University of the Philippines Manila

School of Health Sciences

Palo, Leyte

SERVICE LEAVE PLAN

Nursing Service Leave: Can-agong Catchment, Brgy. Can-agong, Sikatuna, Bohol
FUNCTIONAL PLANNED ACTIVITIES RESOURCES RESPONSIBLE TIME FRAME EXPECTED
AREA OBJECTIVES TARGET MANPOWER MATERIAL PERSON Sept. Oct. OUTPUT

COCD/Pre-entry To be oriented with the Conduct and attend BSN 37th batch Community Service Leave BSN 37th batch Notes from the
phase expectations, the orientation for the students (3 Preceptors: Guidelines students orientation
objectives, schedule, Nursing Service Leave groups) Prof. Helen sent through fb Documentation:
and activities to be through zoom meeting Gumba (course re- photos during the
accomplish during the with the community Prof. Carmen design for COVID zoom meeting
nursing service leave. preceptors. Firmo BATCH) with the
a. Objectives, Prof. Jusie Lydia List of community
duration, Sur requirements preceptors
requirements and prescribed
and format, format List of safety
faculty Safety protocols protocols
supervisory
scheme and
safety protocols
in this trying
times.

To set work directions Formulate a master Master Plan for BSN 37th batch Format for the BSN 37th batch Service Leave Plan
and schedule activities plan for the service the whole student: Master Plan and student: Monthly Plan
for the Nursing Service leave and monthly plans duration of the Charisse Lindsey the Weekly (or Charisse Lindsey
Leave for implementation in Service Leave D. Namalata monthly) plans D. Namalata
the community. Nursing Service
Leave Guidelines
a. reviews the Laptop, Mouse,
Nursing Service for the encoding
Leave
Guidelines for
the basis of the
 formulation of
the Service
Leave plan.
b. Make monthly
plans that is
detailed in Monthly Plan
dates by week
to be submitted
prior to the
succeeding
month

COCD Entry Phase To establish rapport and Community re-entry 1 face to face LGU Officials: Letter of Namalata, Documentation of
maintain smooth activities: courtesy visit to endorsement to Charisse Lindsey courtesy visit and
interpersonal a. Courtesy calls to LGU officials Mayor Justiniana Mayor, cc: MHO D. other meetings
relationship with the - to LGU Officials, RHU and RHU Staff, Ellorimo and PHN with with LGU officials,
community. staff, if possible. RHU Sikatuna guidelines and key leaders, MHO,
key leaders of Staff expected PHN, head
endorsing community MHO: Dr. Paz A. competencies teacher, OSCA
b. Present copy of Maniwang attached, president as
endorsement letter and PHN: Merdeza permission to needed -
service leave plans to , Altamero access data of minutes/narrative
Mayor, MHO and PHN RHM: Crisa priority with photos
and Bgy Captain. Ganduli programs for
c. Give an overview of program review.
the objectives, duration, Brgy. Officials
and activities for the
service leave. Copies of SL
plans for the
Mayor, Bgy
Captain,
MHO/PHN

COCD
1. To assess the Assessment: RHU staff, BHW’s BSN 37th Student:
ASSESSMENT health status Do a rapid assessment assigned in every Charisse Lindsey
and the status of the catchment using purok D. Namalata Catchment Area
of health secondary data. Catchment Secondary data Profile
program Prepare a catchment profile from barangay
 implementation area profile of their profiles, LGU
in the assigned catchment area scorecard, BSN 37th Student:
community and *Sponsoring barangay RHU / other Charisse Lindsey
DOH program will be simulated into RHU staff agencies D. Namalata
related three such as Brgy. A,
problems. Brgy. B and Brgy. C

Conduct a data review

of health program
RHU staff Accomplished
implementation in their Data entry forms
assigned catchment area HDR forms and
for health data program Review
utilizing RHU data and program
review.
Accomplish worksheets
for the program data Data Entry Form
review -ws 1.1, 1.2, 2.1 Worksheets Worksheets 1.1,
Worksheets 1.1, 1.2, 2.1
1.1, 1.2 and 2.1
1.2 and 2.1

To identify priority Data Analysis, Problem

health and other Identification and
community health Prioritization:
problems. 1. list of
community RHU staff; BHW Completed BSN 37th Student: Summary of
needs and Worksheets 1.1 health and Charisse Lindsey priority
problems and 1.2 program data D. Namalata community
according to review and problems and
priority and top worksheets program related
5 priority problems with
programs and analysis.
areas with low
accomplishment
requiring
intervention to
improve
performance RHU Staff, Brgy.
2. Share output Officials, BHW BSN 37th Student:
with community Documentation of
assigned in every Charisse Lindsey
leaders/ PHN session
purok D. Namalata
through a with the key
written report leader/PHN or
and allow them their written
comments
 to comment. regarding the
program review, if
face-to-face is not
possible.
Draft an operational
PLANNING To formulate an plan and present the 1 RHU Staff, Operational plan
operational plan to plan in a face to face Operational Brgy. Officials, Format for the BSN 37 th with signature of
address health and meeting IF, already Plan in every BHW assigned operational plan Student: barangay captain
health program related allowed or in written Simulated Brgy. in every purok with action plan Charisse Lindsey and PHN as
problems in the form to the key integrated D. Namalata indication that
catchment leaders/PHN for their Ballpen, they were
comments and approval. Bondpaper, involved in its
Revise plan as needed. Ruler formulation.

IMPLEMENTATIO Prepare action plan and Action Plan

N To implement schedule of
identified 1 action plan in RHU staff, BHW, Action plan BSN 37th
implementation format
interventions/activities activities by month and every brgy. Brgy. Officials, Student:
in the operational plan week based on the Community Charisse Lindsey
in collaboration with operational plan people D. Namalata
the community/RHU * To minimize
staff. meetings, this may be
done with the RHU staff, BHW,
operational planning. Brgy. Officials
Provide the RHU and
community with the
summarized schedule of
activities for their
guidance.

Schedule and undertake

implementation of
activities identified in
the action plan in
coordination with
community and RHU.
Monitoring plan
Ensure that activities Develop a monitoring
1 Monitoring Sample BSN 37 th and
and interventions are plan and tool to include RHU staff, BHW,
MONITORING Plan in every Monitoring Tool Student: Monitoring tool
implemented as FHSIS. Brgy. Officials,
Simulated Brgy. Charisse Lindsey
planned and Community Monitoring report
 scheduled. Monitor implementation people D. Namalata To include FHSIS
of activities and output as part of the
using the developed tool monthly
accomplishment
report

To determine the
RHU staff, BSN 37th Evaluation plan
extent to which targets Conduct actual 1 evaluation and tools,
EVALUATION have been achieved. BHW, Brgy. Evaluation Plan Student:
evaluation activity with conducted in Charisse Lindsey Evaluation report.
Officials and Tools
community and RHU every Simulated D. Namalata
participation if feasible. Brgy.

Analyze evaluation
results against planned
targets.

PROVISION OF To provide promotive, Provision of Health RHU staff, Schedule of BSN 37th Written submission
preventive, curative Care Services as a RHU rotation as Student: of:
HEALTH CARE BHW, Brgy.
agreed with the Charisse Lindsey Dispensary records
and rehabilitative Public Health Nurse: Officials PHN.
health care services D. Namalata
List of referrals
within the 1. Students will done
competence of a rotate to both the
RHU and BHS on
Public Health Nurse. selected days on a
limited basis.
2. Under the
supervision of the
PHN or MHO Elderly assessment,
perform functions Elderly nursing care plan
of a public health assessment form and
nurse such as, but NCP and Evaluation of
not limited to, the evaluation nursing care
care of patients formats rendered
referred by the
midwife to the
PHN, patient
assessment,
dispensing of IMCI protocol
meds, health
education,
referrals to the
MHO.
3. RHU – Referral forms
focus on the learning
opportunities in relation to
the role of the nurse. Dispensary records
Wellness and of pediatric cases
Perform nursing care Health education handled showing
functions to clients (high plans application of IMCI,
risk or otherwise) in their referrals as
own homes limited to applicable.
family members.

Manage referred cases

from BHW or RHM
Documentation of
Render health care to wellness and health
special population groups: education activites
1. Elderly –
* - Identify caseload for
‘care of elderly within
their household or
immediate family or an
immediate relative.
* - Do initial nursing
assessment on elderly
caseload
* - Prepare, implement
and evaluate a plan of care
for their elderly caseload
based on problems
identified in the
assessment.

2. Children
* Under the supervision
of the PHN, implement
IMCI strategies in care of
ill children referred to
them

- Make referrals as need

arises
- Follow-up all referrals
made.

- Implement wellness
program identified in the
OP
 - Health Education
activities particularly on
Covid

Plan with the PHN how

To familiarize you will
go about this. Permission to
themselves with the access RHU Documentation on
functions of the PHN Manual, records the observed
Orientation to RHU set-
the management of up, .personnel, routines, and reports. functions of the
the nursing policies, activities and PHN as prescribed
component of the work schedule of RHU Permission to in the RHU Manual
attend selected and expanded
Rural Health Unit. staff meetings functions performed.
Read the RHU Manual

Orientation to the various Include insights and

responsibilities of the new learnings
RHU personnel, especially gained as well as
of the PHN challenges you see
From the RHU Manual in working as a PHN
and shadowing of the PHN
Written submission
Assist the PHN in the of Supervisory plan
actual performance of her
duties.

Assist in the preparation of

reports

Observe and document the

role, functions and
activities of the PHN and
match this with what is
expected in the RHU
manual.

Describe expanded
functions of the PHN that
are not specified in the
RHU Manual.

Include in your
documentation
insights/new learnings
 gained regarding the work
of a PHN.

Based on program review

develop a supervisory plan
for the midwife related to
need for skills
development or
improvement of program
performance.
Note: this is only a
theoretical supervisory
plan and need not be
implemented.

Attend staff meetings

when allowed.

Format for the Written submission

Identify the target group Training TNA, Training of the training report
To assist in capacity for training based on the Management Design and according prescribed
building activities of operational plan Training Report format and content
community
Perform a training needs
leaders/members, analysis of target
health and auxillary participants.
workers.
Formulate a training
design for the desired
training.

Online sharing session 4 to

present the TNA, TD

Conduct actually training,

if conditions already allow
face to face activities.

Prepare a training report

RECORDING AND a. Record and document Document all activities using - RHU Staff Ballpen, Namalata, Charisse Complete
health/health related appropriate form: - Namalata, Charisse TCL Logbook, Lindsey D. submission of all
REPORTING activities 1. Target Client List Lindsey D Program Review reports, final
 2. Program Review Forms, accomplishment
b. Keep appropriate records 3. ABHP Worksheet 1.1 Worksheet 1.1 reports and other
and file required reports 4. APSP Worksheet 1.2 Form, relevant
5. Worksheet 2.1 Worksheet 1.2 documentation.
6. Worksheet 3.1 Form, These must be
7. Dispensary Record Worksheet 2.1 attested to
8. Weekly Plan Form, PHN
9. Accomplishment Report Worksheet 3.1 - Daily Group
10. Daily Diary of activities Form,
Diary/Journal – is
11. Minutes of the meeting Dispensary logbook,
the daily diary to be
b. Updating of weekly plan of Weekly Plans and
activities Accomplishment
submitted or for
c. Updating of daily diary and Report, their use to keep
Accomplishments Daily Diary logbook tract of their work
to facilitate
Document and maintain preparation monthly
Format of all accomplishment
complete records and records and
reports of activities report.
reports required,
performed during the
service leave. Schedule for
Submit monthly submission of
accomplishment reports reports.
and other reports on time
Completion of final report

PROFESSIONAL To engage in Attend sharing sessions. Access to internet Namalata, Charisse Documentation of
professional Attend staff meetings Lindsey D. meetings attended
DEVELOPMENT
when allowed. especially on
development and life- Search attend health and insights gained
long learning public health webinars. rather then a minute
activities. Readings on current trends of the meeting.
and updates on health
issues and other public Evidence of
health trends attendance I
webinars.in at least
2 webinars per
quarter.

Summary of
readings done.
Highlight new
learnings obtained
from each.. At least
one reading per
month