Community Health Nursing 2 (CHNN312) Past Paper PDF

1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Community Health Assessment Tools COMMUNITY ASSESS...

1st Semester October 2024 COMMUNITY HEALTH NURSING 2 CHNN312 Community Health Assessment Tools COMMUNITY ASSESSMENT Community assessment is a process that identifies a NECESSARY WHEN: community's strengths, resources, assets, and needs. ◦ No Available Information It's a comprehensive process that involves collecting, ◦ Needs to collect data from a particular community analyzing, and sharing information about the community. ◦ Reveals a particular health problem USES OF SURVEY COLLECTING PRIMARY DATA ◦ A survey is also useful in determining the following: OBSERVATION community attitudes, knowledge, health behaviors and It is an act of extracting information from subjects being perception of health and services. studied ◦ A survey is used to identify patterns of utilization of health ◦ OCULAR SURVEY OR WINDSHIELD SURVEY services (Maurer & Smith, 2009) ▪ This involves rapid observation of a community and ◦ A survey is an opportunity for making the community more performed either by walking through it, driving or riding aware of community problems and their effects and more in a vehicle. conscious of their capacity to influence the decision ▪ This give the nurse a chance to observe: making about health policies & plans, giving them a sense ▫ PEOPLE: Spot vulnerable groups and peoples of empowerment appearance. SURVEYS IN ASSESSMENT ▫ ENVIRONMENT: Terrain, Homes, Housing Density & ◦ In COMPREHENSIVE NEEDS assessment: Cleanliness, Vegetation, Street Animals ▪ Data collected is about a “random sample of a ▫ FACILITIES/COMMUNITY RESOURCES: Health population.” Facilities, Barangay Halls, School, Places Of Worship, ◦ In PROBLEM-ORIENTED assessment: Open Spaces ▪ “Purposive sampling” is indicated where the sample ▪ The nurse talks to people to know their perception of population consists of the population “healthy community” and their “community facilities” ▪ Susceptible to the problem being studied. (Eg. Mother ◦ PARTICIPANT OBSERVATION with young children) ▪ Purposeful observation of formal and informal INFORMANT INTERVIEW community activities by sharing in the life of the A purposeful talk with either key informant or ordinary community. members of the community. ▫ FORMAL: community activities are barangay ◦ KEY INFORMANT assemblies, school parent-teacher meeting, church ▪ Formal: persons of position and leaders or as leaders in meeting. local government ▫ INFORMAL: gatherings are in variety of setting such ▪ Informal: community leaders or persons of position and as sari-sari store, community recreation area or influence, such as schools and business schools ◦ INTERVIEW ▪ Helps in determining the following in a community: ▪ Structured: is where the nurse directs the talk based on ▫ Values an interview guide ▫ Belief ▪ Unstructured: is where the informant guides the talk. ▫ Norms COMMUNITY FORUM ▫ Priorities Community Forum is an open meeting of the members of the ▫ Concerns community ▫ Power or Influence Structures ◦ PULONG-PULONG SA BARANGAY: is an illustration of a ▪ Suits community organizing and participatory research. community forum, this offers the nurse an information SURVEY regarding community perceptions on their needs, health A made of series of questions for systematic collection of and health care information from a sample of individuals or families in a Community Forum is good in providing folks with a medium of community conveying their views and developing their capability to ◦ Time consuming influence decision makers ◦ Expensive The forum is set in coordination with the leaders of the public ◦ Written or Oral if the community forum is initiated by the nurse. ◦ They are the barangay leaders or other informal leaders. Kath Venus 1 1.06 – COMMUNITY HEALTH ASSESSMENT TOOLS – CHNN312 The community forum can be used for data gathering. ◦ If death occurred without medical attention: the nearest Also, it can be used as a venue for informing the people relative or any person who has knowledge of the death about secondary data, for data validation and for getting ◦ In the absence of a health officer: the death should be feedback from the public about previously gathered data. reported to the mayor, municipal secretary or any member FOCUS GROUP of the Sangguniang Bayan, who shall issue the death Assessment of health needs of specific groups certificate for the purposes of burial. ◦ Focus group is made up of much smaller group usually 6-12 Registration of death shall be made within 30 days from the member only occurrence of death at the Local Civil Registry Office of the Membership is more homogeneous which is person with city or municipality. similar sociocultural or health conditions Fetal deaths are registered following the same process ◦ GUIDELINES IN THE CLASSIFICATION OF DATA COLLECTING SECONDARY DATA ▪ Reckoning of Vital Events: All vital events are registered REGISTRY OF VITAL EVENTS and reported by place of occurrence, not by place of ACT 3753 (Civil Registration Law, Philippine Legislature) residence. ◦ Enacted in 1930 ▪ Reckoning of Age: age is recorded as of last birthday ◦ Established the civil registry system in the Philippines ▪ For Neonatal Death: In the first day of life (day zero), ◦ Requires the registration of vital events such as births, age at death should be recorded in units of completed marriages and deaths minutes or hours of life. For the succeeding days until RA 7160 (Local Government Code) the 27th completed days of life, age at death should be ◦ Assigned the function of civil registration to local recorded in days governments HEALTH RECORDS AND REPORTS ◦ Mandated the appointment of Local (city/municipal) Civil Executive Order No. 352 (Office of the President, Republic of registrars the Philippines, 1996), the Field Health Service Information NATIONAL STATISTICS OFFICE System (FHSIS) ◦ The NSO serves as the central repository of civil registries ◦ This is the official, recording and reporting system of the and the NSO Administrative and the Civil Registrar NSCB to generate health statistics. General of the Philippines. ◦ The FHSIS is an essential tool in monitoring the health ◦ Reliable civil registration and vital statistics provide status of the population at different levels. realistic basis for program planning and implementation. FHSIS Basis for: ▪ The birth and death registries are of particular ◦ Priority setting by local governments importance to the nurse, since they are sources of ◦ Planning and decision making at different levels fertility and mortality data. ◦ Monitoring & evaluating health program BIRTHS FHSIS is composed of recoding and reporting tools. Live birth is the complete expulsion/extraction from mother of ◦ Records are facility-based. a product of conception, regardless of duration of pregnancy ◦ Kept at the Barangay Health Station or at Rural Health Unit ◦ After such separation, breathes or with evidence of life or health center. (ex. beating of heart, pulsation of umbilical cord, or ◦ With day-to-day account of activities of health workers, movement of voluntary muscles, whether or not umbilical service delivered to clients are basis of data entered in the cord been cut or placenta is attached) each product of records. such birth is considered LIVEBORN. ◦ A basis of reports. Who will register the births? ◦ Reports consists of summary data that are transmitted or ◦ Facility-based births: facility administrator submitted monthly, quarterly, annually to higher level. ◦ Outside birth facility: physician, nurse, midwife or anybody ◦ From BHS → RHU or health center → Provincial → to who attended the delivery, Regional Office Health Office ◦ Default of the Hospital: either parent may also register the The FHSIS Manual of Operations (DOH-IMS, 2011) lists and birth describes the following recording tools: ◦ Aboard a vehicle, vessel, or airplane while in transit: joint ◦ INDIVIDUAL TREATMENT RECORD (ITR) responsibility of the driver, captain or pilot and the parents ▪ Is the fundamental building block of FHSIS. The record The birth of a child should be registered within 30 days from contains the date, name, address of patient, presenting the occurrence of the birth at the Local Civil Registry Office symptoms or complain of the patient on consultation of city or municipality where the birth occurred (NSO, 2010). and the diagnosis (if available), treatment and date of DEATHS treatment Death is a permanent disappearance of all evidence of life ▪ ITR is maintained at the facility. Health workers are at any time after live birth has taken place (postnatal advised not to rely on client-maintained records like the cessation of vital functions without capability of home-based mothers record. resuscitation) ◦ TARGET/CLIENT LISTS (TCLs) Presidential Decree 856. Sanitation Code ▪ Are the second building block of the FHSIS. ◦ In 1975, Office of the President necessitates death ▪ Target or Client Lists maintained in the RHU and health certificate before burial of deceased centers: Who will register the deaths? ▫ TCL for Prenatal Care ◦ Physician: The physician who last attended the deceased ▫ TCL for Postpartum Care ▫ TCL of Under1-Year Child Children Kath Venus 2 1.06 – COMMUNITY HEALTH ASSESSMENT TOOLS – CHNN312 ▫ TCL for Family Planning ▹ Morbidity Report (M2) ▫ TCL for Sick Children Contains a list of all cases of disease by: ▫ National Tuberculosis Program TB Registrar ◦ Age ▫ National Leprosy Control Program Central ◦ Sex Registration Form ▫ QUARTERLY FORMS ▪ These service records have the following purposes: ▸ Are usually prepared by the nurse ▫ To plan and carry out patient care and service ▹ Municipality/City delivery since midwives and nurses use TCLs to There should only be one Quarterly Form for monitor target or eligible populations for particular the municipalities/cities with two or more health services. RHUs or health centers. ▫ To facilitate monitoring and supervision of service Consolidation done under the direction of delivery activities. Municipality/City Health Officer ▸ priority setting by local governments ▹ Provincial ▸ planning & decision making at different levels Quarterly forms are submitted to the (barangay, municipality, district, provincial & Provincial Health Office. national) ▸ Types of Quarterly Forms ▸ monitoring and evaluating health program ▹ Program Report (Q1) implementation contains the 3-month total of indicators ▫ To report services delivered, thus reducing the need categorized as maternal care, family to refer back to the ITRs to accomplish reporting. planning, child care, dental health and ▫ To provide a clinic-level database that can be disease control. accessed for further studies. ▹ Morbidity Report (Q2) ◦ SUMMARY TABLE is a 3 month consolidation of Morbidity ▪ This is accomplished by the Midwife. Report ▪ It is a 12-column table in which columns correspond to ▫ ANNUAL FORMS the 12 months of the year. ▸ A-BHS ▪ This record is kept at the BHS and ▹ is a report by the midwife that contains: ▪ It has two components: Demographic ▫ Health Program Accomplishment and Environmental ▫ Morbidity/Disease Natality data ▪ Summary Table is supposed to be updated on a monthly ▸ Annual Form 1 (A-1) basis. ▹ is prepared by the nurse and is the report of the ▪ The Health Program Accomplishment provides the RHU or health center. midwife with: ▹ It contains demographic and environmental ▫ Tool for assessment of accomplishments data, and data on natality and mortality for the ▫ Ready source for reports entire year. ▪ The monthly summary of morbidity gives information on: ▸ Annual Form 2 (A-2) ▫ Monthly trend of disease ▹ Prepared by the nurse, is the yearly morbidity ▫ Serves as a source for the 10 leading cases of report by age and sex. morbidity in the municipality/city ▸ Annual Form 3 (A-3) ▪ The Summary Table is also a source of data for any ▹ Also prepared by the nurse, is the yearly report survey or research. of all deaths (mortality) by age and sex. ◦ MONTHLY CONSOLIDATION TABLE (MCT) ▫ UPON OCCURRENCE ▪ Accomplished by the nurse based on the Summary ▸ E-1 Notification of Death Forms Table. ▸ E-2 Maternal Death Report ▪ It serves as: ▸ E-3 Perinatal Death Report ▫ the source document for the Quarterly Form ▫ WEEKLY ▫ the Output Table of the RHU or health center ▸ Weekly Report of Notifiable Disease ▪ REPORTING FORMS OF MCT DISEASE REGISTRY ▫ MONTHLY FORMS A listing of persons diagnosed with a specific type of disease ▸ Are regularly prepared by the midwife and in a defined population. submitted to the nurse who then uses the data to Data collected through disease registries serve as a basis for prepare the Quarterly Forms. These are: monitoring decision making and program management. ▹ Program Report (M1) The Department of Health has developed and maintained Contains indicators categorized as: registries for HIV/AIDS and chronic non communicable ◦ Maternal care disease, particularly cancer, diabetes mellitus, chronic ◦ Child care obstructive pulmonary disease and stroke. ◦ Family planning CENSUS DATA ◦ Disease control. It is a periodic governmental enumeration of the population. The midwife copies the data from the It provides for a national census of population and other Summary Table related data in the Philippines every 10 years. Kath Venus 3 1.06 – COMMUNITY HEALTH ASSESSMENT TOOLS – CHNN312 The Philippine Statistical System provides statistical information and services to the public. The NSCB is the policy-making and coordinating body of the PSS. ◦ NSO is the PSS arm that generates general-purpose statistics: ▪ Population ▪ Employment ▪ Process ▪ Family income/expenditures. During a census, people may be assigned to a locality by de jure or de facto method ◦ DE JURE: based on the legally established place of residence of people ◦ DE FACTO: according to the actual physical location of people. The NSO conducts the national census using the de jure method. ◦ The census population consists of Filipino nationals, to include those residing in and out of the Philippines, and nationals of other countries having their usual residence in the Philippines. ◦ Demographic characteristics, household size, and data on fertility and mortality are some of the census information that the nurse can utilize for needs assessment. Census data are accessible at the NSO. METHODS TO PRESENT DATA PURPOSES Inform health teams and members Make member of community appreciate the significance of health information in their lives Solicit broader support Validate findings. PIE-CHART Show percentage distribution or show composition SCATTER PLOT OR DIAGRAM Show correlation between two variables LINE GRAPH Visual image of trends in data over time or age BAR GRAPH To compare values across different categories of data Kath Venus 4