Health Care Delivery System PDF

WHAT IS PUBLIC HEALTH NURSING?  PUBLIC HEALTH NURSING ► Is a synthesis of public and nursing practice. ► A field of professional practice in nursing and in public health in which technical nursing, interpersonal, analytical and organizational skills are applied to problems of health as t...

WHAT IS PUBLIC HEALTH NURSING?  PUBLIC HEALTH NURSING ► Is a synthesis of public and nursing practice. ► A field of professional practice in nursing and in public health in which technical nursing, interpersonal, analytical and organizational skills are applied to problems of health as they affect the community. ► is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. According to Dr. Ce Winslow Public Health is a Science and Art of 3 P’s : PREVENTION OF DISEASE PROLONGING LIFE PROMOTION OF HEALTH AND EFFICIENCY THROUGH ORGANIZED COMMUNITY EFFORT  OBJECTIVES OF PUBLIC HEALTH c Control of communicable diseases O Organization of Medical and Nursing Services D Development of social Machineries Education of Individual, family, community on E personal Hygiene S Sanitation of the Environment REMEMBER : PUBLIC HEALTH NURSING IS CONCERNED WITH THE SERVICES PROVIDED BY THE GOVERNMENT WHAT IS COMMUNITY HEALTH NURSING?  COMMUNITY HEALTH NURSING ► Is a synthesis of Nursing Practice and Public Health practice applied to promoting and preserving the health of populations 2 MAJOR SOURCES A. Public Health - Addresses itself to the health of the public with the Ultimate goal of a healthy, vital community. B. NURSING - One of the helping professions, join forces in a practice aimed at promoting and protecting the general health of the community  COMMUNITY HEALTH NURSING ► Is “NURSING FOR THE COMMUNITY’S HEALTH” ► Its uniqueness lies in its emphasis on the health of the population as a whole ► Community health nurses address both the personal and environmental aspects of health and deal with community factors which either inhibits or facilitate healthy living. ► The word CLIENT or CONSUMER are used in Community Health Nursing.  COMMUNITY HEALTH NURSING ► Itis the utilization of the Nursing process in the different levels of clientele- individuals, families, population groups and community, concerned with the promotion of health, prevention of diseases and disability and rehabilitation. REMEMBER : COMMUNITY HEALTH NURSING IS CONCERNED WITH THE SERVICES PROVIDED BY BOTH PRIVATE AND GOVERNMENT/PUBLIC BASIC CONCEPTS AND PRINCIPLES IN COMMUNITY HEALTH NURSING PRACTICE  BASIC CONCEPTS AND PRINCIPLES IN COMMUNITY HEALTH NURSING PRACTICE ► 1. The Family is the basic unit of care, hence the community health nurse consider the health needs of all members of the family in providing nursing services ► 2. The community as a whole is the focus of the service and the client ► 3. The CHN is deeply concerned with the increasing capability of her four levels of clientele- individual, family, population, community to deal with its own recognized needs and health problem ► 4. The goal in improving Community Health is realized through multidisciplinary approach. HEALTH CARE DELIVERY SYSTEM  PUBLIC PRIVATE NATIONAL LOCAL DOH LGU Specialty, retained Provincial and and regional district hospitals, hospitals, medical RHUs, BHSs centers, DOH representatives TERTIARY CARE SECONDARY CARE PRIMARY CARE Level of Prevention Prevention: Prevention is the action aimed at eradicating, eliminating or minimizing the impact of disease and disability, or if none of these are feasible, retarding the progress of the disease and disability. Primordial prevention: Primordial prevention is defined as prevention of risk factors themselves, beginning with change in social and environmental conditions in which these factors are observed to develop, and continuing for high risk children, adolescents and young adults. It is the prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared. The main intervention in primordial prevention is through individual and mass education.  Primordial prevention, a relatively new concept, is receiving special attention in the prevention of chronic diseases. For example, many adult health problems (e.g. obesity, hypertension) have their early origins in childhood, because this is the time when lifestyles are formed(for example, smoking, eating patterns, physical exercise). Primordial prevention begins in childhood when health risk behaviour begins. Parents, teachers and peer groups are important in imparting health education to children. Examples : National policies and programs on nutrition involving the agricultural sector, the food industry, and the food import- export sector Comprehensive policies to discourage smoking Programes to promote regular physical activity Making major changes in lifestyle Primary prevention: Primary prevention can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. It signifies intervention in the pre-pathogenesis phase of a disease or health problem. Primary prevention may be accomplished by measures of “Health promotion” and “specific protection”  Primary prevention Achieved by Achieved by Health Specific promotion protection Immunization Health education chemoprophylaxi Environmental modifications s of specific nutrients or supplementations Use Protection against occupational hazards Nutritional Safety of drugs and foods interventions Life style and behavioral Control of environmental hazards, e.g. air pollution changes Approaches for Primary Prevention: The WHO has recommended the following approaches for the primary prevention of chronic diseases where the risk factors are established: – a. Population (mass) strategy – b. High -risk strategy Population (mass) strategy: “Population strategy" is directed at the whole population irrespective of individual risk levels. For example, studies have shown that even a small reduction in the average blood pressure or serum cholesterol of a population would produce a large reduction in the incidence of cardiovascular disease The population approach is directed towards socio-economic, behavioral and lifestyle changes High -risk strategy: The high -risk strategy aims to bring preventive care to individuals at special risk. This requires detection of individuals at high risk by the optimum use of clinical methods. Secondary prevention: It is defined as “ action which halts the progress of a disease at its incipient stage and prevents complications.” The specific interventions are: early diagnosis (e.g. screening tests, breast self examination, pap smear test, radiographic examinations, case finding programme, etc) and adequate treatment. Cont.. Secondary prevention attempts to arrest the disease process, restore health by seeking out unrecognized disease and treating it before irreversible pathological changes take place, and reverse communicability of infectious diseases. It thus protects others from in the community from acquiring the infection and thus provide at once secondary prevention for the infected ones and primary prevention for their potential contacts. Early diagnosis and treatment WHO Expert Committee in 1973 defined early detection of health disorders as “ the detection of disturbances of homoeostatic and compensatory mechanism while biochemical, morphological and functional changes are still reversible.” The earlier the disease is diagnosed, and treated the better it is for prognosis of the case Tertiary prevention: It is used when the disease process has advanced beyond its early stages. It is defined as “all the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions.” Intervention that should be accomplished in the stage of tertiary prevention are disability Disability limitation: Disease Impairment Disability Handicap Impairment: Impairment is “any loss or abnormality of psychological, physiological or anatomical structure or function.” Disability: Disability is “any restriction or lack of ability to perform an activity in the manner or within the range considered normal for the human being.”  Handicap :Handicap is termed as “a disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role in the community that is normal (depending on age, sex, and social and cultural factors) for that individual.” Rehabilitation: Rehabilitation is “ the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability.”  Classification of Hospitals According to Ownership: A. Government Created by law. May be under DOH, DND, DOJ, PNP, LGU, SUCs, GOCC and others B. Private May be a single proprietorship, partnership, corporation, cooperative, foundation, religious, non-government organization and others A.O. No. 2012 – 0012 Rule V. B. 1. a., p. 6  Classification of Hospitals According to Functional Capacity: A. General Hospital Provides medical and surgical care to the sick and injured and maternity care and shall have as minimum, the following clinical services: medicine, pediatrics, obstetrics and gynecology, surgery and anesthesia, emergency services, out-patient and ancillary services. B. Specialty Hospital Specializes in a particular disease or condition or in one type of patient.  Examples of SPECIALTY HOSPITALS Particular Particular Particular Group of Disease Organ(s) Patients National Philippine Children’s Orthopedic Lung Center Medical Center Hospital National Center for Philippine Heart National Children’s Mental Health Center Hospital National Kidney and Dr. Jose Fabella San Lazaro Transplant Institute Memorial Hospital Hospital Classification of General Hospitals OLD NEW RE-CLASSIFY TO OTHER LEVEL I HEALTH FACILITIES LEVEL 2 LEVEL 1 LEVEL 3 LEVEL 2 LEVEL 4 LEVEL 3