CHNN211 LEC PRELIM.pdf

Discussed by: Prof. Aida Garcia Bachelor of Science in Nursing 2YA CHNN211 LEC: BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 Coverage for Prelim:...

Discussed by: Prof. Aida Garcia Bachelor of Science in Nursing 2YA CHNN211 LEC: BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 Coverage for Prelim: Commonwealth Act No. 430 Evolution PHN in the Phil - Philippine government National/ Global Health Situation - Under Philippine gov. they put up dep. Of health and Community Health Nursing called it Department of Public Health and Welfare. Phil Health Care Delivery System - Pinagsama ang 2 dep. Na to dhil they become the case of Primary Health Care mortality ung pag nag kasakit pwede mamatay at kumuha Rural Health Unit ng needs so lalo hihirap. Family Health Nursing - Modern times: department of health and DSWD Herbal Medicine - DSWD – pinipili nila ung mga indigent, children. Family nursing care plan - Hindi pa ito na fully implement nood dahil mahitap ang ph kaya nung nag bago ang pres. nagpatupad ng↓ EVOLUTION: PUBLIC HEALTH NURSING IN THE EO No. 317 (1941) PHILIPPINES - Full implementation of Commonwealth Act No. 430. 1577 Dr. Jose Fabella - Franciscan Friar Juan Clemente (Priest) opened medical - 1st Department Secretary of Health and Public Welfare. dispensary in Intramuros for the indigent. 1947 – Post war - This medical dispensary is now san Lazaro hospital - the Department of Health was reorganized into bureaus: - Dispensary – nag bibibgay ng libreng gamot - Bureau of Hospitals and a Bureau of Quarantine were 1690 created under DOH. - Dominican Father Juan de Pergero (Priest) worked toward - Took charge of municipal and charity clinics. installing water system in San Juan del Monte and Manila. - (DOH nagging 2 dept. kase lalong nag hirap ang ph - They adopted the idea of john snow who find out that after nung war at maraming infectious diseases) cholera contaminates water so they put up water station. - Creation of Nursing Service Division. 1805 1) Bureau of Health with the sanitary divisions under it. - Smallpox vaccination was introduced by Francisco de - Originally male nurses handle sanitation during Balmis, a personal physician of King Charles IV of Spain. Spain time 1876 - Eventually nung nag karoon ng sanitary div. at - First medicos titulares (Certified doctor) were appointed doctor na ang boss nila. by the Spanish government. - After non ung sanitary division pinasok na nila - Dumarami na ang sakit dito sa pilipinas kaya nag padala yung trabaho under DOH sila ng mga doctor pero maraming doc. ang ayaw - DOH responsible na ngayon sa disease pumunta dito. Kaya gumawa sila ng 2yrs course sa UST↓ prevention and health promotion 1888 2) Bureau of public welfare (became the Social Welfare - 2-year courses consisting of fundamental medical and Administration, katumbas ng DSWD) dental subjects - First offered UST. 3) Bureau of hospitals – curative - Graduates were “cirujanos ministrantes”. 4) Bureau of hospitals – preventive care services. - Serve as male nurses and sanitation inspectors. They are 1951 the one who are given the responsibility when it comes to - Sanitary district was converted into a Rural Health Unit. sanitation of the community. - 81 selected provinces (ginawa lang sa mga probinsyang 1901 Malaki ang problema). - United States Philippine Commission - Vital statistics - bilang ng mga namatay, nag kasakit at - Act 157, created Board of Health of Philippine Islands gumaling. Ang binibilang lang ay ung mga sakit na with Commissioner of the Public Health (like duque), as mabilis kumalat. chief executive officer (now DOH) - 7 Basic Health Services: Fajardo Act of 1912 1. Maternal and Child Health - created Sanitary Divisions made up of one to four 2. Environmental Health municipalities. 3. Communicable Disease Control - Each sanitary division had a president who had to be 4. Vital Statistics physician. 5. Medical Care 1915 6. Health Education - Philippine General Hospital began to extend public health 7. Public Health Nursing nursing services in homes by organizing unit called social 1954 – R. A. 1082 or Rural Health Act and home services. - Initially known as sanitary district/division. 1905 Asociacion Femenista Filipina - Creation of RHU in every municipality. - La Gota de Leche was the first center dedicated to the - Created post for Municipal Health Officer. service of mother and babies. - Originally 81 provinces have this now lahat na ay meron. J.A.K.E 1 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) 1957 – R. A. 1891 2005 - amend certain provisions in Rural Health Act. - FOURmula One (F1) for health and Universal Health - Created 8 categories of rural health units corresponding to Care in 2010 – agenda launched in 1999 the population size of the municipalities. - Health Service Delivery - Both the national government - Barangay Health Station – branch RHU; no dentist; main and LGUs manage the delivery of promotive, preventive, stay midwife; barangay health worker. curative and rehabilitative health services. - Rural Sanitary Inspector – siya na nagiinspect ng - Health Financing – The National Health Insurance Act of sanitation. 1995 created the Philippine Health Insurance Corporation 1970 (PhilHealth) to provide health insurance coverage for all - Classification of health services into: Primary, Secondary Filipinos. and Tertiary Levels of Care. - Health governance and regulation – The enactment of - PHN population ratio is 1: 20,000. (1-nurse) LGC in 1991 led to dual governance in health, with the - Primary Level of Care – for health promotion and disease DOH governing at the national level and the LGUs at the prevention. (Rural Health center formal na tawag sa subnational level. health center) 2010 - Secondary Level of Care – pag may sakit, moderate - Agenda launched in 1999 Health Service Delivery. Both specialized care. District hospital the national government and LGUs manage the delivery - Tertiary Level of Care – highly specialized care. of primitive, preventive, curative and rehabilitative health RA 1891 services. - In 1957 amend certain provisions in rural health act Universal Health Care - Created 8 categories of rural health units corresponding to - Aims to achieve the health system goals of better health the population size of the municipalities outcomes, sustained health financing, responsive health - Ung mga lugar na hindi naabot ng health center ay system that will provide equitable access to health care. tinayuan ng barangay health station- branch of rural health Universal Health Care Act Kalusugan Pangkalahatan unit (Republic Act No. 11223) - Barangay health station- no dental chair and no nurses and - automatically enrolls all Filipino citizens in the National doc available unlike in RHU. Health Insurance Program. - Rural sanitary inspector- inspects environment if it can - Provide all Filipinos with access to affordable, quality, and cause sickness. comprehensive health services. 1991 October, R. A. 7160 or Local Government Code - Decentralization of entire government – all structures, personnel, and budgetary allocations from the provincial NATIONAL OR GLOBAL HEALTH SITUATION health level down to the barangays were devolved to the Population local government unit (LGU) to facilitate health service - Demographic – yung bilang delivery. - Population by gender = Male 50.5% and Female 49.5% - What happened in the health system in phil because of the - Population by age = age 5-14 – 21% and age 15-24 – 20% local government code? – decentralized kase nag hati-hati - Life expectancy – mas tumatagal ang buhay ng mga na sa work. kababaihan. - Delivery health services – now the responsibility of the M 68.8 & F 74.3 (2015-2020) LGU Annual Ave Pop Growth Rate (%) - DOH changes its role from one of implementation to one 2010 – 2015 1.73% of governance. 2015 – 2020 1.59 % 2000 2020 - 2025 1.41 % - Millennium Development Goals - adopted during world summit in September. Created 8 goals Projected Population / Total - 1 – connected to poverty Yr. 2020 109,947,900 - 4, 5, 6 – connected with health Yr. 2025 117,959,400 Yr. 2030 125,337.500 - Using the annual average population growth rate, you will compute for projected population. - Ave fertility in the Philippines = 3 Natality - Birth - Live births by age of the mother - Live births by sex and regions (NCR, CAR, REG 1…) - Live births by attendance (M.D, Public health nurse, Midwife, Traditional birth attendant, others) J.A.K.E 2 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) - Infectious – microorganism (morbidity) - Lifestyle – naninigarilyo, pagiinom ng alak (mortality) - NCR has many facilities In 2013 - 531,280 registered deaths from all causes and all ages. - Males: 304,516 (57%) Females: 226,764 (43%) - For every 1,000 population - More than 5 people die. Notifiable Diseases - Dengue 361,000 confirmed cases. 1, 373 deaths. January 1 to October 25 (2018 – 2019) - Diphtheria 197 confirmed cases, 47 deaths. January 1 to October 5 (2018 – 2019) Measles 42, 400 confirmed cases, 560 deaths. January 1 to October 12 (2018 – 2019). Most affected 1 year old. - Pinagbabawalan na yung pagpapaanak sa bahay. Polio 3 confirmed cases, 13 confirmed environmental - Traditional birth attendant – manghihilot samples; 4.4 Million target immunization for children up to 5 years old. Morbidity or Mortality October 2019 to January 2020 - Sickness and death - Morbidity: ten leading causes (TB other forms, Dengue fever, TB respiratory, Acute water diarrhea…) - Mortality: all causes by age group J.A.K.E 3 of 28 COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) J.A.K.E 4 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Global Health Situation Personal behavior and coping skills – (sa mga nag online April 10, 2020 games dapat may social interaction pa din sila sa family - Coronavirus Disease 2019 (COVID-19) is an infectious nila or friends) disease caused by a new coronavirus recently introduced Genetics to humans for the first time”. Gender - WHO called it a pandemic. Culture - Virus spreads all over the world. Public health - About 80% of COVID-19 (+) have mild symptoms. - In tgaalog pangkalusugang pang kalahatan September 2019 Winslow - Synchronized polio vaccination campaigns Nov to Dec - A science and Art of Prevents Disease, promote 2019 in targeted regions reached a total of 1,404,517 health/efficiency, Prolong life. (exceeding target) children below 5 years old in NCR and - Organized community effort for: 2,937,327 (95%) children in Mindanao.” Sanitation environment January 30, 2020 Control communicable disease - Polio vaccination must intensify until last child is reached Education personal hygiene and fully protected. Organization of medicine April 7, 2020 Nursing service. - Urgent Need for Investment in Nursing. - (↑ kapag naman nagawa ito lahat ng tao mag kakaroon ng ↓) - “In Philippines, shortfall of nurses at 249,843 by 2030. - For early detection and prevent treatment of disease. Greater investment now to retain them in Philippine - Development of social machinery to ensure a standard of health sector.” adequate living for maintenance of health. (Social machinery- para malaman kung anong part ng govt. COMMUNITY HEALTH NURSING ang tutulong) Community - Enable every citizen to realize birth right of health and - A group of people with common characteristics or interests longevity. (kaya mula noon hanggang ngayon bawal ang living together within a territory or geographical boundary abortion bcs we have the right to live and live long) place where people under usual conditions are found (mass - Nung ginawa niya ito maraming sakit at nakita niya na approach). kapag nag tulong-tulongan ang mga tao na co-conquer - Common illness ang tinatarget naman ito. Health WHO - WHO: states of complete physical, mental and social – - Art of applying science in the context of politics. wellbeing. Not merely an absence of disease or infirmity (Madalas kausap ang politics kaya meron politics sa (This should be complete so kapag malabo ang mata mo you meaning) are not healthy dapat kase kumpleto) - Public health is a core element of government attempt to - Modern definition: OLOF or Optimum Level of Functioning improve citizens welfare (gov. dpat ang unang mangalaga sa - Generally, influences health  eco-system health ng kalahatan) Political – safety, oppression, people, and empowerment. Essential public health function. (ito dpat ang gawin ng Behavior – culture, habits, ethnic customs. gov.) Heredity – generic endowment (defect, strengths, risk). Development of policy in public health regulation to Health care delivery system – promotive, preventive, protect public human resources. curative, rehabilitative. Surveillance (mga sakit na binibilang) Environment – air, food, water waste, urban or rural, Research, innovation solution. noise, pollution, radiation. (↑ kapag nagawa ito lahat ng govt. mag kakaroon ng) Socio-economic – employment, education, housing Ensure quality health service health promotion. (at para - Determinants of health – is affected by combination of many ma bawasan ang hindi pag kakapantay pantay dahil factors (using this malalaman mo kung ano ang tinatarget mo lagging nag kakasakit nag mga mahihirap ↓) sa isang community): Reduce inequalities; ensure best health for the greatest Environment and circumstances number. Income and social status – (ang poverty could result to - DOST – to research (tuberculosis, dpaat gawan ng research infection and bad lifestyle) sa 4th year) Employment and working conditions – (mas mabigat ang QUESTIONS: trabaho ng mga males kumpara sa females) 1. Trabaho ng government – WHO Education – (madalas mag kasakit ang mga less educated 2. Kapag ginawa natin ito ay hahaba ang buhay natin – kase may sarili silang beliefs at kulang ang pinag aralan Winslow nila) 3. Dapat gumaw ng policy and rergulate ito – WHO Physical environment – (kung madumi tataas ang 4. Kayo-kayo mag linis ng katawan/kapaligiran ninyo – infection) Winslow Health services – (walang resources) Social support networks – (para masustain ang health) J.A.K.E 5 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Public Health Nursing - Not confined in PHN. Lillian Wald - Coined (made the word public health nursing) Concept of Community Health Nursing - (orphanage) Director: Henry St. Settlement in New York 1. Focus of care – health promotion. - Service that is available to all people or “public”  2. Duration of care – over a long period of time. government agency  care of poor people. 3. Coverage of care - Invented bag technique All ages - Since nurse in govt. she thought to take care of the public. All types of health care National League of Philippine Government Nurses Care for all regardless of race - Practice of nursing in local or national government health Creed department and public school. Nationality - Position, title, designation (civil service commission) Socio-economic - Public health nurse (nurse in local or national health Nationality department or public school) 4. Benefits – family and community. - Difference of Public health nursing and community health 5. Knowledge used – current, multi-disciplinary (biology, nursing is only one area or setting of work as dictated by ecology, social science). funding. (gov. sa tax kumukuha ng sahod; CHN mas Generalist in terms of practice. malawak at lahat ng working sa community or hindi nag Applies nursing process in taking action. wowork sa hospital are working here like health center. Goal of CHN  raise level of health. PHN naman working in government hospitals) - Another definition of public health na gumawa sa PH Principle of Community Health Nursing - Samahan ng mga nurses na working in PH Must fully understand objectives and principles. (Orient ka - Working in public instituition either in public school, public muna sa vision and mission) local dep, public national dept. Primary Responsibility: health teaching. Community Health Nursing Care is based on recognized needs of Individual, Family, and Dr. Ruth Freeman Community. - A service rendered by professional nurse with the individual, Resources of community (GO & NGO) must be fully utilized. family, group, and community at home, health clinic, clinics, There should be Accurate Record & Reporting. (to know if schools, places of work for: nag de-decrease or nag i-increase. The promotion of health (main emphasis, kapag ito ang Family (unit of service). lumabas sa borad exam) Knowledge used - No Knowledge will be obsolete Current, Prevention of illness Updated. Care of sick at home Evaluation: periodic. Rehabilitation Part of health team. (Rural health sanitary inspector na ang - Ex. In hospitals 1 bed per nurse kaya individual, at kapag nangangalaga sa environment hindi na nurse) nasa community ang nurse aalagaan niya ang family, group, Philosophy: worth and dignity of man (Dr. Margaret Shetland) and community. - Patient – may sakit na The Public Health Nurses - Client – walang sakit - Professional qualifications: licensed - 4 level of client: - Personal qualifications: o Individual – unique, sick or well, the “entry point”. People skills o Family – group of people bound by blood. Marriage strength on physical, mental and emotional. and adoption, the “unit of service”. (Unit of service in Tested in leadership, resourcefulness, creative, honesty, community are buong pamilya. In hospitals u can say and integrity. “pwede po mag pa BP pero uunahin ko muna po ang Difference in interest, willingness (capacity to work with mga patient ko balikan ko na lang po kayo” pero in people). community “dpat each family have healthy status”) - Function consistent: o Group – population group or risk group. Nursing law 2002 - Philippine nursing RA 9173 a) Same age group – bata at matanda Program policies of DOH (series of intervention ang ibig b) Same characteristics – mga buntis sabihin ng program) c) Exposed to same environmental factor – Polices of local government health agency (Ex. Acc. To sisilipin ang environment. rule bawal na mag paanak sa bahay) (Considered as one population group kaya sila - Competencies skill and knowledge: naka bukod-bukod) 1) Nursing Process o Community – group of person sharing the same culture 2) Nursing Procedure (vaccination, usually diagnosing situated in same geographical location. Main patient procedure and health education, home visit or clinic visit) and main concern. 3) Community Organizing (for third year students) Jacobson 4) Health Promotion and Education (first year subject) - Broader than PHN. 5) Surveillance, records and reports - Nursing practice in a wide variety of services and consumer advocate areas, variety roles, including independent practice. J.A.K.E 6 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Functions of PHN Public Health Nursing 1. Nursing care function PHN II - Based on Science and Art of caring - Frontline Health Worker. - Towards health promotion and disease prevention of - First Contact of patient (works in health center). individual, family, and community. - Prime mover for all health programs and activities. - Uses nursing process and recognized needs of the client. - Assist physician during consultation. - Home visits or referral (other health provider, - Provides health education (pre or post clinic visit). environmental health, social services) - Reaches out in community. - Every Wednesday is bakuna day in Luzon, Visayas and - Organizes community assemblies for health promotion. mindanao - Performs Home Visits. 2. Collaborating and coordinating functions - Prepare, submit reports (W, M, Q, A). - Bring group of activity in harmony with each other. PHN III - PHN care coordinator. - Acts as nurse in charge. - Linkages with: - Supervises, guides, coordinates work of nurse. Government agencies - Interpret policies, participates in planning health program. NGO - Toward managerial Health professionals PHN V Private sector. - Supervising PHN. 3. Research function - Assigned in health center with lying-in. (paanakan) - Activity – Disease Surveillance Continuous collection and - Takes charge of staff and unit. analysis of data of cases and deaths. - Participates in program planning. (madalas nasa munisipyo to - Purpose of Disease Surveillance: measure magnitude of supervise nurse 2 ) problem and measure effect of program to improve - Attends, meeting, conference for improvement of health strategies. services. - Data will be used to improve care. - Aside form BSN kailangan nag masteral of science in nursing - CHN2- 10 family ang iinterviewhin = 120 people ka tatanggalin na kase ung MAN 4. Training function - Candidate for managerial nurse ang nag masteral. - Initiate staff development and training program for PHN VI midwives and barangay health worker. - Nurse program supervisor. - Training Needs Assessment (TNA). - Conducts Program Orientation. - Design, conducts training with resources person, and - Conducts pre-service and in-service orientation. evaluate training. - Consolidate reports. - Training of nursing and midwifery affiliates (RLE). - Study ratings of PHN performance. - Community organizing. - Initiate meeting, conferences for joint planning. 5. Health promotion and education function - Nursing consultant on technical matters. - Health education Laws Affecting PHN Is part of our basic health service. RA 6758 – Standardized salaries of government employees Major components of health program that is done on - Nursing personnel. daily basis. RA 7305 – Magna Carta of Public Health workers. Solid knowledge of principles of teaching or learning. - Improved the social and economic well-being of health - As an educator that provides information (better choices) workers. - Uses skills in advocacy, influence for health promotion. - Higher basic salary, hazard allowance, laundry allowance, 6. Supervisory function subsistence allowance - Supervisor of midwives and auxiliary health workers. RA 6713 – Code of conduct and ethical standard for public - Formulate supervisory plan and conducts supervisory visit - Officials and employees. Utmost responsibilities, integrity, (supervisory checklist). competence, loyalty, lead modest lives and uphold public - Identifies with supervisee issue or problem. interest over personal interest. - Breach of procedure or protocol  coaching stat  training (needs further capacity enhancement). Levels of Care 7. Management function Primary level of health care - Organizes nursing service – implement nursing service 1. Rural Health Unit (RHU) plan as part of the overall municipal health plan. 2. Barangay Health Station (BHS) - 5 management functions: 3. Puericulture Center 1) Planning 4. Clinics of large Industrial firms – employee 2) Organizing 5. Private practitioners or private clinics and others 3) Staffing Basic level of health care. 4) Directing Promotion of health, early diagnosis of disease or 5) Controlling (evaluation) disability and prevention of disease. The FIRST CONTACT between community members and other levels of health facility. J.A.K.E 7 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Secondary level of health care DOH – Specialty Hospital 1. Emergency Hospital (pag aari ni mayor) Lung Center of the Philippines 2. District Hospital (pag aari ni mayor) National Kidney and Transplant Institute 3. Provincial Hospital (pag aari ni governor) Philippine Children’s Medical Center 4. City/ Municipal Hospital (pag aari ni governor) Philippine Heart Center Moderately specialized equipment and laboratory DOH – Metro Manila Hospitals facilities Capable of Minor surgeries Referral Center for Amang Rodriguez Memorial Medical Center PHC. Dr. Jose Fabella Memorial Hospitals Kapag hindi kaya nito ipapadala sa ↓ East Avenue Medical Center Tertiary level of health care Jose R. Reyes Memorial Medical Center 1. Regional health service National Center for Mental Health 2. Regional medical services and training hospital National Children’s Hospital 3. National health services E. Rodriguez, Quezon City 4. Medical centers 5. Teaching and training hospital Philippine Orthopedic Center Ultimate highly specialized health personnel Quirino Memorial Medical Center Highly specialized technical level Research Institute for Tropical Medicine Specialized ICU Rizal Medical Center Advanced diagnostic services for: San Lazaro Hospital o Diagnosis Tondo Medical Center o Treatment of disease and disability - These hospitals are considered as covid referral hospitals QUESTIONS: DOH – Regional Hospital 1. Emphasis of care – promotion Regional Hospital in Cagayan Valley 2. Primary responsibilities if maayos pakiramdam – health Batanes General Hospital teaching Cagayan Valley Medical Center 3. Four levels of client – I, F, G, C Southern Isabela General Hospital Region II Trauma and Medical Center Regional Hospitals on NCR PHILIPPINE HEALTH CARE DELIVERY SYSTEM Dr. Jose N. Rodriguez Memorial Hospital – Tala, Caloocan The Philippines City - Paano yung sistema na pagbibigay serbisyo pagdating sa Las Piñas General Hospital and Satellite Trauma Center kalusugan sa mga Pilipino. San Lorenzo Ruiz General Hospital - Archipelago with 7,100 islands. Valenzuela Medical Center - Geographically, divided into 3 main islands: Luzon, Visayas - Regional hospital – governor, mas Malaki ang sahod dahil and Mindanao. galling sa DOH - 17 regions, including the Autonomous Region of Muslim - Health center – mayor Mindanao (ARMM). Levels of Health Care Delivery - 82 provinces. - Section 8 “Minimum Standards and Construction of a - 135 cities. Hospital.” Republic Act No. 4226 (Hospital Licensure Law) - 1,493 municipalities. categorized based on “service capacities and compliance with - 2 Sectors: standards for manpower, equipment, construction and physical Private Sector activities. - production and provision of health goods and 1) Primary prevention – maintenance services (private clinics, hospitals and laboratories, 2) Secondary prevention – referral hospitals drugstores, and other facilities) 3) Tertiary prevention – highly skilled and technology Public Sector - Decentralized health care system. Department of Health (DOH). Local government units (LGUs). - Devolving primary and secondary health services delivery Local government units (LGUs) RA 7160: Implementing Rules and Regulation (IRR) of the local Government Code of 1991 - Devolution of hospital services. - Decentralization of basic hospital services. In public sector: - Managed, coordinated, and regulated by the DOH. - Year 2015 bumagsak tayo sa no. 4, 5, 2 o DOH - So nag conduct ng self-evaluation ang Pilipinas at nalaman ito: − Composed of Central Office (San Lazaro Manila) − 17 Regional Offices (ROs) − Retained hospitals J.A.K.E 8 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) NICU – critical care sa bata (Neonatal Intensive Care Unit) An organized staff of qualified and competent personnel with Chief of Hospital or Medical Director and appropriate board-certified Clinical Department Heads. Medical director – pinaka mataas Level 3 Level 2 plus Teaching or training with accredited residency training program in 4 clinical services. (intern doctor – like student nurses) Physical Medicine and rehabilitation unit. - Maraming namatay sa region na ito pero marami naman Ambulatory surgical clinic (can perform minor surgery) palang hospital so they checked the hospital claiming that they Dialysis clinic are hospital but below the standard of RA 4226. Teaching and/or training hospital with accredited residency Millennium Development Goals: training program for physicians in the four (4) major 1) Eradicate extreme poverty and hunger. specialties, namely: 2) Achieve universal primary education. 1) Medicine 3) Promote gender equality and empower women. 2) Pediatrics 4) Reduce child mortality. 3) Obstetrics and Gynecology 5) Improve maternal health. 4) Surgery 6) Combat HIV/ Aids, Malaria, and other disease. 7) Ensure environmental sustainability. General Level 1 Level 2 Level 3 8) Global partnership for development. - For sustainable development. Level 1 plus all: Level 2 plus all: New Classification of Hospitals and Other Facilities Teaching or Consulting According to Ownership training with specialists in: - Government – created by law. May be under DOH, DND, accredited Medicine Departmentaliz DOJ, LGU, SUCs, GOCC, and others. residency Pediatrics ed clinical - Private – may be single proprietorship, partnership, training OB-GYNE services corporation, cooperative, foundation, religious, non- program in the Surgery government organization, and others. 4 major clinical According to Scope of Services services - General Hospitals – provides medical and surgical care to the Clinical sick and injured and maternity care and shall have as services Emergency minimum, the following clinical services: medicine, pediatrics, for in- and out- Physical Respiratory unit obstetrics, and gynecology, surgery and anesthesia, emergency patients patients medicine and services, out-patient and ancillary services. services rehabilitation - Specialty Hospitals – specializes in a particular disease or unit Isolation condition or in one type of patient. General ICU facilities Hospital classification scheme General Hospital Surgical or - Services for all types of illness, injuries or deformities. High risk Ambulatory maternity Level 1 Pregnancy unit surgical clinic facilities You must be able to deliver the care of the general public. Consult: medicine, pedia, OB-Gynecology, surgery Dental clinic NICU Dialysis clinic ER and OPD Isolation Facility Secondary Tertiary lab Surgical or Maternity facilities Tertiary clinical clinical with Dental clinic laboratory laboratory histopathology A staff of qualified medical, allied medical and Ancillary administrative personnel. (dapat may license) Blood station Blood station Blood bank services Headed by a physician duly licensed by the Professional 1st level x-ray 2nd level x-ray 3rd level x-ray Regulation Commission (PRC) Level 2 Pharmacy Level 1 plus (lahat nasa lvl. 1 nandito) Departmentalized clinical services Specialty Hospital Respiratory unit (respiratory therapist works here) − for specific disease, condition or type of patient, particular General ICU – critical care sa matanda disease, particular organ or groups of organs, particular group High Risk Pregnancy Unit such as children, women, elderly and others J.A.K.E 9 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Examples of Specialty Hospitals b) Trauma – receiving facility - A DOH licensed hospital w/ in the trauma service area Particular Particular Group Particular Organ(s) which receives trauma pt. for transport to the point of care Disease of Patients or a trauma center National Philippines - Open 24/7 Orthopedic Lung Center Children’s Medical Department of Health Hospital Center - The Philippines’ Department of Health (DOH) (Filipino: National Center Kagawaran ng Kalusugan) is the principal health agency in the Philippine Heart National Children’s for Mental ph. Center Hospital Health - It is the executive department of the Philippine Government San Lazaro National Kidney and Dr. Jose Fabella responsible for ensuring access to basic public health services Hospital Transplant Institute Memorial Hospital to all Filipinos through the provision of quality health care and the regulation of providers of health goods and services - Main governing body Health Facilities Classification - Guidance / technical assistance to LGU Category A – Primary Care Facility - Center for Health Development - W/out in pt. Health charts, out pt. Clinic, dental clinics – first Provincial Government contact health facility - Administration of provincial or district hospital - W/ in-pt. – birthing (lying-in), infirmaries – first contact health Municipal or City Government facility - In charge of PHC (RHU/Health Center) Category B – Custodial Care Facility - BHS - Long term care w/ food & shelter to chronic condition needing - Plan, implementation basic health services (health services) ongoing health & nursing care due to impairment, reduce independence in activities of daily living and rehabilitation. DOH Rules and Functions - Ex. Custodial psychiatric facilities substance drug abuse Leadership in health: therapy and rehab center, nursing homes, leprosaria/sanitaria - National Policy and regulatory institution Category C – Diagnostic / Therapeutic Facility - Leader in formulation, monitoring, and evaluation of - Lab facility national health policies - Radiologic facility - Advocate adoption of health policies - For cancer diagnosis facility Enabler and capacity builder: Category D – Specialized Outpatient Facility - Taga turo - Dialysis clinic - Innovate new strategies in health - Ambulatory surgical - Oversight function & monitoring, evaluation of national - Cancer chemotherapeutic health plan - Center/ clinic - Ensure highest standard - Radiation facility Administrator of specific services: - Physical medicine - Manage selected national health facilities - Rehab center/clinic - Administer direct service for emergent concern - Administer health emergency response services Attached Agencies - The DOH – constituted of various central bureaus and services in the Central Office, Centers for Health Development (CHD) in every region, and DOH retained hospitals - CHN - always updated kaya sa board exam dpt balikan ito Filipinos – Vision, Mission, Core Values, & Strategic Goals 1) Vision - Filipinos are among the healthies people in Sountheast Asia by 2022, and Asia by 2040 2) Mission - To lead the country in the development of a Productive, Resilient, Equitable and People-centered health system for Universal Health Care 3) Core Values Professionalism - DOH performs its functions in accordance with highest ethical standards, principles of Classification of Hospitals accountability, and full responsibility. According to Trauma Capability: Guidelines formulated by PCS a) Trauma – capable facility Responsiveness - A DOH licensed hospital designated as a trauma center. Integrity - The Department believes in upholding truth & - Open 24 /7 pursuing honesty, accountability & consistency in - Tertiary hospital performing its functions J.A.K.E 10 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Compassion & Respect for Human Dignity - DOH 5) Performance Accountability – use management systems to upholds quality of life, respect for human dignity is drive better execution of policies and programs in the DOH encouraged by working w/ sympathy & benevolence for while ensuring responsibility to all stakeholders people in need. Cross-cutting pillar of F1 Plus for Health Excellence - DOH continuously strive for the best by - which is on performance accountability, it introduces fostering innovation, effectiveness & efficiency, pro- evidence-based metrics in the health system to action dynamism, and openness to change objectively monitor and ensure its responsiveness to Commitment – With all our hearts & minds, the Dept. addressing the healthcare needs of Filipinos. commits to achieve its vision for health & development of - It supports the achievement of Ambisyon Natin 2040: future generations Matatag, Maginhawa at Panatag na Buhay Teamwork – DOH employees work together with a result- oriented mindset. Stewardship of the health of the people – Being stewards of health for the people, the Dept shall pursue sustainable development & care for environment since it impinges on the health of Filipinos. Strategic Goals – Better Health Outcomes, More Responsive Health System, More Equitable Healthcare Financing, Financing, Service delivery, Regulation , Governance 4) Goal - Formula 1 for Health – Pres. Gloria Macapagal Arroyo - HSRA – health sector reform agenda Health financing Health regulation Local health system Public health programs Hospital system Frameworks of HSRA – 4mula One for Health Plus (F1 Plus) 4 Pillars of F1 for Health 1) Health financing – secures sustainable investment to improve - Mas specific na ito kesa sa millenum developmental goal at health outcomes and ensure efficient and equitable use of ang tawag na dito ngayon ay sustainable developmental goals. health resources 2) Health regulation – ensure high quality and affordable health Health targets of Sustainable Development Goals (SDG) 2030 produts, devices, facilities, and services. RA 11223 Pang - Goal 3 “Good health & well-being” and other health-related kalusugang pangkalhatan universal health care. targets in: 3) Health Service Delivery – ensure the accessibility of essential Goal 1 “No poverty”, quality health services at appropriate levels of care Goal 2 “Zero hunger” 4) Good Governance – streghthen leadership and management Goal 6 “Clean water and sanitation” capacities, coordination and support mechanisms necessary to Goal 7 “Clean energy” ensure functional people-centered and participatory health Goal 11 “Sustainable cities and communities” systems Goal 13 “Climate action” Goal 16 “Peace, justice” J.A.K.E 11 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) World Health Organization (WHO) - Accessible – means w/in 30 min narating na ung health center - A specialized agency of the United Nations (UN) provides at w/in 1 hr naman kapag hospital global leadership on health matters - Through full participation of family – active participation - WHO constitution came into force on April 7, 1948. - At cost can afford to maintain – hindi na ilalabas yung pera. - 1946 – natapos ang gera - At every stage of their development - In Spirit of self-reliance & self-determination 5 Core Functions of WHO Universal Goal 1) Provide leadership on matters critical to health & engage - Health for all by year 2000. (hindi na attain) partnerships when joint action is needed - Acceptable level of health for all in the world. 2) Shape research agenda. Stimulate generation, translation, & - Through Individual and Community self – reliance. dissemination of valuable knowledge. - LOI theme: Health in the Hands of the people by 2020 3) Setting norms, standards. Promote & monitor implementation. - Primary health care: 4) Articulating ethical and evidence-based policy options. 1) Education for health. (using internet fb live) 5) Provide technical support, catalyze change & build sustainable 2) Locally endemic disease treatment. (malaria etc) institutional capacity. 3) EPI – NIP (National Immunization Program) 4) MCH with responsible parenthood (pagaalala sa buntis at bata PRIMARY HEALTH CARE at pag bibigay contraceptives – maternal and child health) - Essential health care. 5) Essential drugs (libreng gamut) - Practical, significantly sound, and socially acceptable methods 6) Nutrition. (vitamins, iron na libre) and technology. 7) Treatment of communicable disease and non-communicable - Universally accessible to individual and family in community. disease. - Through full participation, At cost can afford to maintain; At 8) Safe water and sanitation. every stage of their development. - In Spirit of self-reliance and self-determination. Key Principle of PHC 1. Accessibility – within 30 mins narating PHC History 2. Affordability – wala silang gagastusin September 6 – 12, 1978 3. Acceptability – within the culture. - First international Conference for Primary Health Care. 4. Availability – available dapat resources natin - Happened at: At Alma Ata and USSR (Russia) 5. Support mechanism - Organized by: WHO and UNICEF (United Nations Children’s Fund) - Concept: Health and development of workers for the protection and promotion of health of all the people. (kapag healthy daw ang tao madedevelop ang country katulad ngayong pandemic kapag maraming may sakit bumabagsak din ang ating ekonomiya) - Alma Ata Declaration on Primary Health Care - Health – fundamental right. - Global burden of health inequalities exists. - Economic and Social development – basic importance for full attainment of health for all. - Government has responsibility for health of people. - President at this time is Ferdinand Marcos 6. Multi sectoral approach Letter Of Instruction (LOI) 949 of 1979 - Intersectoral linkages – w/in the health system (hospital) - First Asian country. (na nagpatupad nito dahil kay - Intersectoral linkages Ferdinand Marcos) - Philippines has a challenge when it comes to location. - Health – is a product of Socio and Economic development. - Geographically we are isolate w/ one another because - What is the legal basis of primary health care – Letter of we are island. instruction 949 - It needs bridges and roads to reach other people. - Legal basis of primary health care - DPWH ang dapat tumulong sa atin dito - Hindi na dumaan s amga senado kundi nag bigay lang ng - Personal hygiene reason kung bakit nagkaka infection instruction si president marcos hanggang sa isinam a ito sa libro - Hindi nahirapan yung presidente na ipublish yan sa 7. Community participation pilipinas dahil bago pa mangyari yan, meron na tayong - Clients are not recipients of care but active partners. mga RHU na pinatayo in 81 provinces. - Dito tayo laging bumabagsak kay dapat tayong mag scaling or rating, wag mag lagay ng mataas na score kung Definition of Public Health Care alam namn hidni susunod ang community - Essential health care 8. Equitable distribution of health resources - practical, significantly sound & socially acceptable methods & - (DTTB) Doctors to The Barrio Program – if you want to technology study medicine at have scholarship avail this but this have - Universally accessible to I & F in community (mga madaling return service. If you study on state and government mapuntahan) university hindi sila agad agad makakapag abroad. J.A.K.E 12 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) - RN Heals – ang munisipyo ang mag papasweldo sa - Health information, education, & communication tauhan na nasa loob. Nung maraming pinagaawa ang - Organizes community DOH na ang magbabayad to pay and hire these nurses but - Facilitate brgy health planning ilalagay sa facility ni mayor. - Mga ginagawa dito is related with reproductive health 9. Appropriate technology RSI / Rural Sanitary Inspector - Health technology – tools, drugs, methods, procedures - Ensures healthy environment and techniques. - Through advocacy, monitoring, regulatory - Criteria: - Ex. Inspect water supply 1) Safe - Community sanitation ay sa nurses dati pero ngayon hindi na 2) Effective BHW / Barangay Health Worker 3) Affordable - Interface between community & RHU 4) Simple - Trainings: preventive health care. FP, 5) Acceptable - MCH, Nut, San’tion, Rep’tive H. 6) Feasible or reliable - RA 7883 – Entitled to hazard & subsistence allowance 7) Ecological effects 8) Potential to contribute to individual and community Local Health Board development - Chairman – mayor / prov. Governor → municipal health - Lagundi and leopolds maneuver officer, doctor → sanggunian → rep. from the people - Representative from the people – example representative ng RURAL HEALTH UNIT mga matatanda = president of Senior Citizen; sa mga kabataan - Main Health Centers = SK Sangguniang kabataan – usually this are the people who - Primary level health facility in municipality has a capacity to decide and they can help in planning. These - Focus: preventive, promotive health services are the people who have the capacity to decide and be part of - Supervision of BHS the planning. - 1 : 20,000 - Function: Barangay Health Station Prepares budget - 1st contact health care facility Advisory committee - Basic services at brgy level Advisor - Satellite station of RHU - Manned by volunteer BHW under the supervision of midwife Health Referral System - Branch ito ng health center - Set of activities undertaken by health care provider in response - Ang pagkakaiba dito sa main health center, ang BHS ay to its inability to provide necessary health intervention kulang ng health care workers. - 2-way referral system: - What facility of the government is considered as smallest? - If the one health facility cannot provide the health service, barangay health station. it will refer to the hospital. (hindi kakayanin ng health center ang confinement ni patient so irerefer siya sa Rural Health Unity – Personnel hospital and vice versa) MHO / Municipal Health Officer If the hospital cannot provide the health service, it will - Or Rural Health Physician refer to the health facility. - Head the health services - Roles/ functions: Administrator of RHU – plan & budget Interlocal Health Zone - ILHZ - Community physician Composition - Mga mataas ang doctor dito sila ang tumatayong admin at - People – Ideal health district population size (100,000 & humahawak ng pondo at medico legal 500,000) for optimum efficiency, effectiveness (WHO, 1986). - Medico-legal officer of Municipality – pag mag dedemanda, - Population Vary - depending on number of LGUs decide to may assessment from para ditto. cooperate & cluster - Manager of health center: Nurses - Boundaries – Clear boundaries between Inter Local Health PHN / Public Health Nurse Zones - determine accountability & respective health service - RHM - Supervises/guides providers. - Field Health Service Information System (FHSIS) – Prepares, - Geographical locations & access to referral facilities such as report – main responsible in recording report district hospitals are usual basis in forming the boundaries - Nursing Process – utilize when responding - Health Facilities – A district or provincial hospital (referral NCP – Nursing Care Process (one person) hospital for secondary level of health care), Rural Health Units FNCP – Family Nursing Care Plan (family) (RHU), Barangay health stations (BHS) & other health services deciding to work together as an integrated health CNCP – nursing process for whole community system. - GO, NGO, private business, people – performing collaboration - Health Workers – Right mix of health providers needed to - Hospital one nursing process will be used while in community deliver comprehensive health services. three nursing process will be used - Groups of health providers are: PHM / Public Health Midwife - Manages BHS, trains BHW barangay health worker Department of Health - Provides midwife services & program District hospital - Pt. assessment for referral Rural Health Unit J.A.K.E 13 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Basic Health Unit Family Assessment Private clinics - The family interview: Volunteer health workers Effective communication is essential in the 1st step to Non-Government Organization establish trusting relationship. Community-based organizations. Same principles used in an effective interview with a - They form LHZ team to plan joint strategies for district health client apply. care. Family assessment tools are available. - Hindi pwedeng mag pagamot sa health center kapag hindi siya Many agencies have a standard form. sakop ng boundary dahil: Tool: IDB or Initial Data Base - Sa reporting and recording - NCP: vital signs and cephalo caudal assessment - Mauubos ang pondo natin - Mauubusan ang gamit tapos ung kabila madami pang stock. - Kapag lumagpas an sa 100, 000 kailangan ng isa pang health center. Yun ang tinatawag na district 1, 2, 3 - Health facility, dpt ung district 1 kumpleto ang gamit may health center, referral hospital at kumpletong health worker. Kung anong meron sa isa ganun din dpt sa district 2. Bawal ang hiraman ng health worker dito. FAMILY HEALTH NURSING National Statistical Coordination Board - Family - a group of people usually living together and Components of Initial Data Base: composed of the head by blood, marriage and legal adoption. 1) Family structure, characteristics and dynamics (Community will not develop kapag nag ka-kanya-kanya) 2) Socio-economic and cultural characteristics (sahod, pinag - Johnson – Social unit interacting with the larger society. aralan, religion, saan sila nag mula) - Allen – Characterized by people together because of birth, 3) Home and environment (malinis ba ung bahay, gawa ba marriage, adoption, or choice. (he is foreigner and divorce in saan) their country is legal) 4) Health status of each member (sinong mga nag ka sakit, - Executive Order 209 Family Code – Marriage is special commonly respiratory diseases, mag banggit ng top 10 contract of permanent union between man and woman. diseases) (President ang nag sabi nito, in our society we accept a male 5) Values and practice on health promotion, maintenance with a partner as one family pero kapag legalities they are not and disease prevention (hand washing, sleeping pattern, accepted. Kaya kapag namatay ang dalawang mag kasintahang vaccination history – mga batang 5 years old and below parehas na lalaki o babae pwedeng i-contest ng mga kamag lang ang tanungin) anak ang mga naiwang ari-arian) - Friedman - two or more persons who are joined together by Family forms or family structure bonds of sharing and emotional closeness and identify Based on Internal Organization and Membership or Components. themselves as part of family. (hindi kailangan kasal; like live Dyad in partners) - Empty nester. (newlywed, or matgal ng kasal but do not have a child) Cohabitating - Live-in. J.A.K.E 14 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) - Common law spouses and children. (means live-in but Neo-Local this is what we should use in our form) - When a married couple sets up a home separate from - Not married legally but they are married in terms of the either side of their families. law of masses or common table. - Can stand on their own - Medical professional should not use the word “live-in Based on Pattern of Lineage verbally and by documenting - Kayamanan ang pag uusapan dito, usually happens in Chinese Compound family people - Man has more than 1 wife. Patrilineal Family - Acceptable under Presidential Degree 1083. - This type of family occurs when property and title - This is not acceptable for woman. inheritance pass down through the father’s side. - Muslim relationship can do this Matrilineal Family Blended - his is where the property and title inheritance pass through - 1 or both spouses bring in child or children from previous the mother’s side. marriage in their new living arrangement. Based on Amount of Mates - parehas patay/hiwlay sa asawa at may anak at nag sama as Monogamous Family one family at nag ka sariling anak. Maraming challenge - In this instance, a husband only has one wife. This is the dito western idea of a typical marriage. Nuclear Polygamous Family - Husband, wife, children, marriage, procreation. - In this case, the husband has more than one wife at the Extended same time. This type of family can be found mostly in - 3 generations. Married sibling and their family with Saudi Arabia. grandparents. Polyandrous Family Single Parent - This family consists of a wife with more than one husband. - Pregnancy outside of wedlock, separation, death of spouse. This can be found in the Todas of Southern India. - usually sa babae napupunta ang anak Gay or Lesbian Family Genogram - Cohabitating couple of same sex, not legal. - Known as McGoldrick–Gerson study, a Lapidus schematic or - Acceptable as a family in society but not acceptable in the a family diagram. legality - A pictorial display of a person's family relationships and medical history. Classification of family Based on Authority MALE FEMALE Patriarchal - Authority is vested on the oldest male in the family, often the father. - kung sino ung nag de-decide siya dpt ang interviewhin Matriarchal - Authority is vested in the mother or mother’s kin. - Straight line signifies good relationship to each other, broken lines broken family Matricentric - Prolonged absence of the father gives the mother a dominant position in the family, although the father may also share with the mother in decision making. - kapag nasa abroad ung asawa at humingi ng decision making sa kanya, kung sino ung nasa bahay siya pa din ang masusunod Patricentric - Prolonged absence of the mother gives the father a dominant position in the family, although the father may also share with the mother in decision making. - kabaliktaran nung matricentric Based on Pattern of Residence - Newly wed need assistance kase maraming bata at matandang namamatay dito sa PH - This would determine who are the supports person of the family Patrilocal - When a married couple lives with or near the husband’s family. Matrilocal - When a couple lives with or near the mother’s family. J.A.K.E 15 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Language spoken at home and in the community Health beliefs Crisis events (In PH umbilical cord are displayed in front of the house) Holidays and special events Contact with cultural and religious institutions Values about education and work Values about family structure (power, hierarchy, rules, subsystems, and boundaries) Developmental Assessment - Duvall (1977) theory of development stages of family life - Stages within the life cycle of every family; each stage includes distinct family developmental tasks. Marriage - For a family to function as a unit they should ↓ - Formation of identity as a couple. - Inclusion of spouse in realignment of relationship with extended families. (kapag kinasal tapos nakitira sa pamilya) - Parenthood decision making. Family with Young Children - Integration of children into family unit. (reason why in the us Culturagram naghihiwaly madalas ang mag asawa ay dahil parehas - Develop a better understanding of the sociocultural context of workaholic so ung responsibilidad sa anak hindi na the family as well as identify appropriate interventions for the nagagampanan) family. (Congress & Kung, 2005) - Adjustment of tasks: Child rearing, financial and household. - Most important because this causes hindrance, hindi mo - Accommodation of new parenting and grand parenting role. maayos ang health niya if marami siyang pinaniniwalaan (parehas dapat tutulong) Reasons for relocation Family with Adolescent Legal status - Development of increasing autonomy for children. (children Time in the community practice independence) - Midlife re-exam of marital and career issues. J.A.K.E 16 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) - Initial shift towards concern for older generation. (alam na - Start of first interaction in the family. nilang tatanda na sila) Status placement - Consider children as blacksheep of the family kase makulit na - Family confers its social rank into the society. but we have to explain na dumadaan lang tlga sa ganon. - Kung mahirap ang magulang un na rin ang classification - Anong problema ng pamilya na may adolescent na anak ng mga bata Family as Launching Centers Economic function - Establishment for different identities for parents and children. o Rural family – unit of production. - Renegotiation of marital relationship. o Urban family – unit of consumption, enterprise. - Re-adjustment of relationship to include in-laws and Physical maintenance grandchildren. (kung dati ung magulang lagi na susunod - Survival needs of dependents. ngayon may asawa na dpt din iconsider ung kabilang pamilya) - Pinagkukuhanan ng mga kagamitan - Dealing with disabilities and older generation. Welfare and protection - Ga-graduate na ang anak, mag kaka sariling pamilya, etc o Partners - companionship, affective, sex, socioeconomic. Aging Family o Children - Emotional gratification, psychological - Maintaining as couple or individual while adapting to aging security, motivation, morale. process. Levels of Preventive Care - Support role of middle generation. 1) Primary Prevention - Support and autonomy of older generation. Health promotion - Preparation for own death; deal with loss of spouse, sibling, Specific promotion peers. Genetic counseling - Highest stress is a death of a spouse tapos walang support ng Environmental change pamilya hihina katawan niya at mamatay na din siya. Hearing conservation Family according to Defrain and Montalvo Immunization Description of a healthy family working as a unit: Prenatal care - Interact with one another. Vocal hygiene - Can establish priorities. Prevention of secondary communication disorder - Support, respect, and affirm one another. 2) Secondary Prevention - Members has flexible role. Early diagnosis and prompt treatment - Foster responsibility and value service to others. Disability limitation - Have sense of play. 3) Tertiary Prevention - Ability to cope with stress. Restoration and rehabilitation Characteristics of a Healthy Family HERBAL MEDICINE - Republic Act 8423, known as the Traditional and Alternative Medicine Act (TAMA) of 1997 - traditional medicine program. - Traditional and Alternative Medicine Act (TAMA) Authored by Senator Juan Flavier and approved on December 1997. (dati siyang secretary of DOH) - This gave rise to the creation of Philippine Institute of Traditional and Alternative Health Care (PITAHC). - Tasked to promote and advocates use of traditional and Functions of Family alternative health care modalities through scientific research Procreation and product development. - Universal accepted institution for reproductive - Philippine Department of Health (DOH) through its functioning or child-rearing. "Traditional Health Program" has endorsed 10 medicinal - Most Filipinos are catholic so we are mono type plants to be used as herbal medicine in Philippines due to its relationship health benefits. Socialization of family members - Family as a first teacher of societal rules. J.A.K.E 17 of 28  COMMUNITY HEALTH NURSING 1 LEC – BSN 2ND YEAR 1ST SEMESTER PRELIM 2021 (MAM GARCIA) Traditional Health Program Rheumatism, sprain, contusions, insect bites – Pound the - 10 medicinal plants as herbal medicines in Philippines. leaves and apply on affected area. - Attested by National Science and Development Board. Yerba Buena - Sum total of knowledge, skills and practice on health care, not - Mentha cordifelia – scientific name necessary explicable in the context of modern, scientific - Analgesic to relive body aches and philosophical framework. pain due to rheumatism and gout. It is - Recognized by people to help maintain and improve their also used to treat coughs, colds and health towards the wholeness of their being, community and insect bites. society and their interaction based on culture, history, heritage - Uses and preparation: and consciousness. Swollen gums – Steep 6 g. of fresh plant in a glass of boiling water for 30 minutes. Use as a gargle solution. Medical Plants Preparation Toothache – Cut fresh plant and squeeze sap. Soak a piece Decoction of cotton in the sap and insert this in aching tooth cavity. - Boil recommended parts in water. (this is only for a remedy) - Boiling time: 20 minutes. Menstrual and gas pain – Soak a handful of leaves in a - Kapag maligam-gam na hatiin into equal parts into 3. class of boiling water. Drink infusion. - Inumin 3 times a day Nausea and Fainting – Crush leaves and apply at nostrils - Pinapakuluan ng walang takip with minimal water para of patients. (amoy nito ay pwede ibigay sa pt.) mas concentrated - Mas magandang gamitin ang palayok para mas Insect bites – Crush leaves and apply juice on affected makatasan ang dahon. area or pound leaves until like a paste, rub on affected area. Infusion - Plant part soaked in hot water like tea. Pruritis – Boil plant alone or with eucalyptus in water. - 10 – 15 minutes. Use decoction as a wash on affected area. (sa pangagati ipanghuhugas natin ito) Poultice - Directly apply recommended part on affected area. Pain (headache, stomachache) – Boil chopped leaves in 2 - For bruises, wounds, rashes. glasses of water for 15 minutes. Divide decoction into 2 - Di-dik-dikin