community HEALTH NURSING

3P of PHN

  • Prevention of disease

  • Prolonging of life

  • Promoting health. ( no risk factor)

MARGARETTE SHETLAND- philosophy of dignity

Lillian Wald- public health nursing

Ruth freeman - community health nursing

PUBLIC HEALTH- C.E Winslow. Birthright and longevity

Virginia Henderson - make patient independent

Health educator- best role of community health nurse

Roles of PUBLIC HEALTH NURSE

EDUCATOR- provide health teaching

ClINICIAN- provide direct care to client

SUPERVISOR - supervising midwives. Work with them hand in hand

MANAGER- leader of the nurses

RESEARCHER- gather data. During COPAR, outbreak,

FACILITATOR- make sure patient are active partners

COORDINATOR- establish linkages, partnerships outside the community

COLLABORATOR- collaborate within community

SCHOOL HEALTH NURSING

  • targets are student, teachers, staff, etc within school

  • Do physical assessment once a year

    VISION

  • Standard snellen chart - used for literate patients

  • Hand held snellen chart- near

  • Snellen E/ tumbling E- for illiterate patients

  • ishihara test - check for color blindness ( red, blue, yellow)

    HEARING

  • Check for lateralization of vibrations

    NUTRITION

  • BMI- best indicator of nutrition in community health nursing

  • High bmi- most likely indicator of CVD

    DENTAL

  • Check up every 6 months

OCCUPATIONAL HEALTH NURSING

  • health promotion

  • Disease prevention

  • Safety

  • Check for health hazards

Levels of prevention

Primary - no disease

  • health educate

Secondary

  • with or without disease

  • Early Detections, treatment, and lab testing

Tertiary

  • rehab

  • Disease is permanent but manageable most of the time.

Levels of clientele

  1. Individual- point of entry

  2. Family- basic unit of care

  3. Community-

  4. Population - representative of community

    nuclear- most common set up in community

    multigenerational or extended family- most common in Philippines.

    cohabitation- live in without marriage

    communal- live in single house but not blood related

    compound- living together in one area and blood related

    coaster or adoption

    Dyad - mother, father walang anak

Patrilocal - father residence

Matrilocal- mother residence

Matrilineal - mother culture

Patrilineal- father culture

DEPARTMENT OF HEALTH

Maria Rosario vergerie - secretary

Responsibility of DOH

LEADERSHIP- number one leader and promoter of health in Philippines.

Formulate - write protocols.

Advocate - to protect the right of client

Regulate- monitor all health program or agency public or private

ENABLER AND CAPACITY BUILDER - innovate, update or improve healthcare system

Monitor- supervise hospitals.

Ensure- make sure healthcare system is safe and effective

ADMINISTRATOR OF SPECIFIC SERVICES- conduct emergency services, manage selected hospitals

MISSION- productive, resilient, equitable, people centered

VISION- healthiest people in Asia by 2040

Goal- HSRA ( HEALTH SECTOR REFORM AGENDA)

Framework- FOURmula 1 for health

goals of fourmula

  • Better health outcome

  • Equitable healthcare financing

  • Responsive healthcare system- should be acceptable

  • good governance- partner in local and national

  • Healthcare financing- investment ( philhealth) most important

  • Healthcare regulation- safe and effective and affordable healthcare

  • Service delivery- availability and accessibility

PUBLIC HEALTH SECTOR - government held, budget thru taxNational- DOH, NATIONAL HOSPITALS.

Local- provincial and municipal. Non government

Provincial - governor leader

Municipal- mayor leader

PRIVATE HEALTH SECTOR- business communities. Health services with fee.

Profit group - medical center, insurance companies, pharmaceutical companies, lab and diagnostic center

Non- profit group- Red Cross, churches, unicef

REFERRAL SYSTEM

1) primary- lying in clinics, RHU, BHC (25-75 bed capacity) basic procedures

R.A. 1082- RHU ACT ( created 81 RHU)

2) secondary - (100-200 bed capacity) do minor operations and lab exam. Provincial hospitals and districts

3) tertiary - surgeries. Medical centers and regional hospitals. Complex procedure

PRIMARY HEALTHCARE

-is the health for all. Provide services for the people and made universally accessible

LOI 949

PILLARS OF PHC (AMUS)

  1. Active participation

    • mandatory - 4P’s

    • Participant- attend but not listening

    • Planner- attend with plan but no output

    • Implementer - attended, with output and outcome

  2. Multi sector

    • intrasectoral- within health care agency (same)

    • Intersectoral - outside health agency (different)

  3. Use of Appropriate technology

  4. Support system

COMMUNICATION

  1. Sender - nurse

  2. Message - health education

  3. Receiver- patient

  4. Feedback- most important

LOCAL ENDEMIC (R.A. 11332)

Report death within 1 day

Report disease communicable within 1 week

Epidemiology- backbone of disease prevention because we study the cause, occurrence and treatment of disease

  1. Endemic - constantly present (malaria in Palawan, Schistosomiasis in Samar, Leyte, filariasis in Bicol )

  2. Epidemic- sudden increase of cases in short period of time

  3. Sporadic- seasonal

  4. Pandemic- worldwide (HIV, covid)

Types of immunity

  1. Antibody- fights infection by immune system p

  2. Antigen- causative agent like bacteria, virus, toxins

    • Active - self made

      • active natural- got sucked and recovered (chickenpox- the body made antibodies- now immune na)

      • Active artificial- You received a vaccine (a weakened or dead form of the disease).Example: MMR vaccine (measles, mumps, rubella)

    • Passive- antibodies from other source

      • passive natural- mother to baby (placenta or breastmilk)

      • Passive artificial- antibody thru injection (rabies immunoglobulin AFTER a bite)

GAMED

IgG- fights infection and transplacental

IgA- Anmum

IgM- bIGGEST AND SENSITIVE and for viral infection

IgE- Ellergy

IgD- Ogk

PD996- 7 communicable disease

BCG- @birth, 0.05, intradermal in deltoid

Hepa b- @birth, 6&8 weeks, 0.5, IM

DPT- @6/10/14 mos

MEASLES- 9 mos, subcutaneous upper arm

OPV- @6/10/14 mos, oral

Penta- @6/10/14 mos

PCV- @6/10/14 mos

Contraindications of vaccines

  1. Convulsions

  2. Immune compromised

RA 10152

Birthday vaccines - MMR subcutaneous at upper arm

Penta- DPT, HEPA b, hip b ( haemophilus influenza b)

  • pertussis - wait for 30 mins before giving cause it’s sensitive or after last vomit. High fever

Rota vaccine- prevent diarrhea (1 vial) @6&10 weeks) oral

PCV - immunococal to avoid pneumonia

BCG- TB, Leprosy, meningitis

Freezer (-15- -25)- OPV, MEASLES

Ref- (+2-8) others

4 hours after opening- BCG

6 hours - measles

8 hours- others

ESSENTIAL DRUG ( 9502) - BOTIKA NG BARANGGAY- at least 1 trained pharmacist

  1. Lung cancer- deadliest

  2. Prostate cancer- common in male

  3. Colon cancer

5A PROGRAM fo smoking

  1. Ask

  2. Assess

  3. Advice

  4. Assist

  5. Arrange

  1. COPD

  2. DIABETES- free losartan, metropopol, amlodipine, metformin

Sanitation code (PD 856) - supervise for food sanitation.

  • Store in room temp for 2 hours

  • 4 rights

    • right source

    • Right preparation - hand hygiene, utensils and food clean

    • Right cooking- cook food beyond 70* Celsius

    • Right storage - less than 10* Celsius -69

  • Water facilitation

    • Direct source - own by everybody ( ilog), 15-25 families can get from it, 250 m distance

    • Communal- shared in the community, 100 family member, 25 m distance

    • Individual motor- privately owned source of water within home ( NAWASA)

  • Toilet facilities

    • non water system- no septic tank

    • Water system- need water and has septic tank

    • Water system with treatment- big facilities , water is circulating. Waste water treatment

    • Open pit- dig and leave

    • Close pit- dig and cover

    • Bored hole- with pipe

    • Paled system- plastic

    • Over hung- hung in bodies of water

    • Antipolo- low lying

FAMILY PLANNING ( R.A. 10354)

  • birth spacing- 3-5 years

  1. CALENDAR METHOD- natural family planning

  2. BASAL BODY TEMPERATURE

  3. CERVICAL MUCUS METHOD

  4. CERVICAL CUP

  5. INTRAUTERINE DEVICE- used for 5-10 years. not applicable if there is bleeding upon inserting and weight loss of 5 kg and surgery of lower extremities. Copper- neutralizes the acidity of sperm

  6. CONDOM- insert when hard/ erected, before penetration

  7. HORMONAL PILLS-don’t give when high BP.

  8. INJECTABLE- every 3 months

  9. IMPLANTATION- consult first

  10. SURGERY- vasectomy (male- cutting vas deferens). Bilateral tubal ligation- cutting

ANTI- NATAL CARE

vit. A/ retinol- start at 4 months (10-000 IU)Prevent color blindness or seropthalma

Iron - 60 mg- prevent anemia

(B9)Folic acid- 400 mg- prevent neural tube defect @6 mos

Iodine-1 capsule per year or 200 mg. Prevent thyroid problem

Tetanus Toxoid