Community Health Nursing - Presentation

8/4/2019 Community Health Nursing - Presentation

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Lecturer: Ana Lee V. Pendon, RN


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Goal: Promotion of the clients optimum level offunctioning through teaching and delivery of care

Mission of DOH: Ensure accessibility of health care toimprove the quality of life of all Filipino , especially thepoor


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Basic Principle: To improve health

Ensure Universal access to basic health services

Epidemiological shift from infectious to degenerativedisease must be managed

Enhance the performance of health sectors

Ensure the prioritization of health and nutrition ofvulnerable groups


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- Philosophy:Based on the worth and dignity of

man

- Primary focus: Health Promotion

- Family is the unit of service

- Health teaching is the primaryresponsibility of the community health

nurse


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Vision: A lifetime oral health and no tooth decay for thenext generation

Objective: To prevent and control dental diseases andconditions

Sang Milyong Sepilyo project for Social Mobilization ofDental Health Program


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Community Organizing

Participatory Research (COPAR)

A Continuous process ofawareness building,organizing and mobilizing

community developmentPhases and Activities

I. Pre-entry

II. Entry phase

III. Core-GroupFormation andMobilizing

IV. Organization Building
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-Preparation of the staff

-Site Selection


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Integration with the communityCourtesy calls; information

Campaigns: identification of potential leaders


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III. Core-Group Formation and

Mobilizing

Integration with core group


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Networking and establishing

Linkages; Implementation of livelihood

projects; developing secondary leaders


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The Primary Health Care

According to the World Health Organization is anessential health care made universally accessible toindividuals and families in the community by meansacceptable to them through their full participation andat the cost that the community and country can afford

at every stage of development


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Goal OF PHC

Health for all Filipinos and health in the hands ofthe people by the year 2020


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Letter of instruction (LOI)949, October 19, 1979


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The Four Cornerstones/Pillars in

Primary Health Care include:

Active community participation

Intra and inter sectoral linkages Use of appropriate technology

Support mechanism made available


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Reproductive Health

Exercise of reproductive right with responsibility

Vision: Reproductive health practice as a way of life forevery man and woman throughout life


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Goals Every pregnancy should be intended

Every birth should be healthy Every sex act should be free of coercion and infection

Achieve a desired family size


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Care of Older

Persons


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First cause of morbidity among the 50 plus

year old Influenza

Top cause of mortality among the 60 plus year

old: Disease of the Heart

Goal: A longer Disability Free Life

Resolution 46: The UN principle for olderpersons to add life to years that have been

added to life


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Nutritional Guidelines forFilipinos


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Goal: Improvement of the nutritionalstatus, productivity and quality of life

of the population, through adoptionof desirable dietary practices andhealthy lifestyle


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Acupuncture


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- Goal : Manipulation of energy flow

throughout the body following a thoroughassessment by a practitioner

- Indication: acute & chronic pain andmotion disability

- Contraindicated: Pregnant, Hemoplilia andAcute CVD

M l d Child H l h N i


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Maternal and Child Health Nursing

Goal: Promotion and maintenance of optimal healthof women and their foetuses/newborn

There should be at least three prenatal visits during

pregnancy: 1st trimester

2nd trimester

3rd trimester


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-Home deliveries only in thefollowing circumstances:

1. In areas where there are nolicensed

2. Trained Hilot (TBAs) may beallowed to attend healthpersonnel in maternal care or

when the personnel is notavailable


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Iron Supplementation shall be given from 5th month of

pregnancy up to 2 months post partum, 100-200 mg P.O for210 days

Home De iviries Pointers: 3 c eans:


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- Home De iviries Pointers: 3 c eans:Clean hand, Clean surface & Clean

cord

- First Postpartum visit: within 24

hours after delivery, next visit atleast one week after

- Check the sucking reflex andbreastfeeding practices and

problems


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-

-Under the supervision of the public health nurse

- Plans for activities in the clinic BHS, follow up inhomes and field visit in the community

- Mobilize community for health action


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Four Pillars

Quality assurance

Grants and technical assistance

Health promotion

Award


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Epidemiology

Systematic and scientific study of the distributionpatterns and determinants of health , disease andcondition.

Purpose of promoting wellness and preventing diseaseconditions


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Formulas:


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No. Of live birth

_________________________________ X 1,000

Estimate midyear population


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No. Of overall deaths during one year

_________________________ X 1, 000

Average mid-year population at risk


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No. Of new cases of specified illness during

specific Time interval

______________________________________ X 1,000

Estimated mid-interval population at risk


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No. Of death from puerperal causeduring one year

_________________________________ X 1,000

No. Of women giving birth the same year


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No. Of deaths under one year of ageduring one year

______________________________ x 1,000 livebirths

No. Of livebirths of the same year


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No. Of old new cases of specific illness duringSpecified time interval

________________________________ x 1,000

Estimated mid-interval population at risk


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Expanded Program of

Immunization

Objective:

-To reduce the mortality and morbidity amonginfants and children caused by six childhoodimmunizable diseases

Elements: Target setting


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Presidential Degree No. 996 Providing for compulsory basicimmunization for infants and children below8 years of age

Presidential proclamation No.6 Implementing a United Nations goal onUniversal Child Immunization

Basic Immunization should be completed onor before a childs first birthday

Administration of vaccines:


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Vaccine Content Form & Dosage # of Doses Route

BCG Live attenuated

bacteria

Freeze dried

infant- 0.05ml

Preschool-0.1ml

1 ID

DPT DT- weakened

toxin

P-killed bacteria

liquid-0.5ml 3 IM

OPV weakened virus liquid-2drops 3 Oral

Hepa B Plasma

derivative

Liquid-0.5ml 3 IM

Measles Weakened virus Freeze dried-

0.5ml

1 Subcutaneous

Administration of vaccines:

Schedule of Vaccines:


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Vaccine Age at 1st dose Interval

between dose

Protection

BCG At birth

DPT 6 weeks 4 weeks DPT

OPV 6weeks 4weeks Poliomyelitis

Hepa B @ birth @birth,6th

week,14th week

HepaB

Measles 9m0s.-11m0s. measles

Schedule of Vaccines:

6 th li d f l


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6 monthsearliest dose of measlesgiven in case of outbreak

9months-11months- regular

schedule of measles vaccine

15 months- latest dose of measles given

4-5 years old- catch up dose

Fully Immunized Child (FIC)-


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Vaccine Minimum age

interval

% protected Duration of

Protection

TT1 As early as possible 0% 0

TT2 4 weeks later 80% 3 years

TT3 6 months later 95% 5 years

TT4

1year later/duringnext pregnany

99%

10 years

TT5 1 year later/third

pregnancy

99% Lifetime

Fully Immunized Child (FIC)

less than 12 months old child with complete

immunizations of DPT, OPV, BCG, Anti Hepatitis,

Anti measles.


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Cold Chain under EPI:

Cold Chain is a system used to maintain potency ofa vaccine from that of manufacture to the time it isgiven to child or pregnant woman.

h ll bl i f f h


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The allowable timeframes for the

storage of vaccines at different

levels are:

o 6months- Regional Level

o 3months- Provincial Level/District Level

o 1month-main health centers-with ref.

o Not more than 5days- Health centers usingtransport boxes.


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Most sensitive to heat: Freezer

(15 to -25 degrees C)

o OPV

o Measles


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Sensitive to heat and freezing

(body of ref. +2 to +8 degrees

Celcius)

o BCG

o DPT

o Hepa B

o TT


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- Use those that will expire first, mark X/

exposure, 3rd- discard,

- Transport-use cold bags, let it stand in roomtemperature for a while before storing DPT.

- Half life packs: 4hours-BCG, DPT, Polio, 8hours-measles, TT, Hepa B.


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- FEFO (first expiry and first out)

vaccine is practiced to assure that allvaccines are utilized before the expiry

date.

- Proper arrangement of vaccines

and/or labeling of vaccines expiry date

are done to identify those near to

expire vaccines.


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L di


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Lagundi Uses & Preparation:

Asthma, Cough & Fever -Decoction

( Boil raw fruits or leaves in 2 glasses ofwater for 15 minutes)Dysentery, Colds& Pain - Decoction ( Boil a handful ofleaves & flowers in water to produce aglass, three times a day)

Skin diseases (dermatitis, scabies,ulcer, eczema) - Wash & clean theskin/wound with the decoction

Headache - Crush leaves may be

applied on the forehead Rheumatism, sprain, contusions,

insect bites - Pound the leaves andapply on affected area

( )
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Yerba (Hierba) Buena ( Mentha cordifelia)

Uses & Preparation:

Pain (headache, stomachache)Boil chopped leaves in 2 glasses ofwater for 15 minutes. Dividedecoction into 2 parts, drink one partevery 3 hours.

Rheumatism, arthritis andheadache Crush the fresh leavesand squeeze sap. Massage sap onpainful parts with eucalyptusCough & ColdSoak 10 fresh leaves

in a glass of hot water, drink as tea.(expectorant)Swollen gums Steep 6 g. of freshplant in a glass of boiling water for 30minutes. Use as a gargle solution

Yerba (Hierba) Buena ( Mentha cordifelia)
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Yerba (Hierba) Buena ( Mentha cordifelia) ToothacheCut fresh plant and

squeeze sap. Soak a piece of cotton

in the sap and insert this in achingtooth cavityMenstrual & gas pain Soak ahandful of leaves in a lass of boiling

water. Drink infusion.

Nausea & Fainting Crush leavesand apply at nostrils of patientsInsect bitesCrush leaves andapply juice on affected area or

pound leaves until like a paste, rubon affected areaPruritisBoil plant alone or witheucalyptus in water. Use decoctionas a wash on affected area.

Sambong ( Blumea balsamifera)
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Sambong( Blumea balsamifera)

Uses & Preparation:

Anti-edema, diuretic, anti-urolithiasis Boil chopped leavesin a glass of water for 15 minutesuntil one glassful remains. Divide

decoction into 3 parts, drink onepart 3 times a day.

Diarrhea Chopped leaves and

boil in a glass of water for 15minutes. Drink one part every 3hours

T G b ( C )
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Tsaang Gubat( Carmona retusa)

Uses & Preparation:Diarrhea -Boil choppedleaves into 2 glasses ofwater for 15 minutes.Divide decoction into 4parts. Drink 1 part every3 hours

Stomachache Boilchopped leaves in 1 glassof water for 15 minutes.Cool and strain.
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Niyug-Niyogan( Quisqualis indica L.)

Uses & Preparation:Anti-helmintic -Theseeds are taken 2 hours

after supper. If no wormsare expelled, the dosemay be repeated afterone week. (Caution: Not

to be given to childrenbelow 4 years old)

Bayabas/Guava( Psidium guajava L )
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Bayabas/Guava( Psidium guajava L.)

Uses & Preparation:For washing wounds -Maybe use twice a dayDiarrhea - May be taken 3-4times a dayAs gargle and for

toothache -Warmdecoction is used for gargle.Freshly pounded leaves areused for toothache. Boilchopped leaves for 15minutes at low fire. Do notcover and then let it cool andstrain
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Akapulko( Cassia, alata L.)

Uses & Preparation:Anti-fungal (tinea flava,

ringworm, athletes foot andscabies) - Fresh, matured leavesare pounded. Apply soap to theaffected area 1-2 times a day
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Ulasimang Bato( Peperonica pellucida)

Uses & Preparation:Lowers uric acid(gouty) One a half

cup leaves are boiledin two glass of waterover low fire. Do notcover pot. Divide into

3 parts and drink onepart 3 times a day

B /G li
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Bawang/Garlic

Uses & Preparation:Hypertension -Maybefried, roasted, soaked invinegar for 30 minutes,or blanched in boiled

water for 15 minutes.Take 2 pieces 3 times aday after meals.Toothache -Pound a

small piece and apply toaffected area
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Ampalaya Uses & Preparation:Diabetes Mellitus(Mild non-insulin

dependent) - Choppedleaves then boil in a glassof water for 15 minutes.Do not cover. Cool and

strain. Take 1/3 cup 3times a day after meals
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Process of examining the community

Three dimension

- Status: mortality, morbidity, life expectancy, crimerates and education

- Structure: Socioeconomic, Age, Gender &Resources

-Process: How the community operates andfunction as a whole

Community competence refers to


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Community competence refers to

the communitys ability to

Identify needsAchieve working consensus

Agree and work together to meet goals


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Home Visit

Face to face contact made by the nurse to the client

Should have a purpose or objective

Frequency of home visit take into


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Frequency of home visit take into

consideration the following factors

Acceptance of the family and the ability to recognizetheir own needs

Physical, psychological and educational needs Other health agencies involved

Policy of the given agency

Evaluation of past services given to the family


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Bag technique a tool making use of public health bag

through which the nurse, during his/her home visit, canperform nursing procedures with ease and deftness, saving timeand effort with the end in view of rendering effective nursingcare.

Public health bag - is an essential and indispensableequipment of the public health nurse which he/she has to carryalong when he/she goes out home visiting. It contains basicmedications and articles which are necessary for giving care.

Rationale

To render effective nursing care to clients and /or members ofthe family during home visit.


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Principles

The use of the bag technique should minimize if not totallyprevent the spread of infection from individuals to families,

hence, to the community. Bag technique should save time and effort on the part of the

nurse in the performance of nursing procedures.


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Principles Bag technique should not overshadow concern for the

patient rather should show the effectiveness of total

care given to an individual or family. Bag technique can be performed in a variety of ways

depending upon agency policies, actual homesituation, etc., as long as principles of avoiding transfer

of infection is carried out.

Contents of the Bag


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g

Paper lining

Extra paper for making bag for waste materials (paperbag)

Plastic linen/lining

Apron

Hand towel in plastic bag

Soap in soap dish

Thermometers in case [one oral and rectal]

2 pairs of scissors [1 surgical and 1 bandage] 2 pairs of forceps [ curved and straight]

Syringes [5 ml and 2 ml]

Contents of the Bag


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Hypodermic needles g. 19, 22, 23, 25Sterile dressings [OS, C.B]Sterile Cord TieAdhesive Plaster

Dressing [OS, cotton ball]Alcohol lampTape MeasureBabys scale

1 pair of rubber gloves2 test tubesTest tube holder

Contents of the Bag

C f h


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Contents of the Bag Medicines

betadine

70% alcohol

ophthalmic ointment (antibiotic)

zephiran solution hydrogen peroxide

spirit of ammonia

acetic acid

benedicts solution

Note: Blood Pressure Apparatus and Stethoscopeare carried separately.

CHN Clinic Visit


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Pre-Consultation Conference:

-Clinical history taking vital sign, physicalassessment, laboratory exams and documentation

Medical Examination:

- Ensure privacy, safety and comfort of the patientthroughout procedure

Post-Consultation:

- Explain findings and needed care: Refer asneeded: make appointment for next clinic/home visit

Environmental Pollution Roles


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Health Education- main nursing responsibility

Help in implementing P.D. 856: sanitation code of the

Philippines

Assist in the Disaster Management

Environmental Sanitations


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Level 1 (Point Source) a protected well, a developspring; without distribution system

Level 2 (Communal faucet system / Stand post) asource reservoir, a piped distribution network andcommunal faucet not more than 25 meters from the

farthest house

Level 3 (waterworks system /individual house

Connections) - a source reservoir, a piped distributionnetwork and household taps; Requires minimumtreatment of disinfection


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Purpose: To enhance the educational process

Program Management: establish and maintain acomprehensive school program

Activities of a School Nurse


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Activities of a School Nurse

Primary prevention: Immunization, Health Education

Secondary Prevention: Health screening,

communicable disease monitoring, pre-schoolvisitation and assessment

Tertiary Prevention: preventing recurrence of acute /

chronic conditions; school environmental hygiene


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CHN

The Dental Health Program of the Department of


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Health has committed to contribute to the

improvement of the quality of life of Filipinos through

its project. Isang Milyong Sepilyo. This Program Isproject for:

A. Operation research studies

B. Partnership with other sectors

C. Social Mobilization

D. Capability Building and Value formation

In Primary health care, what do


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In Primary health care, what do

you expect from the people of

the community?

a. Active involvement and participation

b. Preparation of teaching materials

c. Donation of money and materials

d. Voluntary time without cost

Th i i f PHC t b


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The mission of PHC must be

embodied in the hearts of the careproviders through;

a. Supporting conditions for healthy habits

b. Letting people manage their own health

c. Increasing opportunities to be healthy

d. Financing health care program

To encourage community


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To encourage community

participation, which of the

following should a nurse do?

a. Invite people from civic organizations

b. Encourage sponsorship to programs

c. Refer to the doctor for prescriptions

d. Listen when people relate their problems

Whi h f h i ifi i d b h


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Which of these scientific processes is used by the

nurse wherein biological and sociological sciences

are utilized to obtain community resources?

a. Nursing management

b. Nursing networking

c. Nursing program

d. Nursing process

As a nurse, you organize community groups


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As a nurse, you organize community groups

to participate in community activities. In

what way could you motivate people toparticipate in your program?

a. Instruct them to agree with you

b. let people decide for themselves

c. Assign roles

d. conduct group work

What factor contributes at the


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What factor contributes at the

effectiveness of care to your clients

as a rural health unit nurse?A. Interpersonal relationship with barangay officials

B. Expertise in health education

C. Knowledge of the objectives of health program

D. Respect of customs, beliefs and values of clients

8. Which one of the following is the


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mission of the Department of Health?a.Promote healthy lifestyleb.Ensure accessibility and quality of health carec.Reduce morbidity and mortalityd.Improve general health status of the people

l i l l i di


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9. Involvement is not only cleaning surroundings

and toilet construction but also sharing

responsibilities and participation in one

of the following:

a. Problem- solving criminals

b. Meeting with barangay officersc. Social work about livelihood

d. Defining health needs

10. A pregnant woman seeks the help of


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a trained hilot. What are the reasons

why they like the hilot?

a. Cumadrona s busyb. Hilot renders holistic touch

c. Babylan is better than none

d. Trained hilot are less expensive

Community Health Nursing - Presentation

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