community health nursing reviewer
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Incomplete review notes on community health nursing, Comment is much appreciated....Currently editing this document.. ang tagal na pala, ngayon ko lang uli nabasa na di pala to kumpleto.. a like and a comment is much appreciated.. salamat po sa lahat ng nag like and sa bumasa.TRANSCRIPT
COMMUNITY HEALTH NURSING REVIEWERLecturer: Ms, Rhea Mallari, RN, MAN
CO-PAR Community Organizing – Participatory Action Research
Community Organizing Process by which health services, agencies, and people and of the people of the community brought
together to:o Identify/learn their own problem
o Plan activities
o Act on this basis
o Evaluate
COMMUNITY ORGANIZING EMPHASIZE Strengthening the community members capability in:
o Problem solving skills
And Necessary for self-reliant developmento Decision making skills
Community Organizing process has someone plays the role of a Community Organizer
Roles and Responsibilities of a Community Health NurseManagerGuideAdvocateCoordinator, Counselor, Change AgentHealth Care ProviderNurse TrainerResearcherOrganizerLeaderEducator – Primary role, Primary responsibilities promotion of health and prevention of illnessSupervisor
Community Organizer Person who mobilize:
IndividualFamily Sick or WellCommunity
To come together in unity and collectively address given:IssuesNeedsProblem
* assess by way of research
PARTICIPATORY ACTION RESEARCH Is an investigation on problems and issues of the community by way of research. Representatives of community participates in the actual research.
Local Researcher Outside Researcher = Community Health Nurse
Act as researchers themselves, doing research of their own problem. The essential element of Participatory Action Research is participation
Participatory Action Research Objectives:o To encourage consciousness of the suffering
o To empower people to determine the cause of their own problem
o To analyze these problem
o To develop competence for changing their own situation
o To act by themselves in responding to their own problems
Ideal participatory research process involves the community in all research aspect1. Identification of research problem2. Formulation of research design3. Data gathering4. Validation of research5. Data presentation6. Recommendations7. Action of activities
COPAR Phase/ProcessAccording to (Sister Jimenez)
PRE ENTRY PHASE At the NGO level
o Formulation of institutional goals, objectives and targets for the program
o Revision of curriculum
o Training of faculty if CO-PAR
o Coordinate participation of other departments within the institution
At the community levelo Community consultations/dialogues
o Setting of issues related to site selection
o Development of criteria for site selection
Criteria in selecting community Site must be
Depressed and underservedOppressedPoor
ExploitedStruggling
Area must not have a serious peace and order problem Willingness to be organized Community needing health assistance
o Check vital health statistic can determine general health status
o Malnutrition rate
o Lack of health facility/health care providers
Counter-part of the community (support, commitment, resources) Accessible to transport and communication
o Site selection
o Preliminary Social Investigation (PSI)
Identify contact person Gather “overview” of the demographic characteristics, health services and facilities of the
communityo Networking with LGU’s, NGO’s and other departments
ENTRY PHASE Integration with the community main objective: Gain Trust
First task courtesy call to the Brgy. CaptainEstablish rapport* house calls* joining to social activities
Imbibe their lifestyle
Immerse yourself
Live with them
Reside on the area* live in the center/modest dwelling
Sensitization of the community social preparation Information campaign on health services Continuing/deep social investigation
Process of collecting, collating, analyzing data to draw the clear picture of the community
Core Group formation (CG)o Consist of identified potential leaders
Characteristics of a potential leaders1. Respected community members2. Responsible/committed3. Willing to work for a desired change4. Has good communication skills5. Has wide “influence” to elite/poor community members
Self-awareness and leadership training (SALT) Coordination with other community organization
o Representing different sectors of the community
COMMUNITY DIAGNOSIS/STUDY PHASE(research phase)
Selection of the research team Training on data collection Planning for the actual gathering of data Data gathering Training on data validation Community validation Presentation of the community study/diagnosis and recommendations Prioritization of community needs/problems for action
COMMUNITY ORGANIZATION/CAPABILITY BUILDING PHASE Community meetings to draw-up guidelines for the organization Election of officer Development of management systems:
(Delineation of the Roles, Function, and Task of Officers) Training of leaders Team building exercises to enhance cohesiveness Action-Reflection-Action-Session
COMMUNITY ACTION PHASE Organization and training of BHW’s Village or Grassroot Workers PIME of health services
Project Implementation/Monitoring and Evaluation (Project Management) Resource mobilization
5 M’SMANPOWERMACHINEMATERIALMETHODMONEYSPACE
Setting up of linkages/network/referral system
SUSTENANCE AND STRENGTHENING PHASE Formulation and ratification of constitution and by-laws Identification and development of “secondary” leaders Setting up a financing scheme Continuing education and training of BHW’s Development of long term community health development plans Formalizing linkages, networks and referral system
TURNOVER/PHASE OUT Transfer of community organizer roles and responsibilities and documents subsequent follow-up
CO-PAR main goal is to attain COMMUNITY DEVELOPMENT better quality life * Basic needs are met * Equal rights * Self-reliance * Active participation
COMMUNITY HEALTH NURSINGDefinition:WHO Health – is a state of complete physical, mental and social well beingModern Concept Health – refers to optimum level of functioning of individual, family, community
OLOF is influence by the Eco SystemEco System Factors
Socio-economic status Education Employment Housing
Hereditary factor genetic Health care delivery systemActivities and Behavior mag HL tayo
Manage StressRegular ExerciseDo not Smoke Priority MessageRegular health check-upEat healthy foodsWeight loss
Political factorsEnvironmental factors
WHO – special field of nursing that combines:o Skills of nursing
o Public health
o Social assistance and functions
Dr. C. E. Winslow – public health is a science and art of 3 P’so Promotion of health
o Prevention of illness/hazards through organize community efforts
o Prolonging life
Statement: “every citizens has his BIRTHRIGHT of good health and longevity”
CHN according to Dr. Ruth Freeman A service rendered by a professional nurse
o To individuals, family, community and population groups
o At home
o Clinics
o Schools
o And workplace
CHN subspecialty School Health Nursing Occupational Health Nursing
CHN according to Dr. Maglaya The utilization of the nursing process in the different levels of clientele, individual, family, community
and population groups concerned with thePromotion of healthPrevention of diseaseAnd Disability and Rehabiliation
CHN as Field Of Nursing Practice Hallmark of CHN is that it is Population or Aggregate-Focused Emphasis on the importance of the “Greatest Good for the Greatest Number” “Goal of improving Community Health is realized through interdisciplinary/multi effort”
Philosophy of CHN Dr. Shetland CHN is based on the Worth and Dignity of Man
Ultimate Goal of CHN “To raise the level of health of the citizenry”
Principles of CHN Based on recognized needs of the community Understand the objectives and policies of the agency Family is the basic unit of service Always available to all regardless of Race, Creed and Socio-economic status Use available community health resource
- Indigenous resourceo Dried proteins
Pounded Dilis Pounded Shrimp Pounded Monggo
Record and report data accurately research/legal Health teaching is primary responsibility Evaluation of programs Continuous professional growth
CONCEPTS OF COMMUNITY HEALTH NURSING Health promotion primary responsibility Generalist never Specialist
Situational analysis
Goal/Objective setting
Strategy setting
Evalutaion
Population is the main focus Individual, Family, Community including Population Group Pregnant, Newborn, Elderly, Youth
Population Group – those who share a common characteristics, developmental stages and common exposure to health problems
Community health nursing process is implicit in the practice of CHN Essence of nursing Dynamic and cyclic process Systemic approach
CHN PROCESS1. Assessment
o Establishing rapport
Greetings Introduce self
o Collection of data/facts/information
METHODS TO COLLECT DATAInterviewRecords review Family Health RecordPhysical assessmentObservationDiagnostic exam
o Diagnosis – identification of the client, families and community needs based on the gathered data
2. Planningo Prioritizing needs
Ranking and Scaling Nature of problem Preventive potential Modifiability of the problem Salience – perception
o Stating goals and objective
o Goal setting
o Expected outcome
o Developing parameters evaluation process
THE PLANNING CYCLE/PROCESS
1. Situational Analysis Where are we now?
o Gather, tabulate, analyze and interpret data
o Identify the problems/issues/needs
2. Goal and Objective Setting Where do you want to go?
o Define program goals and objectives
o Assign priorites among objectives
3. Strategy and Activity Settings How do we get there?
o Design CHN programs
o Ascertain resources
o Analyze constraints and limitations
4. Evaluation How do we know we are there?
o Specify criteria and standards
o Determine outcomes
HOME VISIT (should always have: PURPOSE and OBJECTIVE)Is a professional face to face contact done by the nurse to the family
Factors Affecting Frequency of Home Visitso Physical/psychological and educational needs
o Acceptance of the family (PRIORITY NEEDS)
o Policy of a given agency
Steps during Home Visit1. Greetings/Introduce Self2. Stating purpose and objective
Priorities during Home Visit1. Newborn (FIRST)2. Post-Partum3. Pregnant mother4. Morbid individual (LAST)
PUBLIC HEALTH BAG Is an essential and indispensable equipment of the Public Health Nurse used during home visit
BAG TECHNIQUE
A tool making use of a Public Health Bag and which the Public Nurse can perform procedures during home visits
Rationale in the use of PHN BAGo Technique during Home Visit:
“It help render effective nursing care” Principle of Bag Technique
1. Minimize if not totally prevent the spread of infection2. Save time and effort3. Not to overshadow the concern of the client and family
BP apparatus, stethoscope and umbrella are carried separately
SPECIAL CONSIDERATIONSBag and its contents must be free from any contaminationAlways do hand washingGather necessary equipment’s to render Nursing Care Place waste bag, paper lining outside
SOLUTION1. Benedict solution for sugar detection2. Acetic acid solution for albumin detection3. Zephiram solution soaking solution4. Alcohol, Betadine5. Ammonia
LEVELs of CLIENTELEIndividual, Family, Community, Population Group Sick or Well
LEVELS OF PRIMARY HEALTH FACILITYPRIMARY – Client in Fair health and with early symptoms of illness
o Barangay Health Center (BHC), City Health Office (CHO), Municipal Health Office (MHO),
Lying-in Clinics, Puericulture Center, Community HospitalsSECONDARY – Patient in symptomatic stage of an illness and requires moderately specialized
knowledge/facilitieso Provincial Hospitals, District Hospitals, Municipal Hospitals, Emergency Hospitals
TERTIARY – Patients seriously threaten and requires highly technical facilities and knowledgeo National Hospitals, Teaching/Training Hospitals, Regional Hospitals
(SPECIALTY HOSPITALS)
2 TYPES OF PRIMARY HEALTH CARE WORKERS1. Village/Grassroot workers – Trained hilots
o Trained individuals
BHW, TBA, Trained hilot, Trained Dentist, Trained Nutritionist2. Intermediate Health Care Workers
o Professional Groups
RH Physicians, RH Nurse, RH Midwife, RH Dentist, Medtech, Nutritionist, Sanitary Inspector
Ratio to Populationo 1 Physician = 20,000
o 1 Nurse = 20,000
o 1 Med Tech = 20,000
o 1 Sanitary Inspector = 20,000
o 1 Dentist = 50,000
o 1 Midwife = 5,000
QUALIFICATIONS OF A COMMUNITY HEALTH NURSE BASIC REQUIREMENT
o BSN
o RN
o MAN with Positions
Positions1. Chief Nurse
o BSN, RN, MAN
o 5yrs experience as Community Health Nurse
o 3yrs experience as Supervisor
2. Assistance Chief Nurseo 5yrs experience as Community Health Nurse
o 2yrs experience as Supervisor
3. Regional Training Nurseo BSN, RN, MAN
o 6yrs experience as Community Health Nurse
o 3yrs experience as Trainor /Educator
4. Regional Supervisoro BSN, RN, MAN
o 5yrs experience as Community Health Nurse
o 2yrs experience as Supervisor
5. Provincial Supervisoro BSN, RN, MAN
o 5yrs experience as Community Health Nurse
6. Nurse Instructoro BSN, RN, MAN
o 3yrs experience as Community Health Nurse with teaching abilities
7. Nursing Program Supervisoro BSN, RN, MAN
o 7yrs experience as Community Health Nurse with Training to DOH programs
PRIMARY HEALTH CARE Is an essential Health Care based on practical and socially acceptable methods and technology
Public Health Nurse 2
Made universally accessible to Individual, Family, CommunityHistory of Public Health CareWHAT: Alma Ata ConferenceWHEN: September 6-12, 1978WHERE: Alma Ata,USSR/RussiaWHO: WHO/UnicefWHO: Dr. Dizon/Dr. VillarLegal Basis: LOI 949
Signed by: Pres. Ferdinand Marcos on October 1979
GOAL OF PUBLIC HEALTH CARE Health for all Filipinos and health in the hands of the people by year 2020
MISSION Strengthening the health system wherein people will manage their own health care
KEY/CORE STRATEGY“PARTNERSHIP”
PILLARS/CORNERSTONE OF PUBLIC HEALTH CARESupport Mechanism mad availableCommunity Participation ActiveAppropriate technologyMulti-Sectoral linkages
CHARACTERISTIC OF PUBLIC HEALTH CAREAccessible/AvailableCommunity BasesAffordableSustainableIntegral/ImportantAcceptable
VITAL HEALTH STATISTIC Is the study on vital events such as Birth-Fertility
Deaths – MortalityMorbidity
Main Objective: to determine general health status of the community