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the wellbeing of a child and their education for a healthy living. A school health programme refers to all activities that contribute to the initiation, maintenance and improvement of the health of school children and personnel. These include health learning, health practice during school hours and health services. The school health programme is a continuation of the infant and pre-school health programme. In 1909, the school health programme began in India. The medical examination was carried out in the city of Baroda for the school students. The objectives of the school health programme are as follows Objectives: School health service aims to 1. Promote health and develop concern for their health as well as their families and community. 2. Detect disease deviations from normal health at an early age and arrange for prompt treatment and follow-up. 3. Prevent communicable and non-communicable disease. 4. Provide a healthy and safe environment for all around development at childs physical, mental, social, emotional and moral well-being. 5. Help the children to make the best use of education to utilize leisure and recreation opportunities in a productive and constructive manner. 6. Help the children, their parents and teachers to be health conscious and develop a right attitude towards health and illness. 7. Increase the basic knowledge and skills of children and those concerned in their welfare in all levels of prevention.
STEPS TO CONDUCT THE SCHOOL HEALTH CHECK-UP The following steps are suggested for initiating and planning a The following steps were followed in conducting School health health programme programs in the Kailash Puram Government School. Step 1: Visit each school in the area where we work. Talk informally and unofficially with the principal and teachers to discover 1. Kinds of health problems that are evident in the school 2. What are the steps taken towards the problem? 3. What teachers think and should be done to prevent and subsidise the problem? 4. Observe the environment and note the latrine facilities, water supply, light and ventilation and provision for school lunch and record whether all the children were vaccinated. Step 2: Record your exploratory visit to each school and complete a report showing the location of each classroom. Step 1: Visited each school in the urban area and eventually the Kailaspuram Government School was selected. We did visit the school and spoke to the headmistress, staff and students in order to collect the necessary information about the health status of the students and their environmental status too. Physical facilities for the children in the school such as water supply, light, ventilation, latrine facilities and provision for school lunch and vaccination of children were observed. Step 2: The information collected is as follows 1. It is a Government school 2. Consists of 12 classrooms 3. Starts from 1st to 10th standard 4. It is co-education with facilities like a) Benches and chairs for all classrooms b) Black board and chalk in the classrooms c) Adequate lighting during daytime d) Toilet facilities for both boys and girls e) Drinking water facilities f) Lunch facility g) Playground h) Separate hall for conducting programs
Observation: i. Facilities are adequate for all children ii. Environment sanitation is maintained a) Presence of closed sanitation b) The toilets were clean c) Cleanliness was maintained in classrooms iii. There is a first aid box with proper equipments iv. Annual check-up is done and the health records were maintained v. Common problems among the children a) Fever b) Cold and cough c) Vision problem d) Dental caries e) Tonsillitis f) Upper respiratory tract infection g) Knee pain h) Anemia i) Poor personal hygiene Step 3: Discuss the school report with the supervisor and health director and obtain sanction to organize a school health check-up. Step 3: After visiting the school, we decided to conduct the health checkup and discussed the above report with the Supervisor, Govt. School, block officer and obtained the permission for the same. Step 4: The matter was discussed with the school principal, teachers and the administrative officer to conduct the health check-up for the children.
Step 4: Make arrangement for a conference inviting the school principal, teachers, medical officer, nurses, health visitors, social education officers, village worker, head of the Panchayat and other head professional and lay members of the school community and parents with the addenda for the need of a school health programme. a) The appointment of a representative committee to survey each school as a first specific step in diagnosing the health
Step 5: At the second meeting, the agents should present the report of the school health survey and the appointment of school health planning committee with representation from the school health unit community project and the Panchayat board of the local body. Step 6: Work with the committee and develop a program based on the needs, no of students and the facilities available. The nurse who serves 10,000 to 20,000 population located in various villages wont be able to do a complete job in each school. However, the nurses never to do the whole job herself, and follow the vital job daily observation facilities. Step 7: The proposed plans should include realistic goals and estimated target data. Step 8: Make schedule with the help and approval of the school to include work with each school and health committee. Visits to the schools should be on the same day at the same time and each week.
Step 5: The report was discussed in detain with the school authorities and our community facilities and our Head of the Dept, Mrs. Hephzibah Shadrach and Mrs. Jyothi and finalized a date for the program.
Step 6: Based on the problems identified, we planned to conduct the health education program on Jaundice, Hepatitis A, Hepatitis B, menstrual hygiene.
Step 9: Plan on educational program for the school health staff, sanitarians and midwives will meet regularly to learn together about school health.
Step 10: At the end of the school health program was evaluated.
Step 10: Evaluate the program at the end of the school year and make plans for the following term.
COUNTERS AND RESPECTIVE MEMBERS PLANNED FOR SCHOOL HEALTH CHECK-UP SL. NO 1. 2. 3. 4. 5. 6. 7. 8. 9. COUNTER Registration counter Anthropometric measurement counter Vital signs counter Physical examination counter Vision test counter Doctors counter Dressing counter Pharmacy Health Education counter NAME OF THE STUDENT Mrs. Anu Mrs. Geethanjali Miss. Josini Joy Mrs. Geethanjali Mr. Joby Thomas Mrs. Jasmine Miss. Sherine Babu Miss. Arunima Miss. Arunima Mrs. Jacintha Mrs. Gangamma MEMBER 2 2 1 1 1 1 1 1 1
2. 3. IX 1. 2. 3. 4. 5. 6. 7. 8. 9. X 1. 2. 3. 4. 5. 6. 7. 8. XI 1. 2. 3. 4. 5.
Snellen chart Torch Doctors counter Chair Table Table cloth Medicine slip Writing pad Torch Spatula Stethoscope Gloves Pharmacy Table Chair Medicine slip Medicine cover Plastic cover Stapler, pen and scale Papers Medicines Health education counter Table Flash cards Charts Models Scale
Drugs: the following drugs were used to treat the school children in the school health check-up programme Sl. No 1. Name of Drug Tab. Paracetamol Dose 250mg Route Oral Action Anti-pyretic Side Effects Nausea, allergic reaction, skin rashes, acute renal necrosis GI discomfort, headache, nausea, dry mouth Nursing Intervention Check the vital signs, assess for any hyper sensitivity by reaction Advice to chew or crush and mix. Advice to drink more oral fluids Withhold the drug if the patient has any hypersensitivity reaction Advice to take with meals or milk. Advice to inform in presence of weakness Advice not to drink with fluids. Advice to take warm liquids. Diet which contains high protein and calorie should be advised Advice to store in cool place. Advice not to take calcium supplements with iron Supplements Quantity
23
2.
Tab. Albendazole
400mg
Oral
Anti-helmenthic
18
3.
5mt
Oral
Anti-helmenthic
4.
Tab. Citrizine
5mg
Oral
Anti-nistamine
5.
Syp. Cofstop
5mt
Oral
Cough syrup
Insomnia, headache,dizziness, dry mouth, vomiting epistaxis, abdominal pain Insomnia, headache, epistaxis, abdominal pain Myopathy, fatigue, weakness, hallucination, blurred vision Hypertension, rashes, myalgia
17
6.
Tab. B Complex
75mg
Oral
Vitamin supplement
16
7.
Ferrous sulphate
100mg
Oral
Iron supplement
8.
Tab. Sporalac
5mg
Oral
Anti-diarrhoeal
9.
Syp. Orofer
5mg
Oral
Iron supplement
Abdominal pain, distension, discomfort, constipation Hypertension, rashes, myalgia Diarrhoea, dizziness, chest pain, nausea
5 Do not administer in case of hypersensitivity Do not administer to children below 12 years. Advice to take before food
10.
Tab. Pantop
40mg
Oral
Items
Charts Colour paper Floating candles Candles Match box Ribbon Pictures Marker Pen Gum Flowers Refreshments Juice powder Sugar Disposable cups Snacks Miscellaneous Total
No of items
15 20 1 packet 1 packet 1 1 10 4 5 1 2 1 1.5kg 120 12
LIST OF AV AIDS
The following are the audio visual aids used in the health education for students. SL. SUBJECT FLASH CHARTS MODEL NO CARD 1. Menstrual hygiene 4 2 2. Hepatitis A 2 4 3. Hepatitis B 2 4 4. Jaundice 1 3 5. Dental carries 2 6. Child safety 1 7. Prevention of diarrhoea 1 8. Personal hygiene 1 9. Worm infestation 2 2 10. Protein rich diet 2 Programme Agenda: 1. Prayer Mrs. Geethanjali 2. Welcome address - Mrs. Anu 3. Lamp lighting Headmistress, Mrs. Hephzibah Shadrach, HOD, Community Health nursing, HMCON, School teachers and Doctors 4. Health check-up programme 5. Vote of thanks 6. Refreshments
: 12/6/2012 :
10 1
: 12/6/2012 :
2 3
:
, . .
:
...() . () ( ) . .
GOVERNMENT HIGH SCHOOL KAILASH PURAM MANDI MOHALLA, MYSORE ORGANIZED BY 3rd YR G.N.M, 2nd YR P.C.B.Sc (N) AND 2nd YR M.Sc (N) STUDENTS HOLDSWORTH MEMORIAL COLLEGE OF NURSING (MISSION HOSPITAL) MANDIMOHALLA, MYSORE- 21
E n t r a n c e
Registration counter
E x i t
Pharmacy
Dressing counter
Prescription counter
IMPLEMENTATION PHASE: On 12th of June 2012, we conducted the school health check-up on behalf of Holdsworth memorial hospital, Mysore. The programme started with a lamp lighting ceremony by Dr. Avinash, Mrs. Hephzibah Shadrach, HOD, Community Health Nursing, HMCON and the school Headmistress. We had 10 counters and a student was allotted with specific responsibilities. 1. Registration Counter: Mrs. Anu and Mrs. Geethanjali were posted in the registration counter with the registration card which contained the following datas. Reg. No Name Age Sex Class Complaints Diagnosis Treatment : : : : : : : : Vital Signs :
Temperature : Pulse :
2. Anthropometric Measurement Counter: Miss. Josini Joy and Mrs. Geethanjali were posted in this counter where the following details were recorded a) Height b) Weight c) Mid arm circumference
3. Vital Signs Counter: Mr. Joby Thomas was posted in this counter which checked the following data
a) Temperature b) Pulse c) Respiration and blood pressure 4. Vision Test Counter: Miss. Sherin Babu was posted in this counter to record their visual acuity. 5. Physical Examination Counter: Mrs. Jasmine was posted in this counter, who conducted the following a) Head to foot examination b) Assisting the doctors 6. Doctors counter: Miss. Arunima was posted in this counter to assist the doctors. 7. Dressing Counter: Miss. Arunima was posted in this counter to conduct dressing as per doctors prescription. 8. Pharmacy: Mrs. Jacintha was posted to distribute the drugs which the doctor has prescribed. 9. Health Education Counter: Miss. Gangamma was posted here to provide health education to students using AV aids as per their complaints.
REGISTRATION Sl No 1. Name Ms. Yashoda Age 14 Sex F Height Weight Vision test (cms) (Kg) Left Right 138 37.2 6/6 6/6 TPR T- 37C P- 88/mt R- 24/mt T- 37C P- 92/mt R- 22/mt T- 37C P- 86/mt R- 26/mt T- 37C P- 80/mt R- 24/mt T- 37C P- 84/mt R- 26/mt T- 37C P- 80/mt R- 22/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 78/mt R- 24/mt T- 37C P- 84/mt R- 22/mt T- 37C P- 80/mt Health status Throat painacute tonsillitis Rheumatic arthritis Dental carries, cough Tonsillitis, cough Dental carries Treatment Tab. PCT Tab. Citrizine Tab. PCT Tab. Albindozole Tab. PCT Tab. Albindozole Tab. PCT Tab. Citrizine Tab. PCT Tab. Albindozole Remarks Advised hygienic practices Advised iron rich diet Advised hygienic practices Advised to avoid cold food. Advised hygienic practices Advised to prevent from infection Advised to avoid stress
2.
Ms. Akshatha
14
134
41.5
6/6
6/6
3.
Ms. Sukanya
15
147
42
6/6
6/6
4.
Ms. Lavanya
14
146
40
6/6
6/6
5.
Ms. Rani
14
134
36.5
6/6
6/6
6.
Ms. Devika
15
153
51.7
6/6
6/6
7.
Ms. Arpitha
14
144
47.6
6/6
6/6
Upper Tab. PCT respiratory tract Tab. Citrizine infection Stress, head ache Tab. PCT Tab. Albindozole Normal Tab. Albindozole
8.
Ms. Bhavani
14
146
41
6/6
6/6
9.
Ms. Jayalakshmi
14
142
50
6/6
6/6
10.
Ms. Sindhu
14
136
45
6/6
6/6
11.
Ms. Sucha
15
144
58
6/6
6/6
12.
Ms. Meenaskhi
14
136
42
4/6
4/6
R- 22/mt T- 37C P- 82/mt R- 26/mt T- 37C P- 80/mt R- 26/mt T- 37C P- 84/mt R- 26/mt T- 37C P- 86/mt R- 24/mt T- 37C P- 88/mt R- 24/mt T- 37C P- 84/mt R- 24/mt T- 37C P- 82/mt R- 22/mt T- 37C P- 92/mt R- 26/mt
Tab. Citrizine
13.
Ms. Lakshmi
14
133
40
6/6
6/6
Sinusitis
14.
Mr. Jayanth
15
150
50
6/6
6/6
15.
Mr. Kumar
15
134
37.5
6/6
6/6
16.
Mr. Shivarudhra
15
155
46
6/6
6/6
17.
Mr. Rohith
15
153
45
6/6
6/6
Upper respiratory tract infection Upper respiratory tract infection Upper respiratory tract infection Normal
Tab. PCT Tab. Albindozole Tab. Citrizine Tab. Citrizine Tab. Albindozole Tab. Citrizine Tab. Albindozole Tab. PCT Tab. Citrizine Tab. Albindozole
Advised to prevent from infection Contact ophthalmologist for further evaluation Advised to avoid cold food Advised to prevent from infection Advised to prevent from infection Adviced to take boiled and cooled water
18.
Mr. Sunarth
15
146
41
6/6
6/6
Normal
Tab. Albindozole
19.
Mr. Kiran
15
150
40
6/6
6/6
Normal
Tab. Albindozole
20.
Mr. Siddhartha
16
155
45
6/6
6/6
21.
Mr. Chandrashekar
15
151
45.5
6/6
6/6
22.
15
146
44
6/6
6/6
23.
Mr. Rajesh
15
150
43
6/6
6/6
24.
15
146
59
6/6
6/6
25.
15
154
43.5
6/6
6/6
26.
14
159
48
6/6
6/6
27.
Mr. Narayana
15
150
48
6/6
6/6
28.
Mr. Neruha
14
132
27
6/6
6/6
29.
Ms. Shilpa. S
14
137
34
6/6
6/6
30.
Ms. Shilpa
14
132
35
6/6
6/6
T- 37C P- 88/mt R- 22/mt T- 37C P- 88/mt R- 22/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 74/mt R- 22/mt T- 37C P- 92/mt R- 22/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 82/mt R- 22/mt T- 37C P- 86/mt R- 24/mt T- 37C P- 82/mt R- 22/mt T- 37C P- 82/mt
Dental carries
Normal
Leg pain
Tab. PCT Tab. Albindozole Tab. PCT Tab. Citrizine Tab. Rantac Tab. Albindozole Tab. Rantac Tab. Albindozole
Advised to avoid stress Advised hygienic practices Advised to avoid spicy food Advised to avoid spicy food
Gastritis , fever
Fatigue
Acute gastritis
Normal
31.
Ms. Sushmitha
14
137
37.8
6/6
6/6
32.
Ms. Akshatha
14
148
36
6/6
6/6
33.
Ms. Pooja
14
146
43
6/6
6/6
34.
14
151
55
6/6
6/6
35.
13
134
40
6/6
6/6
36.
14
132
35
6/6
6/6
37.
Ms. Megha
14
148
47
6/6
6/6
38.
Ms. Neha
14
148
45
6/6
6/6
39.
Ms. Pooja.K
14
134
45
6/6
6/6
40.
Ms. Chandana
14
141
44
6/6
6/6
R- 22/mt T- 37C P- 86/mt R- 24/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 84/mt R- 24/mt T- 37C P- 84/mt R- 24/mt T- 37C P- 84/mt R- 24/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 86/mt R- 24/mt T- 37C P- 82/mt R- 22/mt T- 37C P- 86/mt R- 26/mt T- 37C P- 88/mt R- 26/mt
Tab. Citrizine Tab. Albindozole Tab. Citrizine Tab. Albindozole Tab. PCT
Advised to prevent from infection Advised to prevent from infection Advised to avoid stress
Normal
Normal
Normal
Normal
Stress, headache
Tab. PCT
Normal
Headache
Tab. PCT
41.
Ms. Suhana
14
135
33
6/6
6/6
42.
Ms. Chaithanya
13
141
44
6/6
6/6
T- 37C P- 82/mt R- 24/mt T- 37C P- 84/mt R- 26/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 84/mt R- 26/mt T- 37C P- 84/mt R- 24/mt T- 37C P- 82/mt R- 26/mt T- 37C P- 82/mt R- 24/mt T- 37C P- 84/mt R- 26/mt T- 37C P- 84/mt R- 24/mt T- 37C P- 84/mt R- 26/mt
43.
14
140
42.5
6/6
6/6
Headache
Tab. PCT
Advised to prevent from infection Advised to avoid stress. Take iron rich food Advised to avoid stress Advised to prevent from infection Advised to prevent from infection Advised to prevent from infection
44.
Ms. Hemalatha
13
140
40
6/6
6/6
45.
Ms. Nishantha
14
139
35
6/6
6/6
46.
Ms. Razil
14
148
42.5
6/6
6/6
47.
16
157
44
6/6
6/6
Upper respiratory tract infection Upper respiratory tract infection Upper respiratory tract infection Normal
Tab. Citrizine Tab. Albindozole Tab. Citrizine Tab. Albindozole Tab. Citrizine Tab. Albindozole
48.
13
124
25
6/6
6/6
49.
Mr. Sandesh
14
132
51
6/6
6/6
50.
Mr. Raju
14
150
35
6/6
6/6
Submitted to Mrs. Hephzibah Shadrach Head Of Department Community health nursing HMCON Mysore
Submitted on:
Time 1mt
Specific objectives
Content Introduction: Menstruation is the sign of a normal female body. It is not unhealthy or unhygienic. These facts are the basic demerits of hygiene during menstruation. Signs and symptoms: Physical and psychological changes accompanying the menstruation includes Pain in waist, legs and pelvis Tendency of fatigue Slight changes in the mood or psychological condition There may be some changes in the breast Some factors regarding menstrual cycle Menarche (first menstrual show) may appear any time between 10 to 17 years Quantity of menstrual discharge is approximately (30 to 180mt). Blood constitutes the major part of it. Menstrual cycle can be approximately 16-34 days General duration of discharge is 1-7 days. (clots are signs of abnormality) Major factors altering the menstrual cycle includes Change in environment, working hours, emotional setback, disease, use of medicines etc
A.V. Aids
Evaluation
Define menstruation
What is menstruation?
2mts
5mts
3mnts
As soon as the girls step into adolescence, they should be taught about menstrual discharge and cycle. Menstrual discharge is a physical process which has nothing to do with purity and impurity of women Menstrual period is not a barrier for a normal daily life List out the cleanliness and care during menstrual cycle
5mts
Cleanliness and care during menstrual cycle: Daily bath and keeping the genital organs clean is necessary. Clean sanitary pads should be used to absorb the discharge. Old clothes used to absorb discharge may cause infection. Physician should be consulted in case of more or less discharge or irregular periods Middle aged women should be educated about process of menopause. Health teaching for during menstruation: Knowledge of psychological process Stress, fatigue and exercise might alter the menstrual cycle. Emphasis on personal hygiene to wear pads during early period of heavy flow. Consult physician of Daily shower for comfort, Keep perennial Cotton underwear is recommended whereas the nylon panty and light fitting
3mts
5mts
Myths and beliefs during menstrual cycle The girl is isolated from the family members by Giving separate plates to eat Not permitted into the altar room Not allowed to participate in the rituals Believe that menstrual period is an unhealthy period Diets during menstrual period Lots of fluid should be consumed like clean water around 2-3 litres a day Fruit juices like lemon and orange are advised Consume lot of green leafy vegetables like spinach, drumstick leaves etc Maintain a high calorie diet. Eg tender coconut & rice
Bibliography a) B.T. Basavanthappa; Community health Nursing;3RD edition; Jaypee brothers medical publishers; Page nos 206-208 b) Keshav swarankar; Community health Nursing; 2nd edition; N.R. brothers publications; P.no. 429-431
EVALUATION: Response from the children: The children understood the importance of menstrual hygiene and were motivated to follow the steps learnt during the teaching session. Self evaluation: I Geethanjali, from II year MSc in community health nursing along with the III year GNM students and II P.C.B.Sc (N) students planned a school visit and the school health check-up was conducted. The health education program concluded by teaching them about Hepatitis A and B and also a session on menstrual hygiene was conducted for the girls. PowerPoint presentations, flash cards and charts were used as AV aids in presenting the topics effectively. Conclusion: By organizing the health education program, we were able to explain to the children about Hepatitis A and B and menstrual hygiene. The response from the students and the staff showed that the health education was beneficial.
SUBMITTED TO: Mrs. Hephzibah Shadrach Head Of Department Community health nursing HMCON, Mysore
SUBMITTED BY: Mrs. Geethanjali. N II yr M.Sc in comm. health nursing HMCON, Mysore.
SUBMITTED ON: