CHAPTER 1: FUNDAMENTAL CONCEPTS OF COMMUNITY HEALTH NURSING

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83 Terms

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PWD, Children, Elderlies, Senior citizens, Immunocompromised Patients

Susceptible in community

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HEALTH

ā€œa state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.ā€

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WHO

Definition of Health According to: ____________

ā€œa state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.ā€

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COMMUNITY

Seen as a group or collection of locality-based individuals, interacting in social units, and sharing common interests, characteristics, values, and/ or goals.

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The Philippine Public Healthcare Scenario

The scenario requires strategies that will maximize limited resources such as

LGU augment national budget to an undetermined extent.

The scenario requires strategies that will maximize limited resources such as health promotion and disease prevention.

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relatively small

The national budget allocation for health care is _________-

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LGU

they augment national budget to an undetermined extent

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Health promotion

- starts on ourselves.

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Community/Public Health Nursing

The synthesis of nursing practice and public health practice.

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Major Goal of CHN

Preserve the health of the community and surrounding population by focusing on health promotion and health maintenance of individual, family and group within community.

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CHN/ PHN

is associated with health and identification of population at risks rather than with an episodic response to patient demand.

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Mission of Public Health

Social justice that entitles all people to basic necessities, such as adequate income and health protection, and accepts collective burdens to make possible.

Social injustice starts with poverty

Social justice can be achieved through implementing equality, and establishing fairness.

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Social justice

entitles all people to basic necessities, such as adequate income and health protection, and accepts collective burdens to make possible.

can be achieved through implementing equality, and establishing fairness.

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social injustice

starts with poverty

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CONCEPTS OF HEALTH

The variety of characterization of the world illustrates the difficulty of standardizing the conceptualization of health.

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People

Place

Interaction

Common characteristics, interests, and goals.

Defining attributes of community

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  1. Geopolitical Communities AKA Territorial Communities

  2. Phenomenological Communities AKA Functional Communities

Two Main Types of Communities

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Geopolitical Communities (Territorial Communities)

Most traditionally recognized.

Defined or formed by both natural and man-made boundaries and include barangays, municipalities, cities, provinces, regions, and nations.

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Phenomenological Communities AKA 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.

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Territorial Communities

also known as Geopolitical Communities

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Functional Communities

also known as Phenomenological Communities

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  1. Income and Social Status

  2. Education

  3. Physical Environment

  4. Employment and Working Conditions

  5. Social Support Networks

  6. Culture

  7. Genetics

  8. Personal Behavior and Coping Skills

  9. Health Services

  10. Gender

Determinants of Health and Disease

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Income and Social Status

Higher-income and social status are linked to better health. The greater the gap between the richest and poor health, the greater differences in health.

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Higher-income and social status

are linked to better health. The greater the gap between the richest and poor health, the greater differences in health.

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Education

Low education levels are linked with poor health, more stress and lower self-confidence.

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Low education levels

are linked with poor health, more stress and lower self-confidence

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Physical Environment

Safe water and clean air, healthy workplaces, safe houses communities and roads all contribute to good health.

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Employment and Working Conditions

People in employment are healthier, particularly those who have control over their working conditions

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Social Support Networks

Greater support from families, friends and communities is linked to better health.

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Culture

Customs and traditions, and the beliefs of the family and community all affect health.

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Genetics

Inheritance plays a part in determining lifespan, healthiness, and the likelihood of developing illnesses.

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Personal Behavior and Coping Skills

Balanced eating, keeping active, smoking, drinking and how we deal with life’s stresses and challenges all affect health.

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Health Services

Access and use of services that prevent and treat disease influences health.

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Health promotion

Activities enhance resources directed at improving well-being.

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Disease prevention

Activities protect people from disease and effects of disease

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  1. Primary Prevention

  2. Secondary Prevention

  3. Tertiary Prevention

Leavell and Clark’s Three Levels of Prevention

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Leavell and Clark’s Three Levels of Prevention

  1. Primary Prevention

  2. Secondary Prevention

  3. Tertiary Prevention

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Primary Prevention

General health promotion and specific protection.

Ex. Brgy. Health center

Relates to activities directed at preventing a problem before it occurs by altering

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Secondary Prevention

• Early detection and prompts intervention.

• Ex. District hospitals

• 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 (Keller).

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Tertiary Prevention

• Targets populations that have experienced disease or injury and focuses on limitations of disability and rehabilitation.

• Aim: Reduce the effects of disease and injury and to restore individuals to their optimum level of functioning.

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• Physical Activity

• Walking for health

• Healthy Eating

• Stop Smoking

• Mental Health

• Sexual Health

• Community Development

• Healthy Schools

• Health Trainers

Health Promotion

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PHN (FREEMAN 1963)

may be defined as the field of professional practice in nursing and in public health in which technical nursing, interpersonal, analytical, and organizational skills are applied to problems of health as they affect the community.

These skills are applied in concert with those of other persons engaged in health care, through comprehensive nursing care of families and other groups and through measures for evaluation or control of threats to health, for health education of the public and for the mobilization of the public for health action.

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PHN (ANA 1996)

ā€œThe practice of promoting and protecting the health of populations using knowledge from nursing, social and public health sciencesā€

ā€œPopulation-focused, 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.ā€

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CHN

• emphasizes preservation and protection of heath

• the primary client is the community

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Community-based Nursing

•Emphasizes on managing acute and chronic.

Application of the nursing process in caring for individuals, families and group where they live, work go to go school, or they move through the health care system.

Setting-specific, and the emphasis is on acute and chronic care and includes practice areas such as home health nursing and nursing in outpatient or ambulatory setting.

Focused on individual and family health needs.

Moving from traditional settings to community/neighborhood locations.

Integrated system of health care including institutions, providers, agencies, policies, payment plans, family, and patients.

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individual and the family

the primary clients in community-based nursing are the

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Population-Focused Nursing

Concentrates on specific groups of people and focuses on health promotion and disease prevention, regardless of geographical location (Baldwin et al., 1998).

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Focused Practice

1. Focuses on the entire population

2. Based on assessment of the populations’ health status

3. Considers the broad determinants of health

4. Emphasizes all levels of prevention

5. Intervenes with communities, systems, individuals and families

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promote healthy communities

goal of population-focused practice

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Home Health Care

Hospice Home Care

Entreprenurse

Faith Community Nursing or Parish Nursing

EMERGING FIELDS OF CHN IN THE PHILIPPINES

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Home Health Care

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

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Hospice Home Care

Homecare rendered to the terminally ill. Palliative care is particularly important

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Entreprenurse

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.

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To deliver home health care services.

Main Purpose of Entreprenurse

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Faith Community Nursing or Parish Nursing

Nurses in practice in which provides spiritual care.

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  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. Records Management

  10. Communication

  11. Collaboration and Teamwork

COMPETENCY STANDARDS IN CHN

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Safe and Quality Nursing Care

knowledge of health/illness status of the client, sound decision making; safety, comfort, privacy, administration of meds and health therapeutics and nursing process.

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Management of Resources and Environment

organization of workload; use of financial resources for client care; mechanism to ensure proper functioning of equipment and maintenance of a safe environment

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Health Education

assessment of client’s learning needs; development of health education plan and learning materials and implementation and evaluation of health education plan.

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Legal Responsibility

adherence to the nursing laws as well as to national, local and organizational policies including documentation of care given to clients.

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Ethico-moral Responsibility

respect for the rights of the client; responsibility and accountability for own decisions and actions; and adherence to the international and national codes of ethics for nurses.

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Personal and Professional Development

identification of own learning needs, pursuit of continuing education; involvement in professional image; positive attitude towards change and criticism.

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Quality Improvement

data gathering for quality improvement; participation in nursing rounds; identification and reporting of solutions to identifies problems related to client care.

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Research

research-based formulation of solutions to problems in client care and dissemination and application of research findings

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Records Management

accurate and updated documentation of client care while observing legal imperatives and record keeping

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Communication

uses therapeutic communication techniques, identifies verbal and nonverbal cues, responds to client needs, while using formal and informal channels

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Collaboration and Teamwork

establishment of collaborative relationship with colleagues and other members of health team.

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1577

- Franciscan FriarJuan Clemente opened medical dispensary in Intramuros for the indigent

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1690

- Dominican Father Juan de Pergero worked toward installing a water system in San Juan del Monte and Manila

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1805

Smallpox vaccination was introduced by Francisco de Balmis , the personal physician of King Charles IV of Spain

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1876

- First medicos titulares were appointed by the Spanish government

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1888

- 2-year courses consisting of fundamental medical and dental subjects was first offered in the University of Santo Tomas. Graduated were known as ā€œcirujanos ministrantesā€ and serve as male nurses and sanitation inspectors

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1901

- 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

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Fajardo Act of 1912

- Created sanitary divisions made up of one to four municipalities. Each sanitary division had a president who had to be a physician

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1915

- The Philippine General hospital began to extend public health nursing services in the homes of patients by organizing a unit called Social and Home Care services

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Asociacion Feminista Filipina (1905)

- Lagota de Leche was the first center dedicated to the service of the mothers and babies

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1947

- The Department of Health was reorganized into bureaus: quarantine, hospitals that took charge of the municipal and charity clinics and health with the sanitary divisions under it.

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1954

- Congress passed RA 1082 or the Rural Health Act that provided the creation of RHU in every municipality

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RA 1891

- Enacted in 1957 amended certain provisions in the Rural Health Act. Created 8 categories of rural health units corresponding to the population size of the municipalities.

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RA 7160 (Local Government Code)

- 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.

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Millennium Development Goals

- Adopted during the world summit in September 2000

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1999

- FOURmula One (F1) for health, 2005 and Universal Health Care in 2010 agenda

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Universal Health Care

• 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.