be accessible and located within the region where the nursing school is situated. In the case of nursing schools located in Metro Manila, the base hospital should be located within Metro Manila.
d. Sixty per cent (60%) of the total bed capacity of the base hospital shall be used for the RLEs of students.
e. Should have a master rotation plan indicating the schedule/areas of all the schools utilizing the hospital for training of students.
Affiliation Hospital is a health facility being utilized by the higher education institution in specialized areas for supplementary clinical learning of students such as mental, orthopedics and communicable diseases. A Contract of Affiliation shall be used as a legal document to show the terms of references among involved parties. Parties to the contract of affiliation should provide and maintain
27 an environment conducive for the attainment of the teaching -learning objectives. The nursing school and the hospital agency should establish effective coordination and cooperation. Open communication should exist among the medical staff and the school personnel.
Cross regional affiliations will not be allowed unless in cases where specialty areas cannot be found in the region.
The base hospital/s, affiliation hospital/s and community health agency/ies being used by the students for RLEs either conducted in urban or rural community should have the following facilities:
a. classroom for conference b. library c. comfort room d. dressing room e. lounge f. locker
Provision should be made for adequate physical facilities, supplies and equipment for effective nursing care and learning experiences of students.
The nursing service should be provided with a designated training coordinator and the required staffing composed of qualified professional and non- professional personnel.
The faculty and the nursing service personnel of the affiliation agency should work together in the planning, implementation and evaluation of the related learning experiences of students.
There should be an adequate number of patients varying in age, sex, level/acuity and types of illness desired for teaching-learning experience of different curricular levels.
13.5. Virtual Nursing Skills Laboratory:
Higher education institutions are encouraged to put up Virtual Skills Laboratory to supplement and complement the related learning experiences prior to actual experience.
ARTICLE VII INSTRUCTIONAL STANDARDS
Section 14. Standard of Instruction. The institution must maintain a high standard of instruction, utilizing appropriate and updated course syllabi/references and instructional methods/strategies taking into consideration the key areas of responsibility (safe and quality nursing care, health education, communication, collaboration &
28 teamwork, legal responsibility, ethico-moral responsibility, personal & professional development, research, quality improvement, records management and management of resources and environment) that contribute to quality nursing education. The following should be strictly observed:
a. Professional nursing subjects should be offered with the corresponding RLEs taking into consideration the pre-requisites, sequencing, continuity and integration requirements.
b. Credit for the completion of the course shall be based on the fulfillment of curricular requirements. The grades on professional courses shall be based on the course credit (i.e. lecture units and RLE units).
c. The ratio of faculty to student in science laboratory class is 1:25 while regular classroom is 1:50. The institution shall provide for a systematic and continuing plan of evaluation of the students progress through a marking system that is consistent and congruent with set objectives.
d. A system of academic evaluation shall be instituted and implemented for monitoring and evaluating students and teacher performance.
e. There shall be a regular academic audit on instructional resources such as syllabi, textbooks, modules, audiovisual materials and others such as software.
f. Academic records of faculty members must be properly kept and maintained in the college of nursing.
g. The competency standards for nursing practice in the Philippines must be an integral part of the nursing education process, therefore, the Philippine Nursing Core Standards shall serve as the framework for the development of instructional standards of the BS Nursing curriculum as provided by the PRC-BoN Resolution No.112 s. 2005 and future amendments consistent thereto; as well as PRC-BoN Memorandum No. 01 s. 2009 dated April 14, 2009 entitled, Policy Guidelines on Intrapartal, Immediate Care of the Newborn and Intra-operative Care.
Section 15. The teaching-learning process is composed of the theoretical/didactic and experiential/RLE. The Related Learning Experience (RLE) is composed of Clinicals and Skills Laboratory. The RLE activities are carefully selected to develop competencies utilizing the nursing process in varying health situations. The following conditions must be observed:
a. Related Learning Experience (clinicals) shall be offered simultaneously or immediately after the lecture. Classroom and RLE activities must be congruent with the objectives of the course.
b. Faculty teaching the lecture shall supervise students in their RLE. In the case of team teaching, there should be close coordination and collaboration between the lecturer and the clinical faculty.
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c. A documented RLE rotation plan showing distribution of students and faculty supervision in each clinical area of base hospital and affiliation agencies shall be made available.
d. Faculty compensation shall be based on the computation that one (1) hour RLE is equivalent to one (1) lecture hour.
e. Effectiveness and efficiency of the Related Learning Experience, shall consider the following factors:
e.1 Quality of supervision of clinical instructors and teaching-learning process e.2 Readiness and capability of the learner e.3 Quality of the learning resources both in institutions and communities e.4 Adequate number and variety of clientele e.5 Utilization of appropriate feedback mechanism e.6 Adequate number of qualified nursing staff and other personnel e.7 Quality of nursing care services e.8 Compliance with the required equivalence of fifty one (51) hours to to one (1) unit RLE e.9 Ratio of student to clientele depends upon the objectives and the capacity of the student.
The ratio of student to clientele shall be:
Level 1 st Semester 2 nd Semester I NA 1:1 II 1:1 1:2 III 1:2-3 1:3-4 IV 1:5 1:6
The ratio depends upon the client group, e.g, ICU 1:1-2; Psych 1:1; Community-based experience 1:1 Family; 1:1 Population Group per catchment area; 1-2:1 Community (depending on the size of the barangay).
The ratio of faculty to student for RLE (Skills Laboratory) shall be:
Level 1 st Semester 2 nd Semester Summer I NA 1:8-10 1:8-10 II 1:8-10 1:8-10 NA III 1:10-12 1:10-12 NA IV 1:12-15 1:12-15 NA
30 The ratio of faculty to student for RLE (Clinicals in Hospital/Community setting) shall be:
Level 1 st Semester 2 nd Semester I NA NA II 1:8-10 1:8-10 III 1:10-12 1:10-12 IV 1:12-15 1:12-15
Section 16. Recognition and Accreditation
a. For government recognition, an increase in student population shall be subject to proportionate increase in resources both in classroom and clinical area, subject to CHED approval. For this purpose, CHED Regional Offices shall strictly monitor compliance herein.
b. Nursing schools that are in existence for a period of five (5) years are encouraged to undergo program accreditation.
ARTICLE VIII RESEARCH REQUIREMENTS
The administration shall encourage and support research among its students and faculty and promote utilization of research findings to guide and improve nursing practice, educational management and other aspects of the nursing program.
All students shall complete a research project during the course of study.
Faculty research outputs and publications shall be considered in faculty promotions and academic ranking. Strict adherence to ethics in research must be observed.
There shall be an adequate budget allocated for research and publication. A functional research committee or office should support research and publication activities.
ARTICLE IX ADMISSION, SELECTION AND RETENTION OF STUDENTS
The school shall have a well-defined admission, selection, promotion and retention policy published and made known to students and reflected in the Student Handbook. In addition, the college shall administer entrance examination to incoming freshmen students covering the following areas:
a. English b. Science c. Mathematics d. Inductive Reasoning The number of students admitted to the College of Nursing shall be based on the following:
31 a. qualified faculty b. teaching/learning resources c. resources of the base hospital/affiliation agencies based on: - clientele - staffing - facilities/services - number of student affiliates
Records and evidences of actual implementation of these policies must be made available.
A student is allowed to enroll a course after he/she has satisfactorily passed all its pre-requisite courses.
A student shall be allowed to enroll only the regular semestral load. However, academic load for graduating students must be guided by appropriate CHED issuances.
All students in the BS Nursing program shall strictly adhere to the regular rotation of RLE and schedule of classes. The Special BS Nursing program provided in CMO No. 9 s. 2004 shall no longer be allowed.
ARTICLE X RESIDENCY REQUIREMENTS
As a general rule, a candidate for graduation must have taken the last curricular year level in the college. The student shall be evaluated according to the criteria or system of evaluation required by the college to determine proficiency in all professional courses.
ARTICLE XI SANCTIONS
Non-compliance with the provisions of this CMO shall, after due process, cause the Commission to revoke government permit/recognition or deny issuance of authority to operate the nursing program.
The average national passing percentage in the Philippine Nurses Licensure Examination from 2004 to 2008 is 45.91%. Two thirds (2/3) of 45.91% is thirty percent (30%), the basis for the implementation of gradual phase-out.
Thus, in the initial implementation of the gradual phase out of the nursing program, an average of below 30% for a three -year period (SY 2010-2011, 2011-2012, 2012-2013) in the Philippine Nurse Licensure Examination starting from 2013 shall be implemented by the CHED, subject to the following guidelines:
1. The official results of the Nurse Licensure Examination issued by the Board of Nursing of the Professional Regulation Commission shall be the basis in phasing-out of nursing programs.
2. The performance of the school shall be based upon the average rating obtained within the schoolyear, namely, ratings in the June and December
32 examinations. If the school has only one examination undertaken in a year, this shall be considered the annual rating.
3. The average passing rate obtained by HEIs for the past three (3) years shall be the basis in phasing-out the program.
4. The computation of the 30% shall only involve the ratings of the examinees who took the Nurse Licensure Examination for the first time.
ARTICLE XII TRANSITORY PROVISION
Higher education institutions that have been granted permit or recognition to offer the BS Nursing program are required to fully comply with all the requirements in this CMO within three (3) years after the date of effectivity. There shall be close monitoring of nursing programs by the Commission.
ARTICLE XIII SEPARABILITY AND REPEALING CLAUSE
Any provision of this Order, which may thereafter be held invalid, shall not affect the remaining provisions.
All CHED issuances, rules and regulations or parts thereof that are inconsistent with the provisions of this CMO are hereby repealed.
ARTICLE XIV EFFECTIVITY CLAUSE
Higher education institutions [HEIs] that opted to implement CMO No. 30 s. 2001 shall allow their students to the finish BSN curriculum under CMO No. 30 s. 2001 while those HEIs that opted to implement CMO No. 5 s. 2008 during the SY 2008-2009 shall allow their students to graduate under CMO No. 14 s. 2009.
This CMO shall take effect starting Schoolyear 2009-2010, fifteen (15) days after its publication in the Official Gazette or in a newspaper of national circulation.
NCLEX-RN Health Promotion and Maintenance Exam Prep:300 Practice Questions with Detailed Answers and Explanation to Master Your Exam: NCLEX-RN EXAM PREP:PRACTICE QUESTIONS AND ANSWERS, #2