Community Health Nursing
CHW – group of people with common chrematistics or interest within a territory or geographical boundary
Community
- Patient/Client
- Setting – outside curative institutions
- home – family HNSg
- school – SHSg
- places of work – occupational HNSg
World Views:
- Community integral part of society compose of families
Eg. – poor community
- under nutrition
- poor food supply
- level of knowledge – poor
- intrapersonal conflict – choosing what to wear
- intrapersonal family
- intrapersonal community (interfamilial) regionalism – parochial
- intra sociedad (inter societal)
- Conflicts/contradiction – always present in the community
Note: Should be positive in dealing with conflict.
- Condition in the family is always changing
Health
- Wellness – Illness continuum
Optimum – internal ————- death
Wellness – external
External
Macro system
- political
- economic
- socio cultural – education, customs, beliefs, practices, tradition, mass media
- maintain continuum balance and purpose direction with environment
- progress toward a high level of FXU, lice to the fullest potential
- Epidemiologic model
- High Level Wellness
- Agent Host Environmental Model
Agent (Etiologic Facts)
- Infections/biological factor
- Mechanical
- Physical
- Carcinogenetics – pringels, tobleron (GMO’s – chemical
- Poison – eg. MSG
- Allergies
- Nutritive elements
- Psychological
Host – intrinsic factor – age, sex
- exposure
- response – susceptibility
– resistance
environment – extrinsic factor
- Health Belief Model
- relationship bet a person’s belief and his behavior in health
3 components
1. Susceptibility to illness
2. Seriousness of an illness
3. Benefits taking the action
AN/AIDS
Common in
- Commercial Sex Worker – unprotactive penetrated sex
- Sea farers
- Religious Nums
Vaginal – male and female 1:000
Oral – male to male also common in male to female 1:200
Felacio – mouth to penis
Oral – cumaningus – mount to vagina
Aningus – mouth to amus
Preventive :
- abstinence – sex (safe)
- Be Faithful – Mutual/Monogamy
- Correct continous consistent use of condom
- Do no penetrate
- Evolutionary Based Model
- illness and death sometimes serves an evolutionary function
Elements:
- life events
- life style determinants
- control perception
- viability emotions
- health out comes
- client’s won being
- health is not merely the absence of DSE illness of infirmity
- state of complete physical mental, and social wen being
- Health Promotion Model
- WHO – Definition 1978 – Alma Ata
Health
1. Social phenomenon – Health outcome is interplay of different societal factors
outcome with interplay of different factors and society:
- biological
- physical
- ecologic multiple causation Theory
- political (Holistic)
- economic
- socio-cultural
Community Health
Part of medical paramedical intrapersonal which is concerned and the heath of the whole population.
Major Concept
1-health promotion & DSE prevention
2- people participation
Individual Applied Community
Client Study As Client
– Anatomy – structure – demography
– Physio – functions – Sociology
– Patho – malfunction – epidemiology
Public Health & Longetirity (CBQ)
WINSLOW – contribution to the most effective total development and life on the
Individual and the society.
HANLON – priority the survival of the species the prevention of condition which
lead to the structure destruction or retardation of human function and
potential in early year of life.
Communication Health Nursing
– special field of nursing that combines the skills of nursing public health, and some phases of social assistance and FXUS as part of the total health project and promotion of health.
JACOBSON – is a learned practice discipline with the ultimate goal of contributing as individual and in collaboration with others, promotions of clients’ optimum level of fractioning through teaching and delivery care.
Jacobson Major Roles
1. Health Educator
2. Provider of Nursing Care
FREEMAN – aimed developing and enhancing health capability of people,
Individual, families and communities.
Community
People Organization (PO)
Agency
1. Ngo
2. GO – DOH – National – Regional – Province – Municipal – BHW
RA – 7305 – Magna Corta of PHWorker
RA – 7160 – Local Government Code
Devolution of Health Services
CHN CONCEPTS:
1. 10 Focus on CHN is an heath promotion
2. CHN practice is extended to benefit not only individual but whole & family
3. CHN are generalist in terms of their practice throughout life’s continuum – its full range of Health problems and need.
4. Contact with client may continue over a long period of time which includes all ages and types of HC
Levels
Primary HC – community
20 HC – Regimal, Provincial, Municipal & District
Tertiary – sophisticated medical center
Assessment:
Community Dx
- health problems and needs
- sources of solve to problem
Principle of Community Health Nursing
1. Recognize needs of individual
2. Knowledge and understanding of agency and policies facilitates goal achievement
3. The family is the unit of service
Planning
1. Prioritization
2. Goal setting
3. Objectives
4. Actions/Intervention
5. Evaluation out come:
– criteria
– standard
Health Education and Counseling
- common goal – behavior change or modification
Basic Different
Health Education – dive advice
Counseling – provide all option
Implementation:
Community – family focus of /unit of care
4. Respect values, customs and beliefs of clients – as nurse we should not be judgmental
5. Health education and counseling are vital parts of CHN
6. Collaborative working relationship with the health team facilitates goals achievement.
7. Continuing staff education ensures quality client care and upgrade nursing practice.
8. Indigenous and communication resources
appropriate tech – methods and tech both scientifically sound and socially
and acceptable
9. Individual families and communities must actively participate in decision making
10. Supervising of nursing services be qualified personnel provides guidance and direction to work.
11. Accurate recording and reporting serve as bases for evaluation and guide for future actions.
12. Periodic and continuing education
board quest
how would you evaluate – objective – if both present answer this
criteria
HEALTH SITUATION
1. Health Indices
A. Basic Indicators Anemia
1. Nutrition 48% of Filipinos
2. DSE Pattern 58% of pregnant women
– morbidity
– mortality
infant mortality rate according to DOH – 18.7
life expectancy: Female 69.2
Male 63.7
HEALTH PROMOTION
Consist of activities directed towards increasing the fever of well being and actualizing the health potential of individuals families communication and societies.
Different with prevention
- not desl dysixy or health problem financial
- “approach “ behavior not
- avoidance behavior
- seeks to expand (+) potential for health
Multidimensional Nature of Health Promotion
1. Individual – lifestyle
– personal habits & practices affecting health
-lifestyle
– lifestyle responsibility
2. Family – health behavior and belief
3. Community – norms
4. Environment – harmony and bal bet human and surroundings
5. Society – basic human needs
HEALTH PROMOTION METHODS
- health education
- Good standard nutrition adjusted to development phases of life
- Attention to personality development
- Provision of adequate housing
- Recreation and agreeable working condition
- Genetics counseling
- Periodic selective examination – self breast examination (SBE)
SCREENING METHOD
Presumptive identification of unorganized dse or defect by the application of test, examination or other procedures that can be applied rapidly and inexpensively population.
- mass screening
- case finding
- contact tracing
- multi phasic screening eg HIV antibody testing
- surveillance
RA 7305 – Jon reporting of communicable dse
Tertiary Prevention
- methods
- Dx
- Tx
- Mx
- Rehabilitation
Community Organizing
- Awareness raising
- Organizing
- Mobilizing / responsible action
Key Concepts and Principles
1. Objective analysis of objective condition – scientific
2. Basic trust among people
3. By the people from the people, for the people
4. People want and can change
5. Self-willed changes will have move meaning and performance than imposed changes.
Primary Health Care
– Essential care based on scientifically – sound and socially acceptable methods and technology made universally available to individuals families and communities at the cost they can afford at any given stage development than their full participation towards self-reliance and self determination.
8 Primary Health Care
1. Health Education
2. Food Supply and Nutrition
3. Immunization
4. Hw and Basic Sanitation
5. Prevent & control of common dse
6. Tx of endemic dse
7. MCH including FP
Individual
1. Assessment
a. Data collection
2 types data – subject & objective
2 methods – interview & observation
4 Instruments
1. Nursing History (subjective)
2. Physical Examination
3. Laboratory Exam
4. Process Recording
b. Data Analysis
2. Nsg. Dx
Health Care V/E Etiology
3. Planning
a. Prioritization
b. Goal
c. Objective
d. Nsg. Intervention
e. Evaluation Outcomes – Criteria , standard
4. Implementation
– health educator
– provider of HC
– supervisor Client /Patient Advocate
– researcher
– health organizer
– CH, Monitor
8 Basic Tasks:
1. Physical Maintenance
2. Allocation of Resources
3. Division of Labor
4. Socialization of Family Members
5. Reproduction, recruitment and releases
6. Maintenance of order
7. Placement of members in larger society – production of good member
8. Maintenance of motivation and morale
Nuclear Family – Mother, Father, son & daughter
Extended – grandparent relation or daughter in law.
First Level Assessment
- Health Threats
- Health Deficits
- Forcible Crisis/Stresspoints
Family Tasks
1. Ability to recognize the presence of the problem
2. Ability to make decisions.
3. Ability to perform nursing care to sick
4. Ability to provide home environment
5. Ability to utilize community resources
Incubation Pd- entry of Pathogen to appearance of 1st SK
IMMUNITY
Passive – quick to come/to go active – slow to come / to go
1. natural – utero, breast feeding 1. Natural – getting the dse
2. Artificial – sevum prob. Antitoxin 2. Artificial – utanus toxoid
Pregnant
TT1 – 4th month
TT2 – 8th month
Pregnancy 2
TT3 – booster 1st
Pregnancy 3
TT4 – booster 2nd
Pregnancy 4
TT5 – booster – lifelong immunization
Community Mental Health Nursing
1. A unique process which includes an integration of concepts from nursing mental health, social psychology community network.
Occupational Health Nursing
– Application of Nursing principles and procedure conserving health of the healthworkers.
School Health Nursing
Components
1. School Health Services
2. Health Instruction
a. direct – nurse doing the school teaching
b. indirect
3. Health School Living
4. School – Community Linkage
Median age of Filipinos is 20 yrs old
50 % – 20 years old
50% – above 20 years old
Vital Statistics – application of statiscal measure to vital events fertility , mortality, morbidity
RA 3753 – Civil Registry Law
Requires the registration of births and deaths to local registrars
RA 3573 – Law on reporting notifiable disease
Family Planning Program
Goal Improve material & child through:
- proper timing of pregnancy
- proper spacing of pregnancy
- number of pregnancies
Pregnancy :
Ideal age: 30-30- yrs.
20 -18 – 30 – 35 with risk
18 – 35 – high risk
Ideal interval – 3 years
2 years – with risk
4 years – high risk
ideal No – 3
4 – with risk
4 – risk