Question & AnswerQ&A (DOH Administrative Order No. 2015-0020)
The main objective is to strengthen the capacity of nurses and midwives in maternal and newborn care by ensuring they are trained in Basic Emergency Obstetric and Newborn Care (BEmONC) and allowed to perform all BEmONC signal functions including administration of life-saving drugs as mandated by Republic Act 10354.
Registered nurses and midwives who have completed the required BEmONC training and certification are authorized to administer life-saving drugs in emergencies where no physician or health facility is available.
The life-saving drugs include oxytocin, magnesium sulfate, antenatal steroids, antibiotics, and other medicines used to prevent and manage pregnancy-related complications.
It applies to all heads of health facilities providing birthing services and to registered nurses and midwives providing skilled maternal and newborn care services in both public and private sectors.
BEmONC refers to life-saving services for emergency maternal and newborn conditions that include administration of parenteral oxytocics, anticonvulsants, antibiotics, antenatal steroids, assisted vaginal deliveries, removal of retained placenta or placental products, neonatal resuscitation, provision of warmth, referral, and blood transfusion where possible.
Nurses must complete an 11-day BEmONC skills training course and be certified, while midwives must complete either an 11-day or 7-day BEmONC training and be certified. The training includes administration of life-saving drugs.
A verbal order must be obtained by phone, read back to the physician for confirmation, and recorded by the nurse or midwife. The physician must sign the order once physically available. In cases where orders cannot be obtained due to calamities or armed conflict, a signed clinical protocol shall guide administration.
The patient must be immediately referred to the nearest facility providing comprehensive emergency obstetric and newborn care (CEmONC) after the loading dose or as the situation warrants, with proper documentation and communication with the referral facility.
LGUs must ensure birthing centers comply with DOH licensing, ensure availability of life-saving drugs, allow and support staff training, implement the Order locally, establish referral and transport systems, and conduct monitoring and supervision.
An emergency is a condition where, based on objective findings by a prudent medical officer, nurse, or midwife, there is immediate danger and delay in support or treatment may cause loss of life or permanent disability.