Compre: COMMUNITY HEALTH NURSING

Sir Jessie Daclis Compre Lecture (June 18 - 20)

Community Health Nursing Occurs where?

Outside the hospital

What is the primary responsibility?

Health Teaching

What is the focus of health teaching?

Health Promotion and Illness Prevention

To increase the level of health

Health Promotion

Health Promotion makes a _____ person ________

healthy, healthier

Maintenance of health, a healthy person kept healthy, all about specific protection

Illness Prevention

Primary Focus between health promotion and Illness prevention?

Health Promotion

What is the goal of CHN ?

OLOF, Optimum Level of Functioning

Public Health Nurses are nurses who are under the _____________-

Government

In the Philippines, how much is the salary of Nurses?

SG15, 40K/Month

Subspecialty of Public Health Nurses

School Health Nurse
Occupational Health Nurse
Mental Health Nurse (RA 11036)

The focus of this subspecialty is the safety and health of workers

Occupational Health Nurse

An occupational Health nurse is needed if the company has ___ or more workers

50 or more

This act states that Mental Health Services should be available in Health Centers

RA 11036 Mental Health Act

What are the 4 Facets of Mental Health Burden?

1. Defined Burden

2. Undefined Burden

3. Hidden Burden

4. Future Burden

This type of burden affects the individual.

Defined Burden

This type of burden affects other individuals

Undefined Burden

Stigma and violation of human rights burden

Hidden Burden

type of burden affects the future generation

Future Burden

4 CLIENTS in the Community

Individual
Family
Group/ Aggregate Population
Community

Basic Unit of Service/ Basic unit of care

Family

Share common characteristics and developmental stage, e.g., Infants undergoing vaccination

Group/Population Aggregate

Share common geographical boundaries, and is the PRIMARY CLIENT

Community

What is the RA for Magna Carta of PHN?

R.A. 7305

The Magna Carta is comprised of 2:

Tenure of 5 years, every 5 years the sweldo rises up to 5%

Night Differentials increase of 10%

Principles of CHN (FAT MAN)

Family, All, Teaching, Member, Active, Needs

Goal of CHN:

Optimum Level of functioning

Goal of Primary Health Care

Self Reliance in Health

Goal of COPAR (CHD):

Community Health Development

Determinants of Health (General):

Social Economic Environment
Physical Environment
Individual Characteristics and Behaviours

Philippine Healthcare Delivery System

Primary, Secondary, Tertiary

What type of delivery system is PHDS?

Intrasectoral Delivery System

Primary PHDS should be A_______ and _________

Accessible and within 3-5 km away with 30 mins distance

Examples of PH HDS

Barangay Health System
Health Center/Rural Health Unit

This is the satellite station and smallest unit of primary facility

Barangay Health System

The BHS consists of

Midwives and Brgy Health Workers

Main Primary Center and consists of complete health care team

Health Center/RHU

Who is the frontliner in the HC/RHU who accommodates patients?

Public Health Midwives

Who supervises the midwives?

Public Health Nurse

who manages the overall activities in the HC/RHU?

Rural Health Physician

Other members of the Health Care team in RHU/HC

Sanitary Inspector, Dentist, Medical Technologist

This type of referral system is used by the PHDS.

Two-way referral system

DOH is the _________________

National Authority for Health

E.O. _____ DOH has ___ Functions

E.O. 102, 3 functions

what are the 3 functions of DOH?

Leadership
Enabler and Capacity Builder
Administrative function

DOH makes policies for health e.g., botica dapat may pharmacist

Leadership

DOH makes new strategies and training for health e.g., Unang yakap

Enabler and Capacity Builder

Manager of tertiary hospitals, emergency services, and Specialty hospitals

Administrative Function

What is the Local Government Code

RA 7160

RA 7160 (DE-DE)

Decentralization and Devolution

Transfer of Power, Before DOH Formulates and Implements but now who formulates and who implements?

Formulates: DOH
Implements: LGU

Provincial Government
Chairman:
Vice Chairman:
Manages what:

Governor
Provincial Health Officer
Secondary Hospitals

Municipal/City Government
Chairman:
Vice Chairman:
Manages what:

Mayor
Municipal/City Health Officer
Primary Hospitals

DOH Vision:

Filipinos will be the healthiest in Asia by 2040

DOH Mission is to develop PREP

Productive, Resilient, Equitable, and People oriented Health System

The roadmap for all stakeholders for health
Goal of DOH
Lists of national Health Goals

National Objective for Health

Overriding goal of DOH (2nd Goal of DOH)

Health Sector Reform Agenda (HSRA)

Under HSRA by Gloria Macapagal Arroyo

Fourmula One for Health

Aquinos and their Theme?

Aquino Health Agenda
Theme: Universal Health Care (Pangkalahatang kalusugan)

Dutertes HSRA with theme?

Fourmula One Plus
Theme: Boosting Universal Health Care

F1 Plus has 5 pillars namely (FR S GG PA)

Health Financing
Health Regulations
Health Service Delivery
Good Governance
Performance Accountability

What is the Universal Health Care Law and what does it entail?

RA 11223, All Filipinos automatically enrolled in Phil Health

Better Investment for health, National Health Insurance Program

PhilHealth: Case Rate Method; Per diagnosis

Health Regulation: RAQ

Regulation is Affordable and Quality

Health Service Delivery

Service is Accessible and Available

Good Governance (TAE)

Transparent
Accountable
Efficient

Performance Accountability:

Outcome Based Approach

Family Care Plan: Nursing Process “APIE”

Assessment Planning Intervention Evaluation

Data Collection, Interview, Observation

Assessment

2 types of Assessment

First Level Assessment
Second Level Assessment

This type of assessment focus on the “what” are the problems

First Level Assessment

Categories of First Level Assessment

Wellness State
Health Deficit
Health Threat
Foreseeable Crisis/Stress Points

Healthy Regular Exercise, Avoid Vices, Applicable for Healthy Patients

Wellness State

Patient has disease or disability

Health Deficit

Patient is in a situation high risk of illness and injury like drinking alcohol, smoking/vape

Health Threat

Anticipated Problem

Foreseeable Crisis

The “why” of problems

Second Level Assessment

First Step of Planning is

GOAL SETTING

Second Step:

Construct Plan of Action choose nursing interventions

Third step is to prioritize, how do we prioritize?

Using a Criteria in Solving Namely

Nature Of the Problem 1
Modifiabiity of the Problem 2
Preventive Potential 1
Salience 1

Nature of the Problem: Type of Nursing Problem

Wellness State 3
Health Deficit 3
Health Threat 2
Foreseeable Crisis 1

Modifiability of the problem - solution of the problem

Easily 2
Partially 1
Not Modifiable 0

Preventive Potential - future reoccurances

High 3
Moderate 2
Low 1

Salience - perception of the client about the problem

Immediate 2
Not that Immediate 1
Not a problem 0

FORMULA FOR PRIORITIZATION

SCORE/HIGHEST SCORE X WEIGHT

Outcome, Quality assurance elements

EVALUATION

3 ELEMENTS: (SOP)

Structural
Outcome
Process

Basic Health Care, WHO: 1978
Alma Ata Conference (USSR) Kazakhstan

Primary Health Care

LOI 949

Legal Basis of PHC, signed by Pres Marcos (1979)

Vision of Primary Health Care?

Health in the Hands of People (Self Reliance)

Mission

Increase opportunities that people will manage their own health care

2 core principles of PHC

Partnership with the people
Empowerment - transfer Knowledge, Skills, Attitude

4 PILLARS OF PRIMARY HEALTH CARE: AIUS

Active Community Participation
Intra, Intersectoral Linkages
Use of Appropriate Technology
Support Mechanism Made Available

Characteristics of Primary Health Care

Community Based
Accessible
Sustainable
Affordable
Self Reliance
Available

Elements of PHC

Education
Locally Endemic Disease
Essential Drugs
Maternal Child Health
Expanded Program on Immunization
Nutrition
Treatment of Communicable Disease, Non Communicable, and Emergency
Sanitation

Competency Based Teaching and Learning Principles:

1. Learning is considered an intellectual and emotional process

2. Learning is an individual manner

3. Learning is facilitated when experience have meaning to the learner

3 levels of prevention

Primary, Secondary, Tertiary

Healthy, Health promotion, Illness Prevention

Primary

High Risk, Early diagnosis and treatment

Secondary

Post treatment, Prevent Complication, Rehab, Palliative care

tertiary prevention