COPAR

Community Organizing Participatory Action Research (COPAR)

___ is a process of building people's organizations by empowering communities to identify, analyze, and solve their own health and social problems through active participation.

COPAR

___ is a people-centered, participatory approach where the community becomes an active partner rather than a passive recipient of healthcare.

Game Changer:

___ = empowerment + participation + community action

1. Empower communities to solve their own problems

2. Develop community leadership

3. Encourage self-reliance

4. Promote participation in decision-making

5. Improve community health conditions

6. Establish sustainable health programs

COPAR aims to:

People Empowerment

Community Participation

Self-Reliance

Social Transformation

Partnership

Principles of COPAR

Facilitator

Educator

Organizer

Advocate

Researcher

Role of the Nurse in COPAR

facilitator

Game Changer:

In COPAR, the nurse's role is ___, not decision-maker.

Pre-Entry Phase

Game Changer:

The goal is to establish readiness for community entry.

Activities:

• Select community

• Gather background information

• Coordinate with local leaders

• Prepare resources

• Identify possible partners

Entry Phase

Game Changer:

The nurse enters the community and begins building relationships.

Activities

• Meet community leaders

• Establish rapport

• Introduce purpose

• Identify initial contacts

Important concepts:

• Respect culture

• Build trust

• Avoid imposing solutions

Integration

Game Changer:

___ builds trust and allows accurate assessment. The nurse becomes part of the community to understand its culture, needs, and concerns.

Activities:

• Living/working with the community

• Observing community life

• Developing relationships

• Identifying informal leaders

Community integration

Game Changer:

___ is essential before implementing programs.

Community Study / Diagnosis

Game Changer:

The community identifies and analyzes its problems.

Activities:

• Data gathering

• Community assessment

• Problem identification

• Priority setting

Tools:

• Surveys

• Interviews

• Community mapping

• Observation

Organization Building

Game Changer:

The goal is for the community to manage its own programs.

Formation and strengthening of community organizations.

Activities:

• Identify potential leaders

• Develop people's organizations

• Train community members

• Establish committees

Mobilization

Game Changer:

Community members take action to address identified problems.

Activities:

• Implement health projects

• Conduct campaigns

• Use community resources

Examples:

• Clean-up drives

• Nutrition programs

• Disease prevention activities

Evaluation

Game Changer:

Determining the effectiveness of community actions.

Evaluates:

• Achievement of goals

• Community participation

• Sustainability of programs

1. Passive Participation

2. Consultative Participation

3. Active Participation

4. Self-Mobilization

Community Participation Levels

Passive Participation

Community only receives information. Example: Attending a lecture without involvement.

Consultative Participation

Community gives opinions but does not decide.

Active Participation

Community helps plan and implement activities.

Self-Mobilization

Community independently initiates and manages programs

Traditional vs COPAR approach review

Recording

___ is the systematic documentation of health information, nursing care, and community health activities to provide a permanent written or electronic record.

Game Changer:

Documentation of care and health information

Accurate

Complete

Clear

Timely

Confidential

Game Changer:

Principles of Good Recording

Documented

Game Changer:

“If it is not ___, it is considered not done.”

Family Health Record

Individual Health Record

Community Health Records

Clinic Records

Home Visit Records

Nursing Notes

Game Changer:

Types of Records in Community Health Nursing

Reporting

Game Changer:

Communication of health information to appropriate persons/agencies.

Family Health Record

Contains:

• Family profile

• Health history

• Health problems

• Services provided

Purpose: Tracks health needs of the family.

Individual Health Record

Contains:

• Personal information

• Medical history

• Immunizations

• Treatments

Community Health Records

Contains:

• Population census

• Morbidity reports

• Mortality reports

• Disease surveillance data

Clinic Records

Contains:

• Consultation records

• Immunization records

• Prenatal records

• Treatment records

Home Visit Records

Contains:

• Date and purpose of visit

• Assessment findings

• Nursing interventions

• Follow-up plan

Nursing notes

Documents:

• Care provided

• Patient/community response

• Health teaching

Target Client List (TCL)

A record used to monitor priority clients.

Family Treatment Record

Contains

• Family Health problems

• Interventions

• Outcomes

Monthly Report Form (MRF)

Summarizes:

• Health activities

• Services provided

• Disease cases

Individual Treatment Record (ITR)

Contains:

• Patient visits

• Treatments

• Follow-up

Reporting

Game Changer:

is the organized communication of health information from one healthcare level to another. It ensures that health information reaches decision-makers for planning and action.

Routine Reports

Special Reports

Incident Reports

Types of reports

• Communicable diseases

• Outbreaks

• Unusual health events

Disease surveillance reporting content

Electronic Health Records (EHR)

Digital version of patient records.

Advantages:

• Easier access to information

• Improved continuity of care

• Reduced documentation errors

Health Information Systems (HIS)

Information technology used to:

• Collect health data

• Monitor programs

• Support decision-making

Telehealth / Telemedicine

Use of technology to provide healthcare services remotely.

Examples:

• Online consultations

• Remote monitoring

• Health education through digital platforms

Disease Surveillance Systems

Information technology used for:

• Tracking disease cases

• Monitoring outbreaks

• Reporting public health concerns

Data Management

Technology helps with:

• Data storage

• Analysis

• Program evaluation

Field Health Services Information System (FHSIS)

Game Changer:

It is the primary health information system used in Philippine public health.

Data Sources:

• Rural Health Units

• Barangay Health Stations

• Community health workers

Confidentiality

Game Changer:

___ must always be maintained in electronic and written records.

Internal Referral

Referral within the same healthcare facility.

Example:

Patient referred from

• Nurse → Physician

• Outpatient department → Laboratory

External Referral

Referral to another healthcare facility.

Example:

• RHU → Provincial hospital

Vertical Referral

Referral between different levels of care.

Example:

• Barangay Health Station → RHU → Hospita

Horizontal Referral

Referral between facilities of the same level.

Example:

• One primary care clinic → another primary care clinic

“Use the appropriate level of care according to patient needs”

Game Changer:

Referral is NOT simply sending a patient away; it is a coordinated transfer of care.

• Primary care is the first level where most patients enter the health system.

• Referral follows the principle: "___"

Clinical Information

• Chief complaint

• Assessment findings

• Vital signs

• Diagnosis/problem

• Treatment provided

Patient Information

• Name

• Age

• Address

• Contact information

In referral documentation, a referral form should include:

Feedback

Game Changer:

A nurse must stabilize emergency patients before referral.

___ from the receiving facility is essential for continuity of care.

Referral system supports:

• Primary Health Care

• Universal Health Care

• Continuity of nursing care

Emergency Conditions

Conditions Beyond Facility Capability

High-Risk Patients

Referral Criteria (When to Refer)

1. Accessibility

2. Communication

3. Coordination

4. Continuity

5. Feedback Mechanism

Characteristics of a good and effective referral system

Health Education

___ is a process of helping individuals, families, and communities acquire knowledge, attitudes, and skills needed to promote, maintain, and restore health.

___ is a major function of community health nursing and a primary tool for prevention.

Game Changer:

It is a core function of community health nursing.

Individual

Family

Population Group

Community

Health Education Across Levels of Care

Individual teaching = specific and personalized

Family teaching = focuses on family as a unit

Group teaching = shared characteristics

Community education = population-wide interventions

Game Changer:

Health education for each individual, family, group, and community.

Demonstration + return demonstration

Game Changer:

The best method for skill learning is ___.

Evaluation is essential to determine learning effectiveness.

Research utilization

___ is the process of applying findings from scientific research into nursing practice to improve the quality, safety, and effectiveness of care. It bridges the gap between “what is known from research” and “what is done in practice.”

Research

___ utilization improves quality of care in community health nursing.

It is applied to:

• Individuals

• Families

• Population groups

• Communities

Quantitative Research

Type of research

• Uses numbers and statistics

• Measures outcomes

Examples:

• Incidence of disease

• Effectiveness of vaccine programs

Qualitative Research

Type of research

• Explores experiences and perceptions

Examples:

• Patient satisfaction

• Cultural beliefs about illness

Epidemiologic Research

Type of research

• Studies disease distribution and determinants

Examples:

• Outbreak investigations

• Risk factor studies

Evidence-Based Practice (EBP)

Game Changer:

Type of research

It is the gold standard in modern nursing.

Integration of:

• Best research evidence

• Clinical expertise

• Patient preferences

Lack of time

Lack of resources

Resistance to change

3 Barriers in evidenced based practice (EBP)

apply research findings

Game Changer:

In Evidenced-Based Practice (EBP), nurses must be able to interpret and ___.

Lack of Time

Lack of Resources

Lack of Research Skills

Resistance to Change

Organizational Barriers

5 Barriers to Research Utilization

Research Utilization vs Evidence-Based Practice (EBP) Review