CHN 104 Transes (Prelims) PDF

CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C In the Philippines, Public Health Nursing developed PUBLIC HEALTH NURSING - this blends nursing and along with the Department of Health, which is public health to tackle community health issues. It responsible f...

CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C In the Philippines, Public Health Nursing developed PUBLIC HEALTH NURSING - this blends nursing and along with the Department of Health, which is public health to tackle community health issues. It responsible for health protection and promotion uses nursing skills, communication, analysis, and and employs many health workers, including public organization to improve health. Public health nurses health nurses. Historical records indicate that nurses work with other health professionals to care for in communities were already known as Public families, address health threats, educate the public, Health Nurses as early as the 1900s. and drive health initiatives. Their role involves assessing health risks, teaching about health, and encouraging community action to boost overall COMMUNITY HEALTH NURSING - the application of health. the nursing process in the care of client in the community setting. To do this effectively, nurses PUBLIC HEALTH NURSES (PHNs) - nurses working in need to master the basic steps of nursing care. local or national health departments or public schools, regardless of their official job title. DEFINITIONS & FOCUS COMMUNITY HEALTH NURSING - nursing care that COMMUNITY - a group of people sharing common takes place outside of acute-care settings; meets its needs, interests, resources and environments. goals by identifying problems and involving the community in improving and maintaining their POPULATION - a statistical aggregate or subgroup health. of people with similar or identical characteristics; (Mary Jo Clark) as, “a synthesis of nursing may or may not interact with one another. knowledge and practice and the science and practice of public health, implemented via a HEALTH - “a state of complete physical, mental and systematic use of the nursing process and other social well-being and not merely the absence of processes to promote health and prevent illness in disease or infirmity.” ~ WHO population groups” PUBLIC HEALTH (Dr. C.E. Winslow) FF. STATEMENTS CHARACTERIZE CHN: “Science and art of preventing disease, prolonging life, promoting health and efficiency through Promotion of health and prevention of disease organized community effort for the sanitation of the are the goals of professional practice; environment, control of communicable diseases, the Community health nursing practice is education of individuals in personal hygiene, the comprehensive, general, continual and not organization of medical and nursing services for the episodic; early diagnosis and preventive treatment of disease There are different levels of clientele ~ and the development of the social machinery to individuals, families, and population groups and ensure everyone a standards of living adequate for the practitioner recognizes the primacy of the the maintenance of health, so organizing these population as a whole; benefits as to enable every citizen to realize his The nurse and the client have a greater control birthright of health and longevity. “ in making decisions related to health care and they collaborate as equals; COMMUNITY HEALTH - refers to the health status of The nurse recognizes the impact of different a defined group of people, or community, and the factors on health and has a greater awareness of actions and conditions that protect and improve the his/her clients’ lives and situations. health of the community. SEPT 14, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C DIFF. BETWEEN PHN & CHN GLOBAL AND COUNTRY HEALTH IMPERATIVES Public health systems work in the midst of constant change, which puts a lot of pressure on them. Changes include: 1. Shifts in demographic and epidemiological trends in diseases, including the emergence and re-emergence of new diseases and in the prevalence of risk and protective factors. 2. New technologies for health care, communication and information. 3. Existing and emerging environmental hazards some associated with globalization. 4. Health reforms CLIENTS OF CHN 1. INDIVIDUAL CHN work with people daily, whether they’re sick or well. They know that an individual’s health is linked to their family and community, so by helping individuals, they also address wider family and community health issues. 2. FAMILY A family is a group of people who depend on and interact with each other. In Filipino culture, families may have adapted their roles in supporting health and their ability to support each other. 3. POPULATION GROUP A population is a group of people with shared traits or experiences that lead to similar health issues. It includes those with specific FRAMEWORK FOR CHN developmental needs and vulnerable groups. 4. COMMUNITY The macro framework for CHN practice has 4 A group of people living in the same area or components: sharing common values and interests. It’s a 1. Health Care Delivery System network of relationships and interactions where 2. Clients people are interconnected and rely on each 3. Health other. 4. Economics, Sociocultural, Political, and Environmental Factors INDIVIDUAL & FAMILY - THEY ARE THE PRIME FOCUS OF CARE IN THE COMMUNITY SEPT 15, 2024 CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C PUBLIC HEALTH NURSING IN THE PHILIPPINES PRE - SPANISH ERA NO RECORDS SPANISH REGIME (1591 - 1898) Bro. Juan Climente (1577) - started Introduced small pox vaccine. Public Health Services through a Creation of position of district, provincial, dispensary in Intramuros. national health officers. Started water sanitation AMERICAN REGIME (1898 - 1942) 1898 - creation of the Board of Health for 1915 - PHN began in Manila with 2 Nurses Physicians. who offered who offered follow-up care 1899 - appointment of the first of OB patients and environmental Commissioner of Health. sanitation services under an American 1906 - abolition of the Board of Health; nurse. Creation of the Bureau of Health. 1917 - four graduate nurses paid by the 1912 - The Fajardo Act. PHN started when City of Manila were employed to work in the Bureau of Health employed 4 the City Schools. graduate nurses from the Philippine 1919 - the organization was established. General Hospital of Nursing in Cebu and Public health nursing inaugurated its were engaged purely on maternal and pioneer work in Tondo, Manila. - The first child health services. Filipino nurse supervisor under the Bureau of Health. JAPANESE REGIME (1942 - 1945) Public Health Nursing services were interrupted. The effects of WW2 on Dec 8, 1941: Public Health Nurses in Manila were assigned to devastated areas to attend to the sick and the wounded civilians causes by bombing. Feb 1946, after the world war, the Bureau of Health showed the increased number of public health nurses. SEPT 15, 2024 CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C PUBLIC HEALTH NURSING IN THE PHILIPPINES ERA OF THE REPUBLIC OF THE PHILIPPINES (1946 TO PRESENT) 1947 - the Dept. was renamed Department of Health (DOH) and divided into 3 Bureaus: 1. Bureau of Health 2. Bureau of Quarantine 3. Bureau of Hospital May 18, 1954 - RA 1082 (RURAL HEALTH UNIT ACT) was enacted and implemented in July of the same year. It established rural health units and funded the hiring of health personnel, including nurses, to improve health conditions in rural areas. June 1957 - RA 1891 (AN ACT STRENGTHENING HEALTH AND DENTAL SERVICES IN THE RURAL AREAS, AND PROVIDING FUNDS THEREFOR) was approved; created 8 categories of RHUs corresponding to 8 population groups to be served. 1991 - the Local Government Code of 1991 (RA 7160) was passed and implemented. This resulted in devolution which transferred the power and authority from the national to the local government units. It was aimed to build their capabilities for self government and develop them fully as self-reliant communities. STANDARDS OF IN THE PHILIPPINES PUBLIC HEALTH NURSES (PHNs) refer to the nurses in the local/national health dept. or public schools whether their official position title is Public Health Nurse or Nurse or School Nurse. PUBLIC HEALTH nursing refers to the practice of nursing in national and local government health departments (which includes health centers and rural health units), and public schools. It is community health nursing practiced in the public sector. SEPT 15, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C ROLES AND RESPONSIBILITIES OF A CHN MANAGER / SUPERVISOR Formulates individual, family, and aggregates CASE MANAGER - assisting clients to make centered care plan. decisions about appropriate health care services and Interprets and implement program policies, to achieve service delivery integration and memoranda and circulars. coordination which are among the important roles Organizes work force, resources, equipment, and of the community health nurse. supplies and delivery of health care at local levels. ADVOCATE - clients in the community health Provides technical and administrative support to nursing setting frequency are unable to negotiate for Rural Health Midwife (RHM). Conducts regular change in the health care system. The nurse seeks to supervisory visits and meetings to different RHMs promote an understanding of health problems, and gives feedback on lobby for beneficial public policy and stimulate accomplishments/performances. supportive community action for health. COMMUNITY ORGANIZER TEACHER - application of teaching - learning Responsible for motivating and enhancing principles to facilitate behavioral changes among community participation in terms of planning, clients is a basic intervention strategy in community organizing, implementing, and evaluating health health. programs/services. Initiates and participates in community PARTNER & COLLABORATOR - the aim of development activities. partnership & collaboration is to get people to work together in order to address problems or concerns HEALTH EDUCATOR/ TRAINER that affect them. The community health nurse Identifies and interprets training needs of RHMs, establishes and maintains valuable working Barangay Health Workers/ Volunteers relationship with people such as people’s (BHW/BHV) and Hilots. organizations, health organizations, educational Formulates appropriate training program institutions, socio-civic organization, sectoral groups, designs. and the like. Provides and arranges training experiences of nursing and midwife affiliates. HEALTH PLANNER / PROGRAMMER Conducts training for health personal. Identifies needs, priorities, and problems of Acts as resource speaker on health and health individuals, families, and communities. related service as he need arises. Formulates nursing component of health plans. In doctor less, area, she is responsible for the CASEFINDER - because of the nurse proximity to formulation of the municipal health plan. families and aggregates in the community, case Interprets and implement the nursing plan, finding has been strategic role for many years. program policies, memoranda, and circulars for ex.: at-risk children are identified and followed the concerned staff/ personnel. periodically as the develop. Provides technical assistance to rural health midwives in health matters. SEPT 16, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C ROLES AND RESPONSIBILITIES OF A CHN EPIDEMIOLOGIST - the nurses uses the epidemiological method to study disease and health among population groups and to deal with community-wide health problems: collecting data on health problem and care is an important epidemiological role. RECORDER / REPORTER / STATISTICIAN Prepare and submits required records and reports. Review, validates, consolidates, analyses, and interprets all records and reports. COMMUNITY LEADER - the CHN, being leader, a role model and respected in the community is in a better position to empower others. Empowerment is giving your influence to others for purposes of personal and organization growth. SEPT 22, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C 2. Sustainable Development Goals (SDGs) - The HEALTH CARE DELIVERY SYSTEM SDGs, also known as the Global Goals, are a universal This system includes all services aimed at protecting call to end poverty, protect the planet, and ensure or restoring health for individuals and communities. peace and prosperity for all people. It covers both government and private facilities like hospitals and clinics, and focuses on prevention, The Sustainable Development Goals (SDGs) treatment, and rehabilitation. Government health were adopted by all UN members in 2012 at the centers mainly handle preventive care, while Rio de Janeiro Council Meeting to promote a hospitals provide curative care. healthy and developed future for the planet and its people. In 2015, the SDGs were implemented WORLD HEALTH ORGANIZATION (WHO) following a successful fifteen-year development Founded in 1948, the WHO is a UN agency that plan known as the Millennium Development focuses on global health. It provides information and Goals. guidance to promote health and prevent disease. 17 SUSTAINABLE DEVELOPMEN GOALS The WHO works with member countries to develop 1. No Poverty health resources, coordinate research, and 2. Zero Hunger implement health programs. 3. Good Health and Well-Being 4. Quality Education 1. Millennium Development Goals (MDGs) - These 5. Gender Equality goals focus on values like freedom, equality, and 6. Clean Water and Sanitation health. Improving health is important because it is 7. Affordable and Clean Energy closely linked to development. Poor health causes 8. Decent Work and Economic Growth poverty, and poverty can lead to despair and 9. Industry, Innovation, and Infrastructure conflict. 10. Reduced Inequalities 11. Sustainable Cities and Communities The Eight Millennium Development Goals 12. Responsible Consumption and Production (MDGs): 13. Climate Action 1. Eradicate extreme poverty and hunger. 14. Life Below Water 2. Achieve universal primary education. 15. Life on Land 3. Promote gender equality and empower 16. Peace, Justice, and Strong Institutions women. 17. Partnership for the Goals 4. Reduce child mortality. This last goal aims to help realize strong 5. Improve maternal health. partnership and global cooperation for the 6. Combat HIV/AIDS, malaria, and other SDGs. diseases. 7. Ensure environmental sustainability. PHILIPPINE DEPARTMENT OF HEALTH (DOH) 8. Develop a global partnership for The Department of Health (DOH) in the Philippines development. works to improve the health of Filipinos by partnering with government agencies, private organizations, NGOs, and communities. It used to oversee all barangay health stations, rural health units, and many hospitals across the country. The DOH regulates health facilities and products and sets policies and standards for healthcare services and personnel. SEPT 28, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C MISSION-VISION OF DOH INTER LOCAL HEALTH SYSTEM Vision: Filipinos are among the healthiest people in The Inter Local Health System is important for Southeast Asia by 2022, and Asia by 2040. combining hospital and public health services to Mission: To lead the country in the development of a provide comprehensive care. It identifies ways for productive, resilient, equitable and people-centered different stakeholders to collaborate in delivering health system for Universal Health Care. health services, including: Local government units (LGUs) MANDATE OF DOH Department of Health The DOH helps local government units, People's Philippine Health Insurance Corporation (PHIC) Organizations, and community members Communities implement programs and services that: Non-Government Organizations (NGOs) a. Promote the health and well-being of all Filipinos. Private sector and others. b. Prevent and control diseases in at-risk groups. c. Protect communities from health hazards. Expected Achievements of the ILH System d. Treat and rehabilitate individuals with diseases 1. Universal health insurance coverage and disabilities. 2. Improved quality of services in hospitals and Rural Health Units (RHUs) HISTORICAL BACKGROUND OF DOH 3. Effective referral system For over forty years after gaining independence, the 4. Integrated health planning Philippine healthcare system was managed by a 5. Appropriate health information systems central agency in Manila, which oversaw resources, 6. Improved drug management systems policies, and health facilities nationwide. In 1991, the 7. Development of human resources Local Government Code (Republic Act 7160) was 8. Effective leadership through Inter-LGU enacted, shifting control of health services, cooperation personnel, and budgets from the provincial level 9. Financially sustainable hospitals down to local government units, allowing for better 10. Integration of public health and hospital care health service delivery. 11. Strengthened cooperation between LGUs and health sectors LOCAL HEALTH SYSTEM & DEVOLUTION OF HEALTH SERVICES Guiding Principles for Developing the ILH System The Inter Local Health System, promoted by the 1. Financial and administrative autonomy of the Department of Health, aims to ensure quality provincial and municipal administrations (LGUs) healthcare at the local level. It functions like a 2. Strong political support district health system, where individuals, 3. Strategic synergies and partnerships communities, and healthcare providers in a specific 4. Community participation area work together to deliver equitable and 5. Equity of access to health services by the accessible healthcare. This collaboration is based on population, especially the poor partnerships among local government units (LGUs). 6. Affordability of health programs 7. Appropriateness of health programs 8. Decentralized management 9. Sustainability of health initiatives 10. Upholding of standards of quality health service OCT 20, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C COMPOSITION OF THE INTER-LOCAL HEALTH ZONE SENTRONG SIGLA MOVEMENT (HEALTH ANG UNA!) 1. People: The number of individuals may vary from zone to zone, affecting health service needs. The Sentrong Sigla Movement is a collaboration 2. Boundaries: Clear boundaries between Inter between the Department of Health (DOH) and local Local Health Zones establish accountability and government units (LGUs). Its goal is to promote the responsibility for health service providers. These availability of quality health services in health centers boundaries are based on geographical locations and hospitals, ensuring these services are accessible and access to referral facilities, such as district to all Filipinos. hospitals. 3. Health Facilities: This includes district or A key component of the movement is a certification provincial hospitals (serving as referral hospitals and recognition program that establishes and for secondary-level healthcare), Rural Health promotes standards for health facilities. Units (RHUs), Barangay Health Stations (BHS), and other health services working together as an Guiding Principles for Sentrong Sigla integrated health system. 1. Recognition for achieving quality will be the main 4. Health Workers: The right mix of health incentive for Sentrong Sigla (SS) certification. providers is essential to deliver comprehensive 2. Quality improvement is an ongoing process. health services effectively. 3. SS certification will focus on core public health programs that are cost-beneficial, such as child LOCAL HEALTH SYSTEM & DEVOLUTION OF health, maternal care, family planning, HEALTH SERVICES prevention and control of infectious diseases, and promotion of healthy lifestyles. Devolution of Health Services - Devolution is the 4. Quality improvement is a partnership that transfer of power from the national government to empowers all stakeholders. local government units (LGUs), enabling them to take 5. Roles, responsibilities, and contributions should on specific functions and responsibilities. Mandated promote appropriate collaboration and by Section 17 of the Local Government Code of 1991 reciprocity. (RA 7160), this process aims to make LGUs self-reliant 6. To ensure an even distribution of quality health and active partners in nation-building. services, DOH assistance will be targeted based on carefully identified health priorities and needs. With increased power, authority, and resources, 7. Assessments will involve various partners, governors and mayors are responsible for managing including non-DOH government and non- devolved health services. government agencies, to ensure objectivity and diverse perspectives. The Local Government Code significantly changed healthcare in the Philippines, promoting Long-Term Goal decentralization and accountability. The country has The long-term goal of the Sentrong Sigla Movement about 79 provinces, 113 cities, 1,496 municipalities, is to establish Continuous Quality Improvement (CQI) and 41,943 barangays. In 1993, health services were in healthcare by building leadership, skills, and transferred from the Department of Health to LGUs: processes within the health sector. This aims to provincial hospitals to provincial governments, and enhance health promotion and disease prevention. Rural Health Units (RHUs) and Barangay Health It recognizes that improving healthcare quality is an Stations (BHSs) to municipal governments. By 1999, ongoing journey, with no final endpoint. there were 2,381 RHUs and 11,393 BHSs. OCT 20, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C CLASSIFICATION OF HEALTH CLASSIFICATION OF HOSPITALS ACCORDING TO FACILITIES (DOH AO-0012A) FUNCTIONAL CAPACITY The Department of Health (DOH) Administrative Order A. General Hospital No. 2012-0012 outlines the rules and regulations for Provides medical and surgical care to the sick and classifying hospitals and other health facilities in the injured, including maternity care. Minimum clinical Philippines, based on Section 16 of Republic Act No. services must include: 4226, also known as the Hospital Licensure Act. Medicine Hospitals are classified according to: Pediatrics 1. General or Special: Determining the type of hospital. Obstetrics and Gynecology 2. Service Capabilities: Assessing the range of services Surgery and Anesthesia offered. Emergency Services 3. Size or Bed Capacity: Based on the number of beds Outpatient and Ancillary Services available. B. Specialty Hospital 4. Training Classification: Whether the hospital is a training institution or not. Focuses on a specific disease or condition or caters to a particular type of patient. CLASSIFICATION OF HEALTH FACILITIES (DOH AO-0012A) The Department of Health (DOH) Administrative Order No. 2012-0012 outlines the rules and regulations for classifying hospitals and other health facilities in the Philippines, based on Section 16 of Republic Act No. 4226, also known as the Hospital Licensure Act. Hospitals are classified according to: 1. General or Special: Determining the type of hospital. 2. Service Capabilities: Assessing the range of services offered. 3. Size or Bed Capacity: Based on the number of beds available. 4. Training Classification: Whether the hospital is a training institution or not. OCT 20, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C PRIMARY HEALTH CARE (PHC) It is an essential health care that is made universally accessible to individuals and families in the community. It emphasizes: Accessibility: Health services are available to everyone. Community Participation: The involvement of the community in the process. Affordability: Services are provided at a cost that the community and country can sustain. This approach aims to ensure that health care is acceptable and effective at every stage of development, as defined by the World Health Organization (WHO). Brief History In 1978, representatives from 134 countries attended the International Conference on Primary Health Care in Alma-Ata, USSR, where they signed the Declaration on Primary Health Care (PHC). This declaration arose from concerns about the unjust global health situation, highlighting the significant disparities in health between underdeveloped and developed countries, as well as within countries PHILIPPINE HEALTH AGENDA 2010-2022 themselves. The Health Sector Reform Agenda (HSRA) is the primary goal of the Department of Health (DOH). To Three Strategies in Delivering Health Services support this agenda, the DOH focuses on: 1. Restructured Health Care Delivery System Organizational Development: Building effective (RHCDS) - Aims to improve health service structures within health organizations. organization, regulated by Presidential Decree Strong Policies: Implementing robust policies and 568 (1976). procedures. 2. Management Information Systems - Focuses on Capable Human Resources: Ensuring skilled collecting and managing health data, governed personnel are available. by Republic Act 3753 (Vital Health Statistics Law). Adequate Financial Resources: Securing sufficient 3. Primary Health Care (PHC) - Legalizes the funding for health initiative implementation of PHC in the Philippines, promoting accessibility and community participation, established under LOI 949 (1984). OCT 20, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C CREATION OF RHCDS Elements of Primary Health Care 1. Environmental Sanitation: Ensuring access to 1. RHO (Regional Health Office): Manages regional safe water and proper waste disposal. health services, collaborating with: 2. Control of Communicable Diseases: PGH (Philippine General Hospital): Major Implementing measures to prevent the spread of specialized hospital. infectious diseases. Heart Center for Asia: Focuses on heart care. 3. Immunization: Providing vaccinations to protect NKI (National Kidney Institute): Specializes in against diseases. kidney health. 4. Health Education: Informing the community 2. MHO & PHO (Municipal/Provincial Health about health practices and issues. Offices) - Handle local health services. 5. Maternal and Child Health and Family Planning: 3. BHS & RHU (Barangay Health Station/Rural Supporting the health of mothers and children, Health Unit) - Provide basic health care in and providing family planning services. communities. 6. Adequate Food and Proper Nutrition: Ensuring DEFINITION OF PHC access to nutritious food for all. 7. Provision of Medical Care and Emergency Community Organization: Engages local people Services: Offering medical care and emergency to use their resources and knowledge for self- response. reliance and development. 8. Provision of Essential Drugs: Ensuring Community-Based Approach: Ensures basic availability of necessary medications. needs are met through partnerships between government, NGOs, and the community to Principles of PHC promote self-sufficiency. 1. People-Centered Development: Focus on Essential Health Services: Provides health individuals and communities. services that are available, acceptable, accessible, 2. Equity: Prioritize support for underserved and affordable, and sustainable, relying on community involvement and collaboration across disadvantaged groups. sectors to foster self-reliance and social change. 3. Respect for Local Knowledge: Value community insights and abilities. Mission and Goals 4. Social Accountability: Ensure health services Mission: Strengthen the healthcare system by respond to community needs. enabling people to take charge of their own 5. Empowerment through Devolution: Use local health. governance to enhance community control. Key Strategy: Foster partnerships and empower 6. Balanced Care: Integrate preventive and curative individuals to enhance their healthcare health services. management. 7. Strengthening Capacity: Continuously improve PHC systems. Strategies of PHC 8. Paradigm Shift: Adapt and evolve practices to 1. Reorganization of Health Care: Restructure national meet PHC goals. health care to support local governance (Local Government Code of 1991). 2. Preparation for Health Action: Enable effective health initiatives at all levels. 3. Community Mobilization: Help people identify health needs and find local solutions. 4. Appropriate Technology: Develop technology that relies on community resources. OCT 20, 2024 CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C REFERRAL SYSTEM IN HEALTH CARE LEVELS 1. Barangay Health Station (BHS) - Managed by a Rural Health Midwife (RHM). 2. Rural Health Unit (RHU) - Supervised by a Public Health Nurse (PHN). 3. Public Health Nurse (PHN) - Serves a population of 1:10,000, manages RHU policies and activities, and acts as the administrator under supervision. UNIVERSAL HEALTH CARE (UHC) UHC, or Kalusugan Pangkalahatan (KP), means providing every Filipino with high-quality health care that is: Accessible, Efficiently Distributed, Adequately Funded, Fairly Financed, Used Appropriately by an informed public. Universal health coverage (UHC) aims to: Expand Access - Ensure all Filipinos have access to effective health care services. Reduce Financial Hardship - Minimize costs related to illness. Improve Health Outcomes - Enhance overall health for the population. According to the 1987 Philippine Constitution, health is a right for every citizen, and the state must ensure equitable access to health services. REFERRAL SYSTEM Key Legislation Republic Act No. 10606: Amends the National Health Insurance Act of 1995 to ensure affordable and quality health benefits for all Filipinos. Republic Act No. 11223: Known as the "Universal Health Care Act," it automatically enrolls all citizens in the National Health Insurance Program and implements reforms in the health system. UHC's Three Thrusts 1. Financial Risk Protection - Expand enrollment and benefits of the National Health Insurance Program (NHIP). 2. Improved Access - Enhance access to quality hospitals and health care facilities. 3. Health-Related Goals - Achieve health-related Millennium Development Goals (MDGs). OCT 20, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C ATTAINMENT OF HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS (MDGS) To achieve health-related MDGs, we will: Enhance Public Health Programs: Focus on reducing maternal and child mortality, and tackle diseases like tuberculosis, malaria, and HIV/AIDS. Organize Community Health Teams (CHTs): Establish CHTs in key areas, aiming for 20,000 CHTs and 10,000 trained RNHeals nurses by the end of 2011 to coordinate with community workers. Implement a Life Cycle Approach: Provide essential services such as: Family planning Ante-natal care Safe delivery in health facilities Newborn care Garantisadong Pambata package Improve Coordination: Foster collaboration among agencies like DOH, DepEd, DSWD, and DILG for effective health initiatives. UNIVERSAL HEALTH CARE (UHC) OCT 21, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C Characteristics of Families: THE FAMILY 1. Contextual: Families are influenced by their A group of two or more individuals from the same or environment. different kinship backgrounds who live together, 2. Unique Lifestyle: Each family has its own way of share emotional bonds, and have mutual life. obligations. It can include those related by blood, 3. Holistic Operation: Families function as cohesive marriage, adoption, or living arrangements over units. time. 4. Individual Needs: Families adapt to meet individual needs. TERMINOLOGIES 5. Community Connection: Families relate to their Family Health: A dynamic state of well-being that community. encompasses the physical, mental, spiritual, and social health of both the family unit and its Basic Requirements for Family Survival and individual members. Growth: 1. Reproduction: Managing family size. Family Health Nursing: Nursing focused on the 2. Physical Care: Providing food, clothing, shelter, family as a unit, aiming to promote health within the and medical care. family. 3. Socialization: Preparing children for adult roles. Clear Expectations: Setting roles for family Family Process: The ongoing interactions among members. family members that help them accomplish daily Family Goals: Establishing shared objectives. tasks. 4. Resource Management: Dividing tasks and responsibilities. Family-Centered Nursing: A nursing approach that Authority and Accountability: Designating considers the health of the entire family alongside roles and responsibilities. that of individual members. Economic Management: Handling income and resources. A. THE FAMILY AS THE UNIT OF CARE IN Task Specialization: Dividing roles for COMMUNITY HEALTH NURSING efficiency. The family is the central unit of care in community Time Management: Scheduling health nursing, aimed at improving community health. responsibilities. Reasons to Focus on Families: 5. Order Maintenance: Keeping harmony within 1. Basic Unit - Families are fundamental to society. the family and with others. 2. Health Management - Families identify and Internal Harmony: Addressing emotional address health issues. needs and communication. 3. Interconnected Health - Health problems affect External Relations: Connecting with other multiple family members. groups and structures. 4. Decision-Making - Families make key health- 6. Morale and Motivation: Keeping family members related choices. engaged in tasks. 5. Community Involvement - Families play a crucial 7. Membership Management: Organizing the entry role in community health efforts. and exit of family members. 6. Environmental Impact - Families shape their health environment. 7. Social Interaction - Families engage with the wider community, affecting health initiatives. OCT 21, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C B. FAMILY-CENTERED NURSING APPROACH Based on Place of Residence: Patrilocal: Residing near the groom's parents. Four Approaches in Family Health Nursing: Matrilocal: Near the bride's parents. 1. Family as Context: Focuses on an individual’s Bilocal: Option to live with either set of parents. health within their family environment. Neolocal: Independent residence. 2. Family as Client: The family is the main focus, Avunculocal: Near the groom's maternal uncle. with individual members seen as part of the whole. 3. Family as a System: Views the family as an interconnected unit, emphasizing interactions among members. Nursing interventions target both individuals and the family together. 4. Family as a Component of Society: Recognizes the family as one of many institutions in society, integral to the social structure. Family Structure Refers to the characteristics (age, sex, number) of family members. 1. Nuclear Family: Consists of a husband, wife, and their children living together. In the Philippines, it's known as "mag-anak." Can also refer to polygamous families among some groups. 2. Extended Family: Combines multiple nuclear Family Health Tasks Perspective families, including grandparents, parents, and 1. Recognize Health Status: Identify wellness or children, living together. health issues. 3. Single-Parent Family: One parent raising one or 2. Make Health Decisions: Choose appropriate more children. This type of family often faces actions to maintain wellness or manage health economic and social challenges. problems. 4. Childless Family: A couple without children, 3. Provide Nursing Care: Care for sick, disabled, or which may not fit traditional societal views. at-risk family members. 5. Step Family: Formed when two families merge 4. Maintain a Healthy Home: Create an after a divorce, involving a new couple and their environment that supports health and personal children from previous relationships. growth. 6. Grandparent Family: Grandparents raising their 5. Utilize Community Resources: Access healthcare grandchildren, often due to parents being absent services and support in the community. or unable to care for them. Classification of Family Structure Based on Internal Organization: Nuclear Family: Primary family unit. Extended Family: Includes additional relatives through various relationships. OCT 21, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C Characteristics of a Healthy Family 1. Good Communication: Family members listen and share openly. 2. Supportive Environment: Members affirm and support each other. 3. Respect: Teaching respect for others is prioritized. 4. Trust: A sense of trust exists among members. 5. Playfulness: Families enjoy activities together and share humor. 6. Balanced Interactions: All members engage with each other equally. 7. Shared Leisure: Families spend quality time together. 8. Shared Responsibility: Members share household duties. 9. Traditions and Rituals: Families maintain customs and traditions. 10. Shared Beliefs: Common religious or spiritual values are present. 11. Privacy: Individual privacy is respected. 12. Seeking Help: Families are open to seeking support for problems. Classification of Family Structure Based on Descent: Patrilineal: Kinship traced through the father. Matrilineal: Kinship traced through the mother. Bilateral: Kinship traced through both parents. Based on Authority: Patriarchal: Authority held by the oldest male, often the father. Matriarchal: Authority held by the mother or her relatives. Matricentric: Authority shifts to the mother when the father is absent. Family Functions 1. Affective: Supports emotional stability and psychological needs. 2. Socialization: Teaches members to adapt to family and community life. 3. Reproduction: Ensures family continuity through procreation. 4. Economic: Manages financial resources to meet family needs. 5. Health Care: Provides basic needs like food, clothing, and shelter. OCT 21, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C LABORATORY Benedict’s Test ALTERNATIVE NAMES: Urine Glucose Test Glycosuria Test Glucusuria Test PURPOSE Screening to detect diabetes. Gauges the amount of sugar present in the urine. To monitor the effectiveness of medication and other methods used to treat patients from illnesses arising from the detection of glucose in CAUSES OF GLUCOSE IN URINE the urine. To confirm diagnosis of diabetes. (gestational DIABETES MELLITUS - In unmanaged diabetes, diabetes in pregnant women) high blood sugar makes it hard for the kidneys to reabsorb glucose, causing it to leak into the ABNORMAL CONSTITUENTS OF URINE urine. HYPERTHYRODISM - too much thyroid hormone In patients with certain renal or non-renal can reduce glucose absorption, leading to (metabolic) disorders, the urine may contain some glucose being expelled in the urine. abnormal constituents like: HIGH SUGAR DIET - excessive sugar can raise Glucose (Glycosuria) blood glucose level that kidneys can’t properly Proteins (Proteinuria) reabsorb, which causes some glucose to be Bile pigments passed into the urine. Ketone bodies (Ketonuria) BENIGN GLYCOSURIA - A rare inherited Blood (Hematuria), Hemoglobin condition where the kidneys allow sugar to leak (Hemoglobinuria) into the urine, typically with no other symptoms. LIVER CIRRHOSIS - affects how the body SYMPTOMS OF SUGAR IN URINE processes carbohydrates, causing high blood sugar that can lead to glucose in the urine. 1. Fatigue EMOTION - emotions can trigger adrenaline 2. Increased hunger release, which breaks down sugar for energy 3. Persistent infections during stress. This can lead to a temporary rise in 4. Excessive thirst blood sugar and more glucose in the urine. 5. Frequent desire to urinate 6. The feet or hands may experience tingling sensations or other abnormal feelings 7. Irritability. 8. Loss of weight without any known reason. 9. The wounds, cuts may be very slow to heal sometimes. SEPT 22, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C CHARACTERISTICS OF NORMAL URINE COMPLICATIONS OF SUGAR IN URINE VOLUME : 700 - 2500 ML excreted in 24hrs APPEARANCE : clear/transparent CARDIOVASCULAR COMPLICATIONS LIKE: ODOR : pungent ammonia smell - Heart attack COLOR : straw in color - Hypertension REACTION : acidity Issues with vision, kidney function damage, nerve SEDIMENT : absent damage, as well as sores on the hands and feet SPECIFIC GRAVITY : 1.010 to 1.025 may also occur. CONSTITUENT OF URINE : 96% water, 2% urea, 5 CC BENEDICT’S SOLUTION 2% uric acid. + 3-5 DROPS URINE NORMAL LEVEL OF GLUCOSE IN URINE : 0 - 0.8 mmol/l or 0 - 15 mg/dl. RESULTS PRECAUTION OF URINE FOR SUGAR TEST FOR MALE Retracts the foreskin, if present and clean the head of his penis with medicated towels or swabs, FOR FEMALE Spread open the genital folds of skin with one hand. Then, she can use other hand to clean the urethra with medicated towels or swabs. NOTED: BAD GIRLS YELL ON BOYS PREPARATION OF THE PATIENT FOR GLUCOSE URINE TEST 1. Wash hands 2. Clean genital area with cleansing pad. Start to urinate into the toilet. 3. Move the collection container under your urine stream. 4. Collect urine into the container. 5. Finish urinating into the toilet. 6. Return sample container as instructed by your health care provider. 7. Certain medication can change the results of this test. Ex. of medication: tetracycline, sulfonamide, butaphen. 8. Before procedure, provide information of what SUMMARY medication patient is taking. Do not stop intaking prescription without talking to health Glucose in urine usually means diabetes or a provider. condition that affects glucose storage or use. This results in high blood sugar, which the kidneys can't fully absorb, causing glucose to appear in urine. SEPT 22, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C Acetic Acid Test CLINICAL SIGNIFICANCE 3 TYPES OF PROTEINURIA DEFINITION : a test detects albumin in urine. The urine is heated until it becomes cloudy, and then 1. ACCIDENTAL PROTEINURIA acetic acid is added. If the cloudiness increases, the Accidental proteinuria can occur due to urine test is positive for albumin. contamination from vaginal or seminal discharge after prostatic massage or from issues in the Urine typically contains only a small amount of genital tract or bladder. protein, mainly albumin, which is filtered from the 2. FUNCTIONAL PROTEINURIA blood. Other proteins, like globulin, mucus, Non-pathological proteinuria, or physiological hemoglobin, and Bence Jones protein, can also be albuminuria, occurs due to factors like strenuous present but are usually reabsorbed by the kidneys. exercise, fever, cold exposure, congestive heart failure, hypertension, atherosclerosis, pregnancy, Normal range of urine protein is less than 150mg / dehydration, or standing for long periods. 24 hr sample (varying from 2 to 10mg/dL). 3. RENAL PROTEINURIA Conditions that increase the permeability of the DETERMINATION OF PROTEIN IN URINE urinary tract include glomerulonephritis, METHODS diabetes nephritis related to SLE, pyelonephritis, QUALITATIVE TEST cystitis, malignancies, heavy metal poisoning, If urine is alkaline make it slightly acidic by eclampsia, amyloidosis, sarcoidosis, sickle cell adding 3% glacial acetic acid. disease, renal transplant rejection, and multiple Turbid urine should be filtered or centrifuged myeloma. and supernatant should be used INTERPRETING THE HEAT COAGULATION Heat and acetic acid test Sulphosalicyclic acid test Purdy's modification QUANTITATIVE TEST FOR ALBUMIN Qualitative test and semi quantitative test have limitation that they can't detect the exact amount of protein excretion. So quantitative test is done on 24 hr urine. CLINICAL SIGNIFICANCE Proteinuria can occur mainly due to: 1. Glomerular damage 2. Defect in reabsorption of process of tubules WHY DO WE HEAT THE UPPER PORTION Urine in lower part act as control and is used to compare the haziness developed in the upper part with rest of urine. SEPT 22, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C MMDST SCORING THE TEST SCREENING - the process of identifying undetected P - Passed diseases or defects using quick tests or exams. F - Failed SCREENING TEST - help distinguish between R - Refused healthy individuals and those who may have a No - No opportunity problem, allowing those with concerning results to If a child fails to complete an item that is well within receive further diagnosis and treatment as soon as their age range (to the left of their age on the scoring possible. chart), it is considered a developmental delay. The Metro Manila Developmental Screening Test ASPECTS OF DEVELOPMENT (MMDST) is an easy-to-use tool for health professionals to identify serious developmental PERSONAL - SOCIAL: Measures how well the child delays in children. It was developed by Dr. William interacts with others and takes care of themselves. K. Frankenburg and modified by Dr. Phoebe D. FINE-MOTOR ADAPTIVE: Assesses hand-eye Williams from the Denver Developmental Screening coordination, like picking up objects and drawing. Test (DDST). Importantly, it is not an intelligence test. LANGUAGE: Evaluates listening skills, following directions, and speaking. The MMDST kit includes: GROSS-MOTOR: Looks at abilities like sitting, Manual walking, and jumping. Sample test forms Test materials TEST FORM MMDST bag Contains 105 items designed for children from The test materials consist of: birth to six years old. Bright red yarn pom-pom Features age scales at the top and bottom of the Rattle with a narrow handle form. Eight 1-inch colored wooden blocks (red, yellow, Ages are marked in months (1-24) and in years blue, green) (2½ to 6). Small clear glass bottle with a 5/8 inch opening Each item is represented by a bar on the age Small bell with a 2 ½ inch diameter mouth scale. Rubber ball (12 ½ inches in circumference) The bar indicates when 25%, 50% (hatch mark), Cheese curls 75%, and 90% of typical children can successfully Pencil complete the item. These items are used to assess various developmental milestones in children. IMPORTANT CONSIDERATIONS Child's Age: Knowing the child's age is essential before starting the test. Test Items: The items used in the test depend on the child's age. Some items have a small footnote number on Age as a Guide: The child's age helps select the the left side of the bar. This footnote gives appropriate test items and interpret the results instructions for how to administer that item, accurately. which are detailed on the test form. SEPT 29, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C Continuation... To calculate the "Child's Exact Age": Some items have a small footnote number on Subtract the Birth Date from Today's Date: the left side of the bar. This footnote gives 1. If today's date is earlier than the birth date in instructions for how to administer that item, days, add 30 days to today's date and subtract 1 which are detailed on the test form. month from the month. 2. If you also need to borrow months (e.g., if the month becomes negative), add 12 to the month and subtract 1 from the year. Steps: Some items can be marked as passed based on 1. Calculate days: If you borrowed days, adjust the the parent's report (marked with an "R"). days accordingly. Only items with an "R" can be accepted this way, 2. Calculate months: If you borrowed months, but the tester should observe the child's abilities adjust the months accordingly. when possible. 3. Calculate years: Subtract 1 from the year if you The item "equal movements" has an asterisk (*) borrowed months. at the end of its bar. This process will give you the exact age of the child This means that 100% of typical children pass in years, months, and days. this item at birth, and it is the only item with an asterisk in the fine-motor adaptive section. Nine items have arrows (→) at the right end of their bars. This includes items like "defines words" and "composition of ____." The arrows indicate that typical children may pass these items even after 6 years and 1½ years old. IMPORTANT DATE AND BEHAVIORAL OBSERVATIONS CHILD’S FEELINGS: Note how the child feels DRAWING THE AGE LINE during the test. RELATIONSHIP WITH TESTER: Observe the Accurate Placement: The location of the age line child's interactions with the tester. must be precise, as the interpretation depends ATTENTION SPAN: Assess how long the child can on it. focus on the tasks. Spacing Guidelines: VERBAL BEHAVIOR: Take note of the child's 2 weeks apart for ages up to 14 months. speech and communication. 1 month apart from 14 to 24 months. SELF-CONFIDENCE: Observe the child's From 24 months to 5 years, spaces represent 3 confidence in completing the tasks. months each. After 5 years, spaces represent 6 months each. CALCULATING CHILD’S AGE Ensure that each segment reflects these intervals DATE OF TEST YR MONTH DAY accurately for proper assessment. DATE OF BIRTH YR MONTH DAY Adjusting for prematurity (if born more than 2 weeks before expected delivery date, and less than 24 months of age) SEPT 29, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C ADJUSTING FOR PREMATURITY SELECTING ITEMS TO BE ADMINISTERED Impact of Prematurity: Premature birth can 1. Preliminary Phase: affect a child's ability to perform tasks that Establish rapport with the child. typical children can do at the same age. Make the child comfortable (e.g., have an Adjustment Guidelines: infant on the mother's lap). Adjust developmental expectations for children Ensure that all materials are easily accessible. 2 years old or younger. 2. Testing Order: After 2 years, no adjustments are needed Personal-Social Sector: Start here to help the (Frankenburg, et al.). child adjust to the tester and allow parents to Postterm: No adjustments are made for children provide insights that can be scored. born postterm. Fine-Motor Adaptive Sector: Follow this section, where the child can perform tasks without needing to talk to the tester, helping them warm up. Language Sector: At this stage, the child is likely more comfortable with the tester and will be more willing to talk and engage. Gross-Motor Sector: Conduct this last, as many children may be shy at the beginning of the test. SCORING DELAYS IN DEVELOPMENT A test item is considered a delay if it is failed and falls completely to the left of the age line. SELECTING ITEMS TO BE ADMINISTERED This means the child did not pass an item that Administer all items that cross the age line. 90% of children typically pass at a younger age. The child should have a minimum of three Delays are important for interpreting the overall passes to the left of any failure. MMDST results. Each developmental sector should have at least On the test form, delays are highlighted by three passes and three failures to ensure a shading the right end of the bar for the delayed comprehensive assessment. item. WHICH MAY NOT BE CHANGED The manner in which each test is administered must remain consistent. The wording and directions provided during the test cannot be altered. SEPT 29, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C INTERPRETING THE TEST RESULTS DISCUSSING THE TEST RESULT The MMDST result can be classified as NORMAL, At the end of the test, ask the parent if the child's QUESTIONABLE, ABNORMAL, or UNTESTABLE performance seems typical for their abilities. based on the number of delays. This is important because factors like shyness, Key Point: A delay is defined as any failure that illness, tiredness, or upset feelings can affect completely falls to the left of the age line. performance. Steps for Interpretation: If there are multiple delays, remind the parent 1. Mark Delays: Heavily shade the right end of the that this is just a screening test and suggest bar for each delay. retesting in about two weeks. 2. Count Sectors: Count the number of sectors RETESTING with 2 or more delays. 3. Count Scores: Count the number of scores To retest, use a different color pencil to draw the with 1 delay and no passes intersecting the age age line on the same form. line in the same sector. Write the date at the top of the new age line. 4. Interpret Results: Use the criteria to If the child is still marked as abnormal, determine the final interpretation based on the questionable, or untestable, refer them to a counts from Steps 2 and 3. pediatrician for further evaluation. Nurses can help parents learn skills for developmental stimulation. Continuous monitoring and periodic retesting are important. Indicating the Test Result. At the bottom of the age line, write the test result and interpretation. Example: Result: Abnormal Reasons: 2 sectors have 2 delays. SEPT 29, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C VACCINATION IMMUNITY - Protection against an infectious disease. If you’re immune, you can be exposed to the disease without getting sick. VACCINE - A product that helps your immune system build protection against a specific disease. Vaccines are usually given as injections, but can also be taken by mouth or as a nasal spray. TYPES OF IMMUNIZATION VACCINATION - The process of giving a vaccine to create immunity against a specific disease. ACTIVE IMMUNIZATION - This involves giving a vaccine that helps the body produce its own antibodies, providing long-lasting protection against Republic Act No. 10152 "Mandatory Infants and diseases. Children Health Immunization Act" of 2011 signed PASSIVE IMMUNIZATION - This offers temporary by President Aquino III in July 26, 2010. The immunity by providing ready-made antibodies from mandatory includes basic immunization for children humans or animals. It gives quick protection but under 5 including other types of diseases doesn’t last long. determined by the DOH EXPANDED PROGRAM ON IMMUNIZATION (EPI) Immunization is the process of making a person immune or resistant to an infectious disease, usually through the administration of a vaccine. Vaccines work by stimulating the body's immune system, prompting it to recognize and fight off specific pathogens. This helps protect individuals from future infections or diseases. The Expanded Program on Immunization (EPI) aims to ensure that all individuals, particularly children, receive essential vaccines to prevent common infectious diseases, thereby improving overall public health. SIX VACCINE-PREVENTABLE DISEASES Tuberculosis Poliomyelitis Diphtheria Tetanus Pertussis Measles SEPT 30, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C COLD CHAIN The cold chain is a temperature-controlled supply system that keeps vaccines and other perishable products effective. It includes: 1. Storage: Vaccines are kept in refrigerators or freezers at specific temperatures. 2. Transportation: Vaccines are moved in insulated containers with temperature monitoring to ensure they stay cool. 3. Handling: Correct procedures are followed during loading, unloading, and administration to maintain the cold chain. Keeping the cold chain intact is essential for ensuring vaccines remain safe and effective. Temperature Ranges Refrigerated Vaccines: Typically stored between 2°C and 8°C (36°F to 46°F). Frozen Vaccines: Usually maintained at -15°C (5°F) or colder. POSITIONING INFANT AND CHILDREN FOR VACCINATION Cuddle Position Bed Position Upright Position Straddle Position Independent Position SEPT 30, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C EQUIPMENT USED IN THE COLD CHAIN Refrigerators: Designed specifically for storing vaccines, with precise temperature control (typically 2°C to 8°C). Freezers: For storing vaccines that require freezing, maintained at -15°C (5°F) or colder. Insulated Transport Containers: Styrofoam boxes or coolers with gel packs to keep vaccines cold during transport. Ice Packs and Gel Packs: Used in transport containers to maintain low temperatures during shipping. All Vaccines can be stored at +2°C to +8°C (presence Carts and Trolleys: For easy movement of of solid ice) during SUPPLEMENTAL IMMUNIZATION vaccines between storage areas and ACTIVITIES administration sites. Backup Power Supplies: Generators or battery backups to ensure continuous refrigeration during power outages. Cold Boxes and Vaccine Carriers: Cold boxes are insulated containers that keep vaccines cold during transport and short-term storage, using ice packs to ensure they remain effective and safe. Foam pad: The foam pad can be used as a temporary lid to keep unopened vaccines inside the carrier cool, while providing a surface to hold and protect opened vaccine vials and keep them cool. CAUSES OF VACCINE LOSS OF POTENCY STORAGE Sensitivity to Heat Sensitivity to Cold NEVER keep any vials that are expired, frozen or MOST SENSITIVE MOST SENSITIVE with VVMs beyond the end point in the cold OPV Measles Hepatitis B chain, as they may be confused with those DTP, yellow fever Hib (liquid) containing potent vaccines. Keep them in the BCG DTP red bag for disinfection and disposal. Hib, DT DT IDENTIFY A DRY SPACE FOR STORING Td, TT, Hepatitis B Td EXPIRED/UNUSABLE VACCINES BEFORE FINAL LEAST SENSITIVE TT DISPOSAL LEAST SENSITIVE OCT 14, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C VACCINE VIAL MONITORS (VVM) LIVE ATTENUATED VACCINES How does a VVM work? They are are made from weakened viruses or The inner square of the VVM starts as a light color bacteria. They can grow in the vaccinated person and darkens when heated. It is initially lighter than but usually cause no or only mild illness. the outer circle. BACTERIA VIRUS Tuberculosis (BCG) Oral polio vaccine (OPV) Measles Rotavirus Yellow fever Immune Response Live microorganisms provide ongoing stimulation to the immune system, leading to strong memory cell production. They can replicate in the body, resulting in an excellent immune response. Safety and Stability Weakened pathogens can sometimes revert to their original form and cause disease. They may be dangerous for people with weakened immune systems (like those with HIV). There’s a risk of persistent infections (e.g., BCG can cause swollen lymph nodes). Contamination can happen during lab processes. Immunization errors can occur (like improper handling or storage). Generally not recommended for pregnant individuals. They are considered less safe than inactivated vaccines. STORAGE MONOVALENT VACCINES contain one strain of one INACTIVATED WHOLE-CELL VACCINES antigen (like the measles vaccine). Inactivated vaccines are made from microorganisms POLYVALENT VACCINES have multiple strains of the (viruses, bacteria, etc.) that have been killed using same antigen. physical or chemical methods. Since the organisms are dead, they cannot cause disease. COMBINATION VACCINES BACTERIA VIRUS Some vaccines combine different antigens into one Whole-cell pertussis (wP) Inactivated polio vaccine shot to protect against various diseases or strains (IPV) (like DPT for diphtheria, pertussis, and tetanus, or MMR). This reduces the number of shots kids need and helps ease their fear of needles. OCT 14, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C INACTIVATED WHOLE-CELL VACCINES CATEGORIES OF SUBUNIT VACCINES 1. Protein-based Subunit Vaccines Inactivated vaccines are made from microorganisms These vaccines present specific proteins from (viruses, bacteria, etc.) that have been killed using pathogens to the immune system without using physical or chemical methods. Since the organisms viral particles. are dead, they cannot cause disease. Examples: BACTERIA VIRUS Bacteria: Acellular pertussis (P) Whole-cell pertussis (wP) Inactivated polio vaccine Virus: Hepatitis B (HepB) (IPV) Commonly Used: Immune Response Acellular Pertussis (aP) Vaccines: Contain The first dose may not always trigger an immune inactivated pertussis toxin and may include response. other bacterial parts. The immune response may not last long, often Hepatitis B Vaccines: Made from the surface requiring multiple doses. protein of the Hepatitis B virus. The immune response is generally weaker 2. Polysaccharide Vaccines compared to live vaccines. These vaccines target bacteria with a sugar capsule Safety and Stability that helps them evade the immune system, Since there are no live components, there is no especially in infants and young children. risk of causing the disease. Examples: These vaccines are safer and more stable than Meningococcal Vaccine: Protects against live attenuated vaccines. Neisseria meningitidis. They have an excellent stability profile. Pneumococcal Vaccine: Protects against pneumococcal disease. SUBUNIT VACCINES 3. Conjugate Subunit Vaccines It does not contain live components of the These vaccines target molecules in a pathogen's pathogen, similar to inactivated whole-cell vaccines. capsule. They link the polysaccharide to a carrier However, they only include specific parts of the protein, leading to a stronger and longer-lasting pathogen that are necessary to trigger a protective immune response, even in infants. immune response. Protein Carriers Used: Immune Response Diphtheria toxoid The first dose may not always trigger an immune Tetanus toxoid response. Examples: The immune response may not last long, often Haemophilus influenzae type b (Hib) requiring multiple doses. Pneumococcal Vaccines (PCV-7, PCV-10, PCV-13) The immune response is generally weaker compared to live vaccines. Safety and Stability Since there are no live components, there is no risk of causing the disease. These vaccines are safer and more stable than live attenuated vaccines. They have an excellent stability profile. OCT 14, 2024  CHN 104 TRANSES (PRELIMS) AVILA, JURISPRUDENCE M. | BSN 2 - C Toxoid Vaccines These are made from toxins produced by bacteria, such as those causing tetanus and diphtheria. These toxins can lead to disease symptoms. Toxoid vaccines are safe because they cannot cause the disease and cannot revert to a harmful form. Examples: Tetanus Toxoid (TT) Diphtheria Toxoid Immune Response Toxoid vaccines often need multiple doses and an adjuvant to boost the immune response. They are not very strong at triggering immunity. Safety and Stability They cannot cause the disease they prevent. Serious reactions are very rare. They are usually stable, long-lasting, and have a great stability profile. GENERAL PRINCIPLES FOR SCREENING CHILDREN FOR VACCINATION 1. All EPI vaccines can be safely given on the same day at different sites. 2. The measles vaccine should be given as soon as the child is 9 months old, even if other vaccines are also given that day. 3. Do not restart the vaccination schedule, even if there are long gaps between doses. 4. Conditions like moderate fever, mild infections, and diarrhea are not reasons to skip vaccination. Only skip if the child needs hospitalization, and the hospital will decide on vaccination timing. 5. Vaccination should be avoided in these cases: DPT2 or DPT3 if the child had convulsions or