CHN 312 MIDTERMS

Community health assessment tools

nursing process emphasizes the active involvement of the clients in its care.

Observation

It is an act of extracting information from subjects being studied.

Ocular survey or windshield survey.

This involves rapid observation of a community and performed either by walking through it, driving or riding in a vehicle

Participant observation

- For: community organizing and participatory research, Purposeful observation of formal and informal community activities by sharing in the life of the community.

Survey

A made of series of questions for systematic collection of information from a sample of individuals or families in a community

Informant interview

A purposeful talk with either key informant or ordinary members of the community.

People

spot vulnerable groups and peoples appearance.

Environment

terrain, homes, housing density & cleanliness, vegetation, street animals.

Facilities / community resources

health facilities, barangay halls, school, places of worship, open spaces.

Formal

community activities are barangay assemblies, school parent teacher meeting, church meeting.

Informal

gatherings are in variety of setting such as sari-sari store, community recreation area or schools.

Structured

is where the nurse directs the talk based on an interview guide.

Unstructured

is where the informant guides the talk.

Community forum

Is an open meeting of the members of the community, Pulong-pulong sa barangay is an illustration of a community forum

Nurse

community perceptions on needs, health and health care

People

expressing their views & influence decision makers

Focus group

Membership is more homogeneous which is person with similar sociocultural or health conditions (Homogeneous - needs specific groups)

Secondary data sources (Registry of vital events)

Act 3753 (civil registration law, philippine legislature) , Ra 7160 (local government code)

Act 3753 (civil registration law, philippine legislature)

the civil registry system in the philippines and requires the registration of vital events such as births, marriages and deaths

Ra 7160 (local government code)

Assigned the function of civil registration to local governments and mandated the appointment of local (city / municipal). Civil registrars.

The NSO (National Statistics Office)

Serves as the central repository of civil registries and the NSO administrative and the civil registrar general of the Philippines.

Reliable civil registration and vital statistics

Provide realistic basis for program planning and implementation. The birth and death registries are of particular importance to the nurse, since they are sources of fertility and mortality data.

Birth

COMPLETE EXPULSION/ EXTRACTION is still considered as LIVEBORN

Death

A permanent disappearance of all evidence of life at any time after live birth has taken place (postnatal cessation of vital functions without capability of resuscitation)

1975, presidential decree 856. Sanitation code,

office of the president necessitates death certificate before burial of deceased.

Reglementary Period and Place of Registration of Death

Registration of death shall be made in the office of the Civil Registrar of the city/ municipality where the death occurred within thirty 30 days from time of death.

The physician

this is the person that last attended the deceased, and shall be held responsible for preparing the death certificate, certifying the cause of deaths and forwarding the death certificate to the health officer within 48 hours.

If death occurred without medical attention,

then the nearest relative or any person who has knowledge of the death shall report to the health officer within 48 hours.

In the absence of a health officer

the death should be reported to the mayor, municipal secretary or any member of the sangguniang bayan, who shall issue the death certificate for the purposes of burial.

Registration of death

shall be made within 30 days from the occurrence of death at the local civil registry office of the city or municipality. (same with fetal deaths)

Guidelines in the classification of data

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Executive order no. 352 (office of the president, republic of the philippines, 1996)

Field health service information system (FHSIS)

Field health service information system (FHSIS)

This is the official, recording and reporting system of the nscb to generate health statistics. an essential tool in monitoring the health status of the population at different levels.

Individual treatment record (ITR)

The fundamental building block of FHSIS, The record contains the date, name, address of patient, presenting symptoms or complain of the patient on consultation and the diagnosis (if available), treatment and date of treatment

Target / client lists (TCLS)

the second building block of the FHSIS, To plan and carry out patient care and service delivery, To facilitate monitoring and supervision of service delivery activities.

Summary table

This is accomplished by the midwife, It is a 12-column table in which columns correspond to the 12 months of the year.

The monthly consolidation table (mct)

accomplished by the nurse based on the summary table, It serves as, Source document for the quarterly form, The output table of the RHU or health center

Monthly forms

Regularly prepared by the midwife and submitted to the nurse who then uses the data to prepare the quarterly forms

Program report (M1)

contains indicators categorized as maternal care, childcare, family planning and disease control. The midwife copies the data from the summary table

Morbidity report (M2)

contains a list of all cases of disease by age and sex.

Quarterly forms

Usually prepared by the nurse, There should only be one quarterly form for the municipalities / cities with two or more rhus or health centers

A-BHS

is a report by the midwife that contains demographic, environmental and natality data.

Annual form 1 (A-1)

is prepared by the nurse and is the report of the rhu or health center. It contains demographic and environmental data, and data on natality and mortality for the entire year.

Annual form 2 (A-2),

prepared by the nurse, is the yearly morbidity report by age and sex.

Annual form 3 (A-3),

also prepared by the nurse, is the yearly report of all deaths (mortality) by age and sex.

Disease registry

A listing of persons diagnosed with a specific type of disease in a defined population.

Census data

It is a periodic governmental enumeration of the population. It provides for a national census of population and other related data in the Philippines every 10 years.

COMMUNITY DIAGNOSIS

Determining community health status is a process called community assessment.

Types of Community Diagnosis

1) Comprehensive community diagnosis, 2) Problem-oriented Community Diagnosis

Comprehensive community diagnosis

This aims to obtain the general information of the community with the intent of determining prevalent health conditions and risk factors

Problem-oriented Community Diagnosis

Made to responds to a particular need of a target group

Demographic variables

This shows the size, composition and geographical characteristics of population.

Socio-economic and cultural variables.

These affects health of the community directly and indirectly.

1) Social indicators

Educational level, housing condition

Educational level

can be indicative of poverty

Housing condition

may reflect health hazards such as congestion fire, exposure to elements

Economic indicators

Poverty level income, Unemployment and underemployment rate

Environmental indicators

Physical / geographical / topographical characteristics of the community

Cultural factors

Variables that may break up the people into groups within the community such as: Ethnicity, Social class, Language, Religion, Race, Political orientation

Health and illness pattern

The nurse may collect primary data about leading causes of illness and deaths and their respective rates of occurrence.

Health resources

This is an essential element in the delivery of basic services in the community. The nurse needs to determine manpower, institutional and material resources provided by states and those from private sector &other NGO.

Manpower resources

Categories of health manpower available, Geographical distribution of health manpower

Material resources

Health budget and expenditure, Sources of health funding

Political / leadership pattern

This is a vital element in achieving the goal of high-level wellness among the people.

Steps in conducting community diagnosis

Step 1 - Determining objectives, Step 2 - Defining the study population, Step 3 - Determining the data to be collected, Step 4 - collecting the data, Step 5 - Developing the instrument, Step 6 - Actual data gathering, Step 7 - Data collation, Step 8 - Data presentation, Step 9 - Data analysis, Step 10 - Identifying the community health nursing problems, Step 11 - Priority Setting

Magnitude of the problem

in priority scaling, it refers to the severity of the problem

Modifiability of the problem

refers to probability of solving problem

Nature of the problem

a criteria in scaling that classifies the health problem

Preventive potential

refers to ability to prevent future problem

Social concern

refers to perception of community on scaling.

Triangulation

data are checked for consistency and validity using different methods.

Community health problems

Are conditions or situations that intervene with the community's capability to achieve wellness. These are health status, resources, health-related problems

NANDA

Now known as NANDA, international, NANDA international (NANDA-I) nanda-international earlier known as the north american nursing diagnosis association (nanda) is the principal organization for defining, distribution and integration of standardized nursing diagnoses worldwide

Shuster and goeppinger proposed format:

In 2004, shuster and goeppinger proposed format of nursing diagnoses for population group of a Three-part statement

Three-part statement consists of:

(1) Health risk or specific problem (2) Specific aggregates or community (3) Related factors

Omaha system

Problem classification scheme consists of four levels of abstraction. Four domains appear at the first or most general level.

Planning

Is a process which involves steps that would be taken in the future to attain desired end. It is performed to source out and allocate resources.

Approaches to planning health

Participatory planning for community health, Primary health care approach. Emphasizes the need to "work with people" as equal partners towards the goals of increased individual & community control, political efficacy, improved quality of community life & social justice.

Community Based Approach

empowers people

Integrated Approach

considers other dimension of health such as lifestyle, environment, health care system

Comprehensive approach

strikes at the root of the problem

Strategic Plan

this is a long term plan that extends about 3 to 5 years. This is usually accomplished by managers of an organization after a review their SWOT analysis (Strength, Weakness, Opportunities, Threats, mission, mission and goals)

Operational Plan

A short range plan that is usually less than 3 years. It usually deals with the routine activities of an organizations. Ex. A system of recording ITR in the FHSIS

Program Plan

It entails a course / set of actions towards improvement of an identified health problem.

Program planning

Deals with the design of a strategy, for the achievement of a given health policy, objectives. It is a type of plan that is concerned with courses of actions

Program for Direction, Coordination and Management

This refers to program to formulate policies, programs and projects to direct.

Program for Health System Infrastructure

Comprises of program for planning and development of a basic health facility network, health manpower, policies and training, health education and public information.

Technology Program

providing functional support like infrastructure development, human resources development, health information, accounting, and budgeting

Situational analysis

Answers the question , "where are we now?", collecting, synthesizing, analyzing and interpreting information in a manner that provides a clear picture of the health status of the community.

Goal and objective - setting

This answers "where do we want to go?" This a process that formulates the goal and objectives of the health program and nursing strategies.

Strategy and activity setting

This answers "how do we get there?" This defines the strategies and the activities that the nurse and community set to achieve in order to realize the goals and objectives.

Structure Evaluation

Involves looking into the manpower and physical resources of the agency responsible for community health interventions.

Process Evaluation

Examining the manner by which assessment, diagnosis, planning, implementation and evaluation were undertaken

Outcome Evaluation

Determining the degree of attainment of goals and objectives

Utility

Value of evaluation in terms of usefulness of results.

Feasibility

Determine if plan for evaluation is doable or not

Propriety

Involves ethical, legal matters. Respect for worth and dignity of participants in data collection should be given due consideration.

Accuracy

Validity and reliability of the results of evaluation

Three aspects of a program that evaluation look into are:

Process Impact outcome

Process

measures the activities, effects of the program & quality and who it is reaching out.