Department of Health Academy (DOHA) Gerontology Nurses Association of the Philippines (GNAP)

TRAINING PROGRAM ON GERONTOLOGY AND GERIATRIC NURSING

4 July to 7 October 2016

Clinical Practicum Journal

Philippine General Hospital
Geriatric OPD and Grand Rounds
September 27, 2016
Reflections/ Insights:
As the world population is getting older, health care for elderly becomes
important. Access to needed medical care has become increasingly important in
today's rapidly changing world. Traditionally, vulnerable populations including
the older persons have a higher risk of being sick and whose access to care is
below average. Some of the elderly underuse needed services due to economic
constraints. They have a lower likelihood of seeing a physician, higher
emergency department use, a greater likelihood of delaying care, and lower use
of preventive care services. Thus, these populations also have poorer health
outcomes and higher mortality rates. Keeping in mind that aging process is
increasing recently, access to health care needs and services including the
number of nurse specialists and physicians caring for elderly should also
increase.
Republic Act 9994 stipulates that all government hospitals should have a
Geriatric Ward. Also, the Department of Health is preparing for the high
population projection of older persons in the future by equipping nurses from
DOH hospitals in the country to specialize in the care of the elderly. With such
scenario, it is a prerogative of hospitals to put up a Geriatric Outpatient Care
Clinic not only to decrease health care costs but also to address all aspects of
care of the older persons. With such, a trained multidisciplinary team is
necessary to understand each healthcare professionals' role in the general
assessment, care coordination and improvement of care of the older persons.
As I observed during the clinical practicum exposure at the geriatric clinic,
the facility can only cater 15 patients every Tuesday of the week as scheduled by
the geriatric nurse. I also recognized that the queuing of the older persons are
not organized and the environment is not suitable for waiting. Considering some
of the older persons have disabilities and other concerns, a comfortable, serene
and quiet environment will most likely help the older persons, as some of them
traveled so far just to have a checkup.
Our institution specializes in rendering care for patients with infectious and
tropical diseases. It is expected that most of the clienteles are afflicted with
communicable and infectious diseases. As most of the older persons have a
lower immune system, standard and universal precautions must be strictly
observed in putting up a wellness center for the elderly. Thus, a strategic plan on
proper location of the geriatric ward and outpatient clinic must be done.
During the grand rounds, we nurses are fortunate to attend such lecture
conducted by specialists. Dr. Alba reiterated that the use of Comprehensive
Geriatric Assessment will bring out significant findings on all aspects of care.
Thus, a holistic care approach should be rendered by a multidisciplinary team. He
also emphasized the physiologic changes in aging that we might encounter
during assessment of the older persons. Dr. Silva, a geriatric dermatologist
discussed noteworthy clinical findings on integumentary system diseases that

Department of Health Academy (DOHA) Gerontology Nurses Association of the Philippines (GNAP)
TRAINING PROGRAM ON GERONTOLOGY AND GERIATRIC NURSING

4 July to 7 October 2016

are common in the elderly. She also conferred malignancies,
tackled on alopecia and medical management of such diseases.

Submitted by:
Orlea A. Francisco, R.N. M.A.N.
Nurse II - San Lazaro Hospital