CHN Lecture Part 4

NURSING PROCESS APPLIED IN THE COMMUNITY

APIE

nursing process in community setting

PRIMARY DATA

1st hand data or information

part of assessment

SECONDARY DATA

records, reports, documents

part of assessment

Data collection

Data collation

Data presentation

Data analysis

Data utilization

ACTIVITIES DONE IN ASSESSMENT

Interview

data collection: primary data

most reliable data collection/best method

may be informal or key-person

Informal interview

conventional type of interview

interviewer and interviewee

Key-person interview

interview with brgy leaders, teachers, priest, elderly

Observation

data collection: primary data

participant

you have to participate of there are activities

ocular inspection/survey

data collection: primary data

type of observation: rapid observation/windshield observation

Survey and Questionnaire

data collection: primary data

through these, majority of data is being collected

Community forum

data collection: primary data

aka community assembly

Pagpupulong-pulong sa barangay - open meeting for the community

For larger group

Focus group

data collection: primary data

smaller meeting

6-12

number of participants in focus group

Review of Records/Reports

Secondary Data Collection

Includes:

• Census data, registration forms

• FHSIS (Field Health Service Info System)

• NESSS (National Epidemio Surveillance System)

• Vital statistics (births, deaths, morbidity, etc

Census

Official enumeration of the population

2 types: de jure and de facto

117 million

PH Population

population

Total number of people

Demography/Sociodemography

in census, this is related to education, religion, language, etc.

Vital statistics

these are the births, deaths, morbidity, mortality (health indicators)

De Jure

type of census

Counted where you're officially from (point of origin)

Used by PSA (Philippine Statistics Authority)

de facto

type of census

Counted where you're physically present during the census

factual/actual location at the time of census

RA 3753

CIVIL REGISTRY LAW OF THE PH

NSO was established

RA 10625

Philippines Statistical Act

Signed by President Noynoy Aquino

Outlines place of registration

Jus Soli

place of registration: place of birth

Jus Sanguineas

place of registration: By blood/parental citizenship

PD 651 and 766

Presidential decrees related to registration

60 days

days of registration according to PD 651

before the effectivity of the PD

30 days

days of registration according to PD 651

after the effectivity of the PD

30 days

days of registration according to PD 766 (amended PD, newest)

significant sections are section 2 and section 5

Birth registration

PD 766 Section 2

Without fee

Late registry

What happens if one does not register birth within 30 days?

No document

What happens if one does not really register birth at all?

Death registration

PD 766 Section 5

Without fee

If not registered? Still alive

MD or RN

when birthed in a facility (hospital), who facilitates the registration?

local civil registrar

where does the birth registration get delivered?

midwife/RN = sign, MD verify

when birthed in a lying-in clinic, who facilitates the registration?

anyone aware of the birth

when birthed outside facility, who reports the birth?

Inform local health office (facilitate registration) → Registration by MD

parents

who will decide the child’s registration?

48 hrs

Death registration process

• to where you are added, you should be subtracted to promote balance of census (dual citizen: both countries)

how many hrs does the attending physician needs to report to the local civil registry in an in-hospital death?

last attending physician, local health officer (MD), mayor/mayor’s secretary

Death registration process: Out-of-Hospital Death

all people involved in reporting/facilitating

PD 856

Code on Sanitation of the Philippines

Law that states death certificate is required for burial

COD: highly infections = no burial → cremation

EO 352

DESIGNATION OF STATISTICAL ACTIVITIES THAT WILL GENERATE CRITICAL DATA FOR DECISION-MAKING OF THE GOVERNMENT AND THE PRIVATE SECTOR

States that the FHSIS is the official reporting and recording system according to DOH

Treatment Record

fundamental building block of FHSIS

TARGET CLIENT LISTS

Secondary building block of FHSIS

Includes:

• prenatal/post natal

• Sick children

• Under 1 y/o

• Family planning

• CD-TB

INDIVIDUAL TREATMENT RECORD

Record of the service that the people avail

FAMILY TREATMENT RECORD

envelope that contains individual treatment records

TALLY REPORTS

summary reports about the health programs of DOH

• Ilan nabakuhan, Ilan nagpapa check up na buntis

• Morbidity

• Ex. Aalamin mo ang may TB

Reports

part of the secondary data of the data collection that includes monthly, quarterly, and annual

Flow: BHS → RHU → Provincial/City Health Office → Regional Health Office

MONTHLY REPORT

Types of report

Done by the Midwife in the level of Barangay

M1

Types of monthly report Done by the Midwife in the level of Barangay

monthly program report

M2

Types of monthly report Done by the Midwife in the level of Barangay

monthly morbidity report

QUARTERLY REPORT

Report prepared by: Public Health Nurse (PHN) at RHU

Q1

Quarterly report: 3 month program report

From monthly report

Q2

Quarterly report: 3 month morbidity report

From monthly report

ANNUAL REPORT

All offices should have this report

BHS, RHU, PROV, REGION, DOH

Midwife, nurse, FHSIS coord

Barangay report

BHU annual report

A1

Annual report: Demographic report (births and death)

BHS

A2

Morbidity report (age and sex)

Provincial

A3

Mortality report (age and sex)

Region

2nd week of every month

When is the BHS monthly report submitted?

2nd week of January

When is the Barangay Report submitted?

3rd week of the 1st month of every quarter

When are RHU quarterly reports submitted?

3rd week of January

When is the RHU annual report submitted?

4th week of the 1st month of every quarter

When are provincial quarterly reports submitted?

4th week of January

When is the provincial annual report submitted?

Q1 and Q2 Reports

What report is submitted monthly at the regional level?

2nd week of the 2nd month of every quarter

When are regional monthly reports submitted?

DOH

Where does the regional office submit its reports?

2nd week of March

When is the regional annual report submitted to the DOH?

National Epidemic Sentinel Surveillance System (NESSS)

Hospital-based disease occurrence monitoring system

To supplement DOH data and identify rising cases and diseases that need monitoring

Information provided:

• Cases by geographical location

• Demographic characteristics of disease

• Information

• Estimates

• Trends

This and FHSIS go hand in hand—if one system shows an increase, the other often does too

diagnosed by lab and clinically

What type of diseases are included in NESSS surveillance?

Part of cases by geographical location provided by NESSS

Malaria

Typhoid Fever

Cholera

COVID-19 (Corona)

Hepatitis A & B

HIV/AIDS

Which diseases are lab-diagnosed under NESSS?

Diphtheria

Pertussis

Other vaccine-preventable or epidemic-prone diseases

Which diseases are clinically diagnosed under NESSS?

Data Collation

Categorization of data

for ease of presentation

Descriptive

data presentation by narration or narrative

Numerical

data presentation by charts or figures

LINE GRAPH

TYPE OF GRAPHS

presenting the trends with the given period of time

• Cases by geographical location

• Demographic characteristics

BAR GRAPH

TYPE OF GRAPHS

showing comparison of variables

PIE CHART

TYPE OF GRAPHS

distribution or composition

6 variables only

• if more than 6, pagsama samahin and gagawing si lang others

SCATTER DIAGRAM

TYPE OF GRAPHS

correlation of variables

POPULATION PYRAMID

TYPE OF GRAPHS

presenting age & sex through pyramid

DATA ANALYSIS

analyzing data using or comparing to the standard and norms

DATA UTILIZATION

Uses Family Assessment

FAMILY HEALTH PROBLEMS

LEVEL OF FAMILY ASSESSMENT: FIRST LEVEL

What do we assess in the first level of assessment?

Individual Data Base (IDB) or Family Health Assessment Form

What tool is used in the first level of family assessment?

Typology of nursing problems

What is the result of first-level family assessment?

Aka family health problems

Health Deficit

Types of family health problems: current disease/problem

Health Threat

Types of family health problems: external risks (e.g., incomplete immunization)

Foreseeable Crisis

future problems (e.g., job loss)

Secondary Level of Assessment

Performance of the family health tasks

Recognition of the problem

Inability

Result of Secondary Level of Family Assessment

North American Nursing Diagnosis Association (NANDA)

Diagnosing nursing problems at the family level

Family Coping Index

Created by Maglaya

tool used by nurses to assess a family's ability to manage health-related challenges and determine their need for nursing support

Community Situational Analysis, Community Diagnosis (CDX)

Community Assessment aka

COMPREHENSIVE CDX

Type of CDx

General data

Assess to see problem

PROBLEM CDX

Type of CDx

Specific data

Problem before assess to know why it exists

OMAHA SYSTEM

tool of assessment in the community

standardized health care terminology consisting of an assessment component (Problem Classification Scheme), a care plan/services component (Intervention Scheme), and an evaluation component (Problem Rating Scale for Outcomes)

has domains: Environmental, psychosocial, physiological domain, health-related behaviors

Environmental

OMAHA Domain

Waste, water, toilet

Psychosocial

OMAHA Domain

Dialect, language, behavior in the community

Physiological

OMAHA Domain

Health, immunization