Community Health Nursing Day 1 PDF

COMMUNITY HEALTH NUR S I NG D AY 1 PNLE 2023 REVIEW Harold James Doroteo, RN MPH Presentation Outline Introduction DOH Programs WASH MCH + First 1000 Days (Nutrition, BeMONC, CeMONC) National Immunization Program (EPI) CHECK-IN QUESTIONS  WHO...

COMMUNITY HEALTH NUR S I NG D AY 1 PNLE 2023 REVIEW Harold James Doroteo, RN MPH Presentation Outline Introduction DOH Programs WASH MCH + First 1000 Days (Nutrition, BeMONC, CeMONC) National Immunization Program (EPI) CHECK-IN QUESTIONS  WHO Combination of nursing skills, sociology and public health FREEMAN A service rendered by a professional nurse with communities, groups, families, and individuals in different settings. CH JACOBSON Achievement of optimum level of functioning through teaching and N HANLON delivery of care Attainment of highest level of physical, DEFINITION mental, and social well-being at a given S place and time BAILON REYES Field of nursing practice where services are delivered outside of purely curative institution MAGLAYA Utilization of nursing process to benefit the individual, family and community. CHN according to Nurses Associations ANA – Organization that overlook into nursing profession in USA. PNA – September 2, 1922, FNA - Anastacia Giron Tupas - 150 nurses Purpose: Promote professional growth towards the attainment of highest standards in nursing ocus rea lients ime cope FOCUS Health Promotion and Disease Prevention Primary Goal: Self-reliance in health Ultimate Goal: Raise the level of health of the population Philosophy: Uphold the worth and dignity of man AREA Public Health Nursing School Health Nursing Occupational Health Nursing Mental Health Nursing Four Facets as PH burden Defined – person with mental disorder Undefined – other person Hidden – stigma and violations of human rights Future – future burden related to social problems  PUBLIC HEALTH NURSING Public Health Nursing – science and art: To promote health To prevent diseases To prolong life Settings Home Health Care Facility Scope Health Promotion and equitable health gain Health Protection Health Public Policy Disease control Injury Prevention SCHOOL HEALTH NURSING DEPARTMENT OF HEALTH HEALTH NUTRITION CENTER MEDICAL DENTAL NURSING HEALTH EDUCATION  SCHOOL HEALTH NURSING Primary Role: To support student learning and ensure that educational potential is not hampered by unmet health needs General Objective: To promote and maintain the health of the school populace by providing comprehensive and quality nursing care  OCCUPATIONAL HEALTH NURSING Primary focus “To assure so far as possible every working man and woman in the country is safe and in health working conditions.” Health promotion and prevention principles Management and administration Worker or workplace health hazard Legal and ethical monitoring assessment and surveillance. Research Injury and illness investigation, analysis Community orientation and prevention. Primary care Case management Counseling OCCUPATIONAL HEALTH NURSING Salient Issue: Categories of workplace hazards affecting worker health and safety CLIENT Classification 1. Multi-crisis Family 2. Migrating Family 3. Very Poor Family 4. Young Family 5. Inadequately Functioning Family 6. With a member suffering from genetic handicap  Stages of Family Development by DUVALL The Beginning Family Physical Maintenance The Early Childbearing Allocation of Resources Family The Family with Preschool Division of Labor Children The Family with School Socialization of Members Children The family with Teenagers Reproduction, Recruitment and Release of Family members The Family as Launching Maintenance of Order Center The Middle Aged Family Placement of Members in Larger Community The Aging Family Maintenance of Motivation of Morale  AREAS OF RESPONSIBILITY 1. Physical Independence 2. Therapeutic competence 3. Knowledge of Health Condition 4. Principles of General Hygiene 5. Health Attitude 6. Emotional Competence 7. Family Relationship 8. Environmental conditions 9. Use of Community resources TIME SCOPE General and comprehensive Nursing Concepts  E Education M Made available for all P People’s Initiative O Organizing W Workers PRINCIPLES OF E Existing resources CHN R Reporting and Recording M Monitoring E Existing Organization N Needs must be recognized T Training ELEMENTS OF CHN SOCIAL DETERMINANTS OF HEALTH (SDH) TYPES OF COMMUNITY Rural Urban Rurban Sub-Urban Metropolitan  PRE-TEST 1) Which of the following is a primary responsibility of a community health nurse in the Philippines? a) Providing direct patient care in a hospital setting b) Administering medications to individuals in the community c) Conducting health education programs for the community d) Assisting doctors in surgical procedures  PRE-TEST 2) What is the main goal of community health nursing in the Philippines? a) Treating acute illnesses in the community b) Promoting health and preventing diseases in the community c) Conducting research on community health issues d) Assisting individuals with chronic diseases in their homes  PRE-TEST 3) The nursing process in community health nursing consists of several steps. Which step involves identifying the health needs of the community? a) Assessment b) Diagnosis c) Planning d) Evaluation  PRE-TEST 4) When developing a community health nursing care plan, which of the following should be the nurse's priority? a) Addressing individual needs of community members b) Implementing evidence-based interventions c) Collaborating with other healthcare professionals d) Encouraging community participation  PRE-TEST 5) In the context of community health nursing, what is the primary purpose of conducting a community diagnosis? a) To identify the social determinants of health in the community b) To determine the prevalence of diseases in the community c) To assess the individual health status of community members d) To identify the health problems and needs of the community  PRE-TEST 6) Which of the following best describes the role of a community health nurse in disaster management? a) Providing immediate medical care to disaster victims b) Coordinating with other agencies to provide relief supplies c) Conducting post-disaster assessments and providing healthcare services d) Educating the community on disaster preparedness  PRE-TEST 7) What is the primary purpose of conducting a community health nursing evaluation? a) To assess the effectiveness of nursing interventions b) To determine the budget allocation for community health programs c) To identify potential health risks in the community d) To establish partnerships with community leaders  PRE-TEST 8) Which of the following is an example of a community- based healthcare delivery system in the Philippines? a) Barangay Health Station b) Private hospital c) Regional referral center d) Medical mission  PRE-TEST 9) Which of the following is a priority when implementing health education programs in a Philippine community? a) Using complex medical terminology to convey information accurately b) Relying solely on print materials for information dissemination c) Considering the cultural beliefs and practices of the community d) Conducting educational sessions during peak working hours  PRE-TEST 10) What is the primary purpose of establishing partnerships in community health nursing in the Philippines? a) To secure funding for community health programs b) To delegate nursing tasks to other healthcare professionals c) To provide job opportunities for nurses in the community d) To enhance collaboration and maximize resources for better health outcomes  DEPARTMENT OF HEALTH PROGRAMS 7 Healthy Habits para sa Contraception and Child Health Infection Prevention Healthy Pilipinas Family Planning Move more, Eat Right Dengue Be Clean, Live Emerging and Re-emerging Sustainability Infectious Diseases Care for small babies Get Vaccinated Filariasis Rare Disease Food and Waterborne Don’t Smoke, Avoid Newborn Screening Family Planning diseases Alcohol, Say No to HIV/STI Newborn Hearing Reproductive Health Malaria Drugs Screening Safe motherhood Leprosy Care for yourself, Immunization Program Schistosomiasis Care for Others Soil-Transmitted Nutrition Practice Safe Sex Helminthiasis Do no Harm, Put Rabies Tuberculosis Safety First The DOH envisions a Healthy Pilipinas where healthy behaviors are the easier choice for everyone, every time, everywhere!  Follow the Pinggang Pinoy Exercise daily for at least 30 minutes Read your food labels Bike, walk, or jog to your commute Avoid trans-fats, sugar-sweetened beverages, and excessive salt  Regularly wash your hands with soap and water for at least 20 seconds Practice the 3 R's: Reduce, Reuse and Recycle Always be prepared with your Emergency Go Bags Make sure you are using clean, potable water when drinking or preparing meals Avoid using single-use plastics, choose reusable containers  Seek what vaccines are available to you Ask your Primary Care Providers about the safety and efficacy of vaccines Complete the 5 visits to the health center before the first birthday of the child Encourage Senior Citizens to take vaccines that are appropriate at their life stage Educate adolescent females and mothers on the age appropriate vaccines for girls  Consult your doctor about tobacco cessation Get information from reputable sources on the risk of Electronic Nicotine Delivery Devices Say no to illicit drugs Seek out and enroll in rehabilitation programs Control your urges for emotional or binge alcohol consumption Know when and who to consult for substance addiction  Give yourself time to rest and relax and take a break to relieve stress and anxiety Give time to do hobbies and activities that makes you happy Build a good support group around you Be a good source of support for others Track your mood and triggers, and know when you need to seek help of a Mental Health Professional Know when and who to consult for your Mental Health  If you are sexually active, undergo voluntary testing for HIV and STIs Know the different modern contraceptive methods, and use the ones that suit you best Make healthy decisions for a safe motherhood Practice safe sexual behaviors Demonstrate sex positivity Promote Equality for Women and LGBTQ+  Say no to fireworks and firecrackers during the holidays! Use alternative noisemakers for celebrations or attend community fireworks displays Don't practice risky behaviors when swimming to avoid drowning Practice road safety by wearing seatbelts, helmets and other safety measures on the road Don't drive under the influence of alcohol or drugs Report incidences of violence, especially to women and minority groups CHILD HEALTH SDG 3 aims to ensure healthy lives and promote well-being for all, at all ages. Care for Small Babies Health and well-being are important at every stage of one’s life, starting from the beginning. It aims to prevent needless suffering from preventable diseases and premature death by focusing on key targets that boost the health of a country’s overall population. Rare diseases are a group of disorders affecting over 300 million people, most of Rare Disease whom are children. In the Philippines, rare disease is defined according to the disease prevalence of 1 in 20,000 Filipinos, with an estimated 6,500 Filipinos. From 1999-2016, the National Institutes of Health - Institute of Human Genetics accounted for 567 patients with inherited metabolic disease which include maple syrup urine diseases, galactosemia, hyperphenylalaninemia, mucopolysaccharidosis, and x-linked adrenoleukodystrophy. Newborn Screening Act of 2004 ensures that every baby born in the Philippines is Newborn Screening offered the opportunity to undergo newborn screening and thus be spared from heritable conditions that can lead to mental retardation and death if undetected and untreated. Newborn screening shall be performed after twenty-four (24) hours of life but not later than three (3) days from complete delivery of the newborn. A newborn that must be placed in intensive care in order to ensure survival may be exempted from the 3-day requirement but must be tested by seven (7) day of age. CHILD HEALTH RA No. 9709 or the "Universal Newborn Hearing Screening and Intervention Act of Newborn Hearing Screening 2009" is hereby established to institutionalize measures for the prevention and early diagnosis of congenital hearing loss among newborns, the provision of referral, follow-up, recall and early intervention services to infants with hearing loss, and counseling and other support services for families of newborns with hearing loss, to afford them all the opportunities to be productive members of the community.  CONTRACEPTION AND FAMILY PLANNING FAMILY PLANNING AND In line with the Department of Health FOURmula One Plus strategy and Universal REPRODUCTIVE HEALTH Health Care framework, the National Family Planning Program is committed to provide responsive policy direction and ensure access of Filipinos to medically safe, legal, non-abortifacient, effective, and culturally acceptable modern family planning (FP) methods. Objectives: 1. To increase modern Contraceptive Prevalence Rate (mCPR) among all women from 25% in 2017 to 30% 2. To reduce the unmet need for modern family planning from 10.8% in 2017 to 8% by 2022 NATIOANAL SAFE This program aims to provide Filipino women access to quality healthcare for a MOTHERHOOD safer pregnancy and delivery. It aims to promote the health and well-being of mothers of a Filipino family. UNIVERSAL HEALTH CARE ACT (RA 11223) An Act Instituting Universal Health Care for All Filipinos, Prescribing Reforms in the Health Care System, and Appropriating Funds Therefore. National Health Human Resource Master Plan National Health Workforce Support System Scholarship and Training Program Return Service Agreement UNIVERSAL HEALTH CARE Population Coverage Service Coverage Automatic inclusion of every Immediate eligibility and Filipino citizen into the access to population- and National Health Insurance individual based health Program services Financing Coverage Population-based Individual-based Health Services: Health Services: funded by National primarily through pre- Government through payment mechanisms DOH (SHI, PHI, HMO) free at point of service FINANCING National Health Insurance Program  Immediate eligibility  No co-payment in basic or ward Entitlement to accommodation—provision of Benefits regular meals, bed in shared room, fan ventilation, and shared toilet and bath (Sec. 4 (c)) FINANCING National Health Insurance Program Co-payment/-insurance for amenities in public hospitals regulated by DOH/PhilHealth Amenities refers to features of the health Entitlement to service that provide comfort or convenience, Benefits such as private accommodation, air conditioning, telephone, television, and choice of meals, among others (Sec. 4 (b)) NATIONAL HEALTH INSURANCE PROGRAM No reduction in current PhilHealth package Entitlement to Additional benefits for direct Benefits contributors SERVICE DELIVERY Individual-based Health Services PhilHealth to contract public, private or mixed health care provider networks that would agree on: ✓ Service ✓ Co-payment/ ✓ Data submission quality co-insurance SERVICE DELIVERY Individual-based Health Services Incentives for health care Apex or end-referral hospitals providers that form networks to be determined by DOH; may from DOH and PhilHealth be contracted by PhilHealth as stand-alone providers SERVICE DELIVERY Individual-based Health Services PhilHealth to shift to PhilHealth to develop PhilHealth institute strong performance-driven, closed- differential payment surveillance and audit end, prospective payments considering service quality mechanisms based on DRGs, validated costing methods and no differentiation between facility and professional fees  ORGANIZATION OF LOCAL HEALTH SYSTEMS Consolidation of Provincial/City Health Board to: Municipalities and cities fragmented providers into  oversee integration of health entitled to have a province-wide and city- services representative in the wide service delivery  manage the special health fund Provincial/City Health Board networks  exercise administrative and technical supervision over health facilities and HRH within their jurisdiction  REGULATION Safety and Affordability Equity Quality Institutionalization Health care providers to Basic accommodation: of a licensing and make price information of ≥ 90% for government hospitals; regulatory system goods and services ≥ 70% for specialty hospitals; in DOH for stand- readily accessible and alone health facilities Drug outlets to carry the ≥ 10% for private hospitals generic equivalent of all Preferential licensing of health drugs in the Primary Care facilities and contracting of health Formulary services for underserved areas GOVERNANCE AND ACCOUNTABILITY Evidence-informed Sectoral Health Information System to be Policy and Planning for UHC maintained by health service providers to require all health-related and insurers, which will be entities to submit health data to electronically uploaded on a regular PhilHealth basis through interoperable system:  enterprise resource planning  human resource information  electronic health records  electronic prescription log  Dental/Oral Health Program Empowered and responsible Filipino citizens taking care of their own personal VISION oral health for an enhanced quality of life. The state shall ensure quality, affordable, accessible and available oral health care delivery. MISSION GOAL: Attainment of improved quality of life through promotion of oral health and quality oral health care. GENERAL: Reduction on the prevalence rate of dental caries and periodontal diseases. SPECIFIC: To increase proportion of Orally Fit Children (OFC) under 6 years old to 12% OBJECTIVES by 20% by 2020 To control oral health risks among the young people To improve the oral health conditions of pregnant women by 20% and older persons by 10% every year till 2016 Operations of Environmental Sanitation PD 856 – Environmental Sanitation code of the Phil PD 825 – Garbage disposal Law RA 9003 – Ecological solid waste mngt. Act RA 8749 – Clean Air Act RA 9275 – Clean Water Act Water Sanitation Program  Purification Process ◦ Filtration ◦ Chlorination ◦ Fluorine ◦ Boiling  Unapproved ◦ Open dug wells ◦ Unimproved spring ◦ Well that needs priming  Approved ◦ Level I – Point Source; 250 m; 40-140L/min; 15-25 ◦ Level II – Communal Faucet System or Stand-Post; 25m; 40- 80L/capital/day; average of 100; faucet is shared by 4-6 households ◦ Level III – Waterworks System or Individual House Connections Excreta Disposal Sewage Sewerage Approved type Level I – Non water carriage toilet and minimal water use toilet Level II – water carriage type; sealed; septic tank; flush type Level III – water carriage; sewerage system with treatment facility Garbage Disposal Major Components Garbage Rubbish WAYS: Household Open Garbage Dumping Open Burning Burial-in-pit Composting Community Collection Sanitary Landfill Incineration Food Sanitation Policies Food establishment is subject for inspection Comply sanitary permit Comply with updated health certificates for food handlers, helpers, cooks All ambulant vendors must submit a health certificate to determine present of intestinal parasite and bacterial infection NPI-EPI I. Rationale The Expanded Program on Immunization (EPI) was established in 1976 to ensure that infants/children and mothers have access to routinely recommended infant/childhood vaccines. Six vaccine- preventable diseases were initially included in the EPI: tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles. In 1986, 21.3% “fully immunized” children less than fourteen months of age based on the EPI Comprehensive Program review.  Overall Goal: To reduce the morbidity and mortality among children against the most common vaccine- preventable diseases Specific Goals: 1. To immunize all infants/children against the most common vaccine- preventable diseases. 2. To sustain the polio-free status of the Philippines. 3. To eliminate measles infection. 4. To eliminate maternal and neonatal tetanus 5. To control diphtheria, pertussis, hepatitis b and German measles. 6. To prevent extra pulmonary tuberculosis among children.  STRATEGIES Conduct of Routine Immunization for Infants/Children/Women through the Reaching Every Barangay (REB) strategy REB strategy, an adaptation of the WHO-UNICEF Reaching Every District (RED), was introduced in 2004 aimed to improve the access to routine immunization and reduce drop-outs. There are 5 components of the strategy, namely: data analysis for action, re-establish outreach services, , strengthen links between the community and service, supportive supervision and maximizing resources. Supplemental Immunization Activity (SIA) Supplementary immunization activities are used to reach children who have not been vaccinated or have not developed sufficient immunity after previous vaccinations. It can be conducted either national or sub-national –in selected areas. Strengthening Vaccine-Preventable Diseases Surveillance This is critical for the eradication/elimination efforts, especially in identifying true cases of measles and indigenous wild polio virus. Procurement of adequate and potent vaccines and needles and syringes to all health facilities nationwide  Polio Eradication Acute Flaccid Paralysis (AFP) Measles Elimination MCV1 (monovalent measles) at 9-11 months old MCV2 (MMR) at 12-15 months old. Maternal and Neonatal Tetanus Elimination Control of other common vaccine-preventable diseases (Diphtheria, Pertussis, Hepatitis B and Meningitis/Encephalitis secondary to H. influenzae type B) Hepatitis B Control EPI Elements Target setting –determine eligible population Wednesday-immunization day Storage All vaccines are heat sensitive Most sensitive to heat – OPV,AMV; -15 to -25C in the freezer Least Sensitive – BCG, HBV, DPT, TT; +2 to +8C in the fridge body only  POST-TEST 1) Which Philippine Department of Health program focuses on providing accessible and affordable essential medicines to Filipinos? a) Expanded Program on Immunization (EPI) b) National Tuberculosis Control Program (NTP) c) Universal Health Care Program (UHC) d) Botika ng Barangay Program  POST-TEST 2) Which DOH program aims to reduce the prevalence of tuberculosis in the Philippines? a) Botika ng Barangay Program b) National Dengue Prevention and Control Program (NDPCP) c) Kilusang Kontra Polio (KKP) d) National Tuberculosis Control Program (NTP)  POST-TEST 3) Which DOH program focuses on providing vaccines to prevent childhood diseases such as measles, polio, and diphtheria? a) Kilusang Kontra Polio (KKP) b) Expanded Program on Immunization (EPI) c) National Dengue Prevention and Control Program (NDPCP) d) Oral Health Program (OHP)  POST-TEST 4) Which DOH program is aimed at preventing and controlling the spread of dengue fever in the Philippines? a) Botika ng Barangay Program b) Expanded Program on Immunization (EPI) c) Kilusang Kontra Polio (KKP) d) National Dengue Prevention and Control Program (NDPCP)  POST-TEST 5) This law aims to provide accessible and affordable health services to all Filipinos, regardless of their socioeconomic status? a) Disease Prevention and Control Bureau (DPCB) b) Universal Health Care (UHC) c) Oral Health Program (OHP) d) National Tuberculosis Control Program (NTP)  POST-TEST 6) Which DOH program is aimed at reducing maternal and infant mortality rates in the Philippines? a) Kilusang Kontra Polio (KKP) b) National Dengue Prevention and Control Program (NDPCP) c) Expanded Program on Immunization (EPI) d) Safe Motherhood Program (SMP)  POST-TEST 7) What is the primary responsibility of a nurse manager in ensuring ethical practice in public health nursing? a) Resolving conflicts among nursing staff b) Advocating for patient rights and privacy c) Implementing quality improvement initiatives d) Managing the recruitment and retention of nurses  POST-TEST 8) What is the primary focus of nursing management in public health nursing? a) Providing direct patient care in hospitals b) Administering medications to individuals in the community c) Ensuring the efficient operation of healthcare facilities d) Promoting and protecting the health of populations  POST-TEST 9) Which of the following best describes the role of a nurse manager in public health nursing? a) Conducting health assessments for individual patients b) Coordinating care for patients within a hospital setting c) Leading and supervising nursing staff in public health programs d) Developing treatment plans for patients with chronic diseases  POST-TEST 10) When developing a public health nursing program, what should be the nurse manager's primary consideration? a) The availability of healthcare resources in the community b) The personal preferences of the nursing staff c) The financial constraints of the healthcare facility d) The prevalence of diseases in the community