COMMUNITY HEALTH NURSING Flashcards
“The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation.” -Maglaya,et.al
COMMUNITY HEALTH NURSING
Major Goal of CHN
Preserve the health of the community by focusing on health promotion and health maintenance of individual, family and group within community
- A specialized field of nursing practice that focuses on a group of people with common interests living together within a territory or geographical boundary
COMMUNITY
Is part of the paramedical and medical intervention/approach which is concerned on the health of the whole population that aims health promotion, disease prevention and management of factors affecting the health
COMMUNITY HEALTH
Is the term used before for community health nursing
PUBLIC HEALTH NURSING
CHN subspecialties
Public health nursing, school health nursing, occupational health nursing
BASIC PRINCIPLES OF CHN
- The community is the patient in community health nursing, the family is the unit of care and there are four levels of clientele: individual, family, population group, and the community.
- In CHN, the client is considered as an ACTIVE partner, not a PASSIVE recipient of care.
- CHN practice is affected by developments in health technology, in particular, changes in society, in general.
- The goal of CHN is achieved through multi-sectoral efforts.
- CHN is a part of the health care system and the larger human services system
3 ELEMENTS IN CHN
- Science of Public Health
- Public Health Nursing Skills
- Social Assistance Functions
The synthesis of public health and nursing practice PHC according to FREEMAN (1963)
PUBLIC HEALTH NURSING
defined as the field of professional practice in nursing and in public health
PUBLIC HEALTH NURSING
Skills applied in PHN
technical nursing, interpersonal, analytical, and organizational skills
Technical nursing, interpersonal, analytical, and organizational skills. These skills are applied in concert with those of other persons engaged in health care through?
comprehensive nursing care of families and other groups
The practice of promoting and protecting the health of populations using knowledge from nursing social and public health sciences
PHC
with the goals of the promoting health and preventing disease and disability for all people through the creation of conditions in which people can be healthy
Population-focused
Objectives of Public Health
C-ontrol of Communicable Disease O-rganization of Medical and Nursing Services D-evelopment of Social Machineries E-ducation of IFC on personal hygiene S-anitation of the environment
ROLES AND FUNCTIONS OF A COMMUNITY HEALTH NURSE
PPTCCHRCRR
- Identifies needs, priorities, and problems of individuals, families, and communities
- Formulates municipal health plan in the absence of a medical doctor
- Interprets and implements nursing plan, program policies, memoranda, and circular for the concerned staff personnel
- Provides technical assistance to rural health midwives in health matters
Planner Programmer
- Provides direct nursing care to sick or disabled in the home clinic school or workplace
- Develops the family’s capability to take care of the sick, disabled, or dependent member
Provider of Nursing Care
- Identifies and interprets training needs of the RHMs, Barangay Health Workers (BHW), and hilots
- Conducts training for RHMS and hilots on promotion and disease prevention
- Conducts pre and post-consultation conferences for clinic clients; acts as a resource speaker on health and health related services
- Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health education purposes
- Conducts pre-marital counseling
• Trainer/Health Educator
- Motivates and enhances community participation in terms of planning, organizing, implementing, and evaluating health services
- Initiates and participates in community development activities
• Community Organizer
- Coordinates with individuals, families, and groups for health related services provided by various members of the health team
- Coordinates nursing program with other health programs like environmental sanitation, health education dental health, and mental health
• Coordinator of Services
- Detects deviation from health of individuals, families groups, and communities through contacts/visits with them
• Health Monitor
- Provides good example of healthful living to the members of the community
• Role Model
- Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health
Change Agent
- Participates in the conduct of survey studies and researches on nursing and health-related subjects
- Coordinates with government and non-government organization in the implementation of studies/research
• Researcher
- Prepares and submits required reports and records
- Maintain adequate, accurate, and complete recording and reporting
- Reviews, validates, consolidates, analyzes and interprets al records and reports
- Prepares statistical data/chart and other data presentation
• Recorder/Reporter/Statistician
The Philippine Nursing Act of 2002
Republic Act 9173
Republic Act 9173
The Philippine Nursing Act of 2002
Scope of Nursing is written on?
Article VI, Section 28.
Phases of Human Development
conception, labor delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood, and old age
nurses are primarily responsible for the promotion of health and prevention of illness
independent practitioners
It shall be the duty of the nurse to:
(a) Provide nursing care through the utilization of the nursing process.
(b) Establish linkages with community resources and coordination with the health team
(c) Provide health education to individuals, families and communities
(d) Teach guide and supervise students in nursing education programs
(e) Undertake nursing and health human resource development training and research
a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
WHO
a state of well-being in which the person is able to use purposeful, adaptive responses and processes physically, emotionally, mentally, spiritually, and socially
Murray
actualization of inherent and acquired human potential through goal-directed behavior, competent self-care, and satisfying relationship with others
Pender
a state of person that is characterized by soundness or wholeness of developed human structures and of bodily and mental functioning
Orem
Is seen as a group or collection of locality-based individuals, interacting in social units and sharing common interests, characteristics, values, and/or goals
COMMUNITY
a collection of people who interact with one another and whose common interests of characteristics form the basis for a sense of unity or belonging
Allender
- a group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share geographic boundary
Lundy and Janes
a group of people who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns
Clark
a locality-based entity composed of systems of formal organizations reflecting society’s institutions, informal groups and aggregates
Shuster and Goeppinger
Two main types of communities is form by?
Maurer and Smith
- also called as territorial communities
- are most traditionally recognized
- defined or formed by both natural and man-made boundaries and include barangays, municipalities, cities, provinces, regions and nations.
Geopolitical communities
- also called as functional communities
- refer to relational, interactive groups, in which the place or setting is more abstract and people share a group perspective or identity based on culture, values, history, interest and goals.
Phenomenological communities
DETERMINANTS OF HEALTH
IEEPPGGCHS
- higher income and social statue ore linked to better health. The greater the gap between the richest and poor health, the greater differences in health
Income and social status
- low education levels are linked with poor health, more stress and lower self-confidence
Education
- safe water and clean air, healthy workplaces safe houses communities and roads all contribute to good health
Physical environment
- people in employment are heather particularly those who have control over their working conditions.
Employment and working conditions
greater support from families, friends, and communities is linked to better health
Social support networks
customs and traditions, and the beliefs of the family and community all affect heath
Culture
- inheritance plays a part in determining lifespan, healthiness and the likelihood of developing illnesses
Genetics
- balanced eating, keeping active, smoking, drinking and how we deal with life’s stresses and challenges all affect heath
Personal behavior and coping skills
-access and use of services that prevent and treat disease influences health
Health services
men and women suffer from different types of diseases at different ages
Gender
- provide morbidity, mortality and other health status related data.
National Epidemiology Center of DOH, PSA
rate of death
mortality
rate of illness
morbidity
- are responsible for collecting morbidity and mortality data and forwarding the information to the higher level of health, such as Provincial Heath Office
Local health centers/offices/departments
should participate in investigative efforts to determine what is precipitating the increased disease rate and work to remedy the identified threats or risks.
Nurses
Public health is the science and art of (1) preventing disease, (2) prolonging life, and (3) promoting health and efficiency through organized community effort is by?
CE Winslow
- activities enhance resources directed at improving well-being
Health promotion
- activities protect people from disease and effects of
Disease prevention
Three Levels of Prevention by?
Leavell Clark
- relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals.
Primary prevention
- early detection and prompt intervention during the period of early disease pathogenesis
- implemented after a problem has begun but before signs and symptoms appear and targets populations who have risk factors
Secondary prevention
- targets populations that have experienced disease or injury and focuses on limitations of disability and rehabilitation
Tertiary prevention
concentrates on specific groups of people and focuses on health promotion and disease prevention, regardless of geographical location
POPULATION-FOCUSED NURSING
Focused-practice includes:
- Focuses on the entire population
- Is based on assessment of the populations health status
- Considers the broad determinants of health
- Emphasizes all levels of prevention
- Intervenes with communities, systems, individuals and families
Demographic example
Vital statistics, Census
Groups at high risk example
Health statistics, disease statistics
Services/Providers available example
City directors, phone books, local/regional social workers, list of low income providers, CH nurse
basic unit of care in CHN
Family
focus in the clinic or health center
Individual
Proposed in the late 1990s by nurses from the Minnesota Department of Health to describe the breadth and scope of public health nursing practice
•The Intervention wheel
recognized as a framework for community and public health practice- consist of 17 health interventions are grouped into 5 wedges
•The Intervention wheel
3 IMPORTANT ELEMENTS OF INTERVENTION WHEEL
- It is population-based
- It contains 3 levels of practice (Community, systems and individual/family)
- It identifies and defines 12 public health interventions
COMMUNITY HEALTH INTERVENTIONS
C10 S3 D2 ORHAP
- monitors health events
Surveillance
- systematically gathers and analyzes data regarding threats to the health of populations
Disease and other health event investigation
- locates populations of interests or populations at risk
• Outreach
- identities individuals with unrecognized health risk factors
• Screening
- identifies risk actors and connects them with resources
Case finding
- assists individuals and families, groups, organizations ad communities to identify and access necessary resources
• Referral and follow-up
- optimizes self-care capabilities of individuals and families
Case management
- direct care tasks that the nurse carries out
• Delegated functions
- communicates facts, ideas and skills that change knowledge, attitudes values, behaviors and practice
• Health teaching
- establishes an interpersonal relationships, with the intention of increasing or enhancing their capacity for self-care and coping
• Counseling
- seeks information and generates optional solutions to perceived problems
• Consultation
- commits two or more persons or an organization
• Collaboration
- develops alliances among organizations
• Coalition building
helps community groups to identity common problems or goals mobilizes resources and develop and implement strategies
• Community organizing
- pleads someone’s cause or acts on someone’s behalf
• Advocacy
- utilizes commercial marketing principles for programs
• Social marketing
- place issues on decision makers’ agendas, acquires plan of resolution
• Policy development and enforcement
- this practice involves providing nursing care nursing care to individuals and families in their own places of residence mainly to minimize the effects of illness and disability.
HOME HEALTH CARE
-homecare rendered to the terminally ill
and Palliative care is particularly important.
HOSPICE HOME CARE
A project initiated by the Department of Labor and Employment (DOLE), in collaboration with the Board of Nursing of the Philippines, Department of Health, Philippines Nurses Association and other stakeholders to promote nurse entrepreneurship by introducing a home health care industry in the Philippines
• ENTREPRENURSE
COMPETENCY STANDARDS IN CHN
HELPSMQRRCC
- Franciscan Friar Juan Clemente opened medical dispensary in Intramuros for the indigent
1577
Dominican Father Juan de Pergero worked toward installing a water system in San Juan del Monte and Manila
1690
smallpox vaccination was introduced by Francisco de Balmis, the personal physician of King Charles IV of Spain
• 1805
- first medicos titulares were appointed by the Spanish government
• 1876
- 2 year courses consisting of fundamental medical and dental subjects was first offered in the University of Santo Tomas. Graduated were known as “cirujanosministrantes” and serve as male nurses and sanitation inspectors
• 1888
- United States Philippines Commission, through Act 157 created the Board of Health of the Philippine Islands with a Commissioner of the Public Health as its chief executive officer (now the Department of Health)
• 1901
- enacted in 1957 amended certain provisions in the Rural Health Act and created 8 categories of rural health units corresponding to the population size of the municipalities
• RA 1891
- enacted in 1991,amended that devolution of basic health services including health services, to local government units and the establishment of a local health board in every province and city of municipality
• RA 7160 (Local Government Code)
- adopted during the world summit in September 2000
Millennium Development Goals (MDGs)
FOURmula One (F1) for Health
2005
Universal Health Care
2010
• FOURmula One (F1) for Health and Universal Health Care launched in
1999
- aims to achieve the health system goals of better health outcomes, sustained health financing, and responsive health system that will provide equitable access to health care
Universal Health Care
was the first nurse to formulate a conceptual foundation for nursing practice
Florence Nightingale
• She believed that clean water, clean linen, access to adequate sanitation and a quiet environment would improve health outcomes
Florence Nightingale
theorist with shared perspectives of health
Dorothy Johnson, Sister Callista Roy, Imogene King, Betty Neuman and Jean Watson
The goal of theory is?
to improve nursing practice by acting as a guide
COPAR
COMMUNITY ORGANIZING PARTICIPATORY RESEARCH ACTION
GOOD CHOLESTEROL
HIGH DENSITY LIPOPROTEIN
SYSTEMATIC PROCESS FOR IDENTIFYING ROOT CAUSES
ROOT CAUSE ANALYSIS
HIGHER MORTALITY RATE
MEN
X-RAY PICTURE OF THE BREAST
MAMMOGRAM
STEP BY STEP METHOD TO EXAMINE BREAST
BREAST SELF EXAM
LEPROSY IS CAUSED BY?
HANSEN’S DISEASE FROM MYOBACTERIUM LEPRAE
SOUND DECISION MAKING
Safe and Quality Nursing Care
MAINTENANCE OF SAFE ENV. AND ORGANIZATION OF WORKLOAD
Management Of Resources And Environment
ASSESSMENT OF CLIENT LEARNING NEEDS AND DEVELOPMENT OF HE PLAN
Health Education
ADHERENCE TO NURSING LAWS INCLUDING DOCUMENTATION OF CARE
Legal Responsibility
RESPECT FOR THE RIGHTS OF CLIENT IN ACCORDANCE TO THE CODE OF ETHICS
Ethico-moral Responsibility
CONTINUING EDUCATION
Personal and Professional Development
DATA GATHERING FOR QUALITY IMPROVEMENT
Quality Improvement
FORMULATION OF SOLUTIONS TO THE PROBLEMS
Research
ACCURATE AND RELATED DOCUMENTATION OF CLIENT CARE AND RECORD KEEPING
Records Management
USE OF THERAPEUTIC COMMUNICATION
Communication
COLLABORATIVE RELATIONSHIP WITH COLLEAGUES AND OTHER HEALTH TEAM MEMBER
Collaboration and Teamwork
- is the basis, in part, of several nursing theories.
• It is applicable to the different levels of the community health nurse’s clientele: individuals, families, groups or aggregates and communities
General Systems Theory
considered as a set of interacting elements that exchange energy, matter or information with the external environment to exist
client
is useful when analyzing interrelationships of the elements within the client and the environment
General Systems Theory
HAS BASIC STRUCTURES OF ALL OPEN SYSTEMS HAVE
Family Environment
SEPARATE FROM ITS ENVIRONMENT
BOUNDARIES
DICTATES THE BOUNDARIES
CULTURE AND FAMILY CODE
EXAMPLE OF THE General Systems Theory
IPO
THE EXTRANEOUS VARIABLE OR OUTSIDE FACTOR
ENVIRONMENT
HAS FEEDBACK FROM CLIENT AND INFLUENCES
IPO
THE MOST IMPORTANT MECHANISM SINCE ALL INFO IS LEARN AFTER
FEEDBACK
are the components of a system that interact to accomplish their own purpose.
(Family members)
Subsystems
are a bigger system composed of families who interrelate with and affect one another. (Families)
Suprasystems
RESPONSE IS A MUST AND IT IS THE?
FEEDBACK
MORE ON IMITATION, OBSERVATION AND ROLE MODEL
SOCIAL LEARNING THEORY
- It is based on the belief that learning takes place in a social context: people learn from one another and learning is promoted by modeling or observing other people.
- It assumes that all personas are thinking beings that are capable of making decisions and acting according to expected consequences of their behavior.
Social Learning Theory
• Application of the SOCIAL LEARNING theory can be done by:
ARIM
FOUNDATION OF HEALTH EDUCATION AND PROMOTION
THE HEALTH BELIEF MODEL
FOCAL POINT OF CHN
HEALTH EDUCATION AND PROMOTION
ABOUT BEHAVIOR MODIFICATION
HEALTH BELIEF MODEL
HEALTH CHANGES IN HEALTH BEHAVIORS
HEALTH BELEIF MODEL
- Initially proposed in 1958,the model provides the basis for much of the practice of health education and promotion today.
- This model found that information alone is rarely enough to motivate people to act for their health. Individuals must know what to do and how to do it before they can take action.
The Health Belief Model
individual’s perceived threat to sickness or disease
perceived susceptibility
belief of consequence
perceived severity
potential positive benefits of action
perceived benefits
perceived barriers to action, exposure to factors that prompt action
cues to action
confidence in ability to succeed
self-efficacy
THE CUE TO ACTION TO PREVENTION OF DENGUE FEVER MAYBE THROUGH AN INFORMATION CAMPAIGN FOR THE BARANGAY TO BE AWARE
HEALTH BELIEF MODEL
IS BROADER THAN HEALTH BELIEF MODEL
Milio’s Framework for Prevention
proposed that health deficits often result from an imbalance between a population’s health needs and its health sustaining resources
Milio (1976
She stated that diseases associated with excess occurred in affluent societies (obesity) and diseases that result from inadequacies in food, shelter and water afflict the poor. Therefore, poor people in affluent societies experience the least desirable combination of factors
• Personal and societal resources affect the range of health promoting or health damaging choices available to individuals. Personal resource include the individuals awareness, knowledge and health beliefs. Money and time are also personal resources.
Milio’s Framework for Prevention
ABOUT SOCIETAL NORMS OR FALLACIES OR MILLEU
Milio’s Framework for Prevention
HAVE A SIMILAR DEFINITION OF HEALTH WITH WHO
Pender’s Health Promotion Model
ABOUT INCREASING A CLIENT WELL BEING
Pender’s Health Promotion Model
DESCRIBES THE MULTIDIMENSIONAL NATURE OF PERSON AS THEY INTERACT WITH NATURE
Pender’s Health Promotion Model
EXPLAINS THE PROCESS OF CHANGE AND HOW TO ADAPT
The Transtheoretical Model
• This model combines several theories of intervention. It is based on the assumption that
behavior change takes place over time, and progresses through stages
• Each stage is stable and is open to change; Meaning one may stop in one stage, progress to the next stage or return to a previous stage.
The Transtheoretical Model
• Change is difficult. People may resist change for many reasons. Change may be unpleasant,
require giving up pleasure, be painful, stressful, etc.
The Transtheoretical Model
ABOUT ASSESSING THE COMMUNITY
Precede-Proceed Model
• It provides a model for community assessment, health education planning, and evaluation.
Precede-Proceed Model
, which stands for predisposing, reinforcing and enabling constructs in educational diagnosis and evaluation is used for community diagnosis
PRECEDE
stands for policy, regulatory, and organizational constructs in education and environmental development, is a model for implementing and evaluating health programs based on PRECEDE
PROCEED
first International Conference for PHC at Alma Ata, USSR, Russia
SEPTEMBER 6-12, 1978
legal basis for PHC in the Philippines AND signed by Pres. Ferdinand Marcos
L.O.I. 949
the essential care made universally accessible to individuals and families in the community through their full preparation, Universal Goal Health For All by the Year 2000
Health in the Hands of the People by 2020
the essential care made universally accessible to individuals and families in the community through their full preparation, Universal Goal Health For All by the Year 2000 CAN BE ACHIEVED THROUGH
community and individual self-reliance
-includes health promotion disease prevention, health maintenance counseling patient education and diagnosis and treatment of acute and chronic illness in different health settings
• PRIMARY CARE
5 KEY ELEMENTS
UHPLS
8 ESSENTIAL HEALTH SERVICES
E- Education for health L- Locally endemic disease control E- Expanded program for immunization M- Maternal and child health including responsible parenthood E- Essential drugs N- Nutrition T- Treatment of communicable and noncommunicable diseases S- Safe water and sanitation
KEY PRINCIPLES
- 4 A’s
- Support Mechanism
- Multisectoral Approach
- Community participation
- Equitable distribution of health resources
4 A’s
ACCESSIBILITY, AFFORDABILITY, ACCEPTABILITY AND AVAILABILITY
- distance/travel time required to get to a health care facility/services.
- the home must be w/in 30 min. from the Brgy. health stations
Accessibility
- consideration of the individual, family, community and government can afford the services
- the out-of-pocket expense determines the affordability of health care.
- in the Philippines, government insurance is covered through PhilHealth
Affordability
- health care services are compatible with the culture and traditions of the population
Acceptability
- is a question whether the health service are offered in health care facilities of is provided on a regular and organized manner.
Availability
Support Mechanism 3 major resources:
- People
- Government
- Private Sectors (e.g. NGO, church)
Multisectoral Approach TYPES
- Intra-sectoral linkages
* Inter-sectoral linkages
- communication, cooperation and collaboration within the health sectors.
• Intra-sectoral linkages
- between the health sector and other
- sectors like education, agriculture and local government officials.
• Inter-sectoral linkages
- a process in which people identity the problems and needs and assumes responsibilities themselves to plan, manage, and control.
Community participation
DTTB
• Doctor to the Barrio (DTTB) Program
RN HEALS
• Registered Nurses Health Enhancement and Local Service
LAGUNDI
VITEX NEGUNDO
YERBA BUENA
CLINOPODIUM DOUGLASSI
SAMBONG
NGAI CAMPHOR
TSAANG GUBAT
FUKIEN TEA TREE
NIYOG-NIYOGAN
COMBRETUM INDICUM
GUAVA
PSIDIUM GUAJAVA
AKAPULKO
SENNA ALATA
ULASIMANG BATO/PANSIT-PANSITAN
PEPEROMIA PELLUCIDA
BAWANG
ALLIUM SATIVUM
AMPALAYA
MOMORDICA CHARANTIA
USED OF LAGUNDI
COUGHS AND COLDS
USED OF YERBA BUENA
MUSCLE PAIN
USED OF YERBA BUENA
MUSCLE PAIN
USED OF SAMBONG
ANTIEDEMA
USED OF TSAANG GUBAT
STOMACHACHE
USED OF NIYOG-NIYOGAN
ANTIHELMINTHIC
USED OF BAYABAS
ANTISEPTIC
USED OF AKAPULKO
ANTIFUNGAL
USED OF ULASIMANG BATO/PANSIT-PANSITAN
LOWERS BLOOD URIC
USED OF BAWANG
HYPERTENSION
USED OF AMPALAYA
DIABETES MELLITUS
BOILING THE PLANT IN WATER FOR 20 MINUTES
DECOCTION
PLANT IS SOAKED IN HOT WATER FROM 10-20. MINUTES
INFUSION
DIRECTLY APPLIED PLANT ON THE AFFECTED PART (BRUISES, WOUNDS, RASHES)
POULTRICE
MIX THE PLANT WITH ALCOHOL
TINCTURE
Application of pressure on acupuncture pts. without puncturing the skin
Acupressure
Uses a special needles to puncture and stimulate specific part of the body
Acupuncture
Combines essential aromatic oils to then applied to the body
Aromatherapy
Nutritional healing, this improves health by enhancing the nutritional value to reduce the risk of diabetes
Nutritional therapy
Follows the principle of balancing energy
Pranic Healing
Application of pressure on the body’s reflex joints to enhance body’s natural healing
Reflexology
Green and Kreuter (1991) any combination of health education and related organizational economic and environmental supports for behavior of individual groups or communities conducive to health.
HEALTH PROMOTION
-Parse (1990) a behavior that is motivated by the desire to increase well-being and to reach the best possible health potential.
HEALTH PROMOTION
- Parse ( 1990) behaviors in which one engages with the specific intent to prevent disease, detect disease in the early stages or to maximize health within constraints of disease
• HEALTH PROTECTION
- The probability that a specific event will occur in a given time frame
• HEALTH RISK
- conducted to determine health risks to individuals, groups and populations. A systematic way of distinguishing the risks posed by potentially harmful exposures
• Risk AssessmenT
• Steps of Risk Assessment- Hazard identification, risk description, exposure assessment and risk estimation.
Hazard identification, risk description, exposure assessment and risk estimation.
- an exposure that is associated with a disease
• Risk factor
3 Criteria For Establishing A Risk Factor:
- The frequency of the disease varies by category or amount of factor.
- The risk factor must precede the onset of the disease.
- The association of concern must not be due to any source of error.
- individual has some control
Modifiable Risk Factors
OTHER TERM FOR Modifiable Risk Factors
PRECIPITATING
- little or no control
• Non-Modifiable Risk Factors
OTHER TERM FOR Non-Modifiable Risk Factors
PREDISPOSING
- a proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health
• Risk Reduction
- process through which public receives information regarding possible threats to health
• Risk communication
MILK CODE
EXECUTIVE ORDER NO.51
were developed to facilitate dissemination simple and practical messages to encourage healthy diet and lifestyle.
The 10 Nutritional Guidelines for Filipinos
is essential component of chronic disease prevention and health promotion.
Sleep
Newborn(1-2 months)
10.5-18 hours
Infants(3-11 months)
9-12 hours during night and 30-minute to 2
hour naps 1-4 times a day
Toddlers(1-3 years)
12-14 hours
Preschoolers(3-5 years)
11-13 hours
School-aged children(5-12 years)
10-11 hours
Teens(11-17 years)
8.5-9.25 hours
Adults
9 hours
The 10 Nutritional Guidelines for Filipinos were
- VARIETY OF FOODS
- BREAST FEED FOR 4-6 MONTHS
- MAINTAIN CHILDRENS PROPER DIET
- Consume fish, lean meat, poultry or dried beans
- Eat more vegetables, fruits and root crops
- Eat foods cooked in edible cooking oil daily
- Consume milk and milk products and other calcium rich foods
- Use iodized salt but avoid intake of excessive intake
- Eat clean and safe food
- exercise regularly, do not smoke and avoid drinking alcoholic beverages
Sleep Hygiene IS COMPOSED OF
- Avoid caffeine and nicotine close to bedtime
- Avoid alcohol
- Retire and get up at the same time everyday
- Exercise regularly but finish all exercise and vigorous activity at least 3 hours before bedtime
- Establish a regular relaxing bedtime routine
- Create a dark, quiet, cool sleep environment
- Have comfortable beddings
- Use the bed for sleep only
- Avoid large meals before bedtime
is an important step in achieving optimum health
Smoking Cessation
The American Cancer Society recommends the following Steps to Quit Smoking:
- Make decision to quit.
- Set a date to quit and choose a plan
- Deal with withdrawal through. Avoid temptation
- Staying off tobacco is a lifelong process. Remind yourself of the reasons why you quit
- Health authorities have defined moderation as not more than 2 drinks a day for the average sized man and not more than 1 drink a day for the average size woman
• Alcohol Consumption
- consuming more than 2 drinks/day on average for men and more than 1 drink per day for women
• Heavy Drinking
- drinking 5 or more drinks on a single occasion for men 4 or more drinks on a single occasion for women
• Binge drinking
- can take the form of heavy drinking/binge drinking/both
• Excessive Drinking
Organized by the WHO, the 1st International Conference on Health Promotion was held at
Ottawa, Canada on November 17-21,1986
. It calls for a commitment to health promotion to achieve the goal of Health for All by the year 2000 and beyond.
1st International Conference on Health Promotion
the process of enabling people to increase control over and improve their health. It is not just the responsibility of the health sector but goes beyond healthy lifestyles to well-being.
health promotion
- a process of changing people’s knowledge, skills and attitudes for health promotion and risk reduction.
• HEALTH EDUCATION
Basic Principles that Guide the Effective Nurse Educator
- Message
- Format
- Environment
- Experience
- Participation
- Evaluation
- send a clear/understandable message to the learner
- Consider factors that may affect learner’s ability to receive and retain info
- Message
- strategy must match the objectives
- Format
- conducive environment for learning, therapeutic and supportive relationship with the learner
- Environment
- organize positive and meaningful learning experience
- Experience
- engage learner in participatory learning by involving then in the discussion, solicit feedback
- Participation
- use tools such as quizzes, individual conferences and return demonstration
- Evaluation
An important aspect of the community in capacity building is the
training of community health workers(CHWS)
Their training does constitute tertiary education
FALSE
In the Philippines, CHWS are known as
Barangay Health Workers
Requisite competencies of BHWs include
communication, interpersonal, teaching, organizational, and advocacy skills
- It is a group of persons usually living together and composed of the head and other persons related to the head by blood, marriage or adoption. It includes both the nuclear and extended family. (National Statistical Coordination Board (NSCB, 2008)
- A social unit interacting with larger society. (Johnson, 2000)
- A family is characterized by people together because of birth, marriage, adoption or choice. (Allen et.al., 2000)
- A family is two or more persons who are joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the family. (Friedman et.al., 2003)
FAMILY
- The family of marriage, parenthood, or procreation
- Composed of a husband, wife, and their immediate children-natural, adopted, or both (Friedman et.al., 2003)
Nuclear family
- Consisting only of a husband and wife, such as newly married couples and “empty nesters”
Dyad family
- Consist of three generations, which may include married siblings and their families and/or grandparents.
Extended family
- Results from a union where one or both spouses bring a child or children from previous marriage into a new living arrangement.
Blended family
- Where a man has more than one spouse. Approved by the Philippine authorities only among Muslims
Compound family
- Commonly described as “live-in” arrangement between an unmarried couple who are called common-law spouses and their child or children
Cohabiting family
- Results from the death of the spouse, separation, or pregnancy outside of wedlock.
Single parent
- Is made up of cohabiting couple of the same sex in a sexual relationship
- They may or may have not children.
Gay or Lesbian family
- Is a special contract of permanent union between a man and a woman entered into in accordance with the law for the establishment of conjugal and family life.
Marriage
- “Same-sex” marriage is legally acceptable in the Philippines.
FALSE
• The family meets the needs of the society through:
PROCREATION, SOCIALIZATION, ECONOMIC FUNCTION
• The family meets the needs of the individual through:
PHYSICAL MAINTENANCE, WELFARE AND PROTECTION
Despite the changing forms of the family, it has remained the universally accepted institution for reproductive function and child rearing.
Procreation
is the process of learning how to become productive members of society. It involves transmission of the culture of a social group
Socialization
Society is characterized by a hierarchy of it’s members into social classes. The family confers its societal rank on the children.
Status placement
- is a unit of production where the whole family works as a team, participating in farming, fishing, or cottage industries
Rural family
- is a unit of consumption where economically productive members work separately to earn salaries or wages.
Urban family
The family provides for the survival needs (food, shelter, and clothing) of it’s dependent members, like young children and the aged.
Physical maintenance
. The family supports spouses or partners by providing for companionship and meeting affective, sexual, and socioeconomic needs. The family is a source of motivation and morale for its members.
• Welfare and protection
In a family unit, any dysfunction (illness, injury, separation) that affects one or more family members will affect the members and the unit as a whole - also known as
the ripple effect
E0 NO. 29
FAMILY CODE OF THE PHILIPPINES
OUTSIDE FORCE
SUPRASYSTEM
EDUCATION, EMPLOYMENT, HOUSING
SOCIAL SYSTEM
Parke (2002) stated that there are three subsystems of the family that are the most important
parent-child subsystem, marital subsystem, and sibling-sibling subsystem.
a noted sociologist, is the forerunner of a focus on family development.
• Duvall
a. Inclusion of spouse in realignment of relationships with extended families
b. Parenthood making decisions
- Marriage, joining of families
a. Adjustment of tasks, child rearing, financial, and household
- Families with young children
a. Development of increasing autonomy for adolescent
b. Midlife re-examination of marital and career issues
- Families with adolescents
a. Establishment of independent identities for parents and grown children
b. Readjustment of relationships to include in-laws and grandchildren
c. Dealing with disabilities and death of older generation
- Families as launching canters
a. Support and autonomy of older generation
b. Preparation for own death and dealing with the loss of spouse and/or siblings and other peers
- Aging families
HEALTH TASK EXAMPLES
BREAST-FEED, HEALTHY DIET, IMMUNIZATIONS, HANDWASHING
• Otto (1973) and Pratt (1976) characterized healthy families as
energized families
It is a professional, purposeful interaction that takes place in the family’s residence aimed at promoting, maintaining or restoring the health of the family or its members.
It’s a family-nurse contact where, instead of the family going to the nurse, the nurse goes to the family.
The nurse makes a home visit upon the family’s request, as a result of case finding. in response to a referral, or to follow-up clients who have utilized the services of a health facility such as health center, lying-in clinic, or hospital.
Home Visit
The nurse contacts the family and determines the willingness for a home visit and a plan of visit is formulated.
Pre-visit phase
This phase begins as the nurse seeks permission to enter and lasts until he or she leaves the family’s home. This consist of initiation, implementation and termination process of visiting a family’s home.
In-home phase -
This takes place when the nurse has returned to the health facility. This involves documentation of the visit during which the nurse records events that transpired during the visit, including personal observations and feelings of the nurse about the visit.
Post-visit phase -
Anderson and Mcfarlene (2011) emphasized the role of the following factors in shaping 215 century health that further influence health care delivery system:
- Health care “reforms”
- Demographics
- Globalization
- Poverty and growing disparities
- Social disintegration
A specialized agency of the United Nations (UN) Or provides global leadership on health matters
World Health Organization (WHO
RA NO. 7160
LOCAL GOVERNMENT CODE
A health system has six building blocks or components:
- Service delivery
- Health workface
- Information
- Medical products, vaccines, and technologies
- Financing
- Leadership and governance or Stewardship.
The WHO strategy on research for health has 5 goals:
Capacity, Priorities, Standards, Translation, and Organization.
WHEND DID world leaders on UN General Assembly participate in Millennium Summit.
September 6 to 8, 2000
The following are the eight MDG’s and the targets corresponding to health-related MDG’s 4,5, and 6.
- Eradicate extreme poverty and hunger.
- Achieve universal primary education
- Promote gender equality and empower women
- Reduce child mortality.
- Improve maternal health
- Combat HIV/AIDS, malaria and other diseases.
- Ensure environmental sustainability.
- Develop a global partnership for development.
WORLD HEALTH DAY
APRIL 7, 1948
main governing body of health services in the country AND in each of the 17 regions
DOH
R.A. 7875
The National Insurance Act of 1995
the national agency mandated to lead the health sector towards assuring quality health care for all Filipinos.
• Department of Health
is to be a global leader for attaining better health outcomes, competitive and responsive health care system, and equitable health financing.
DOH Vision
to guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health.
DOH Mission
• The DOH core values reflect adherence to the highest standards of work namely:
- Integrity
- Excellence
- Compassion and respect for human dignity
- Commitment
- Professionalism
- Teamwork
- Stewardship
Level 1
Primary Care Facility
Level 2
Custodial Facility
Level 3 (Teaching/Training)
Diagnostic/Therapeutic Facility
- a first contact health care facility that offers basic service including emergency services and provision for normal deliveries.
Category A. Primary Health Care Facility
- a health facility that provides long-term care, including basic services like food and shelter, to patients with chronic conditions requiring ongoing health and nursing care due to impairment and a reduced degree of independence in activities of daily living, and patients in need of rehabilitation.
Category B. Custodial Care Facility
- a facility for the examination of the human body, specimens from the human body for the diagnosis, sometimes treatment of disease or water for drinking analysis. The test covers the preanalytical, analytical and post analytical phases of examination.
Category C. Diagnostic/Therapeutic Facility
-a facility that performs highly specialized procedures on a outpatient basis.
Category D. Specialized outpatient facility
commonly known as health center, is a primary level health facility in the municipality
RHU
The recommended ratio of RHU to catchment population is
1 RHU: 20,000 populations.
MAJOR ROLES OF DOH
- LEADER IN HEALTH
- ENABLER IN CAPACITY BUILDER
- ADMINISTRATOR OF SPECIFIC SERVICES
SUPERVISOR IN A RHU
Rural Health Midwife (RHM).
heads the heal services at the municipal level and carries out the following roles and functions:
The Municipal Health Officer (MHO) or Rural Health Physician
was enacted to bring about genuine and meaningful local autonomy. This will enable local governments to attain their fullest development as self-reliant communities and make them more effective partners in the attainment of national goals.
- R.A 7160 or Local Government Code
refers to the act by which the national government confers power and authority upon the various LGU’s to perform specific functions and responsibilities.
- Devolution
is a set of activities undertaken by a health care provider or facility in response to its inability to provide the necessary health intervention to satisfy a patient’s need.
A referral
- occur within the health facility; may be made to request for an opinion or suggestion, co-management, or further management or specialty care.
Internal referrals
- is a movement of a patient from one health facility to another. It may be vertical, where the patient referral may be from a lower to a higher level of health facility or the other way round.
• External referral
: advocacy for exclusive breastfeeding in the first 6 months of life, newborn screening program, immunization, nutrition services, and integrated management of childhood illness.
Expanded Garantisadong Pambata (child health)
started in the 1970s as a family planning service delivery component to achieve fertility reductions.
The Family Planning program
is means to prevent high-risk pregnancies brought about by . the following conditions
• The Family Planning
high-risk pregnancies brought about by the following conditions
- Being too young or too old (less than 18 years or over 34 years old)
- Having had too many (4 or more) pregnancies
- Having closely spaced pregnancies (less than 36 months)
- Being too ill or unhealthy
• Four Pillars of PFFP
- Responsible parenthood
- Respect for life
- Birth spacing
- Informed choice
• EO no. 51
- also known as the MILK CODE
• EO no. 382
- observance of the NATIONAL FOOD FORTIFICATION day in November 7
• RA 7600
- also known as ROOMING-IN and BREAST-FEEDING ACT
• RA 8172
- also known as ASIN (ACT FOR SALT IODIZATION NATIONWIDE)
• RA 8976
-also known as the PHILIPPINE FOOD FORTIFICATION ACT
• RA 10028
- also known as EXPANDED BREASTFEEDING PROMOTION ACT
• AO 36, s2010
- also known as EXPANDED GARANTISADONG PAMBATA
a short facility where the patients spend 1-3 days like lying in or infirmary
within patient bed
health centers is example of
without patients bed
example of custodial
drug rehab center, sanitarium, leprosarium, nursing homes
example of specialized facility
dialysis clinic, ambulatory surgical, cancer radiation, rehab clinic
Republic Act 7305
: Magna Carta of Public Health Workers
ultimate immunity
colostrum
night blindness
Xerophthalmia
