Community Health Nursing Notes PDF

J Medel Notes Community Health Nursing 1 Module 1 LESSON TITLE: Nursing Core Values as a Community Health Nurse, Filipino Culture, Values and Practices in Relation to Health Care of Individual and Family, Global and National Health Situations LEARNING OUTCOMES: By the end of this lesson, student...

J Medel Notes Community Health Nursing 1 Module 1 LESSON TITLE: Nursing Core Values as a Community Health Nurse, Filipino Culture, Values and Practices in Relation to Health Care of Individual and Family, Global and National Health Situations LEARNING OUTCOMES: By the end of this lesson, students will be able to: 1. Demonstrate caring as the core of nursing, love of God, love of country, and love of people in serving the community. 2. Enumerate the roles and responsibilities of a community health nurse. 3. Exemplify love for country in the service of Filipinos and families. 4. Customize nursing interventions based on Philippine culture and values. 5. Discuss global and national health situations and actions holistically and comprehensively. Reference Materials: 1. Famorca, Z. U., Nies, M. A., & McEwen, M. (2013). Nursing Care of the Community. Elsevier Gezondheidszorg. 2. Community Health Nursing Services in the Department of Health Philippines (2000). 3. Community Health Nursing. 9th Edition. National League of Government Nurses, Inc. Definition of Terms Community Social structures that create norms and values establishing social institutions (WHO). Health A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO). Community Health Extends public health to include organized health efforts at the community level through both government and private sectors. Community Health Nursing Utilization of the nursing process at different levels of clientele (individuals, families, population groups, and communities) for the promotion of health, prevention of disease and disability, and rehabilitation (Maglaya, et al). CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 1 of 35  J Medel Notes o Goal: Raise the level of citizenry by helping communities and families cope with health threats and maximize their potential for high-level wellness (Nisce, et al). Role and Responsibilities of Community Health Nurse Programmer/Planner Identifies the needs and concerns of individuals, groups, families, and the community. Formulates health plans, especially in the absence of a community physician. Implements nursing plans and programs. Assists other health team members in implementing health programs. Health Educator/Trainer/Counselor Acts as a resource speaker on health and health-related services. Advocates for health programs in the community through IEC materials. Conducts advocacy education on premarital, breastfeeding, and immunization counseling. Organizes training for groups like pregnant mothers. Identifies and addresses training needs of health team members. Community Organizer Promotes self-reliance and community involvement in health services planning, organizing, implementing, and evaluating. Initiates and implements community development activities. Coordinator of Services Coordinates health services with community health team members, government organizations, and NGOs. Coordinates nursing plans with other health programs. Provider of Nursing Care Provides direct care to clients in various settings (home, school, clinics, work). Involves families in the care of sick or dependent individuals. Health Monitor Monitors and detects health concerns in the community through home visits and data gathering. Records and reports health status and problems in the community. Researcher Conducts systematic monitoring of community health through surveys and home visits. Coordinates with organizations for research implementation. Statistician Records, validates, and reports health data systematically. Analyzes and interprets data for monitoring community health developments. Change Agent CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 2 of 35  J Medel Notes Promotes and motivates change in health practices and lifestyle behaviors. Inculcates self-reliance for community development and improvement. Core Values of a Community Health Nurse Integrity Care Comes First: Listen to others and provide clear information and advice. Confidentiality: Maintain strict confidentiality of patient information. Veracity: Be truthful to build trusting relationships. Accountability: Accept responsibility for actions. Respect Dignity: Protect patient privacy and ensure anonymity in public documents. Honesty and Integrity: Maintain high levels of personal and professional conduct. Uphold Reputation: Be aware of the consequences of actions both inside and outside of work. Professionalism High Standards of Care: Be punctual and seek help when needed. Leadership: Develop leadership skills through communication, respect, and resourcefulness. Competence Conflict Resolution: De-escalate problems by considering everyone's needs and communicating solutions. Ethical Thinking: Make value-based judgments prioritizing patients and colleagues. Adaptability: Combine new information with experience and professional guidelines for effective solutions. Commitment Fidelity: Fulfill commitments to oneself and others. Accountability: Accept responsibility for one's actions and be accountable to patients and colleagues. Openness Confidence in Services: Foster confidence through open communication. Public Scrutiny: Welcome feedback and use it to improve. Encourage Communication: Make it clear that speaking up is valued. Integrity in Communication: Communicate clearly and with integrity. Teamwork Collaboration: Communicate and cooperate with others to develop an efficient work environment. Respect Contributions: Treat everyone with respect and value their contributions. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 3 of 35  J Medel Notes Leadership in Teams: Guide others to provide higher levels of care through excellent communication and leadership skills. Patriotism National Pride: Demonstrate love, devotion, and attachment to the homeland and fellow citizens. Filipino Culture, Values, and Practices in Relation to Health Care Cultural Considerations Cultural Identity: Not all individuals identify strongly with their birth culture, and some may practice selected customs. Rituals: Rituals become important during significant life transitions. Ethical Dilemmas: Consult leaders of spiritual or cultural groups when dilemmas arise. Health Beliefs and Behaviors Response to Illness Family and Faith: Rely on family, friends, and faith in God. Miracles: View improvements in health as miracles. Family Influence: Family members influence health care decisions. Home Remedies: Use traditional home remedies and alternative treatments. Advice from Health Professionals: Seek medical advice from family members or friends who are health professionals. Response to Mental Illness Shame (Hiya): Experience devastating shame related to mental illness. Sensitivity to Criticism (Amor Propio): Be sensitive to criticism. Coping Styles Patience and Endurance (Tiyaga): Tolerate uncertain situations. Flexibility (Lakas ng Loob): Be respectful and honest with oneself. Humor (Tatawanan ang Problema): Laugh at oneself during adversity. Fatalistic Resignation (Bahala Na): View illness and suffering as predestined by God. Group Harmony (Pakikisama): Maintain group harmony by conceding to collective wishes. Cultural Values Smooth Interpersonal Relationships: Value shared identity and equal engagement with others. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 4 of 35  J Medel Notes Personalism: Give importance to individuals rather than agencies or institutions. Respect and Concern: Value sensitivity, respect, concern, understanding, and consideration for others. Interaction with Health Providers One of Us (Hindi Ibang Tao): Trust health providers who are respectful and accommodating. Not One of Us (Ibang Tao): Be reluctant to express feelings to untrusted providers. Family and Filial Responsibility Respect for Elders: Show affection and respect for older family members and authority. Care for Aging Parents: Be obligated to care for older adults and maintain family harmony. Spiritual Life and Religiosity Religion: Deeply embedded in Filipino culture, enabling people to face life's challenges with strength and optimism. Coping Practice: Use spirituality and religion to cope with illness. Global and National Health Situations Global Trends (1955-2025) Population Growth: Increase from 2.8 billion in 1955 to an estimated 8 billion by 2025. Urbanization: Shift from 68% rural in 1955 to 59% urban by 2025. Age Structure: Increase in the proportion of older adults and decline in young people under 20 years. Life Expectancy: Increase from 48 years in 1955 to 73 years by 2025. Leading Causes of Death: Shift from infectious diseases to non-communicable diseases like heart disease and cancer. National Health Challenges (Philippines) Health Sector Initiatives: Address national debt, poverty, high birth rates, and population growth through innovative health care services. Global Health Issues: Address global health challenges such as HIV/AIDS, diabetes, cancer, and non-communicable diseases. National Health Programs: Implement health programs to improve maternal and child health, reduce malnutrition, and control infectious diseases. Health of Specific Populations Infants and Small Children Mortality Reduction: Continued reduction in under-5 mortality. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 5 of 35  J Medel Notes Infant Mortality Rate: Decrease from 148 per 1000 live births in 1955 to a projected 29 in 2025. Malnutrition: High prevalence of low-birthweight babies and underweight children. Older Children and Adolescents HIV/AIDS: Significant health risk for children and adolescents. Risks in Adolescence: Increased risk of violence, delinquency, drugs, alcohol, and sexual hazards. Adults Non-communicable Diseases: Increased prevalence of heart disease, stroke, cancer, diabetes, and lifestyle-related diseases. Premature Deaths: Many preventable deaths among adults aged 20-64 years. Older People Chronic Diseases: High prevalence of circulatory diseases, cancer, and dementia among people over 65 years. Impairments: Increased risk of hearing, vision, mobility, and mental function impairments. Latest Updates in Global Health 1. COVID-19 Pandemic Impact: o Ongoing global efforts to vaccinate populations. o Addressing long-term effects of the pandemic on mental health, economy, and health systems. o Emphasis on strengthening health infrastructure and preparedness for future pandemics. 2. Non-Communicable Diseases: o Rising cases of diabetes, hypertension, and obesity globally. o WHO initiatives to promote healthy lifestyles and prevent non- communicable diseases through public health campaigns. 3. Climate Change and Health: o Impact of climate change on health, including increased prevalence of heat-related illnesses and vector-borne diseases. o Global health initiatives to mitigate climate change effects and promote environmental sustainability. 4. Mental Health Awareness: o Increased focus on mental health due to the pandemic, with global campaigns to reduce stigma and improve access to mental health services. o Integration of mental health into primary health care systems. 5. Digital Health Innovations: CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 6 of 35  J Medel Notes Growth of telehealth and digital health technologies to improve access o to care. o Use of data analytics and artificial intelligence to enhance health outcomes and personalized care. 6. Universal Health Coverage: o Global efforts to achieve universal health coverage by 2030, ensuring that all individuals have access to quality health services without financial hardship. o Strategies to strengthen health systems and improve health equity. Conclusion Community Health Nursing is a dynamic and vital field that integrates nursing skills, public health principles, and cultural sensitivity to promote health and wellness in communities. Understanding the core values, roles, and responsibilities of community health nurses, along with the cultural context of health practices, is essential for providing effective and compassionate care. Addressing global and national health challenges requires a comprehensive and holistic approach to ensure the well-being of individuals, families, and communities. Keeping abreast of the latest updates in global health is crucial for adapting to evolving health needs and improving health outcomes. --- end of notes ---- Module 2 LESSON TITLE: Standards of Public Health Nursing in the Philippines and the Evolution of Public Health in the Philippines LEARNING OUTCOMES At the end of the lesson, the nursing student will be able to: 1. Apply the competency standards of nursing practice in the Philippines in community health nursing practice. 2. Integrate relevant principles of social, physical, natural, and health sciences and humanities in a given health and nursing situation. 3. Discuss appropriate community health nursing concepts and actions holistically and comprehensively. 4. Outline the historical development of public health and public health nursing in the Philippines. Reference Materials CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 7 of 35  J Medel Notes Famorca, Z. U., Nies, M. A., & McEwen, M. (2013). Nursing Care of the Community. Elsevier Gezondheidszorg. Standards of Public Health Nursing in the Philippines Legal Basis Nursing Practice: Governed by section 28 of R.A No. 9173. Scope: Includes nursing services, care during various life stages, health promotion, illness prevention, and collaboration with other healthcare professionals. Duties of a Nurse 1. Provide Nursing Care: o Utilize the nursing process to assess, diagnose, plan, implement, and evaluate nursing care for individuals, families, and communities. 2. Establish Linkages: o Develop connections with community resources and coordinate with the health team to provide comprehensive care. 3. Health Education: o Educate individuals, families, and communities on health promotion, disease prevention, and healthy lifestyle choices. 4. Supervise Students: o Teach, guide, and supervise nursing students in clinical settings. 5. Consultation Services: o Engage in activities requiring the knowledge and decision-making skills of a registered nurse. 6. Human Resource Development: o Conduct training and research to develop advanced nursing practice and improve healthcare delivery. Standards of Care Standard 1: Assessment The Public Health Nurse (PHN) collects comprehensive data pertinent to the health status of the populations. This includes: o Health history and physical examination. o Environmental assessment. o Social and economic factors impacting health. Standard 2: Population Diagnosis and Priorities The PHN identifies expected outcomes for a plan based on population diagnosis and priorities. This involves: o Analyzing assessment data. o Identifying health problems and risk factors. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 8 of 35  J Medel Notes Setting priorities based on community needs and resources. o Standard 3: Outcome Identification The PHN identifies expected outcomes for a plan that is based on population diagnoses and priorities. These outcomes should be: o Specific, measurable, achievable, relevant, and time-bound (SMART). o Aligned with community goals and health promotion strategies. Standard 4: Planning The PHN develops a plan that reflects best practices by identifying strategies, action plans, and alternatives to attain expected outcomes. This includes: o Collaborating with community members and stakeholders. o Developing evidence-based interventions. o Creating a timeline for implementation. Standard 5: Implementation The PHN implements the identified plan by partnering with others. Key activities include: o Coordination: Organize programs, services, and activities to implement the plan effectively. o Health Education and Promotion: Use various strategies to promote health, prevent disease, and ensure a safe environment. o Consultation: Provide expert advice to community groups and officials. o Regulatory Activities: Ensure compliance with public health laws, regulations, and policies. Standard 6: Evaluation The PHN evaluates the health status of the population. This involves: o Monitoring and documenting health outcomes. o Assessing the effectiveness of interventions. o Making necessary adjustments to improve health outcomes. Standards of Professional Performance Standard 7: Quality of Practice The PHN systematically enhances the quality and effectiveness of nursing practice by: o Participating in continuing education. o Implementing best practices. o Engaging in quality improvement initiatives. Standard 8: Education The PHN attains knowledge and competency reflecting current nursing and public health practice through: o Ongoing education and training. o Keeping up-to-date with the latest research and guidelines. Standard 9: Professional Practice Evaluation CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 9 of 35  J Medel Notes The PHN evaluates one’s own nursing practice against professional standards and guidelines. This includes: o Seeking feedback from peers and supervisors. o Reflecting on personal performance. o Making improvements based on evaluation. Standard 10: Collegiality and Professional Relationships The PHN establishes collegial partnerships and contributes to the professional development of peers, students, colleagues, and others by: o Sharing knowledge and expertise. o Mentoring and supporting others. o Building strong professional networks. Standard 11: Collaboration The PHN collaborates with representatives of the population, organizations, and health professionals to promote health by: o Participating in interprofessional teams. o Engaging community stakeholders in health initiatives. o Fostering partnerships to enhance health outcomes. Standard 12: Ethics The PHN integrates ethical provisions in all areas of practice, ensuring that: o Patient confidentiality is maintained. o Ethical dilemmas are addressed appropriately. o Professional standards are upheld. Standard 13: Research The PHN integrates research findings into practice by: o Conducting or participating in research studies. o Applying evidence-based practices. o Sharing research outcomes with the community and colleagues. Standard 14: Resource Utilization The PHN considers factors related to safety, effectiveness, cost, and impact in planning and delivery of nursing and public health programs, policies, and services by: o Using resources efficiently. o Prioritizing interventions that offer the greatest benefit. o Advocating for adequate funding and resources. Standard 15: Leadership The PHN provides leadership in nursing and public health by: o Guiding and inspiring others. o Leading health initiatives. o Advocating for health policies and programs. Latest Updates on Standards of Public Health Nursing in the Philippines CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 10 of 35  J Medel Notes Digital Health Innovations: Integration of telehealth and digital health technologies to improve access to care and health outcomes. Mental Health Focus: Increased emphasis on mental health services, including destigmatization and improving access to care. Climate Change Impact: Addressing the health effects of climate change through public health initiatives. Non-Communicable Diseases: Ongoing efforts to prevent and manage diseases like diabetes, hypertension, and obesity through public health campaigns. Universal Health Coverage: Striving to achieve universal health coverage by 2030, ensuring equitable access to health services. Evolution of Public Health in the Philippines Historical Development 1898: Establishment of the Department of Public Works, Education, and Hygiene The foundation of organized public health efforts in the Philippines. 1912: The Fajardo Act (Act No. 2156) Created Sanitary Divisions; male nurses were assigned in the absence of physicians. Philippine General Hospital sent nurses to Cebu to care for mothers and babies. 1914-1918: Early Public Health Nursing Efforts Nurses provided care to mothers and children, conducted home visits, and worked in school nursing. Reorganization Act No. 2462 created the Office of General Inspection, leading to the employment of Filipino nurses in maternal and child health and sanitation roles. 1923: Establishment of Government Nursing Schools Schools were established to train non-Christian women for service in their communities. Expansion of public health nursing services and gradual increase in public health nurses. 1928: First Convention of Nurses Initiated pre-service training as a prerequisite for appointment. Section of Public Health Nursing was established to provide guidance. 1930: Creation of the Section of Nursing Provided supervision and guidance for public health, hospital nursing, and nursing education. 1941-1945: World War II and Public Health Nursing CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 11 of 35  J Medel Notes Nurses were involved in emergency care, including care for prisoners of war and in guerilla activities. Post-war efforts led to the reorganization and strengthening of public health nursing services. 1950: Establishment of the Rural Health Demonstration and Training Center (RHDTC) Assisted by WHO and UNICEF, it became a training center for health workers. Used as a model for interdisciplinary training in public health practice. 1953: Republic Act No. 1082 (Rural Health Law) Created the first 81 Rural Health Units, enhancing rural health services. Each unit included a physician, a public health nurse, a midwife, a sanitary inspector, and a clerk-driver. 1967: Public Health Nursing Program Supervisors Focused on controlling special diseases and program planning. Increased the roles and responsibilities of nurses in public health programs. 1987-1989: Executive Order No. 119 Reorganized the Department of Health, creating new offices and services. Increased the number of Nursing Program Supervisors and expanded their roles. 1999: Executive Order No. 102 Redirected the functions and operations of the Department of Health. Transferred or devolved many nursing positions to other offices and services. 2006-Present: Philippine Nursing Act of 2002 (Republic Act No. 9173) Updated policies and standards for nursing practice and education. Emphasized the importance of advanced nursing education and the integration of research in nursing practice. Key Milestones in Public Health Nursing 1912: Creation of Sanitary Divisions under the Fajardo Act. 1914: Initiation of school nursing by the Bureau of Health. 1923: Establishment of government nursing schools. 1950: Creation of the Rural Health Demonstration and Training Center. 1953: Implementation of the Rural Health Law (Republic Act No. 1082). 1987: Reorganization of the Department of Health under Executive Order No. 119. 2006: Enactment of the Philippine Nursing Act of 2002 (Republic Act No. 9173). Recent Developments Digital Health: Emphasis on telehealth and digital health technologies to enhance care delivery. Mental Health: Strengthening mental health services, focusing on destigmatization, and increasing access to care. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 12 of 35  J Medel Notes Climate Change: Initiatives to mitigate the health impacts of climate change. Non-Communicable Diseases: Public health campaigns to prevent and manage conditions like diabetes and hypertension. Universal Health Coverage: Efforts to ensure that all Filipinos have access to quality health services by 2030. Conclusion The evolution of public health nursing in the Philippines reflects the dynamic changes in healthcare needs and the continuous improvement of nursing standards. By understanding the historical context and current standards, community health nurses can provide effective, culturally sensitive, and comprehensive care to diverse populations. Module 3 LESSON TITLE: Theoretical Foundation of Community Health Nursing LEARNING OUTCOMES At the end of the lesson, the nursing student will be able to: 1. Integrate relevant principles and theories of social, physical, natural, and health sciences and humanities in a given health and nursing situation in the community. 2. Compare the different theories in community health nursing. Reference Materials Famorca, Z. U., Nies, M. A., & McEwen, M. (2013). Nursing Care of the Community. Elsevier Gezondheidszorg. MAIN LESSON Introduction Community health nursing involves working on complex health problems that require strategic thinking. Health problems often have deep-rooted causes that have existed for generations. Nurses must focus their time, energy, and resources effectively to solve these problems without creating new ones. The advancement of nursing theories has formalized the scientific base of community health nursing, helping nurses conceptualize and implement strategies to enhance community health. Theoretical Approaches in Community Health Nursing 1. General System Theory Overview CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 13 of 35  J Medel Notes Applicability: Individual, family, groups, communities. Concept: Open system where the client interacts with the environment. Key Components Inputs: Resources taken from the environment (e.g., food, water, information). Throughput: Processes these inputs. Outputs: Results of the processing (e.g., health practices, health status). Feedback: Information from the environment allowing adjustments for better functioning. Diagram: General System Theory Figure 1: General System Theory Diagram Application Assessment: Observe interpersonal relationships and environmental conditions. Intervention: Address inputs, processes, and outputs to improve health outcomes. Example Scenario: A family experiencing malnutrition. Assessment: Identify lack of access to nutritious food (input), poor dietary habits (throughput), and malnourished children (output). Intervention: Implement community food programs and educate families on nutrition, then monitor and adjust the program based on feedback. 2. Social Learning Theory Overview Concept: Learning occurs in a social context through modeling or observing others. Key Points People learn by observing the behavior of others. Learning is promoted by seeing others model behaviors. Diagram: Social Learning Theory Figure 2: Social Learning Theory Diagram Application Intervention: Use role models and mentors to demonstrate healthy behaviors. Example Scenario: Promoting handwashing in schools. Intervention: Use older students or teachers to model proper handwashing techniques for younger children. 3. The Health Belief Model (HBM) CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 14 of 35  J Medel Notes Overview Basis: Foundation for health education and health promotion. Key Assumptions Individuals must know what to do and how to do it before taking action. Information must be relevant to the individual's needs. Diagram: Health Belief Model Figure 3: Health Belief Model Diagram Application Assessment: Identify beliefs and perceptions about health behaviors. Intervention: Provide targeted education to address misconceptions and promote health behaviors. Example Scenario: Increasing immunization rates in a community with vaccine hesitancy. Assessment: Identify misconceptions and fears about vaccines. Intervention: Provide factual information and address concerns through community meetings and informational materials. 4. Milio’s Framework for Prevention Overview Concept: Health status is influenced by the availability of critical resources. Key Points Health-sustaining resources (e.g., safe food, shelter) are essential. Excess resources (e.g., too much food) can lead to health problems (e.g., obesity). Health behavior patterns are influenced by knowledge, perceptions, and experiences. Resources Impacting Health Choices Personal: Awareness, knowledge, beliefs, money, time. Societal: Availability of health services, environmental protection, safe shelter, policies. Diagram: Milio’s Framework for Prevention Figure 4: Milio’s Framework for Prevention Diagram Application Intervention: Ensure availability and accessibility of health-sustaining resources. Example Scenario: Addressing obesity in a community. Assessment: Identify factors like lack of access to healthy food and safe places for physical activity. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 15 of 35  J Medel Notes Intervention: Implement community gardens and safe walking paths, provide nutrition education. 5. Pender’s Health Promotion Model (HPM) Overview Focus: Biopsychosocial factors influencing health promotion activities. Key Points Depicts complex interactions affecting health. Includes seven variables related to health behaviors. Does not consider threats as motivators, recognizing that not all age groups are motivated by threats. Diagram: Pender’s Health Promotion Model Figure 5: Pender’s Health Promotion Model Diagram Application Assessment: Identify biopsychosocial factors influencing lifestyle choices. Intervention: Develop health promotion programs focusing on individual motivations. Example Scenario: Promoting physical activity among elderly adults. Assessment: Identify barriers such as lack of motivation or physical limitations. Intervention: Create tailored exercise programs that address individual needs and preferences. 6. The Transtheoretical Model (TTM) Overview Concept: Behavior change occurs over time through stages. Stages of Change 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance Key Assumptions Change is a process that can stop, progress, or regress. People resist change for various reasons (e.g., discomfort, stress, social relationships). Diagram: The Transtheoretical Model Figure 6: The Transtheoretical Model Diagram Application Assessment: Identify individuals’ stages of change. Intervention: Tailor interventions to each stage of change. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 16 of 35  J Medel Notes Example Scenario: Smoking cessation program. Assessment: Identify the stage of change for each participant. Intervention: Provide appropriate support, such as awareness campaigns for those in precontemplation and counseling for those in the action stage. 7. PRECEDE-PROCEED Model Overview Purpose: Framework for community assessment, health education, planning, and evaluation. PRECEDE Predisposing factors: Characteristics motivating health-related behavior. Reinforcing factors: Feedback and support that encourage behavior. Enabling factors: Resources and skills needed for behavior change. Construct: Structure for understanding health behaviors. Educational Diagnosis Evaluation PROCEED Policy Regulatory Organizational Construct Educational Developmental Diagram: PRECEDE-PROCEED Model Figure 7: PRECEDE-PROCEED Model Diagram Application Assessment: Identify predisposing, reinforcing, and enabling factors. Intervention: Develop and implement health education programs, evaluate effectiveness. Example Scenario: Reducing teenage pregnancy rates. Assessment: Identify factors such as lack of sex education, peer pressure, and access to contraception. Intervention: Develop comprehensive sex education programs and provide access to contraceptive resources. Application of Theoretical Approaches Case Study 1: Addressing Malnutrition in a Rural Community Situation: High prevalence of malnutrition among children. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 17 of 35  J Medel Notes Theoretical Approach: General System Theory o Assessment: Identify lack of access to nutritious food (input), poor dietary habits (throughput), and malnourished children (output). o Intervention: Implement community food programs and educate families on nutrition, then monitor and adjust the program based on feedback. Case Study 2: Increasing Immunization Rates Situation: Low immunization rates due to cultural beliefs. Theoretical Approach: Health Belief Model o Assessment: Identify misconceptions and fears about vaccines. o Intervention: Provide factual information and address concerns through community meetings and informational materials. Case Study 3: Promoting Healthy Lifestyles Situation: High rates of obesity and sedentary lifestyles. Theoretical Approach: Pender’s Health Promotion Model o Assessment: Identify biopsychosocial factors influencing lifestyle choices. o Intervention: Develop interactive health promotion programs focusing on nutrition and physical activity, consider individual motivations. Case Study 4: Behavior Change in Smoking Cessation Situation: High smoking rates in the community. Theoretical Approach: Transtheoretical Model o Assessment: Identify individuals’ stages of change (e.g., precontemplation, contemplation). o Intervention: Tailor interventions to each stage (e.g., awareness campaigns for precontemplation, support groups for maintenance). Case Study 5: Community Health Education Situation: Need for comprehensive health education in the community. Theoretical Approach: PRECEDE-PROCEED Model o Assessment: Identify predisposing, reinforcing, and enabling factors. o Intervention: Develop and implement health education programs, evaluate effectiveness and impact. Conclusion Theoretical foundations in community health nursing provide a structured approach to addressing complex health problems. By integrating relevant theories and principles, nurses can develop effective strategies to improve community health. Comparing different theories helps in selecting the most appropriate approach for specific health issues, ensuring holistic and comprehensive care. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 18 of 35  J Medel Notes Module 4: LESSON TITLE: Interpersonal Care in the Community LEARNING OUTCOMES At the end of the lesson, the nursing student will be able to: 1. Demonstrate effective teamwork and communication among members of the health team to ensure safe and high-quality client care. 2. Coordinate and delegate tasks/functions effectively among nursing personnel (midwife, BHW, and utility worker). 3. Apply principles of partnership and collaboration to enhance the delivery of health care services in the community setting. 4. Analyze the roles and responsibilities of various health professionals in community health nursing. 5. Develop strategies to address common challenges in coordinating community health care. Reference Materials Famorca, Z. U., Nies, M. A., & McEwen, M. (2013). Nursing Care of the Community. Elsevier Gezondheidszorg. MAIN LESSON Introduction Community health nursing envisions a multidisciplinary and multisectoral approach to health as a key to development. The community health nurse is a key health professional in the Philippine community health care delivery system, working alongside doctors, midwives, nutritionists, dentists, medical technologists, sanitary inspectors, and barangay health workers (BHWs). Key Health Professionals in Community Health Nursing and Other Health Professionals Community health today involves several sectors and professionals, including: Doctors Nurses Midwives CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 19 of 35  J Medel Notes Nutritionists Dentists Medical Technologists Sanitary Inspectors Barangay Health Workers (BHWs) These professionals work together in various health activities such as: Health Education Environmental Sanitation Health Promotion Health Protection Disease Prevention Roles and Responsibilities Medical Practice Scope of Practice: Defined under Republic Act (R.A.) No. 2382, "The Medical Act of 1959," includes diagnosing, treating, and operating on patients. o A physician is responsible for physically examining patients and diagnosing, treating, and prescribing remedies for any human diseases, injuries, deformities, physical, mental, or physical conditions. Nursing Practice Scope of Practice: Defined under R.A. No. 9173, "The Philippine Nursing Act of 2002," includes providing nursing care, health education, establishing linkages, and collaborating with other health professionals. o A nurse is responsible for nursing care during various stages of life, promoting health, preventing illness, and collaborating with other healthcare providers for curative, preventive, and rehabilitative aspects of care. Midwifery Practice Scope of Practice: Defined under R.A. No. 7392, "The Philippine Midwifery Act of 1992," includes care of women during pregnancy, labor, and postpartum, as well as primary health care services. o A midwife supervises and cares for women during pregnancy, labor, and puerperium, manages normal deliveries, and provides primary health care services, including nutrition and family planning. Nutrition and Dietetics Scope of Practice: Defined under R.A. No. 1286, "The Philippine Nutrition and Dietetics Act of 2013," includes the science of food and nutrition and its application in health care. o A nutritionist-dietitian is involved in therapeutic and food service aspects of nutritional services in health care institutions. Medical Technology CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 20 of 35  J Medel Notes Scope of Practice: Defined under R.A. No. 5527, "The Philippine Medical Technology Act of 1969," includes laboratory testing and procedures to aid in diagnosis and treatment. o A medical technologist conducts examinations of tissues, secretions, excretions, and body fluids using various laboratory procedures and techniques. Dental Care Scope of Practice: Defined under R.A. No. 9484, "The Philippine Dental Act of 2007," includes dental services, hygiene, and technology. o A dentist performs operations on the oral cavity, prescribes treatments for oral diseases, and engages in dental research and education. Sanitary Inspectors Scope of Practice: Defined under R.A. No. 1364, "The Sanitary Engineering Law of 1955," includes water purification, sanitation, and pollution control. o A sanitary engineer or inspector conducts surveys, designs, manages, and consults on public health and welfare projects, including water and sewage systems, pollution control, and industrial hygiene. Barangay Health Workers (BHWs) Scope of Practice: Defined under R.A. No. 7883, "The Barangay Health Workers' Benefits and Incentives Act of 1995," includes primary health care services and community health education. o A barangay health worker is trained to provide primary health care services and health education in the community and works voluntarily or with minimal compensation from local government units. Interpersonal Relationships in Community Health Nursing Importance of Harmonious Relationships Effective teamwork and communication are essential for delivering high- quality care. Collaborative efforts lead to better health outcomes and client satisfaction. Building trust among team members enhances the working environment and improves service delivery. Coordinating Tasks and Functions Community Health Nurse (CHN) must coordinate the tasks of midwives, BHWs, and utility workers to ensure efficient service delivery. Role of the CHN: o Delegating tasks appropriately. o Ensuring all team members understand their roles and responsibilities. o Monitoring and evaluating the performance of the team. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 21 of 35  J Medel Notes Principles of Partnership and Collaboration Partnership: Working with other health professionals, community members, and organizations to achieve common health goals. Collaboration: Sharing responsibilities and decision-making to enhance health care services. Strategies for Effective Collaboration 1. Regular Communication: Hold regular meetings and discussions to ensure everyone is on the same page. 2. Mutual Respect: Value each team member's contributions and expertise. 3. Shared Goals: Establish common objectives to unify efforts. 4. Conflict Resolution: Address disagreements constructively and promptly. 5. Continuous Training: Provide opportunities for team members to enhance their skills and knowledge. Application in Community Health Nursing Case Scenario 1: Coordinating a Vaccination Drive Situation: A rural community with low immunization rates. Action Plan: 1. Assessment: Identify barriers to vaccination through community surveys and feedback. 2. Collaboration: Work with midwives and BHWs to educate the community about the benefits and safety of vaccines. 3. Implementation: Set up vaccination clinics with support from doctors and medical technologists. 4. Evaluation: Monitor vaccination rates and address any issues through follow-up visits and continued education. Case Scenario 2: Health Education Program Situation: High incidence of diabetes in an urban community. Action Plan: 1. Assessment: Gather data on the community's health status and identify high-risk groups. 2. Collaboration: Partner with nutritionists, dietitians, and medical technologists to develop a comprehensive education program. 3. Implementation: Conduct health education sessions on diet, exercise, and lifestyle changes. 4. Evaluation: Measure changes in knowledge, attitudes, and behaviors through pre- and post-intervention assessments. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 22 of 35  J Medel Notes Case Scenario 3: Chronic Disease Management Situation: Managing hypertension and diabetes in a remote area with limited healthcare access. Action Plan: 1. Assessment: Identify individuals with chronic diseases and assess their management needs. 2. Collaboration: Establish telehealth consultations with healthcare providers and coordinate with local health workers for follow-up. 3. Implementation: Develop personalized management plans, provide education on medication adherence, and monitor health status regularly. 4. Evaluation: Track health outcomes and adjust management plans as needed. Case Scenario 4: Disaster Response Situation: Responding to a major flood affecting the community. Action Plan: 1. Assessment: Evaluate immediate needs for safety, shelter, food, and clean water. 2. Collaboration: Work with local authorities, health workers, and volunteers to coordinate relief efforts. 3. Implementation: Set up emergency shelters, distribute essential supplies, and provide medical care. 4. Evaluation: Monitor the health and safety of affected individuals and address any emerging issues. Recent Updates and Trends in Community Health Nursing Integration of Technology Telehealth Services: Provide remote consultations and follow-ups, especially in remote or underserved areas. Electronic Health Records (EHR): Enhance data management, improve continuity of care, and facilitate information sharing among healthcare providers. Community-Based Health Programs 4Ps (Pantawid Pamilyang Pilipino Program): A human development program investing in health and education of poor families. Kalahi-CIDSS (Comprehensive and Integrated Delivery of Social Services): A community-driven development program aimed at improving access to basic services and promoting inclusive growth. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 23 of 35  J Medel Notes Sustainable Livelihood Program (SLP): Enhances socio-economic status through micro-enterprise development and employment facilitation. Enhanced Training and Development Continuous Professional Development: Ensure health workers maintain competence through ongoing training and education. Cultural Competence Training: Equip health workers with skills to provide culturally appropriate care to diverse communities. Policy and Advocacy Policy Development: Engage in policy-making processes to improve access to quality health care. Advocacy: Promote health equity and advocate for resources and support for underserved populations. Conclusion Interpersonal care in community health nursing involves maintaining harmonious relationships, coordinating tasks, and applying principles of partnership and collaboration. By working together, health professionals can provide effective, efficient, and safe client care, ultimately improving health outcomes in the community. Module 5: Community Health Nursing 1: Ethical Considerations in Community Health Nursing Learning Outcomes At the end of the lesson, the nursing student can: 1. Adhere to ethical and legal considerations when providing safe, quality, and professional nursing care. 2. Follow established norms of conduct based on the Philippine Nursing Law and other legal, regulatory, and institutional requirements relevant to safe nursing practice. Overview Ethical and legal principles guide the practice of community health nursing, ensuring the welfare and rights of clients are protected. Professional practice is considered legal if it aligns with existing laws, but it must also adhere to ethical standards to ensure comprehensive client care. Ethical Principles in Community Health Nursing 1. Respect for Autonomy Definition: Autonomy refers to the freedom of action chosen by an individual capable of making and acting on their own decisions. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 24 of 35  J Medel Notes Applications: o Respect for Persons: Clients should be given choices and included in treatment plans. § Example: Elderly patients deciding their life and health plans. o Protection of Privacy: Nurses must protect client privacy and confidentiality. § Example: Keeping patient records confidential. o Informed Consent: Clients must receive all necessary information to make an informed decision. § Example: Explaining a treatment's risks and benefits before obtaining consent. o Freedom of Choice: Respecting clients' rights to accept or refuse treatment. § Example: A competent adult refusing a blood transfusion. o Protection of Diminished Autonomy: Protecting those with limited autonomy, such as children or individuals with mental disabilities. 2. Beneficence Definition: Beneficence involves doing good and preventing harm to clients. Applications: o Balancing Harms and Benefits: Weighing the risks and benefits of healthcare interventions. § Example: Deciding whether a vaccination's benefits outweigh potential side effects. o Cost-Benefit Analysis: Analyzing the costs and benefits of different health programs. § Example: Allocating resources to the most beneficial health programs. 3. Justice Definition: Justice involves fairness in the distribution of resources and respect for individuals' rights. Applications: o Distributive Justice: Fair distribution of scarce resources. § Example: Equitably distributing vaccines during a shortage. o Rights-Based Justice: Respecting individuals' rights. § Example: Ensuring all patients have access to necessary healthcare services. o Legal Justice: Following morally acceptable laws. § Example: Adhering to health regulations and standards. Theories of Justice Entitlement Theory: Individuals are entitled to what they receive by natural lottery without governmental intervention. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 25 of 35  J Medel Notes Utilitarian Theory: Resources should be used to achieve the greatest good for the greatest number. o Example: Allocating funds to the most effective public health programs. Maximin Theory: Prioritizing the needs of the least advantaged. o Example: Providing additional support to low-income families. Egalitarian Theory: Ensuring equal distribution of welfare and resources. o Example: Equal access to healthcare for all citizens. Legal Safeguards for Community Health Nurses 1. Informed Consent Definition: Voluntary agreement to participate in healthcare decisions after being informed of risks, benefits, and alternatives. Example: Explaining the procedure and obtaining written consent before surgery. 2. Contracts Definition: Legal agreements between two parties. Can be written or oral. Example: Agreement between a nurse and patient on the care plan. 3. Collective Bargaining Definition: Negotiations between employers and a group of employees aimed at reaching agreements to regulate working conditions. Example: Nurses negotiating for better working conditions. 4. Competent Practice Definition: Providing care according to established standards and protocols. Example: Following updated clinical guidelines for patient care. 5. Respecting Individual Rights Definition: Respecting clients' rights to make their own health decisions. Example: Allowing patients to refuse treatment. 6. Patient and Family Education Definition: Providing information to patients and families to make informed health decisions. Example: Teaching a diabetic patient how to manage their condition. 7. Executing Physician Orders Definition: Carrying out orders from a physician, ensuring they are clear and documented. Example: Administering medication as prescribed by a doctor. 8. Documentation Definition: Accurate and complete recording of all nursing care provided. Example: Keeping detailed notes of patient interactions and treatments. 9. Adequate Staffing Definition: Ensuring enough qualified staff to provide quality care. Example: Hospitals maintaining nurse-to-patient ratios. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 26 of 35  J Medel Notes 10. Risk Management Program Definition: Identifying and addressing potential risks to patient safety. Example: Implementing protocols to prevent medication errors. 11. Incident, Variance, and Occurrence Reports Definition: Reporting and analyzing incidents to improve safety. Example: Filing a report after a patient falls. 12. Bill of Rights Definition: Ensuring patients' rights to quality care, decision-making, and privacy. Example: Respecting a patient's right to privacy. 13. Good Samaritan Law Definition: Protecting healthcare providers who assist in emergencies. Example: A nurse providing CPR at an accident scene without fear of legal repercussions. 14. Student Liability Definition: Legal responsibilities of student nurses. Example: Students providing care under the supervision of a qualified instructor. Leadership and Management in Legal Issues Role Modeling: Demonstrating ethical behavior in practice. Knowledge Updates: Staying informed about legal and ethical standards. Reporting: Reporting substandard care to appropriate authorities. Respectful Relationships: Building trust with patients and colleagues. Patient Rights: Prioritizing patient welfare and rights. Risk Management: Implementing measures to minimize risks in healthcare settings. Staff Education: Providing training on legal issues affecting nursing practice. Accountability in Community Health Nursing Moral Accountability: Being answerable for promoting and protecting clients' health while respecting their autonomy. Professional Ethics: Emphasizing beneficence in community health nursing to benefit aggregate groups. Laws Affecting Nursing Practice Health Services R.A 1082: Employment of More Health Personnel in Rural Areas (Rural Health Unit Act) o Provision: This act mandates the employment of additional health personnel in rural areas to improve healthcare services. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 27 of 35  J Medel Notes oImportance: Addresses the shortage of healthcare providers in rural communities, ensuring better access to medical care. R.A 7875: National Health Insurance Act of 1995 o Provision: Establishes the National Health Insurance Program to provide health insurance coverage to all Filipinos. o Importance: Aims to reduce out-of-pocket healthcare expenses and improve access to quality health services. R.A 7305: Magna Carta for Public Health Workers o Provision: Grants additional benefits and incentives to public health workers, including hazard pay and subsistence allowance. o Importance: Enhances the welfare of public health workers, encouraging them to continue serving in government health facilities. R.A 7432: Senior Citizen’s Act of the Philippines o Provision: Provides benefits and privileges to senior citizens, such as discounts on healthcare services and medicines. o Importance: Ensures that elderly citizens have access to affordable healthcare and other essential services. R.A 9257: Expanded Senior Citizens Act of the Philippines o Provision: Expands the benefits and privileges provided to senior citizens under R.A 7432. o Importance: Further enhances the support for senior citizens, promoting their well-being and quality of life. Environmental Health P.D 856: Code of Sanitation o Provision: Establishes sanitary standards and regulations for public health and safety. o Importance: Ensures a clean and healthy environment, reducing the risk of disease transmission. R.A 9211: Anti-Tobacco/No Smoking Campaign o Provision: Regulates the packaging, distribution, and use of tobacco products to protect public health. o Importance: Aims to reduce the prevalence of smoking-related diseases and promote a healthier population. R.A 8749: Clean Air Act of the Philippines o Provision: Establishes policies to reduce air pollution and protect air quality. o Importance: Ensures that citizens have access to clean air, reducing the incidence of respiratory illnesses and other health issues related to air pollution. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 28 of 35  J Medel Notes Communicable Diseases R.A 3573: Reporting of Communicable Diseases o Provision: Mandates the reporting of communicable diseases to the Department of Health for monitoring and control. o Importance: Facilitates the timely identification and management of disease outbreaks, protecting public health. R.A 8504: Prevention and Control of HIV/AIDS o Provision: Establishes comprehensive policies and programs for the prevention and control of HIV/AIDS. o Importance: Aims to reduce the transmission of HIV/AIDS and provide support to affected individuals. Family Planning R.A 3753: Civil Registry Law o Provision: Mandates the registration of births, marriages, and deaths. o Importance: Ensures accurate vital statistics for effective public health planning and services. E.O 209: Family Code of the Philippines o Provision: Establishes laws governing family relations, including marriage, family planning, and child care. o Importance: Protects the rights of family members and promotes the welfare of children and families. Maternal and Child Nursing R.A 9288: Newborn Screening Act of 2004 o Provision: Requires newborn screening for certain congenital disorders. o Importance: Ensures early detection and treatment of congenital conditions, improving child health outcomes. R.A 7600: Rooming-In and Breastfeeding Act of 1992 o Provision: Promotes rooming-in and breastfeeding practices in hospitals and health facilities. o Importance: Encourages breastfeeding, which has significant health benefits for both infants and mothers. R.A 8353: Anti-Rape Law o Provision: Defines and penalizes rape and other sexual offenses. o Importance: Protects individuals, particularly women and children, from sexual violence and abuse. R.A 7877: Anti-Sexual Harassment Act of 1995 o Provision: Prohibits sexual harassment in the workplace and educational institutions. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 29 of 35  J Medel Notes o Importance: Ensures a safe and respectful environment for all individuals. Nutrition P.D 491: Nutrition Act of the Philippines o Provision: Establishes a national nutrition program to address malnutrition and promote healthy eating habits. o Importance: Improves the nutritional status of Filipinos, particularly vulnerable populations. R.A 8976: Philippine Food Fortification Act of 2000 o Provision: Mandates the fortification of staple foods with essential nutrients. o Importance: Addresses micronutrient deficiencies and improves public health. Medications R.A 6675: Generic Act of 1988 o Provision: Promotes the use of generic drugs to make medications more affordable. o Importance: Increases access to essential medicines, particularly for low-income populations. R.A 9165: Comprehensive Dangerous Drugs Act of 2002 o Provision: Establishes policies for the regulation and control of dangerous drugs. o Importance: Aims to reduce drug abuse and its associated health and social problems. R.A 8423: Traditional and Alternative Medicine Act of 1997 o Provision: Promotes the safe and effective use of traditional and alternative medicine. o Importance: Provides alternative healthcare options for Filipinos. Professional Concerns R.A 8981: PRC Modernization Act of 2000 o Provision: Modernizes the Professional Regulation Commission (PRC) to improve the regulation of various professions. o Importance: Ensures that professionals meet high standards of competence and ethics. R.A 6758: Salary Standardization Law o Provision: Standardizes the salaries of government employees, including health workers. o Importance: Ensures fair and equitable compensation for public health workers. R.A 9173: Philippine Nursing Act of 2002 CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 30 of 35  J Medel Notes Provision: Regulates the practice of nursing in the Philippines, o including licensure, practice standards, and continuing education. o Importance: Ensures that nurses provide safe, competent, and ethical care. Privileged Communication and Legal Considerations Privileged Communication: Confidential information shared between healthcare provider and patient, protected by law. Seal of Secrecy: Maintaining confidentiality unless patient consents to disclosure. Testimony: Nurses testifying based on facts they know. Expert Witness: Qualified to give opinions based on special knowledge and experience. Summary Ethical and legal considerations are crucial in community health nursing to ensure safe, quality, and professional care. Understanding and adhering to these principles and laws help protect patient rights and promote trust and respect in healthcare settings. Nurses must stay informed and competent, continuously updating their knowledge and skills to meet these ethical and legal standards. Module 6: LESSON TITLE: Care Law of 2012, Save the Children, Violence Against Women, Senior Citizen Laws LEARNING OUTCOMES: At the end of the lesson, the nursing student will be able to: 1. Adhere to ethical-legal considerations when providing safe, quality, and professional nursing care. 2. Enumerate the rights and responsibilities of every child. 3. Adhere to established norms of conduct based on the Philippine Nursing Law and other legal, regulatory, and institutional requirements relevant to safe nursing practice. Care Law of 2012 (Foster Care Act of 2012) The Foster Care Act of 2012 (Republic Act No. 10165) establishes a system where minors are placed in state-certified caregiver homes or with approved family members. This act aims to provide a safe and nurturing environment for children who cannot live with their birth families due to various circumstances. Purpose of Foster Care: CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 31 of 35  J Medel Notes To provide a safe alternative living environment for children whose current home is unsafe or untenable. To support children who have no family or home. Key Provisions: Foster parents provide temporary care without becoming the child's legal parents. Children eligible for foster care include those who are abandoned, neglected, orphaned, abused, with special needs, awaiting adoption, or in difficult social circumstances. Qualifications for Foster Parents: Legal age and at least 16 years older than the child. Genuine interest and capacity for parenting. Good moral character, physical and mental capability. Sufficient resources to provide for the family’s needs. Willingness to undergo training in child care. Assistance to Foster Child: Monthly subsidy from the Department of Social Welfare and Development (DSWD). Health insurance through PhilHealth. Support services including counseling and training. Save the Children Republic Act 7610 provides stronger deterrence and protection against child abuse, exploitation, and discrimination, with penalties for violations. Save the Children advocates for the welfare and rights of children, ensuring they have access to healthcare, education, protection, and opportunities for development. Key Provisions: Protection against abuse, exploitation, and discrimination. Rights to a wholesome family life, balanced diet, proper education, and safe recreation. 12 Rights of the Child 1. Right to be born well: Every child deserves to be born healthy and without preventable disabilities. 2. Right to a wholesome family life: Every child has the right to be loved and cared for in a family setting. 3. Right to well-rounded development: Every child should have opportunities for physical, emotional, and intellectual growth. 4. Right to basic needs: Every child deserves adequate nutrition, clothing, shelter, and healthcare. 5. Right to moral guidance: Every child should be brought up in an environment that fosters moral and ethical values. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 32 of 35  J Medel Notes 6. Right to education: Every child should have access to education that helps them develop their abilities. 7. Right to recreation: Every child should have opportunities for safe and wholesome recreational activities. 8. Right to protection from exploitation: Every child should be protected from harmful influences and exploitation. 9. Right to a healthy environment: Every child should live in a community that promotes health and well-being. 10. Right to state protection: Every child should receive assistance from the state if their guardians cannot provide for them. 11. Right to good governance: Every child should trust in a government that upholds democracy and morality. 12. Right to peace: Every child should grow up in an atmosphere of peace and tolerance. Responsibilities of the Child 1. Upright and virtuous life: Strive to lead a life in accordance with moral and religious teachings. 2. Respect for parents: Love, respect, and obey parents, and help in maintaining family harmony. 3. Sibling support: Show love and helpfulness to brothers and sisters, fostering unity. 4. Development of potential: Work hard to develop abilities and become a valuable member of society. 5. Respect for elders and customs: Honor elders, respect traditions, and uphold the laws of the country. 6. Civic participation: Engage in civic activities and promote the welfare of the community. 7. Human rights and peace: Help uphold human rights and contribute to global peace and cooperation. Violence Against Women Republic Act 9262 (Anti-Violence Against Women and their Children Act of 2004) and Republic Act 9710 (Magna Carta of Women) protect women from various forms of violence and ensure their rights. Forms of Violence: Physical abuse: Inflicting pain or injury. Psychological or emotional abuse: Causing mental anguish. Financial or material abuse: Exploiting funds or resources. Sexual abuse: Non-consensual sexual contact. Neglect: Failure to fulfill caregiving obligations. Legal Provisions: CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 33 of 35  J Medel Notes RA 9262: Recognizes VAWC as a public crime and provides mechanisms for protection and legal recourse. RA 9710: Seeks to eliminate discrimination and promote women's rights, especially in marginalized sectors. Senior Citizen Laws Senior citizens in the Philippines are protected and provided with various benefits under Republic Act No. 7432, RA No. 9257, and RA 9994 (Expanded Senior Citizens Act of 2010). Application for Senior Citizens Pension: An application form can be collected and completed at the Local Board Office in your district. Applicants may be required to attend an age assessment meeting with the Local Public Assistance Board. The Assistance Board decides on all applications and rejected persons have the right to appeal. Key Provisions: 20% discount and VAT exemption on medicines, medical services, transportation, restaurants, hotels, and recreation centers. Mandatory PhilHealth coverage for senior citizens. Monthly social pension of P500 for indigent senior citizens. Express lanes in commercial and government establishments. Example: Case Study: An elderly woman used her senior citizen ID to avail a 20% discount on her medicines and medical services, significantly reducing her healthcare costs. Detailed Provisions for Senior Citizen Benefits: Medicines and Essential Medical Supplies: 20% discount and VAT exemption. Medical and Dental Services: Professional fees for attending physicians and licensed health workers, diagnostic and laboratory fees in private hospitals, medical facilities, outpatient clinics, and home health care services. Transportation: 20% discount on fares for land (jeepneys, buses, taxis, shuttle services, MRT, LRT, PNR), sea shipping vessels, and domestic transport services. Accommodation and Recreation: 20% discount on restaurants, hotels, cinema houses, concert halls, circuses, leisure, and amusement parks. Utilities: 5% discount on water and electric bills for senior citizens whose monthly consumption does not exceed 100 kilowatt hours of electricity and 30 cubic meters of water. Groceries: 5% discount on basic necessities and prime commodities for purchases up to PHP 1,300 per week. Additional Provisions: CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 34 of 35  J Medel Notes Health Insurance: PhilHealth coverage ensures that senior citizens receive health insurance benefits. Social Pension: Monthly social pension of P500 for indigent senior citizens. Express Lanes: Provision of express lanes in all commercial and government establishments. Senior Citizen ID: Necessary to avail of benefits and discounts. Senior citizens should apply for their ID at the Office of the Senior Citizen Affairs (OSCA) or the Department of Social Welfare and Development (DSWD). Conclusion Understanding and adhering to ethical and legal principles is crucial in providing safe, quality, and professional nursing care in the community. Awareness of relevant laws and regulations helps protect the rights and well-being of clients, especially vulnerable populations such as children, women, and senior citizens. CONFIDENTIALITY AND COPYRIGHT NOTICE These notes are the property of Mr. Medel. Unauthorized use, sharing, or reproduction is prohibited. For permission, contact Mr. Medel. © 2024 Mr. Medel. All rights reserved. Page 35 of 35 The Family Justin J.Medel RN  By the end of this lesson, students will be able to: Learning 1. Define what constitutes a family. 2. Enumerate the health tasks of a family. Outcomes 3. Outline the types of family structures observed in the Philippines. 4. Explore the various family structures prevalent in the Philippines.  Basic Unit in Society: The family is the fundamental social unit, influenced by surrounding forces like values, beliefs, and customs. These elements shape the roles and functions of the family, Definition impacting every aspect of family life. Interacting Unit: of Family A family is a group of interacting persons connected by ties of blood, marriage, or adoption. Typically, they reside in the same household, interacting in their respective familial roles, and maintaining a shared culture. Open and Developing System: Families are dynamic systems, characterized by continuous interaction among members. These interactions are shaped by available resources, stressors, and the larger community context. Social Institution: The family is a social institution with continuity across past, present, and future, influencing behaviors within the unit. The Filipino Constitutional Definition: The Philippine Constitution recognizes the Family Filipino family as the foundation of the nation, emphasizing its importance and the need for its protection and development.  Section 1: The state acknowledges the Filipino family as the foundation of the Family nation and pledges to strengthen its solidarity and promote its total development. Code: Section 2: Marriage is upheld as an inviolable social institution and is protected by the state. Section 3: The state defends various rights related to family life, including: The right to form a family. The right to children’s proper care and protection. The right to a family living wage. Section 4: The family is responsible for caring for its elderly members, though the state may provide social security programs to assist.  Nuclear Family: The basic social unit in the Philippines, consisting of parents Characteristics and children. Bilateral Descent: of the Filipino Filipino families often have extended relationships, with Family kinship circles including distant relatives such as third cousins. Family as a Social Institution: Filipino marriage is viewed not just as a union of individuals, but as a union of families. This kinship system comes with obligations and responsibilities, influencing daily decisions and family dynamics. Equality and Authority: There is a significant degree of equality between husband and wife in Filipino families. Older siblings may also hold some authority over their younger siblings.  Nuclear Family: A father, mother, and their children living together but apart from extended relatives. Types of Extended Family: Composed of two or more nuclear families that are economically and socially related, often multigenerational. Family Single Parent Family: A family headed by a divorced, separated, unmarried, or widowed male or female with at least one child. Structures Blended/Reconstituted Family: A family formed by remarriage, with children from previous marriages or the current marriage. Compound Family: A family with one man or woman having several in the spouses. Communal Family: More than one monogamous couple sharing Philippines resources. Cohabiting/Live-in Family: An unmarried couple living together. Dyad Family: A couple living alone without children. Gay/Lesbian Family: A homosexual couple living together, with or without children. No-Kin Family: A group of at least two people sharing a relationship and support, without legal or blood ties. Foster Family: A substitute family for children whose parents are unable to care for them.  Patriarchal: Full authority rests with the father or another male member of the family. Matriarchal: Authority in Full authority rests with the mother or another female member of the family. the Family Egalitarian: Both husband and wife exercise equal authority. Democratic: All family members are involved in decision-making. Autocratic: One family member has absolute authority. Laissez-Faire: Each family member has full autonomy. Matricentric: The mother takes charge in the absence of the father. Patricentric: The father takes charge in the absence of the mother. Descent Patrilineal: Patterns Affiliation with the father's relatives. Matrilineal: Affiliation with the mother's relatives. Bilateral: Affiliation with both parents' relatives. Residence Patrilocal: Patterns Family resides near or with the husband’s parents. Matrilocal: Family resides near or with the wife’s parents. Functions of Physical Survival: Providing food, clothing, shelter, and the Family protection. Cultural Transmission: (Ackerman) Ensuring the continuation of cultural values and norms. Affectional Function: Serving as the primary unit for emotional support. Social Functions: Providing social togetherness, fostering self- esteem, and supporting individual creativity. Universal Reproduction: Ensuring the continuation of the human Functions of species. Status Placement: the Family Assigning social status to family members. (Doode) Biological and Maintenance: Caring for young and dependent members. Socialization: Teaching social norms and values to children. Social Control: Regulating behavior within the family.  Rationale: The family is the natural and fundamental unit of society, generating, preventing, and correcting health The Family as problems within its membership. a Unit of Care Health problems within the family are often interrelated, making the family the primary focus of health decisions and actions. Characteristics as a Client: The family is a product of its time and place, developing its own lifestyle and patterns of behavior. It operates as a group, with individual actions influencing the entire family. The family interacts with the larger community, contributing to and benefiting from community resources.  Stage 1: Marriage and the Family: Merging values and adjusting routines. Stages of Stage 2: Early Childbearing Family: Birth or adoption of the first child. Family Stage 3: Family with Preschool Children: Managing growth, development, and safety needs. Development Stage 4: Family with School-Age Children: (Duvall & Preparing children for the complexities of the world. Stage 5: Family with Adolescent Children: Miller, 1990) Allowing freedom and preparing adolescents for independence. Stage 6: The Launching Center Family: Children leave to set up their own households. Stage 7: Family of Middle Years: Returning to a two-partner nuclear unit. Stage 8: Family in Retirement/Older Age: Adjusting to retirement and aging.  Physical Maintenance: Providing basic needs such as food, shelter, and healthcare. Family Health Socialization: Preparing children to live and interact in the community. Tasks (Duvall Allocation of Resources: Prioritizing family needs. & Niller) Maintenance of Order: Ensuring effective communication and enforcing family values. Division of Labor: Assigning roles such as provider, home manager, and caregiver. Reproduction, Recruitment, and Release: Ensuring the continuation of the family. Placement in Society: Engaging in community activities that align with family values. Maintenance of Motivation and Morale: Supporting each other and maintaining family unity.  Nurturing Figure: The primary caregiver to children or dependents. Family Roles Provider: The one who provides the family’s basic needs. Decision Maker: Responsible for major decisions, such as finances and conflict resolution. Problem Solver: Resolves family problems to maintain unity. Health Manager: Monitors health and ensures adherence to health appointments. Gatekeeper: Determines what information is shared outside the family.  Family Models: Developmental Models (Duvall and Stevenson): Theoretical Focus on stages of family development and Approaches corresponding tasks. Structural-Functional Model (Friedman): to Family Examines family structure, interaction, and Health Care functional outcomes. Systems Model (Calgary’s Family Model): Focuses on family structure, function, and development, with complex interactions among subsystems.  Health Deficit: Conditions of health breakdown or illness in the Health as