CHN Lecture Part 3

Development Goals to Emerging Specializations

Millennium Development Goals (MDGs)

Global development agenda formed at the Millennium Summit

• 191 countries participated

September 6, 2000

Date the MDGs are formed

United Nations Headquarters, New York City

Where did the Millennium Summit take place?

2015

target year of MDGs

Eradicate Poverty

MDG Goal 1 (PEG C MAME G))

Achieve Universal Education

MDG Goal 2 (PEG C MAME G))

Promote Gender Equality

MDG Goal 3 (PEG C MAME G))

Reduce Child Mortality

MDG Goal 4 (PEG C MAME G))

Improve Maternal Health

MDG Goal 5 (PEG C MAME G))

Combat HIV/AIDS, Malaria, and other Diseases

MDG Goal 6 (PEG C MAME G)

Ensure Environmental Sustainability

MDG Goal 7 (PEG C MAME G)

Develop a Global Partnership for Development

MDG Goal 8 (PEG C MAME G)

Global Goals

Sustainable Development Goals (SDGs) are also known as

• Replaces MDGs every 15 years

• 17 goals

September 5, 2020

Date when SDGs were adopted at the UN Assembly

• 193 countries signed, including the Philippines

Transforming Our World: The 2030 Agenda for Sustainable Development

SDGs agenda title

2030

SDGs target year

⭐️ Goal 1: No Poverty

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Eliminate extreme poverty in all forms

⭐️ Goal 2: Zero Hunger

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Focused on nutrition, food security

⭐️⭐️⭐️⭐️ Goal 3: Good Health & Well-Being

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Includes immunization, mRNA tech, monoclonal antibodies (mAb)

Focus on disease treatment & health access

⭐️ Goal 4: Quality Education

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Tied with health promotion (e.g., Ottawa Charter)

Goal 5: Gender Equality

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Empower women and eliminate discrimination

⭐️⭐️ Goal 6: Clean Water and Sanitation

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

WHO’s WASH Program: Water, Sanitation, Hygiene

Waste & pollution control: RA 9003 Waste Management Act, Clean Air Act

Water, Sanitation, Hygiene

meaning of WASH

RA 9003

Ecological Solid Waste Management Act of 2000

RA 8749

Clean Air Act

Goal 7: Affordable and Clean Energy

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Promote renewable and sustainable energy sources

⭐️⭐️ Goal 8: Decent Work and Economic Growth

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Responds to global nursing shortage

Address mismatch in demand and supply of health workers

Goal 9: Industry, Innovation and Infrastructure

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Build resilient infrastructure, foster innovation

⭐️⭐️ Goal 10: Reduced Inequalities

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Ensure equal access to healthcare: RA 11223 (UHC Law)

RA 11223

Universal Healthcare Law

Goal 11: Sustainable Cities and Communities

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Promote inclusive and safe urban development

⭐️⭐️ Goal 12: Responsible Consumption and Production

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Proper use of resources and PPEs

Most used PPE in healthcare: Gloves

⭐️⭐️ Goal 13: Climate Action

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Address climate change and emerging diseases

⭐️⭐️ Goal 14: Life Below Water

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Includes marine conservation

Health hazard: Red tide poisoning

⭐️⭐️ Goal 15: Life on Land

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Address land-based issues like zoonotic diseases

⭐️⭐️ Goal 16: Peace, Justice, and Strong Institutions

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Includes patient safety, malpractice, and RA 9173 (Philippine Nursing Act)

⭐️⭐️ Goal 17: Partnership for the Goals

Sustainable Development Goals (PHHEG CEDII SuRe CA WaLa Peace Partnership)

Emphasizes collaboration and multi-sectoral approach

Stakeholders include WHO, UNICEF

WHO works in 6 regions:

• South-East Asia

• Africa

• Americas

• Eastern Mediterranean

• Europe

• Western Pacific

Western Pacific

region of the PH in WHO

San Lazaro Hospital Complex

WHO Office in PH

Tedros Adhanom Ghebreyesus

WHO Director-General from Ethiopia

Teodoro Herbosa

DOH Secretary (PH)

Antonio Guterres

UN Secretary-General:

Charles Edward Winslow

Science and art of promoting health, preventing disease, and prolonging life

Public health nursing defined by

Promote health, prevent disease

Focus of Community Health Nursing (CHN)

birth rights and longevity (Ensure birth rights and longevity, Right to be born healthy and live a long life)

goal of PHN

Home Setting

Clinic settings

Settings of Public Health Nursing

clinic visit

BHS, RHU, Lying-in

First contact facility of the community

Pre-consultation conference

Medical examination phase

Nursing intervention phase

Post-consultation conference

Phases of Clinic Visit

Pre-consultation conference

phase of clinic visit that identifies chief complaint

Post-consultation conference

phase of clinic visit when nurses do health teaching and arrange for follow-up schedule

Information

Communication

Education

Components of Health Teaching (ICE)

Knowledge

Skills

Attitude

Health Teaching Criteria (ascending order)

knowledge

highest criteria of health teaching

Ottawa Charter for Health Promotion

• Conference held in Ottawa Canada

• Organized by WHO

• Foundational document in public health that outlines strategies and action areas for improving global health

• Focuses on health promotion

• Nov. 17-21, 1986

5 ACTION AREAS FOR HEALTH PROMOTION

result of Ottawa Charter

Develop Personal skills

Reorient public health services

Building public health policy

Strengthening community action

Create supportive environment

5 ACTION AREAS FOR HEALTH PROMOTION (DR. BSC)

Registration

Waiting time

Triaging

Clinical Evaluation

Laboratory Exam

Dispensing of drugs

Referral System

Health Education

Clinic activities

Triaging

Process of prioritization

Should be done in less than 60 mins

1 hr

Golden hour in triage

Sendai Framework

Framework used for disaster traige

orange

Triage color codes: chemical

pink

Triage color codes: biological

Program-based cases

triage in health centers: Based on DOH protocol (e.g., DOTS, IMCI)

Non-program-based

triage in health centers: Out of scope; require referral (e.g., fractures)

Emergency cases

triage in health centers: Provide first aid before referral (e.g., rabies)

screening

focus of laboratory exams done in health centers

Direct Sputum Smear Microscopy

Laboratory test for TB that can be done in a community set-up

Sputum Collection Guidelines:

• Morning specimen, 5 mL, different days

• No oral care before, okay after

• Stop antibiotics 1 day prior

Other TB Tests

• IGRA: Interferon Gamma Release Assay

• T-SPOT test

• QuantiFERON Gold test

• TB GeneXpert: Newest test; uses sputum with cartridge

Acid-Fast Bacilli (AFB)

rod-shaped microorganism indicative of TB

Ziehl-Neelsen stain

stain used in DSSM

confirmed negative

DSSM result: 3 negative smears

repeat smear

DSSM result: 1 bacillus

2-3 bacilli

DSSM result: positive smear

OTC, prescription drugs with DOH program

Drug dispensing in clinics

Cotrimoxazole

Amoxicillin

Rifampicin

Isoniazid

Pyrazinamide

Paracetamol

ORS

Nifedipine

Common drugs that can be dispensed in HC

CARIPPON

Cotrimoxazole

Amoxicillin

medications for infections that can be dispensed in clinics

Rifampicin

Isoniazid

medications for Tb that can be dispensed in clinics

Nifedipine

medications for HPN that can be dispensed in clinics

dehydration, diarrhea

ORS is for

fever

paracetamol is for

Comprehensive two-way referral

referral system used in the PH

Allows back-and-forth referrals

Begins at RHU

Provide nursing Care

Assess the living condition of the family

Provide health teachings

purpose of home visit (PUSA)

Purpose & objectives

Prioritization

Plan of visit

Make use of all available information from the client

Principles of home visits (PM)

Practical

Plexible

Pamilya

Plan of visit should be

pre-visit phase, in-home phase, post-visit

phases of home visit (P-I-P)

plan and purpose

you need to prepare these before going to the house (pre-visit phase)

initiation, implementation, termination

phases of home visit in-home phase stages

initiation

phases of home visit in-home phase stages:

Knock ✊

Use non-threatening voice

Greet the client

Introduce yourself

Observe the environment

Rapport

State the purpose

Implementation

phases of home visit in-home phase stages: use nursing process

ACE:

• Assess

• Care provider

• Evaluate

termination

phases of home visit in-home phase stages

Summarize all activities done in the house

Schedule the next visit or clinic visit

Record findings

post-visit

phase of home visit:

• Return to the facility

• Documentation

  • All the intervention or activities done in the house

• Referral system

Factors Affecting Home Visit Frequency

PAPANO:

Policy of the agency

Acceptance by family

Past services rendered

Ability to recognize needs

Needs of the family

Other health services involved

acceptance of family

most important factor that affects frequency of home viists

Needs of the family

determinant of home visit

Bag technique

tool used by nurses during home visits to efficiently and safely deliver care while preventing the spread of infection. It involves using a specialized bag containing essential supplies and following a systematic procedure for setting up a clean work area, performing procedures, and properly storing items afterward.

PHN bag

equipment used in bag technique

on your lap

where do you put the bag when you are conducting home visit

table with paper and plastic lining

where do you put the bag when you are conducting bag technique

GUIDELINES AND PRINCIPLES OF BAG TECHNIQUE

MESAH:

Miminize if not prevent the spread of infection

Effectiveness of total care

Save time and error

Avoid contamination

Hand washing

top

location in PHN bag:

paper lining

Plastic lining

Gloves

Apron

“Ganunin”

front

location in PHN bag:

TT

thermometer

Test tube

Test tube holder