Community Health Nursing Concepts

Core Concepts

• Community involves the client, health is the goal, nursing is the means
• Essential components include physical, mental, and social well-being, not just absence of disease
• Individuals/groups should realize aspirations, satisfy needs, adapt to change
• Health is a resource, not an objective, emphasizing social, personal resources, and physical capabilities

Levels of Clientele

• Levels of focus include individual, family, community, population groups
• Family shares blood relationship and is fluid, with the health of influence health of community
• Community shares common geographic location, interests, and institutions, focusing services on families
• Population groups are group with shared needs

Social Determinants of Health

• Economic stability factors include employment, income, expenses, debt, medical bills, support
• Neighborhood and physical environment factors include housing, transportation, safety, parks, playgrounds, walkability
• Education factors include literacy, language, early childhood education, vocational training, higher education
• Food factors include hunger and access to healthy options
• Community and social context include social integration, support systems, community engagement, discrimination
• The health care system includes health coverage, provider availability, cultural competency, and quality of care
• Health outcomes include mortality, morbidity, life expectancy, healthcare expenditures, health status, functional limitations

Overarching Goals

• Attain high quality and longer lives free from preventable disease, disability, injury, premature death.
• Achieve health equity, eliminate disparities, and improve the health of different groups
• Create social and physical environments good for health
• Overall quality of life, healthy development, and health, behaviors across life stages must be promoted

Defining Nursing

• Assisting sick or well individuals to help him gain independence is nursing
• Nursing focuses more on primary care services

Community Health Nursing

• Direct and adaptable health support to individual, family, community needs during health and illness
• Aims toward development and enhancement while preserving human dignity

Salient Points Of CHN

• Aim is to promote Optimum Level of Functioning (OLOF) through teaching and delivery of care based on philosophy

Focus on the Community

• Natural environments of people are the setting for intervention
• The setting focuses the setting, and field
• Settings include PHN, SHN, OHN
• Occupational health nursing focuses on work environments

School Health Nursing and RA 124

• Medical Inspection of Children act mandates inspections in private schools, with 300 students to provide medical examinations

Occupational Health Nursing - RA 1054

• Mandates owners and operators of commercial, industrial, and agricultural establishments to administer free medical services

OHN - Regulations

• Specific guidelines exist depending on employee numbers, facility type, and availability of healthcare personnel
• E.O. 442 - Labor Code of the Philippines mandates 8-hour workdays, medications and equipment availability
• E.O. 307 - Occupational Safety and Health Center (OSHC) operates under the employees' compensation commission

Health Protection and Promotion in the Workplace

• Proactive management of health risks, hazard identification, surveillance, and accessibly of protective equipment
• Assessment for hazards to evaluate risks, promote employee lifestyles and provide assistance

Public Health

• Concerned with health and longevity as basic human rights
• Efforts focus on disease preventions, prolonging life, promoting health, and organized community

Preventive Approach to Health

• Health promotion enhances resources for improved well-being.
• Disease prevention involves activities that protect from illness

Levels of Prevention

• Primary includes health promotion and specific protection; secondary focuses on early detection
• Tertiary aims to limit disability and rehabilitate individuals

Health Care Delivery System

• Characterized by different service level depending on specific characteristics

Restructured Health Care Delivery System

• Primary levels emphasize prevention and management of conditions, using outpatient services from barangay health centers
• Secondary levels includes hospitalization and early treatments at district or provincial hospitals
• Tertiary levels offer specialized care from specialized personnel within highly equipped regional or national centers

Two-Way Referral and Local Health

• Support communication among facilities, efficiency of health care delivery, maximizes resources and encourages skill
• Health zones use catchment areas that covers government and private service for public, private mix

Implementing Devolution - RA 7160

• Aims to transform local government units toward self-reliance, partnership, and responsiveness to community and health needs

Local Government Code

• The department manages and facilitates community activity and reports
• The board manages and oversees the reports and activities in the location

Public Health Staff

• Public health nurses guide other nurses, prepare reports, perform health education
• Rural health midwives manage RHMs and conduct patient assessment
• Rural sanitary inspectors ensure healthy environments through advocacy, monitoring
• Barangay health workers interface with communities, provide basic services, and also known as “Frontline health care workers”

Legal Mandates for Workers

• RA 7305 protects workers with 40-hour weeks and salary scales with hazard pay

Primary Health Care - Essential Elements and Legalities

• Mandates accessible, available, and appropriate care that’s also affordable and acceptable
• Legal basis is from the Letter of Instruction (LOI) 949

Key Elements of Primary Care

• Basic factors like sanitation, communicable dx control and education
• Involves planning and collaboration in the community

Herbal Medicines

• RA 8423 promotes indigenous resources and uses practices based on different cultures

Complementary vs Traditional

• Acupressure and other therapies are types of medicine

Herbal Plants

• Lagundi, ulasimang bato, bwang, bayabas

Astana Declaration

• The declaration focuses on strengthening PHC and focus on prevention and integrating the care.

Health Promotion

• The process of enabling control and wellness to happen.

Strategies for Wellness

• Build health public policy and supportive environments, with action and personal skills
• Integrate the health plan

DOH and MDG

• Medical Pool and etc are specific programs

Strategic Goals for Health

• Eradicate poverty to improve health.

MDG Goals for 2030

• Goal aims for support and equity for those affected by environmental challenges.

National Health

• DOH is the agency responsible for the country's health.

DOH

• Filipinos are the healthiest people

Health Objectives

• The DOH has three roles in the sector, lead, enable, and administer

Framework for Quality

• The health sector relies on financing, service, and governance.

Preventative Health

• Involves early intervention.

Evaluation

• Standards must be met

Organization

• Requires that there be communication within the facility.