NCM 104 LEC1

PUBLIC HEALTH NURSING (PHN)

Public Health
- Winslow (1920) it is the science and art of preventing disease, prolonging life, and
promoting health efficiency through organized community effort for:
o Sanitation of environment
o Control of communicable disease
o Education of individual in personal hygiene
o Organization of medical and nursing services for diagnosis and preventive
treatment of disease
o Development of the social machinery
Community health
- Part of paramedical and medical intervention/approach which is concerned on the health
of the whole population. The aims are:
o Health promotion
o Disease prevention
o Management of factors affecting health
Public Health Nursing
- The practice of promoting and protecting the health of populations using knowledge from
nursing, social, and public health sciences
- Evaluations are conducted to determine the extent to which the intervention has an
impact on the health status of individuals and population
Community health nursing
- A unique blend of nursing and public health practice woven into a human service that
properly developed and applies which has a tremendous impact on human well-being;
we need to collaborate with one another which is the vital component in rendering health
services to the people
Basic principles
- PHN gives emphasis on the primary level of prevention
- Involvement and cooperation with the other members of the health care team is needed
Advantages of Public Health Nursing
- Gives the nurse a vivid picture of overall health status of the community
- Learn, conceive, and implement the DOH programs
- Nurses appreciate their role in nation building
- Focuses on care from the individual to the family and the community
- Who tend to assume their health responsibility
- Utilize inside and outside organizations
- lack of facilities, the nurse creates a sense of resourcefulness
Disadvantages of PHN
- Hazardous and the proper universal precaution is not appropriately practiced
- Technological awareness is not practiced and delayed
- Work hours are long and not fixed (sometimes they have to take care 3 health centers)
- Different places have different practices
- Not health workers enjoy and appreciate the world of PHN
Qualities of a Good PH Nurse
- Knowledgeable
- Skillful (know how to utilize the resources)
- Good Judgement (use our clinical eye; signs and symptoms)
- Right Attitude
Functions of PHN
- Manager (manage the entire health center)
- Supervisory (monitor the performances)
- Nursing Care (adequate health care services)
- Collaboration and coordinating
- Health promotion and education
- Training
- Research
Community health nursing
- It practices, promotes, and preserves the health of populations by integrating the skills
and knowledge relevant to both nursing and public health
- Is a specialized field of nursing practice which are anchored on nursing theories and
important concepts such as:
o The greatest good for the greatest number
o Priority of health-promotive and disease-preventive strategies
- We must treat them holistically so that everything will be given appropriately
Responsibilities of CHN
- Providing care to disabled ones
- Maintaining healthy environment
- Teaching/advocating/collaborating
- Identify the needs and referring them for service
- Preventing and reporting neglect and abuse
- Participate in professional development activities
- Ensuring quality nursing research and engagement in nursing research
Levels of health care and referral system (direction where we could bring the patient)
- National health services medical centers
- Regional and training hospital
- City/provincial hospital
- District hospitals
- Rural health unit
- Barangay health unit
Specialized field in CHN
1) School health nursing
a. Focuses on the promotion of health and wellness of students; provide a well-
being of the student
b. Determined by the characteristics of their clientele – their age, developmental
stage, and their common health problems and concerns; indicators that shows us
who are more at risk
i. Other Determinants
1. School children have the result of economic and environmental
factors (geographic location)
2. School nursing practice which include policies and standards of
the department of education, culture and sports and the
department of health and standards of the nursing profession
ii. Health is an important requisite in education
1. Prevents health problems that would hinder their learning and
performance of their developmental tasks (it will affect the well-
being of the child)
2. Affected by factors such as: poverty, family, dynamics, lifestyle
iii. Objective of school nursing
 1. General: to promote quality nursing service to the school
population by providing comprehensive and quality nursing care
iv. HNC (Health and Nutrition Center) of DepEd
1. Mandated to safeguard the health and nutritional well-being of the
total school population
2. DIVISIONS
a. Health
b. Nutrition
3. SECTIONS
a. Mental
b. Dental
c. Nursing
d. Health Education
v. Duties and responsibilities
1. Health advocacy
2. Health and nutrition assessment
3. Supervision of the health and safety of the school plant
4. Treatment of common ailments and attending to emergency
cases
5. Referrals and follow up pupils and personnel
6. Home visits
7. Community outreach like attending community assemblies
8. Recording and reporting of accomplishments
9. Monitoring and evaluation of programs and projects
vi. Skills
1. Assessment and screening skills
2. Health counseling skills
3. Social mobilization skills
4. Good oral and written skills
5. Basic management skills
6. Life skills
vii. Communicable disease control
1. Establishment of data bank on school health and nutrition
activities (physical activity to have a healthy life)
2. School plant inspection for healing environment
3. Rapid classroom inspection
4. Home visitation
2) Occupational health nursing
a. Occupational nursing (aka company nurse)
i. Focused in their places of work, which is a part of a bigger community.
1. PRACTICE
a. Promotion
b. Protection
c. Restoration
ii. Autonomous, it makes an independent nursing judgement in providing
occupational health services – we need to follow the guidelines of health
services mandated by the DepHealth
1. DETERMINANTS
a. Government policies and standards (DOLE, DOH, SSS)
 b. PHN can be an occupational nurse who is in a prime
position to assess the needs of the working population
and design working interventions – we need to asses
because it will affect the operation of the specific company
2. PRIMARY FOCUS
a. To assure that every working man and woman in the
country is safe and in healthful working condition
b. Should be considered in an integral part of all health
services
3. PROFESSIONAL GOALS
a. To achieve the goals of occupational health and safety
i. Occupational health nurses are to promote and
maintain the health and safety of workers through
a systematic process of assessment, planning,
intervention and evaluation with:
1. Occupational physicians
2. Industrial hygienists
3. Safety engineers and other safety
professionals
4. Epidemiologists
5. Toxicologists
6. Industrial engineers
7. Ergonomist
8. Health educators
9. Environmental engineers
4. ESSENTIAL COMPONENTS
a. Health promotion and prevention principles
b. Worker or workplace health hazard assessment and
surveillance
c. Injury and illness investigation, analysis and prevention
d. Primary care
e. Case management
f. Counseling
g. Management and administration
h. Legal and ethical monitoring
i. Research
j. Community orientation
3) Community mental health nursing
a. Works with people who are suffering from various types of mental health
problems
b. They work in: homes, residential unit, national health services (NHS), private
specialist hospital services and secure units
c. Started in the US (1960), they believe that a person gets better faster when
he/she is placed in a familiar environment
d. The patient does not need to be hospitalized away from and community
e. Emphasize work on mental health promotion – significant others will contribute to
a person’s recovery
f. Help people to recover from their illness or come to terms with it in order to
maximize their life potential
 g. WORKS WITH: (to plan and deliver care using a multidisciplinary client-centered
approach)
i. Psychiatrists
ii. Occupational therapists
iii. General practitioner
iv. Social workers
v. Other health professionals
h. ROLE in the community
i. Coordinating the care of patients
ii. Liaising with patients, relatives, and fellow professionals in the community
treatment team and attending regular meetings to review and monitor
patients care plans
iii. Visiting patients in their home to monitor progress
iv. Assessing patient’s behavior and psychological needs
v. Identifying if and when a patient is at risk of harming themselves or others
Standards of PHN Practice
1) Assessment – collects comprehensive data pertinent to the health status of population
2) Population and diagnosis and priorities – analyzes the assessment data to determine the
population diagnosis and priorities
3) Outcomes identification – identifies expected outcomes for a plan that is based on
population diagnosis and priorities
4) Planning – identifying strategies, action plans and alternatives to attain expected
outcomes
5) Implementation – implements the identified plan by partnering with others
a. Coordination – coordinates programs, services, and other activities to implement
the identified plan
b. Health education and health promotion – multiple strategies to promote health,
prevent disease and ensure a safe environment for population
c. Consultation – to facilitate the implantation of programs and services
d. Regulatory activities – identifies, interprets, and implements public health laws,
regulations, and policies
6) Evaluation – evaluates the health status of the population
7) Quality of practice – enhances the quality and effectiveness of nursing practice
8) Education – attains knowledge that reflects current nursing and public health practice
9) Professional practice evaluation – evaluates one’s nursing practice in relation to
professional practice standards and guidelines
10) Collegiality and professional relationship – interacting with representatives
11) Collaboration – collaborates with representatives of the population, organizations and
health & human services professionals
12) Ethics – integrates ethical provisions in all areas of practice
13) Research – integrates research findings in practice
14) Resources Utilization population – considers factors related to safety, effectiveness, cost,
and impact on practice and in planning
15) Leadership – provides leadership in nursing and public health