NCM-113-LEC-PRELIMS-COMPLETE.pdf

NCM 113 LEC PRELIMS 1st The family may be a part of a population COMMUNITY HEALTHCARE NURSING group like being members of a regional group (i.e., V...

NCM 113 LEC PRELIMS 1st The family may be a part of a population COMMUNITY HEALTHCARE NURSING group like being members of a regional group (i.e., Visayan or Kapampangan) Community Health Nursing, as a Distinct field which in turn is part of the bigger group of nursing, has been aptly described as any of which is the community. the following: The client of the community health A field of nursing that is blend or nurse is the community. synthesis of nursing practice with public health using primary health care as the 2. PARTNERSHIP-The community health nurse tool in the delivery of health service. works with, not for, the individual patient, family, A learned practice discipline with the group or community as active partners and not goal of contributing as Individuals and in passive recipients of care. collaboration with others to the These clients are actively involved in the promotion of the client's optimum level organizing, planning, implementation, of functioning thru teaching(Jacobson, management and evaluation phases of 1969). their care. All processes must include partnering PHILOSOPHY OF COMMUNITY HEALTH with representatives of the people. nursing Example: diarrheal outbreak The philosophy of CHN is based on the worth and dignity of men (Shetland, 3. CHANGE 1958). The practice of community health This philosophy of care is based on the nursing is affected by changes in society belief that care directed to the individual, in general, and by developments in the the family, and the group contributes to health field particular. the healthcare of the population as a The environment and socio-economic whole. status have been shown to affect the health of the community. GOAL OF COMMUNITY HEALTH NURSING Ex: contact tracing The goal of Community Health Nursing is to assist the individual, family and 4. HEALTH CARE DELIVERY SYSTEM community in attaining their highest Community health nursing is part of the level of holistic health which is attained community health system and the larger through multidisciplinary effort and to human services system. promote reciprocally supportive The CHN shares with other members of relationship between people and their the health team and other sectors in the physical and social environment. community the responsibility of delivering health care services. CONCEPTS AND PRINCIPLES "3" E's ( Effective, Efficient and 1.family Equitable) nursing service 2.partnership 3.change THE COMMUNITY 4.health care delivery system " Comes from the old French word" communite" which is derived from the 1. FAMILY- The family is the primary unit of care Latin "communitas" ‘with/together + or basic unit of service of community health care minus"gift"), a broad term for fellowship where primary prevention is given priority. or organized society. The individual client or patient is a member of the family. NCM 113 LEC PRELIMS A community can be described as : A group of people sharing common 2.Professional Standards geographic boundaries and/or common 1. Occupational Health Nurses Association values and interests (OHNA) The group which functions within a 2. Philippine Nurses Association (PNA) particular socio-cultural context (no two communities are alike) and varying RA 1054 OCCUPATIONAL HEALTH ACT physical environment and the people's RA 1054 stipulates the healthcare requirements way of behaving and coping differ from for occupations. these are as follows: one group to another. 1. For business with 30 employees-OHN services are provided by the PHN. CLASSIFICATIONS OF A COMMUNITY 2. For business with 301 employees-OHN, There is a big difference between urban supplies, equipment, physician, dentist, and rural communities such as the permanent clinic (1:100) or accessible physical environment, population size hospital within 2km are required. and density, economy, culture, political community health nursing dynamics, availability and adequacy of Mental Health-Mental health is defined social services, and availability of and as a stage of well-being where a person accessibility to health resources. can realize his or her own abilities, to Rural-out in the country." Rural cope with the normal stresses of life and locations are, by nature, not densely work productively. The emotional populated. adjustment that a person can involves Urban-cities and municipal areas the promotion of a healthy state of mind Sub urban- less densely populated than among the whole population through: the cities they surround Developing positive outlook in life Strengthening coping mechanism SPECIALIZED FIELD OF COMMUNITY TREND IN MENTAL HEALTH HEALTH NURSING The modern trend in the care of the occupational health nursing mentally ill is usually home care Occupational health nursing is the management. application of nursing principles and Acute cases are referred to and treated procedures in conserving the health of at the national center for mental workers in all occupation. health(NCMH) or hospitals with facilities It aims to assists the workers in all for psychiatric care/management where occupations to cope with actual and they are later discharged or confined if potentials stresses in relation to their continue supervision or care is needed. work VULNERABLE GROUPS Vulnerable groups to the development of Determinants of Occupational Health mental illness include women, street Nursing Practice children, victims of torture or violence, 1. Government Policies and Standards internal refugees, victims of armed 1. Department of Labor and Employment conflicts, and victims of natural and (DOLE) man-made disasters. 2. Department of Health (DOH) Community mental health nursing is a 3. C. Social Security System (SSS) unique process which includes an 4. Philippine Health Insurance Corporation integration of concepts from nursing, (PHIC) mental health, social psychology, 5. Employees Compensation Commission psychology, community networks and (ECC) the basic sciences. NCM 113 LEC PRELIMS COMPONENTS OF THE MENTAL HEALTH PROGRAM tress management Drugs and alcohol abuse rehabilitation Treatment and rehabilitation of mentally ill patients Special project for vulnerable groups SCHOOL HEALTH NURSING School nursing, a specialized practice of public health nursing, protects and promotes student health, facilitates normal development, and advances academic success School nurses, grounded in ethical and evidence-based practice, are the leaders that bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potentials. Bill proposes one nurse for every public school ( Atienza 2018) is a bill seeking to assign one registered nurse for every public school in the country. Sandoval filed House Bill 7798 or the proposed "Nurse sa Public Schools Act of 2018" which mandates the Department of Health (DOH) to employ at least one registered nurse in every public school.. Nurses engaged under the proposed Act shall have the following minimum qualifications: must have valid RN license issues by the Professional Regulatory Commission; must be willing to relocate to the assigned area for a designated period; and must have a passion for public health. Nurses employed under the proposed Act shall be entitled to a monthly stipend equal to Salary Grade 15, ( P33,575) or as otherwise provided by law, consistent with the mandatory minimum entry-level pay for government nurses under Republic Act 9173, otherwise known as the Philippine Nursing Act of 2002 NCM 113 LEC PRELIMS 2nd Within these 10 components, four TENETS OF COMMUNITY priority areas were identified as key priorities for healthy, equitable COMMUNITY communities that focus on the root A social group of people interacting with each causes of health, grouped as: Healthy other determined by Housing, Healthy Neighborhoods, Geographic boundaries Healthy Schools, and a Healthy Common or sharing the same interest. Economy. Social system Shared interest DETERMINANTS OF HEALTH AND DISEASE Fluid boundaries Population Characteristics of Population DIFFERENCE OF RURAL AND URBAN 1. Population Size and Density- A densely COMMUNITY populated or overpopulated community can Physical environment easily be attacked by communicable diseases Population size and density Total size is generally expressed as the Economy number of individuals in a population. Culture The Philippine capital is one of the most Political dynamics overpopulated places on earth. Availability and adequacy or social The Metro Manila population is services estimated at 12 million but the larger Availability and accessibility of health urban area has a population estimated resources at 21.3 million. The Metro Manila characteristics of a healthy community population swells during the daytime, Awareness that "we are community" ; however, to about 15 million (DBP 2021) Conservation of natural resources; B. Location of the Community Recognition of, and respect for, the Geographical location; Some existence of subgroups; communities are more prone to Participation of subgroups in community diseases due to the geographical affair; location. Preparation to meet crises For example - Some community which Ability to solve a problem are located in swampy areas Communication through an open ARE MORE PRONE TO DISEASES channels especially during heavy rains where Resource available to all floods causes water stagnation causing Settings of disputes through a legitimate organisms to proliferate. mechanisms For example malaria, diarrheal disease. Participation of community in decision C. Social System Within the Community making 1. Government- since the government involves Wellness of a high degree among its planning, implementing and provision of member community services such as water supply, components of community medical supplies and other needs which can The Ten Key Components for creating directly affect the community health. healthy, equitable communities build on 2. Education factors the great work of our partners and were poor education or illiteracy affects the identified through analyzing local health health of a community when people data and research and gathering don't have education on how they can extensive community feedback. prevent themselves from diseases. CH nurse educate the people on: NCM 113 LEC PRELIMS Treated mosquito net - Malaria provided by various members of the Environmental Hygiene- Cholera/ health team. Trachoma Coordinates nursing program with other 3. Individual behavior; health programs like environmental Community health is greatly influenced sanitation, health education, dental by individuals, their perso health, habits health, and mental health. etc. And in order to achieve a healthy trainer/health educator community, i takes a teamwork. Identifies and interprets training needs For example of the RHMs, Barangay Health Workers proper disposal of waste products (BHW), and hilots clearing all stagnant water Conducts training for RHMs and hilots active smokers on promotion of health and disease self-medication prevention NURSE’S ROLES AND RESPONSIBILITIES IN Conducts pre and post-consultation HEALTH PROMOTION conferences for clinic clients; acts as a health promotion and disease prevention resource speaker on health and health Health promotion activities enhance related services resources directed at improving Initiates the use of tri-media (radio/TV, well-being, whereas disease prevention cinema plugs, and print ads) for health activities protect people from disease education purposes and the effects of disease. Conducts pre-marital counseling. level of prevention E. Recorder/Reporter/Statistician 1. Primary- general health promotion and Prepares and submits required reports specific protection. and records 2. Secondary- early detection and prompt Maintain adequate, accurate, and intervention complete recording and reporting 3. Tertiary- reduce the effects of disease Reviews, validates, consolidates, and injury, and restore individuals to analyzes, and interprets all records and their optimal level of functioning report community health nursery roles and Prepares statistical data/chart and other functions: data presentation Provider of Nursing Care F. Researcher Provides direct nursing care to sick or Participates in the conduct of survey disabled in the home, clinic, school, or studies and researches on nursing and workplace health-related subjects. Develops the family's capability to take Coordinates with government and care of the sick, disabled, or dependent non-government organization in the member implementation of studies/research. Community Organizer HEALTH STATISTICS AND EPIDEMIOLOGY Motivates and enhances community definition of epidemiology participation in terms of planning, Etymology: from the Greek words: epi organizing, implementing, and "upon", demos "people," and logos evaluating health services. "study" Initiates and participates in community Last's definition: Study of the distribution development activities and determinants of health-related coordinator of services states or events in specified Coordinates with individuals, families, populations, and the application of this and groups for health-related services study to the prevention and control of health problems NCM 113 LEC PRELIMS Makes use of concepts and methods Used to describe the health status of the from biology, sociology, demography, population (i.e., for situational analysis geography, environmental science, or community diagnosis). policy analysis and statistic There are various types (e.g., morbidity indicators, mortality indicators, fertility demography - the study of human indicators, etc.) depending on the populations aspect of health that is of interest Demography is the study of human populations - their size, composition and distribution across space - and the process through which populations change. Births, deaths and migration are the 'big three' of demography, jointly producing population stability or change. A population's composition may be described in terms of basic demographic features - age, sex, family and household status - and by features of the population's social and economic context - language, education, occupation, ethnicity, religion, income and wealth. Demography What are the roles of Community Health Nurses pertaining to: Number of birth Aging of population Migration Gender distribution Households Educational attainment Demography- the study of human population The distribution of populations can be defined at multiple levels (local, regional, national, global) and with different types of boundaries (political, economic, geographic). Demography is a central component of societal contexts and social change. Health indicators Quantitative measures, usually expressed as rates, ratios, or proportions, that describe & summarize various aspects of the health status of the population. NCM 113 LEC PRELIMS 3rd Applications of Epidemiology in Health Indicators Community Health Quantitative measures, usually expressed as rates, ratios, or Definition of Epidemiology proportions, that describe & summarize Etymology: from the Greek words: epi various aspects of the health status of “upon", demos "people," and logos "study" the population. Study of the distribution and Used to describe the health status of the determinants of health-related states or population (i.e., for situational analysis events in specified populations, and the or community diagnosis). application of this study to the There are various types (e.g., morbidity prevention and control of health indicators, mortality indicators, fertility problems (Last 1988) indicators, etc.) depending on the aspect of health that is of interest. EPIDEMIOLOGICAL TRIANGLE Health indicators are also used for: 1. Determining factors that may contribute The Triangle has three corners (called to causation of the disease and control vertices): of disease Agent, or microbe that causes the 2. Identifying public health problems and disease (the "what" of the Triangle) needs Host, or organism harboring the disease 3. Indicating priorities for resource (the "who" of the Triangle) allocation' Environment, or those external factors 4. Monitoring implementation of health that cause or allow disease transmission programs' (the "where" of the Triangle) 5. Evaluating outcomes of health programs CASE ANALYSIS (Turnock 2007) Barangay Uno is located in an isolated Isla 32 Morbidity Indicators kms from the shore of Barangay Dos. With a Morbidity indicators are generally based total population of 500 inhabitants, the locals on the disease-specific incidence or survive daily living through farming root crops prevalence for the common and severe and fishing. Once a week some of the old folks diseases visits the town proper to buy basic goods by ICan partly answer two epidemiologic riding motorized boat. When it comes to health questions: needs, locals consult traditional Hilot and use "What are the health problems in our traditional medicines. Some of known illness in area?" the island are the following: "How many cases occur in the area?" 1.Parasitism Two types: 2.TB Prevalence 3. Recorded maternal death (Hemorrhage) Incidence’ Practical Applications of Epidemiology Prevalence Proportion (P) Assessment of the health status of the Estimated from cross-sectional studies community or community diagnosis (surveys) Elucidation of the natural history of Provides an indication of the magnitude disease of a health problem Determination of disease causation Used for projecting the scope of health Prevention and control of disease services needed by the community Monitoring and evaluation of health interventions Provision of evidence for policy formulation NCM 113 LEC PRELIMS Where: F is any number of the base 10 (usually PHILIPPINE INFANT MORTALITY RATE 100) that is used as a multiplier to avoid having In 2020, infant mortality rate for decimals. For Prevalence proportion, the most Philippines was 18.42 deaths per common F used is 100 thousand live births. Infant mortality rate Interpretation: percentage of the of Philippines fell gradually from 55.08 population afflicted with the disease deaths per thousand live births in 1971 Incidence Measures to 18.42 deaths per thousand live births Best measures to use for evaluating the in 2020. effectiveness of health interventions Source: PSA Neonatal Mortality Rate (NMR) and Postneonatal Mortality Rate (PNMR) Mortality Indicators NMR and PNMR add up to the IMR Provide important information on the Neonatal deaths are mainly caused by health status of the community because prenatal or genetic factors death is the most serious outcome of a Post-neonatal deaths are influenced by morbid episode. environmental and nutritional factors as Patterns of causes of death indicate the well as infections most life-threatening diseases. Crude death rate (CDR) sometimes called force of mortality is defined as the rate with which mortality occurs in a given population: Factors that affect CDR: age and sex composition of the population, adverse Maternal Mortality Ratio (MMR) environmental, occupational & the Maternal death: "Death of a female from peace and order conditions any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental Infant Mortality Ratio (IMR) causes) during pregnancy and childbirth Used as an approximation of the risk of or within 42 days of termination of dying within the first year of life pregnancy, irrespective of the duration & A good index of the level of health in a the site of the pregnancy". community because infants are very A measure of obstetric risk; affected by sensitive to adverse environmental maternal health practices, diagnostic conditions ascertainment, and completeness of Thus, a high IMR implies low levels of registration of births. health standards, poor environmental FORMULA sanitation, poor maternal & child health care, malnutrition, or deficient health service delivery. Population Indicators Formula Includes not only population growth indicators (e.g., crude birth rate, general fertility rate, total fertility rate, and annual growth rate) but population dynamics indicators (e.g., migration) that can affect the age-sex structure of the population and vice versa NCM 113 LEC PRELIMS Crude birth rate (CBR) measures how Disease registries fast people are added to the population Surveillance system through births Hospital data Affected by the fertility, marriage pattern Health insurance and practices of the place, sex and age School health program composition of a population, and birth Downloadable data sets registration practice Surveys (morbidity, demographic and health) Disease Registry A compilation of information about a General Fertility Rate (GFR) particular disease. More akin to a specific rate than the Aim: to include all cases of the disease CBR since births are related to the in the registry without duplication population sub-group deemed to be Attainment of this aim is dependent on: capable of giving birth, i.e., women in -cooperation of agencies and health the reproductive age groups facilities that feed the registry Reproductive age group: 15-49 years in -having a unique patient identifier that some countries; 15-44 years in others will allow record linkage including the Philippines in the Philippines: A cancer registry covers Metro Manila and Rizal Province -An HIV/AIDS registry intended to include all newly detected cases of HIV Population Pyramid -infection and AIDS in the Philippines Graphical representation of the age-sex Disease Surveillance System composition of the population. Public health surveillance: The ongoing, Should be examined during the systematic collection, analysis and assessment of the health status of the interpretation of health-related data community. needed for the planning, Shape of the pyramid provides insights implementation, and evaluation of public into the fertility and mortality patterns of health practice. the community and the most probable surveillance systems were initially health problems that would likely need developed for monitoring high burden health services. diseases, Population pyramid of the philippines (a) detecting disease outbreaks, and japan (b) 2010 monitoring progress towards attainment oftargets for the control, elimination, or eradication of a specific disease. New public health paradigms for surveillance advocate inclusion of the detection of toxins, hazardous chemicals, genetically modified products, and risky behaviors. The Philippine Integrated Behavioral Sources of Data for Calculation of Health and Serologic Surveillance (IHBSS) Indicators monitors not only seropositivity among Census most at-risk groups for HIV infection but Vital registration system also their behaviors that put them at risk Disease notification for the infection. NCM 113 LEC PRELIMS Disease Surveillance System (continued) Passive surveillance Public health staff receives reports from hospitals, clinics, public health units, or other sources. The count of cases is expected to be grossly underestimated and utility of data may be greatly diminished since it may become available only when it is no longer needed. Active surveillance: Public health staff members actively and regularly contact heath care providers or the population to obtain information about the disease of interest. Much more expensive but yields more accurate and timely data. Allows both an early detection of an impending epidemic and a more valid evaluation of the impact of public health interventions. A very active surveillance system should be used to detect every case to monitor eradication and elimination programs. The Philippine Integrated Disease Surveillance and Response (PIDSR) integrates health statistics generated through the major disease surveillance systems in the country, viz., Notifiable Disease Reporting System (NDRS) Field Health Service Information System (FHSIS) National Epidemiology Sentinel Surveillance System (NESSS) Expanded Program on Immunization Surveillance System (EPI Surveillance) HIV-AIDS Registry In the Philippines, one may request for data from the National Statistics Office for a fee; it takes a long time to avail of the data In developed countries, several data resources can be downloaded from the Internet USAID-funded Demographic and Health Survey that includes many low- and middle-income countries can be downloaded from the Internet NCM 113 LEC PRELIMS Epidemiology and The Nurse cooperation of agencies and health facilities that feed the registry Nurse Epidemiologists having a unique patient identifier that will allow record linkage. Identifies people or populations at high risk; Monitors the progress of Disease Surveillance System diseases; Specifies areas of health care need; Public health surveillance: The determine priorities, size, and scope ongoing, systematic collection, of programs; evaluate their impact. analysis and interpretation of They generally do not provide direct health-related data needed for the patient care but serve as a resource planning, implementation, and and plan educational programs. evaluation of public health practice. Surveillance systems were initially Disease Notification developed for monitoring high burden diseases, detecting disease An integral part of disease outbreaks, and monitoring progress surveillance towards attainment of targets for the Republic Act 3573: Law on control, elimination, or eradication of reporting of communicable diseases a specific disease. mandates health workers to report Passive surveillance Public health notifiable diseases (e.g., dengue, staff receives reports from hospitals, rabies, leptospirosis, and HIV/AIDS clinics, public health units, or other to local and national health sources. authorities The count of cases is expected to be Many people who need services do grossly underestimated and utility of not have access to health facilities. data may be greatly diminished Minimal vigilance in reporting cases since it may become available only of the notifiable diseases among when it is no longer needed. health care providers, particularly Active surveillance: private practitioners Public health staff members actively Leads to gross underreporting and regularly contact heath care >distorted picture of health problems providers or the population to obtain in the community information about the disease of interest. Disease Registry Much more expensive but yields A compilation of information about a more accurate and timely data. particular disease. Allows both an early detection of an Aim: to include all cases of the impending epidemic and a more disease in the registry without valid evaluation of the impact of duplication public health interventions. Attainment of this aim is dependent A very active surveillance system on: should be used to detect every case to monitor eradication and elimination programs. NCM 113 LEC PRELIMS The Philippine Integrated Disease 5. The factor used in the Surveillance and Response (PIDSR) computation of the different rates integrates health statistics generated may be any number of the base through the major disease 10 surveillance systems in the country. 1. Notifiable Disease Reporting Determination of Disease Causation System (NDRS) · Interventions that target the causes 2. Field Health Service Information System (FHSIS) of a public health problem have 3. National Epidemiology greater chances of having Sentinel Surveillance System positive outcomes. (NESSS) · Answering the epidemiologic 4. Expanded Program on questions “What factors Immunization Surveillance contribute to disease causation? System (EPI Surveillance) Why does disease occur?” 5. HIV-AIDS Registry based on valid evidence will Considerations in the Analysis and contribute to the success of Interpretation of Health Indicators health interventions. · A review of literature and an 1. Is the denominator of the rate the most appropriate one? understanding of the natural Preferably, it should be the history of the disease will population in which gave rise to contribute to the development of the events in the numerator. an epidemiologic disease model representing the factors that 2. Is the numerator an accurate influence disease causation. count of the number of events? Inaccuracies can arise due to Models of Disease Causation under-registration, Triad model underreporting, or duplication. · Suggests that the agent and the 3. There should be correspondence susceptible human host are in time and geographical location interacting freely in a common of the events in the numerator (physical, biologic, and the population in the socioeconomic) environment. denominator. · Disease does not occur for as long 4. Time specifications are usually on as the balance is maintained or an annual basis. However, is tilted in favor of the host special indicators may have (because of good nutritional other period specifications and status and high levels of these should be stated. immunity). NCM 113 LEC PRELIMS · Disease eventually occurs when 2. determine the magnitude and the balance is tilted in favor of distribution of the health problem the agent (through increased 3. elucidate the natural history of the dosage, virulence, pathogenicity disease, of the agent). 4. determine why the problem disease occurs, · Environmental elements (i.e. 5. and identify the factors that climate) can also tilt the balance contribute to disease causation in favor of the agent Outbreak Investigation Wheel model Disease outbreak: the occurrence of Gives emphasis on the role of the cases of disease in excess of what genetic makeup of the host that is would normally be expected in a presented as the inner core of the defined community, geographical wheel’s hub. area or season The outer core of the hub includes Occurrence of a single case of a host characteristics (sex, age, communicable disease is considered socioeconomic status, behaviors). an outbreak if the disease: The rim or the outer edge represents 1. Iis a previously unknown the biologic, physical, and chemical diseases environment. 2. has never occurred in the area Web model: 3. has been absent from the population for a long time became more applicable for non-communicable diseases to An outbreak investigation should be capture the complex conducted to: interrelationships of numerous factors that influence disease 1. Identify and eliminate the source of occurrence either by increasing the infection and prevent the occurrence risk or protecting against the of more cases disease. 2. Assess the preventive strategies Under this model, disease can be that are currently implemented prevented by breaking the weakest 3. Devise strategies for preventing strand of the causal web as similar outbreaks in the future identified previously through various types of epidemiologic studies. Basic steps in an outbreak investigation: Prevention and Control of Diseases 1. Operationally define what constitutes a case. Epidemiology can be used to 2. Based on the operational definition, 1. identify the important public health identify the cases. problems of the community. NCM 113 LEC PRELIMS 3. Based on the number of cases status of its implementation in terms identified, verify the existence of an of compliance to the design of the outbreak. program, timelines, and attainment 4. Establish the descriptive of midterm goals epidemiologic features of the cases. As a result of monitoring, the project 5. Record the clinical manifestations of management team is able to: cases 1. Assess the progress of program 6. Based on the clinical manifestations, implementation, incubation period, available 2. Identify problems, laboratory findings, and other 3. Take corrective action, information gathered, formulate 4. Have a tool for quality assurance hypothesis regarding the probable and management etiologic agent, the sources of 5. Measure achievement of midterm infection, the mode of transmission, program objectives, and the best approach for controlling 6. Lay the groundwork for program the outbreak. evaluation. 7. Test the hypotheses by collecting relevant specimens from the patients Evaluation and from the environment. 8. Based on the results of the A process that systematically and investigation, implement prevention objectively assesses compliance to and control measures to prevent the design of the program, the recurrence of a similar outbreak. performance, relevance and success 9. Disseminate the findings of the of a project, that is, the extent to investigation through media and which a project accomplishes its other forms to inform the public. intended results (outcomes) and achieves measurable impacts. Monitoring and Evaluation of Health Employs research techniques and Interventions applies the methods of epidemiology and health statistics. A health intervention plan should Its primary purpose is to provide include the plan for its monitoring feedback on the results (outcomes) and evaluation. and impact of the project in order to Monitoring is done while the inform policymakers and planners intervention is still being about the efficacy of the intervention implemented to provide feedback on It answers such questions as: its current status. 1. Did the program work as intended? · Evaluation is done at the end of the 2. What results (outcomes) did the project to assess whether or not its program accomplish? objectives were achieved 3. What measurable impacts did the program achieve? Monitoring 4. Is the program cost effective? An ongoing activity during program implementation to assess the current NCM 113 LEC PRELIMS Guiding principles for evaluation: The NBS Act of 2004 institutionalized the “National NBS 1. Impartiality System” which ensures that: 2. Independence 1. Every baby born in the Philippines is offered 3. Partnership NBS; 4. communication and coordination 2. A sustainable NBS System is established and 5. Credibility integrated into the public 6. transparency health delivery system; Provision of Evidence for Health Policy 3. All health practitioners are Formulation aware of the benefits of NBS and of their · Epidemiologic evidence is responsibilities in offering necessary for the formulation of it to their patients; and health policy. 4. All parents are aware of · Example: the legislation of NBS and their Republic Act 9288 (Newborn responsibility in Screening (NBS) Act of 2004. protecting their child from any of the disorders. · Passed due to the compelling evidence from a study done by a group of obstetricians and pediatricians from 24 hospitals in Metro Manila. · The Philippine Newborn Screening Project (PNBSP) showed that the incidence of six metabolic conditions is high enough to be considered of public health importance. · Although the sequelae of these conditions can compromise the functionality of cases as they mature, the secondary level of prevention could be relatively simple in some instances, for example, avoiding certain food items. NCM 113 LEC PRELIMS 5th THE NURSING PROCESS IN THE - person of influence COMMUNITY Community forum- an open meeting of the members of the community (Laundy & Janes, 2009) BACKGROUND "Pulong -pulong sa barangay Records is an account of something, " is a good example of community forum written to perpetuate knowledge of events. The PH Nurse/ CH Nurse observe the Records and reports and indispensable fallowing: aids to all who are responsible for giving People best possible service to individuals, Use of your community space families and community. Daily life Good reports are time savers. It prevent The nature of debate duplication of work, decrease errors and Hidden participants show efficiency level of the NURSE. Other Social Media Community field health services information system Managers It is a network of information. It is intended to address the short term SECONDARY COLLECTION OF DATA need of DH and GU staff with managerial or supervisory functions in Registry of Vital Events facilities and program areas. Acts 3753 (Civil Registration Law, It monitor health service delivery Philippines Legislature). Enacted 1930, nationwide. established the civil registry system in Primary Collection of Data the Philippines and requires the registration of the virtual events, such as Primary data births, marriages and deaths. are an important part of community RA 7160 (Local Government Code) health assessment. assigned the function of the civ These data can fill in gaps in secondary registration to local governments and data sources, highlight critical issues or mandated the appointment of Local concerns, and provide opportunities for (city/ municipal) Civil registrars. The community members to actively engage PSA serves as the central repository of in the community health assessment civil registries and PSA Administrators process and Civil Registrar General of the When existing data are not available for Philippines. a particular population, it may be The birth and death registries are of necessary to collect primary data. importance to the nurse since they are primary collection of Data source of fertility and mortality data Observation - ocular survey, Birth Certificate "windshield survey", vulnerable groups In facility-based births, the facility Survey administrator shall be responsible for A survey made up of series of the registration of the event. questions for systematic collection of The physician, nurse, midwife or information from sample of individuals or anybody who attended the delivery has families in a community, and may be the responsibility for registering births written or oral (Maurer & Smith 2009) that occur outside a facility. Information interview -" key person interview" - formal of informal community leaders NCM 113 LEC PRELIMS Death Certificate time series. For example, the trend of PD 856 or also known as Sanitation the total fertility rate or average number Code requires a death certificate before of children per woman in the Philippines burial of the deceased. from 1973 to 2011 "The physician who last attended the Pie Chart deceased shall be responsible for To show percentage distribution or preparing the death certificate, certifying composition of variable, such as the cause of death, and forwarding the population or households. A pie chart is death certificate to the health officer an effective tool in highlighting the value within 48 hours. of a group in relation to the whole Health Records and Reports population. But it can illustrate only a EO 352, the Field Health Service small number of categories, usually not Information System (FHSIS) is the more than six. official recording and reporting system of HEALTH RECORDS AND REPORTS the DOH and is used by the NSCB to generate health statistics. IMMUNIZATION RECORD The FHSIS is an essential tool in An immunization record is a monitoring the health status of the comprehensive timeline of all population at different levels. vaccinations a patient has received Disease Registries Good record-taking will ensure a patient A disease registry is a listing or persons can provide accurate immunization diagnosed with a specific type of records required for certain jobs, travel, disease in a defined population. or school enrollment. Data collected through disease Medical Certification registries serve as basis for monitoring, A medical certificate or doctor's decision making, and program certificate is a written statement from a management ( DOH. 2011) physician or another medically qualified Census Data health care provider which attests to the A census is a periodic governmental result of a medical examination of a enumeration of the population (Merriam patient Webster Online Dictionary, 2012) Batas It can serve as a "sick note" or evidence Pambansa Blg 72 provides for a of a health condition. national census of population and other Or use for insurance claim related data in the Philippines every 10 Medical Record years.' The medical record serves as the "de jure or de facto" method, central repository for planning patient care and documenting communication Graphs for Presenting Community Data and among patient and health care provider Their Uses and professionals contributing to the Bar Graphs: patient's care. To compare value across different DISEASE REGISTRY CENSUS DATA categories of data. For example, a population pyramid is made up of two Leading Cause of Death by 2023 horizontal bar graphs representing the Ischaemic heart disease was the age structure of the male and female Jeading cause of death in the population. Philippines. The number of people who Line Graph: died from this illness was estimated at To have a visual image of trends in data 124,437. Following this, cancer resulted over time or age. This is appropriate for in the deaths of about 71,000 people. NCM 113 LEC PRELIMS Eating habits bone, breast, cervical, esophageal and Heart diseases have been linked to high meat colorectal cancer. consumption, among others. In the Philippines, According to PSA's latest data, more pork has been the most consumed meat type, Filipino women die from cancer followed closely by chicken, While pork meat is compared to men, with 30,954 annual typically produced domestically, the country also cases logged. (Montemayor 2023) imports pork to supplement its supply. However, Pneumonia plant-based food has started paining popularity Pneumonia is the infection of both among Filipinos. In fact, a 2024 survey revealed lungs. In the past decade, it claims the that 69 percent of surveyed Filipinos consumed lives of 57, 089 Filipinos every year. plant-based products, including meat alternative "It is mistaken by some as caused by lung cancer but pneumonia is not just Common diseases in the Philippines due to lung cancer, anybody with a Aside from heart and cerebrovascular compromised immune system like diseases, the Filipino population is also elderlies, diabetics and patients exposed to infections, diabetes, skin undergoing dialysis they are considered diseases, and illnesses resulting from at a high risk of contracting pneumonia," high meat consumption. In 2020, over medical me oncologist Denky Shoji dela 700,000 Filipinos contracted acute Rosa told PNA. (Montemayor 2023) respiratory tract infections, followed by over 400,000 diagnosed with hypertension. In areas with high exposure to rain, dengue infections and leptospirosis have also become prevalent. (Balita 2024) Morbidity cases Ischemic heart disease occurs when the heart does not get enough supply of blood and oxygen due to narrowed arteries. It is the top cause of death among Filipino men with 74,134 cases and the second cause of death among Filipino women with 29,662 cases in a year. Quizon advised against cigarette smoking and alcohol intake, and recommended sugar and cholesterol control, as well as stress management. (Montemayor 2023) Cancer Cancer, also known as neoplasms, is characterized by the presence of a malignant growth or tumor which results from abnormal cell division. The most common types of neoplasms include uterine, urinary bladder, thyroid, soft tissue, prostate, ovarian, skin, lymph node, lung, kidney, gastric, anal, blood,