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It is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
WHAT IS NURSING?
assisting sick individuals to become healthy and healthy individuals achieve optimum wellness.
Public Health Nursing: the term used before for Community Health Nursing According to Dr. C.E. Winslow, Public Health is a science & art of 3 Ps
Prevention of Disease Prolonging life Promotion of health and efficiency through organized community effort
What is Community Health Nursing? The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation. Maglaya, et al
3. C ommunity
DEPARTMENT OF HEALTH
DOH
is the executive department of the Philippine government responsible for ensuring access to basic public health services by all Filipinos through the provision of quality health care and the regulation of all health services and products. It is the government's over-all technical authority on health.It has its headquarters at the San Lazaro Compound, along Rizal Avenue in Manila. The department is led by the Secretary of Health, nominated by the President of the Philippines and confirmed by the Commission on Appointments. The Secretary is a member of the Cabinet. The current Secretary of Health is Enrique Ona.
5 MAJOR FUNCTIONS:
1. Ensure equal access to basic health services 2. Ensure formulation of national policies for proper division of labor and proper coordination of operations among the government agency jurisdictions 3. Ensure a minimum level of implementation nationwide of services regarded as public health goods 4. Plan and establish arrangements for the public health systems to achieve economies of scale 5. Maintain a medium of regulations and standards to protect consumers and guide providers
A Global Leader for attaining better health outcomes, competitive and responsive health care systems, and equitable health financing.
MISSION To guarantee EQUITABLE, SUSTAINABLE and QUALITY health for all Filipinos, especially the poor and to lead the quest for excellence in health.
Principles to Attain the Vision of DOH Equity: equal health services for all-no discrimination Quality: DOH is after the quality of service not the quantity Philosophy of DOH: Quality is above quantity Accessibility: DOH utilize strategies for delivery of health services
oCreation of Restructured Health Care Delivery System (RHCDS) regulated by PD 568 (1976)
oManagement Information Systems regulated by R.A. 3753: Vital Health Statistics Law oPrimary Health Care (PHC) regulated by LOI 949 (1984): Legalization of Implementation of PHC in the Philippines
CREATION OF RHCDS: RHO (National Health Agency) or existing national agencies like PGH or specialized agencies like Heart Center for Asia, NKI MHO & PHO (Municipal/Provincial Health Office)
Type
Service
Type
Example
Primary
Health Promotion, Preventive Care, Continuing Care for Common Health Problems, Attention to Psychological and Social Care, Referrals
Surgery, Medical Services by Specialist Advanced, Specialized, Diagnostic, Therapeutic and Rehabilitative Care
Information Dissemination
Secondary
Screening
Tertiary
PT/OT
LEVELS OF PREVENTION
PRIMARY LEVEL
Health Promotion and Illness Prevention
SECONDARY LEVEL
Prevention of Complications thru early Dx and Tx When hospitalization is deemed necessary and referral is made to emergency (now district) provincial or regional or private hospitals
TERTIARY LEVEL
Prevention of Disability, etc When highlyspecialized medical care is necessary Referrals are made to hospitals and medical centers like PGH, PHC, POC, NCMH, and other Govt and private hospitals at municipal level
Provided atHealth Care/RHU BHS Main Health Center Community Hospital and Health Center Private and SemiPrivate Agencies
REFERRAL SYSTEM:
BHS RHU MHO PHO RHO National Agencies Specialized Agencies
CHARACTERISTICS OF PHC:
SENTRONG SIGLA MOVEMENT (SSM) was established by DOH with LGUs having a logo of a Sun with 8 Rays and composed of 4 Pillars:
1. 2. 3. 4.
Health Promotion Granted Facilities Technical Assistance Awards: Cash, plaque, certificate
4 CONTRIBUTIONS OF PHC TO DOH &ECONOMY: 1. Training of Health Workers 2. Creation of Botika sa Baryo & Botika sa Health Center 3. Herbal Plants 4. Oresol
An antibacterial drug that comes from the Penicillin family Effect is generally bacteriostatic (when source of infection is bacterial) These 2 drugs provide the least sensitivity reaction (rashes & GI) and the adverse effect of other antibiotics is anaphylactic shock
COMMONLY AVAILABLE GENERICS (CARIPPON) TB DRUGS: 3. Rifampicin (RIF) - used in certain types of bacterial infections and tuberculosis. 4. Isoniazid (INH) - used alone or with other drugs to treat tuberculosis (TB) and to prevent it in people who have had contact with tuberculosis bacteria. 5. Pyrazinamide (PZA) - kills or stops the growth of certain bacteria that cause tuberculosis (TB). It is used with other drugs to treat tuberculosis
8 COMMONLY AVAILABLE GENERICS (CARIPPON) 7. Oresol: a management for diarrhea to prevent dehydration under the Control of Diarrheal Diseases (CDD) Program
8 COMMONLY AVAILABLE GENERICS (CARIPPON) 8. Nifedipine: An anti-hypertensive drug According to DOH, 16% of population belonging to 25 years old & above in the community are hypertensive
C. HERBAL PLANTS
RA 8423: Alternative Traditional Medicine Law a program where patient may opt to use herbal plants especially for drugs that are not available in dosage form or patients has no financial means to buy the drug
Lagundi
Vitex negundo
Asthma, Leaves Cough Colds, and Fever (ASCOF) Pain and Inflammati on
Decoction Poultice
Bayabas
Psidium quajava
Decoction
Bawang
Allium sativum
poultice
Tsaang Gubat
Carmona resuta
Decoction poultice
Leaves
decoction
POLICIES TO ABIDE: Know indications Know parts of plants with therapeutic value: roots, fruits, leaves Know official procedure/preparation
Procedures/Preparations: Decoction Gather leaves & wash thoroughly, place in a container the washed leaves & add water Let it boil without cover to vaporize/steam to release toxic substance & undesirable taste Use extracts for washing
Procedures/Preparations:
Poultice
Done by pounding or chewing leaves used by herbolaryo Example: Akapulko leaves-when pounded, it releases extracts coming out from the leaves contains enzyme (serves as anti-inflammatory) then apply on affected skin or spewed it over skin For treatment of skin diseases
Procedures/Preparations: Infusion To prepare a tea (use lipton bag), keep standing for 15 minutes in a cup of warm water where a brown solution is collected, pectin which serves as an adsorbent and astringent
Procedures/Preparations: Juice/Syrup To prepare a papaya juice, use ripe papaya &mechanically mashed then put inside a blender& add water To produce it into a syrup, add sugar then heat to dissolve sugar & mix it
Procedures/Preparations: Cream/Ointment Start with poultice (pound leaves) to turn it semi-solid Add flour to keep preparation pasty & make it adhere to skin lesions To make it into an ointment: add oil (mineral, baby or any oil-serves as moisturizer) to the prepared cream to keep it lubricated while being massage on the affected area
D. ORESOL
Glucose 20 gms 1st significance: For reabsorption of Na Facilitates assimilation of Na 2nd significance: Provides heat and energy
NaCl
3.5 grms
NaHCO3
2.5 grms
Buffer content of solution Neutralizer content of solution Stimulates smooth muscle contractility especially the heart and GIT
KCL
1.5 grms
is the provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public
The Aquino administration puts it as the availability and accessibility of health services and necessities for all Filipinos.
It is a government mandate aiming to ensure that every Filipino shall receive affordable and quality health benefits. This involves providing adequate resources health human resources, health facilities, and health financing.
2.
3.
Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP) Improved access to quality hospitals and health care facilities; and Attainment of health-related Millennium Development Goals (MDGs).
The Health Facility Enhancement Program (HFEP) shall provide funds to improve facility preparedness for trauma and other emergencies. The aim of HFEP was to upgrade 20% of DOH- retained hospitals, 46% of provincial hospitals, 46% of district hospitals, and 51% of rural health units(RHUs) by end of 2011.
Further efforts and additional resources are to be applied on public health programs to reduce maternal and child mortality, morbidity and mortality from Tuberculosis and Malaria, and incidence of HIV/AIDS. Localities shall be prepared for the emerging disease trends, as well as the prevention and control of noncommunicable diseases. The organization of Community Health Teams (CHTs) in each priority population area is one way to achieve health-related MDGs. CHTs are groups of volunteers, who will assist families with their health needs, provide health information, and
RNheals nurses will be trained to become trainers and supervisors to coordinate with community-level workers and CHTs. By the end of 2011, it is targeted that there will be 20,000 CHTs and 10,000 RNheals. Another effort will be the provision of necessary services using the life cycle approach. These services include family planning, ante-natal care, delivery in health facilities, newborn care, and the Garantisadong Pambata package. Better coordination among government agencies, such as DOH, DepEd, DSWD, and DILG, would also be essential for the achievement of these MDGs.
GOAL 2: ACHIEVE UNIVERSAL PRIMARYEDUCATION Target : Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
To implement the KP thrusts and interventions, the DOH will adopt the following general strategies:
1.Focus and engage vulnerable families, starting with provinces where most are found; 2.Partner with poverty alleviation programs like the National Household Targeting System-Poverty Reduction (NHTS- PR) and Conditional Cash Transfer (CCT); 3.Leverage LGU participation and performance through province-wide agreements; and 4.Harness private sector participation
It is a network of information. It is intended to address the short term needs of DOH and LGU staff with managerial or supervisory functions in facilities and program areas. It monitors health service delivery nationwide.
OBJECTIVES OF FHSIS
To provide summary data on health service delivery and selected program accomplishment indicators at the barangay, municipality/ city, and district, provincial, regional and national levels. To provide data which when combined with data from other sources, can be used for program monitoring and evaluation purposes. To provide a standardized, facility-level data base that can be accessed for more in-depth studies. To minimize the recording and reporting burden at the service delivery level in order to allow more time for patient care and promote activities.
IMPORTANCE OF FHSIS
Helps local government determine public health priorities. Basis for monitoring and evaluating health program implementation Basis for planning, budgeting, logistics and decision making at all levels. Source of data to detect unusual occurrence of a disease. Needed to monitor health status of the community Helps midwives in following up clients. Documentation of RHM/PHN day to day activities.
COMPONENTS OF FHSIS
1. 2. 3. 4.
Individual Treatment Record (ITR) Target Client List (TCL) Summary Table The Monthly Consolidation Table (MCT)
The fundamental building block or foundation of the Field Health Service Information System is the INDIVIDUAL TREATMENT RECORD This is a document, form or piece of paper upon which is recorded the date, name, address of patient, presenting symptoms or complaint of the patient on consultation and the diagnosis (if available), treatment and date of treatment.
The Target Client Lists constitute the second building block of the FHSIS and are intended to serve several purposes First is to plan and carry out patient care and service delivery. Such lists will be of considerable value to midwives/nurses in monitoring service delivery to clients in general and in particular to groups of patients identified as targets or eligibles for one or another program of the Department
The second purpose of Target Client Lists is to facilitate the monitoring and supervision of service delivery activities. The third purpose is to report services delivered.
The fourth purpose of the Target Client Lists is to provide a clinic-level data base which can be accessed for further studies
Target Client List for Prenatal Care Target Client List for Post-Partum Care Target Client List of Under 1 Year Old Children Target Client List for Family Planning Target Client List for Sick Children NTP TB Register National Leprosy Control Program Form 2-Central Registration Form
SUMMARY TABLE
The Summary Tables is a form with 12-month columns retained at the facility (BHS) where the midwife records monthly all relevant data. The Summary Table is composed of:
1. Health Program Accomplishment this can serve as proof of accomplishments to show LGU officials whenever they visit the facility.
2. Morbidity Diseases the source of ten leading causes of morbidity for the municipality/city. This summary table will help the nurse and MHO to get the monthly trend of diseases.
The Consolidation Table is an essential form in the FHSIS where the nurse at the RHU records the reported data per indicator by each BHS or midwife. This is the source document of the nurse for the Quarterly Form. The Consolidation Table shall serve as the Output Table of the RHU as it already contains listing of BHS per indicator.
FHSIS REPORTING
These are summary data that are transmitted or submitted on a monthly, quarterly and on annual basis to higher level. The source of data for this component is dependent on the records.
Program Report (M1) The Monthly Form contains selected indicators categorized as maternal care, child care, family planning and disease control.
Morbidity Report (M2) The Monthly Morbidity Disease Report contains a list of all diseases by age and sex. The Midwife uses the form for the monthly consolidation report of Morbidity Diseases and is submitted to the PHN for quarterly consolidation.
Program Report (Q1) The Quarterly Form is the municipality/city health report and contains the three-month total of indicators categorized as maternal care, family planning, child care, dental health and disease control Morbidity Report (Q2) The PHN uses the form for the Quarterly Consolidation Report of Morbidity Diseases to consolidate the Monthly Morbidity Diseases taken from the Summary Table.
FLOW OF REPORT
OFFICE PERSON BHS Midwife RECORDIN G TOOLS ITR TCL ST FORMS Monthly Form (M1 & M2) A-BHS Form Annually FREQUEN CY Monthly SCHEDULE OF SUBMISSION Every 2nd week of the succeeding month Every 2nd week of Jan. Every 3rd week of the 1st month of succeeding quarter Every 3rd week of Jan.
RHU
PHN
ST MCT
Quarterly
Annual forms - A1 - A2 - A3
HEALTH INDICATORS
VITAL STATISTICS
Tool in estimating the extent or magnitude of health needs and problems in the community
INCIDENCE RATE
IR = New Cases of Disease Population X 100
PREVALENCE RATE
PR = New Cases + Old Cases Population X 100
SWAROOPS INDEX