COMMUNITY HEALTH NURSING 2.

Information about the community

IVY V. ROSALES
Levels of Clientele of the Community
DEFINITION Health Nurse

• Synthesis of nursing practice and • Individual

public health practice applied in • Family
promoting and preserving health of • The group/aggregate
populations. • Community as a whole in many
settings
SUBSPECIALTIES
• Public Health Nursing The Intervention Wheel
• School Nursing
• Occupational Health Nursing
• Other developing fields of practice

PUBLIC HEALTH NURSING

• The practice of promoting and
protecting the health of
populations using knowledge from
nursing, social and public health
sciences.

COMMUNITY BASED NURSING

• Refers to the application of nursing
process in caring for individuals,
families and groups where they
live, work or go to schools as they
move through the health care
system.
• Emphasis on chronic care
POPULATION FOCUSED APPROACH AND
COMMUNITY HEALTH NURSING
INTERVENTIONS
POPULATION FOCUSED NURSING
• Concentrates on specific groups of
people and focus on health
promotion and disease prevention,
regardless of geographical location
DATA REQUIRED
1. Epidemiology or the body of
knowledge of a particular problem
and its solution
Important Elements
1. It is population-based
2. It contains 3 levels of practice
(community, systems and
individual/family)
3. It identifies and defines 17 public
health interventions
EMERGING FIELDS OF COMMUNITY
HEALTH NURSING IN THE PHILIPPINES
• Home Health Care
o Providing nursing care to
individuals and families in
their own places of
residence to minimize the
 effects of illness and d. Priority setting based on
disabilities the client’s needs
o Allows a patient to stay at e. Administration of
home and still receive care medications
instead than in a hospital f. Health therapeutics
g. Use of nursing care
• Hospice Care
o Rendered to the terminally 2. Management of resources and
ill patients environment
o Intended to provide a. Organization of workload
comfort to the terminally b. Financial resources for
ill patient client care
o Provides palliative care c. Mechanisms to proper
functioning of equipment
• Faith Community Nursing or d. Maintenance of safe
Parish Nursing environment
o The practice of the arts
and science of nursing 3. Health Education
combined with spiritual a. When the school nurse
care prepares and implements
o A faith community or an age appropriate,
parish nurse usually comprehensive health
focuses on health education plan for
promotion and provision of elementary school
holistic care. students (example)
o The nurse may assume
their roles of: 4. Legal Responsibility
§ Health Educator a. Adherence to the nursing
§ Personal Health law and other relevant
Councilor laws
§ Developer b. Documentation of care to
§ Coordinator of clients
support groups in
the faith community 5. Ethico moral Responsibilities
§ Integrator of Health a. Providing respect for the
rights of the client
COMPETENCY STANDARDS IN b. Responsibility and
COMMUNITY HEALTH NURSING accountability of all
decisions and actions
1. Safe and quality nursing care c. Adherence to the national
a. Knowledge about health and international ethics of
and illness of the client nursing
b. Sound decision making
c. Safety, comfort and 6. Personal and Professional
privacy of the client Development
 a. Identification of own non-formal channels of
learning needs communication
b. Pursuit of continuing 11. Collaboration & Teamwork
education a. Working with colleagues
c. Involvement in and other members of the
professional and civic health team
activities b. A phn participates in a
d. Projection of a workshop to evaluate the
professional image programs implemented
e. Positive attitude towards (example)
change and criticism
f. Adherence to professional SPECIALIZED FIELDS OF COMMUNITY
standards HEALTH NURSING

7. QUALITY IMPROVEMENT 1. School Health Nursing

a. Data gathering for quality 2. Occupational Health Nursing
improvement
b. Participation in nursing SCHOOL HEALTH NURSING
audits and rounds • Visits 4-6 schools per month with
c. Identification reporting of each visit lasting for 3 days or
signs and symptoms in more
client care
School Health Services
8. Research
a. Research based Health Education
formulation to problems in Concepts:
client care • Nutrition
b. COMMUNITY HEALTH • Personal and Oral Hygiene
NURSING Dissemination including WASH (Water Sanitation
and application of and Hygiene)
research • Prevention of soil borne
helminthiasis, mosquito borne
9. Records Management disease and other preventable
a. Accurate and updated on communicable disease
the documentation of • Use of traditional and alternative
client care while observing health care in the management of
legal imperatives common health conditions.
10. Communication Health Education (other areas of
a. Use of therapeutic concern)
communication • Oral Hygiene
b. Establishing rapport • Injury prevention and developing
c. Identify verbal and non- healthy conscious behaviour in
verbal cues the use of school playground,
d. Respond to client’s needs sports, etc.
while using formal and
• Tobacco Use
 • Substance Use
• HIV/AID and other STI
School Health Services
• Physical Education
• Health Services
• Health Screenings
• Emergency Care
• Care of Child
• Student Records
• Nutrition
• Eating Disorders
• Obesity
1. Counselling, psychological and
social services
HEALTHY SCHOOL ENVIRONMENT
SHOULD CONSIST OF:
• A physical, psychological and
social environment that is
developmentally oriented and
culturally appropriate and that
enables the student to achieve
their potential.
• A healthy organizational culture
within the school.
• Productive interaction between
the school and the community
• DepEd Order No. 40 s. 2012 on
the DepEd Child Protection
Policy
OCCUPATIONAL HEALTH NURSING
OSH / OCCUPATIONAL SAFETY AND
HEALTH
• The promotion and maintenance
of the highest degree of physical,
mental health and social well
being of workers in
occupations.
DOLE / DEVELOPMENT OF LABOR AND
EMPLOYMENT
• The lead government agency on
OSH
ELEMENTS OF MULTIDISCIPLINARY BASE
WHERE OCCUPATIONAL HEALTH
NURSING IS DERVIED:
• Nursing Science
o Provides the context for
healthcare delivery and
recognize the needs of
individuals, groups and
population within the
framework of prevention,
health promotion and
illness
o Including risk assessment
& risk communication
• Medical Science
o Specific treatment and
management of
occupational health and
injury
• Occupational Health Science
o Includes toxicology to
recognize routes of
exposure
o Includes industrial hygiene
and safety, ergonomics
• Epidemiology
• Business and economic theories,
concepts and principles
• Social and behavioral sciences
• Environmental Health
• Legal and Ethical Issues
all
HEALTH HAZARDS
• Are the elements in the work
environment that can cause
work-related diseases to the
worker
o Biological Infectious
hazards
o Chemical hazards
SAFETY HAZARDS
• Are the unsafe conditions or
unsafe acts that significantly
increase the risk of a worker to be
injured
o Physical Hazards
CATEGORIES OF HEALTH HAZARDS
1. Biological-infectious hazards
a. Bacteria, viruses, fungi or
parasites
2. Chemical Hazards
a. Medications, solutions and
gases that interact with
body tissues and cells and
are potentially toxic
3. Enviromental Hazards
a. Work environment
b. Malfunctioning equipment
4. Physical Hazards
a. Agents within the work
environment
5. Psychosocial Hazards
a. Factors and situations
encountered with the job
or work environment that
can cause stress or
emotionally-related
problems
CONTROL MEASURES FOR
OCCUPATIONAL HAZARDS
1. Administrative Control
(development &
implementation of policies,
standards, etc.)
2. Engineering (adaption of
physical, chemical or
technological improvements to
limit the exposure of hazards to
workers)
3. Material Provision (providing
workers with supplies or
equipments that can help limit
exposure)
EXPECTED DUTIES AND FUNCTIONS
TO BE PERFORMED BY
OCCUPATIONAL HEALTH NURSES
1. Organizing and administering a
health service program
integrating occupational safety
in the absence of physician;
otherwise these activities of
the nurse shall be in accordance
with the physicians
2. Providing nursing care to the
injuries or ill workers
3. Participating in maintenance
examination
4. Participating in the
maintenance of occupational
health and safety
5. Maintaining a reporting and
records system and, if a
physician is not available,
preparing and submitting an
annual medical report, using
the prescribed form to the
employer as required by this
standard.
LEVELS OF PREVENTIVE CARE AND
OCCUPATIONAL HEALTH NURSING
Primary Prevention
• Health promotion and disease
prevention
• Non occupational programs
o Cardiovascular health
o Cancer awareness
o Personal safety
 o Immunization
o Prenatal
o Post partum health
o Accident prevention
o Retirement health
o Stress management
o Relaxation techniques
Secondary Prevention
• Aimed at early diagnosis, early
treatment interventions and
attempts to limit disability
• Preplacement examination
• Periodic Medical Assessment
• Job transfer evaluations
Tertiary Prevention
• Rehabilitation and restoration of
the worker to an optimal level of
functioning based on limitations
imposed by the disability or
illness
SKILLS AND COMPETENCIES OF THE
OCCUPATIONAL HEALTH NURSE
• Competent
• Proficient
• Expert
COMMUNITY MENTAL HEALTH NURSING
Mental Health
• Defined as the state of well-being
where the person can realize
his/her own abilities to cope with
the normal stresses of life and
work and productivity.
• The emotional adjustment that a
person can involves the
promotion of a health state of
mind among the whole population
through:
o Developing a positive
outlook in life
o Strengthening coping
mechanisms
TREND IN MENTAL HEALTH
• Home Care Management –
modern trend
• Acute Cases – referred and
treated at National Center for
Mental Health (NCMH) or
hospitals and facilities for
psychiatric care/management.
VULNERABLE GROUPS
• Women
• Street Children
• Victims of Torture/Violence
• Internal Refugees
• Victims of Armed Conflicts
• Victims of Natural and Manmade
Disasters
COMMUNITY MENTAL HEALTH NURSING
• A unique process which includes
integration of concepts from
nursing, mental health, social
psychology, psychology,
community networks and the
basic sciences
COMPONENTS OF MENTAL HEALTH
PROGRAM
• Stress Management
• Drug and Alcohol Abuse
• Treatment and Rehabilitation of
Mentally-Ill Patients
• Special projects for vulnerable
groups
MENTAL HEALTH IN THE PHILIPPINES
• 19TH Century at the Hospicio de
San Jose – 1st known organized
care for mentally-ill for sailors of
the Spanish naval fleet
• 1900’s – Americans transformed
treatment for mental health
 • 2002 – NPMH was revived and
renamed to National Center for
Mental Health (NCMH)
MENTAL ILLNESS IN THE PHILIPPINES
According to the survey conducted by UP
Psychiatrist foundation (1993-1994) Inc.
in collaboration with Regional Health
office VI
PREVALENCE OF MENTAL DISORDERS:
35%
1. Psychosis (4.3%)
2. Anxiety (14.3%)
3. Panic (5.6%)
Top 5 Most Prevalent Psychiatric
Conditions for Children and Adolescents
1. Enuresis (9.3%)
2. Speech and Language Disorder
(3.9%)
3. Mental sub-normality (3.7%)
4. Adaptation reaction (2.4%)
5. Neurotic Disorder (1.1%)
1998 NATIONAL PROGRAM FOR MENTAL
HEALTH
Top 5 Priority Concern
1. Patients with mental disorders
2. Victims of disasters and violence
3. Street children and victims of
child abuse
4. Substance abusers
5. Overseas workers
Government Agencies concerned:
1. DOLE
2. DSWD
3. National Defense Department
4. Local Government Departments
5. PDEA
DOH through NPMH supervises and
monitors drug treatment program and
rehab facilities as well as laboratories
MENTAL HEALTH LEGISLATION AND
POLICY
There is no mental health law in the
Philippines
Dangerous Drugs Act- prevention,
treatment and rehabilitation from
substance abuse
PDEA implements the policy and DOH
supervises the laboratories where drug
testing, treatment and rehab takes
place.
April 2001, Secretary of health signed
National Mental Health Policy now
known as AO No. 5 s. 2001
2002 NATIONAL MENTAL HEALTH
PROGRAM
6 Areas of Concern
1. Mental Disorders
2. Substance Abuse
3. Disaster and Crisis Management
4. Women, children and other
vulnerable groups
5. Epilepsy
6. Overseas Filipino Workers
COLLABORATING CENTERS FOR MENTAL
HEALTH
NMHP is also involved in the
development of a demonstration
project in collaboration with Regional
Health Office III.
AIM: Shift mental health care out of the
hospitals to a variety of community-
based services ranging from acute
psychiatric units and outpatient clinics aware of the size and extent of
in the provincial hospitals, home mental health problems.
treatment care and mental cares and
psychosocial rehabilitation in primary
health care.

LUSOG-ISIP PROGRAM

An annual advocacy and mental health

promotion program directed at mental
health concerns other than mental
health disorders. A “life course”
approach has been adopted and its
yearly promotions have ranged from
mental health in children and
adolescents to stress in the workplace.

NURSING RESPONSIBILITIES AND

FUNCTIONS

1. In Mental Health Promotion

a. Health
education/teachings
b. Organize parents class
c. Discuss role of parents in
the care and emotional
support of their children
2. In prevention and control
a. Conduct case finding
studies
b. Be aware of signs and
symptoms
c. Encourage verbalization of
clients fears and anxieties
d. Help family to understand
and accept the patient’s
mental illness
3. Rehabilitation
a. Encourage patients
participation
b. Advice family the
importance of regular
clinic visits
4. In Research and Epidemiology –
participate actively
epidemiological survey to be