COMMUNITY HEALTH NURSING POWER POINT PRESENTATION

COMMUNITY HEALTH NURSING

1. COMMUNITY HEALTH NURSING 1

2. THE DEPARTMENT OF HEALTH MANDATE: The Department of Health (DOH) is the principal health agency in the Philippines. It is responsible for  ensuring access to basic public health services to all Filipinos through the provision of quality health care and regulation of providers of health goods and services . The PRIMARY function of the department is the promotion, protection, preservation or restoration of the health of the people through the provision and delivery of health services and through the regulation and encouragement of providers of health goods and services. (E.O 119, SEC 3)

3. VISION – HEALTH AS RIGHT The Department of Health, as the nation's leader in health, is committed to  nurturing Filipinos to be amongst the healthiest in Asia by 2040 through the development of a productive, resilient, equitable, and people centered health system . HEALTH is a basic human RIGHT. A continuous set of services must be provided to assure the enjoyment of this right, especially by the poor.

4. Mission To lead the country in the development of a productive, resilient, equitable and people-centered health system for Universal Health Care . DOH should work to make enjoyment of the right to health a reality: by making services available by arousing community awareness by mobilizing services by promoting the means to better HEALTH

5. DEFINITION of COMMUNITY HEALTH ACCORDING to WINSLOW (1920) > Public health is the science and art of preventing disease, prolonging life and promoting health and efficiency through organized community efforts for the sanitation of the environment, the control of the communicable infections, the education of the individuals in personal hygiene.

6. AMERICAN ASSIOCIATION OF PUBLIC HEALTH - Has defined the public health as “the art and science of maintaining, protecting and improving health of people through organized efforts.

7. ACCORDING TO WHO Community health refers to the health status of the members of the community to the problems affecting their health and to the totality of health care provided for the community.

8. PUBLIC HEALTH > PROVIDED LIMITED SERVICES OF IMMEDIATE CONCERN > NO INVOLVEMENT OF PEOPLE > NO PRIVATE EFFORTS FOR HEALTH > IMPOSED THROUGH LEGISLATION SOMETIMES CHANGED TO….

9. COMMUNITY HEALTH CONCEPT PROVIDED COMPREHENSIVE HEALTH CARE SERVICES JOINT EFFORTS OF PEOPLE AND GOVERNMENT LAID EMPHASIS ON PRIVATE SERVICES INVOLVEMENT OF PEOPLE

10. COMMUNITY HEALTH (ANA, 2000) COMMUNITY HEALTH NURSING is a synthesis of nursing and public health practice applied to promoting and preserving the health of population. Treat population as a whole. Focus on individual, family, groups community. Utilizing health promotion, health maintenance, health education, and management, coordination and continuity of care for meeting population needs.

11. CHARACTERISTICS OF COMMUNITY HEALTH NURSING IT IS A FIELD OF NURSING IT COMBINES PUBLIC HEALTH AND NURSING IT FOCUS IN POPULATION AND ENVIRONMENT FACTORS THAY MAY IMPACT TO PEOPLES HEALTH IT EMPHASIZE IN HEALTH PROMOTION, ILNESS PREVENTION, AND WELLNESS. IT PROMOTES CLIENT RESPONSIBILITY AND SELF CARE. IT USES AGGREGATE MEASUREMENT AND ANALYSIS IT USE PRINCIPLE OF ORGANIZATIONAL THEORY. IT INVOLVES INTERPROFESIONAL COLLABORATION.

12. THE NATIONAL HEALTH SITUATION Despite having achieved universal healthcare, the Philippines still struggles with unequal access to medical care . As such, the standard of public healthcare in the Philippines generally varies from excellent in urban centers to poor in rural areas.

13. UNIVERSAL HEALTH CARE SYSTEM The government enacted the Universal Health Care (UHC) Act in 2019 to improve access to health care services. The UHC  aims to provide all Filipinos equitable access to high-quality health services with financial risk protection . Republic Act No. 11223 mandated that all Filipinos get the healthcare they need, when they need it, without getting impoverished.  The law enrolled all Filipino citizens in the National Health Insurance Program to be administered by the Philippine Health Insurance Corp. or PhilHealth

14. Under the UHC Law,  all citizens are automatically entitled to PhilHealth benefits, including comprehensive outpatient services . PhilHealth will be responsible for purchasing all individual-based services, including supplies, medicines, and commodities, as well as maintenance and operating expense of health facilities. Duterte has just signed a Universal Health Care (UHC) Bill into law (Republic Act No. 11223) that  automatically enrolls all Filipino citizens in the National Health Insurance Program and prescribes complementary reforms in the health system . Mar 14, 2019

15. DEMOGRAPHIC PROFILE The population of The Philippines stood at  118.2 million  in January 2024. Data shows that the Philippines' population increased by 1.8 million (+1.5 percent) between early 2023 and the start of 2024. 49.2 percent of the Philippines' population is female, while 50.8 percent of the population is male. By age group,  33.4 million (30.7%) were under 15 years of age (young dependents) . On the other hand, persons aged 15 to 64 years (working-age or economically- active population) totaled to 69.40 million (63.9%) while those in age groups 65 years and over (old dependents) comprised the remaining 5.86 million (5.4%).

16. MORBIDITY CASES IN THE PHILIPPINES

17. MORTALITY CASES IN THE PHILIPPINES

18. The major complications that account for nearly 75% of all maternal deaths are: severe bleeding (mostly bleeding after childbirth); infections (usually after childbirth); high blood pressure during pregnancy (pre-eclampsia and eclampsia); complications from delivery; and. unsafe abortion.

19. PRIMARY HEALTH CARE is a term used to describe  the first contact a person has with the health system when they have a health problem or issue that is not an emergency . It is the part of the health system that people use most and may be provided.

20. CONCEPT and DEFINITION OF PRIMARY HEALTH CARE ESSENTIAL HEALTH CARE MADE UNIVERSALLY ACCESIBLE TO INDIVIDUALS AND FAMILIES IN THE COMMUNITY BY MEANS ACCEPTABLE TO THEM. Effective provision of essential health services that are community-based, accessible, acceptable and sustainable Universally accessible Means acceptable to the people Full participation of the community At a cost that the community and country can afford Integral part of country’s health care system Integral part of overall socio-economic development of the country BHW (BARANGAY HEALTH WORKER)

21. ROLES OF COMMUNITY HEALTH NURSE

22.   Clinician Role • Care  provider: The nurse ensures that health services are not only provided to individuals and families but also provided to groups and populations. The clinician role has emphasis on holism, health promotion and skill expansion Holistic practice = considering the broad range of interacting needs that affect the “collective health” of the client as a larger system (Patterson 1998)

23.   Clinician Role (Continued) •  A major clinician role is focusing on promoting wellness. • Nursing service includes seeking out clients at risk for poor health to offer preventive and health promoting services rather than waiting for them to come for help after problems arise. Examples: • Employees of a business are helped to live healthier and happier lives by working with a group who wants to quit smoking

24.   Examples: • Educating fathers  – to – be about fathering skills. • Assist several families with terminally ill patients to gain strengths through a support system of accepting death and the dying process. 6.  Examples • Immunization of infants and preschoolers • Family planning programs • Cholesterol screening • Prevention of behavioral problems in adolescents • Expanded skills in observation, listening, communication and counseling are integral to your role as a CHN with emphasis on psychological and socio-cultural factors

25.   Educator Role • Being  a health teacher is one of the main role of a CHN. • It is an important role because: – Community clients are NOT usually acutely ill and can absorb and act on health information. – A wider audience can be reached leading to a community-wide impact. – The public has a higher level of health consciousness. – Client self-education is facilitated by the nurse. Based on the concept of self-care, clients are encouraged to use appropriate health resources.

26.   Advocate Role Based  on clients’ rights: Every patient or client has the right to receive just, equal, and humane treatment. Why Advocacy? • Current health care system offers de- personalised and fragmented services. Many clients who are poor and disadvantaged are frustrated and the nurse becomes an advocate for clients pleading their cause and acting on their behalf. Goals of advocacy: 1. Help clients gain more independence and self- determination 2. Make the system more responsive and relevant to the needs of clients

27.   Characteristic Actions of  an Advocate 1. Being assertive 2. Taking risks 3. Communicating and negotiating well 4. Identifying resources and obtaining results

28. Manager Role   • Nurse  directs and administers care to meet goals by: Assessing client needs Planning and organizing to meet those needs Directing and leading to achieve results Controlling and evaluating the progress to make sure that the results are met

29.   Nurse as Planner •  Sets the goals for the organization. • Sets the direction. • Determines the means (strategies) to achieve them. • It includes defining goals and objectives. • It may be strategic ( long-term broader goals)

30. Nurse as Organizer Designing a structure for people + tasks to function to reach the desired objectives It includes assignments and scheduling It includes: Deciding what tasks to be done 2. Who will do them 3. How to group the tasks 4. Who reports to whom 5. Where decisions will be made (Robbins 1997)

31.   Questions to be addressed by the organizer 1. Is the clinic, program providing the needed services? 2. Are the clients satisfied? 3. Are the services cost-effective?

32.   Nurse as Leader The nurse directs, influences, or persuades others to make change to positively influence people’s health. • Includes persuading and motivating people, directing activities, effective two-way communication, resolving conflicts and coordinating the plan • Coordination: Bringing people and activities together to function in harmony to achieve desired objectives

33. Nurse as Controller  and Evaluator Controller: Monitors the plan and ensures that it stays on course. – Sometimes plans do not proceed as intended and need to be adjusted – Monitoring, comparing and adjusting are activities of controlling – Comparing performance and outcomes against set goals and standards = Evaluator role

34.   Management Behaviors 1. Decision-making: –  Entrepreneur (Initiating new projects) – Disturbance handler (conflicts among staff, between staff and clients, between clients) – Resource allocator (the distribution and use of human, physical and financial resources) – Negotiator (with higher levels of administration, other agencies)

35. Collaborator Role • Means  working jointly with others on a common project to cooperate as partners It includes: – Clients – Other nurses and physicians – Teachers and health educators – Social workers – Physical therapists – Nutritionists – Psychologists – Epidemiologists and Biostatisticians – Attorneys – Secretaries – City Planners and legislators

36. 1. Transferring of  information – Monitor – Information disseminator – Spokesperson 2. Engaging in interpersonal relationships – Figurehead – Leader and Liaison Management Behaviors

37. Researcher Role • Systematic  investigation, collection, and analysis of data for solving problems and improving community health practice • This role is at several levels: –Agency and organizational studies for job satisfaction among public health nurses –Some CHN participate in more collaborative research with other health professionals

38. .  The Research Process: 1.  Identify an area of interest 2. Specify the research question or statement 3. Review the literature 4. Identify a conceptual framework 5. Select a research design 6. Collect and analyze data 7. Interpret the results 8. Communicate the findings

39. Settings for CHN  Practice Homes 2. Community health centers 3. Schools 4. Occupational health settings (business and industry) 5. Residential institutions: Older age residences 6. Parishes or charitable mosques related organizations 7. Community at large

40. Community health Nursing is  the synthesis of nursing and public health practice applied to promote and protect the health of population . It combines all the basic elements of professional, clinical nursing with public health and community practice. The Importance of Community Health Nursing. Community health nurses are a vital link in the health and welfare of neighborhoods. These nurses focus on  improving the lives of diverse communities of infants, children, adolescents, and adults through education, prevention, and treatment .

41. 1901 Act # 157 (Board of Health of the Philippines); Act # 309 (Provincial and Municipal Boards of Health) were created. 1905 Board of Health was abolished; functions were transferred to the Bureau of Health. 1912 Act # 2156 or Fajardo Act created the Sanitary Divisions, the forerunners of present MHOs; male nurses performs the functions of doctors 1919 Act # 2808 (Nurses Law was created) – Carmen del Rosario, 1st Filipino Nurse supervisor under Bureau of Health

42. Oct. 22, 1922 Filipino Nurses Organization (Philippine Nurses’ Organization) was organized. 1923 Zamboanga General Hospital School of Nursing & Baguio General Hospital were established; other government schools of nursing were organized several years after. 1928 1st Nursing convention was held

43. 1940 Manila Health Department was created. 1941 Dr. Mariano Icasiano became the first city health officer; Office of Nursing was created through the effort of Vicenta Ponce (chief nurse) and Rosario Ordiz (assistant chief nurse) Dec. 8, 1941 Victims of World War II were treated by the nurses of Manila. July 1942 Nursing Office was created; Dr. Eusebio Aguilar helped in the release of 31 Filipino nurses in Bilibid Prison as prisoners of war by the Japanese.

44. Feb. 1946 Number of nurses decreased from 556 – 308. 1948 First training center of the Bureau of Health was organized by the Pasay City Health Department. Trinidad Gomez, Marcela Gabatin , Costancia Tuazon, Ms. Bugarin , Ms. Ramos, and Zenaida Nisce composed the training staff. 1950 Rural Health Demonstration and Training Center was created.

45. 1953 The first 81 rural health units were organized. 1957 RA 1891 amended some sections of RA 1082 and created the eight categories of rural health unit causing an increase in the demand for the community health personnel. 1958-1965 Division of Nursing was abolished (RA 977) and Reorganization Act (EO 288)

46. 1961 Annie Sand organized the National League of Nurses of DOH. 1967 Zenaida Nisce became the nursing program supervisor and consultant on the six special diseases (TB, leprosy, V.D., cancer, filariasis, and mental health illness).

47. 1975 Scope of responsibility of nurses and midwives became wider due to restructuring of the health care delivery system. 1976-1986 The need for Rural Health Practice Program was implemented. 1990- 1992 Local Government Code of 1991 (RA 7160)

48. 1993-1998 Office of Nursing did not materialize in spite of persistent recommendation of the officers, board members, and advisers of the National League of Nurses Inc. Jan. 1999 Nelia Hizon was positioned as the nursing adviser at the Office of Public Health Services through Department Order # 29. May 24, 1999 EO # 102, which redirects the functions and operations of DOH, was signed by former President Joseph Estrada.

49. ORGANIZATIONAL CHART COMMUNITY HEALTH NURSING OFFICE OF THE SECRETARY OF HEALTH SERVICES NURSING PROGRAM SUPERVISOR IN DIFFERENT SERVICES REGIONAL HEALTH OFFICE REGIONAL NURSE SUPERVISOR REGIONAL PUBLIC HEALTH NURSE PROVINCIAL HEALTH OFFICE SUPERVISING PUBLIC HEALTH NURSE RURAL HEALTH UNIT PUBLIC HEALTH NURSE

50. NURSING PROCEDURE AND PRINCIPLES INVOLVED COMMUNITY HEALTH ASSESSMENT NURSING VISIT

51. COMMUNITY HEALTH ASSESSMENT Is another term for COMMUNITY HEALTH DIAGNOSIS. IT IS A PROCESS BY WHICH THE PATERN OF DISEASE IN A COMMUNITY IS DESCRIBED IN TERMS OF THE IMPORTANT FACTORS WHICH INFLUENCE THE PATTERN. PUBLIC HEALTH NURSES ARE PRIMARILY INVOLVED IN THIS PROCESS AS REPORTERS OF CONDITION IN HER AOR.