August 2018-

Promotion July 2019

MEXICAN SOCIAL SECURITY INSTITUTE

VERACRUZ NORTH DELEGATION
FAMILY MEDICINE UNIT N° 73
DEPUTY HEAD OF NURSING EDUCATION

Final Report of Social Service

Membership

Family Medicine Unit

UMF No. 73

Promotion

August 1, 2018 – July 31, 2019

Nursing Intern

Anilu Ramirez Del Angel.

July 31, 2019

Content
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II Justification....................................................................................................................................................4

III Objectives......................................................................................................................................................5

General..........................................................................................................................................................5

Specific..........................................................................................................................................................5

IV Health diagnosis of the town:.......................................................................................................................6

V Organization.................................................................................................................................................11

Work universe.............................................................................................................................................11

Boundaries..................................................................................................................................................11

Time.............................................................................................................................................................11

Schedule......................................................................................................................................................12

VI Resources....................................................................................................................................................12

Human Resources........................................................................................................................................12

Material resources......................................................................................................................................12

Financial resources......................................................................................................................................12

VII Activities carried out..................................................................................................................................13

FINAL REPORT..............................................................................................................................................19

ANNUAL ATTENDANCE CONTROL................................................................................................................25

VIII Schedule of Activities Carried Out.............................................................................................................27

IX Analysis of the report..................................................................................................................................31

X Conclusion....................................................................................................................................................31

XI Main problems detected.............................................................................................................................32

XII Proposals and suggestions..........................................................................................................................34

XIII Final Report Authorization Sheet..............................................................................................................35

XIV Photographic evidence..............................................................................................................................36

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XV Bibliography...............................................................................................................................................40

Introduction

Social service is a temporary - mandatory activity that allows the student to: In the
training field, acquire scientific, social, artistic and humanistic knowledge that facilitates
the development of the ethical/moral structure of the person and gives meaning to the
integration of the professional profile. Consolidate your academic training, put into
practice the knowledge acquired in the classrooms, as well as acquire new knowledge
and professional skills.
Learn to act with solidarity, reciprocity, as well as the importance of teamwork.
In the social sphere with participation in different fields of human activity such as health,
education, culture, gender equality, environment, production of goods and services,
human rights, science and technology.
Which fosters greater fruition of talents and creative capacities, in the
attention/management of their conditions and problems, which will be assumed with
self-responsibility. Helping to raise awareness of the national problem, particularly that
of the most unprotected sectors of the country, extending to society the benefits of
science, technology and culture, putting the knowledge, skills and abilities acquired at
the service of the community 1 .

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While at the same time it will train competent health professionals, for whom it will open
a wide career field.
The final social service report is an extensive document that describes the activities
carried out by the student, after having completed their social service program, where
each of the activities carried out by the student is comprehensively addressed. social
service intern, in each of the areas where I carry out my knowledge and procedures.

Autonomous University of Mexico [Internet] Mexico; 2016 [updated Jul 31, 2017; cited 12 Jul 2018]. Available at:
http://www.dgoserver.unam.mx/portaldgose/servicio-social/htmls/ss-universitario/ssu-definicion.html

Lopez Zavala Professional ethics in university education, R. (2019). Professional ethics in university education. scielo , [Internet] (142),
p.1. Available at: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-26982013000400017Rodrigo [Accessed 13 Jul.
2019].

II Justification
Based on the Project of the Official Mexican Standard 038 SSA3 2016, in Health
Education. Criteria for the use of medical care facilities as clinical fields in the provision of
nursing social service. The objective of application is for those responsible for the training
programs for human resources for health in said establishments within the scope of their
jurisdiction; as well as for those who agree, intervene and provide social service in nursing.
Based on the Official Mexican Standard 009 SSA3 2013 Health education. Criteria for the
use of medical care establishments as clinical fields for provision describe that the intern
must inform health and higher education institutions when they observe problems in the
infrastructure of the clinical field or there is a deficiency in the supply of supplies. , at the
beginning and during the provision of the social service, as well as reporting to the
competent local authorities and informing the health and higher education institutions,
when any incident occurs that affects the provision of the social service or considers that it
jeopardizes risk his physical integrity, so that they can proceed to assist him within the
scope of their jurisdiction.
Make appropriate use of the infrastructure, equipment and supplies of the clinical field.
Collaborate in updating the community health diagnosis in the area of influence of the
clinical field.
Deliver at the end of the social service, the report of the activities carried out.
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This is how this report is carried out as part of the fulfillment of release from social service,
by communicating in writing the activities and experiences in relation to the execution of
professional nursing functions and allows interns to compare the goals planned in the
program. operational and differentiate what was planned from what was carried out, and
also allows evaluating the skills and abilities that were obtained from each of the services
by being in direct contact with patients, family members and the multidisciplinary health
team.
Mexican Official Standard Project NOM-038-SSA3-2016, Health Education. DOF Official Gazette of the Federation . [Internet]
Available at: http://www.dof.gob.mx/nota_detalle.php?codigo=5354092&fecha=28/07/2014 [Accessed 13 Jul. 2019].

Official Mexican Standard NOM-009-SSA3-2013, Health Education. DOF Official Gazette of the Federation [Internet] Available at:
III Objectives
https://www.gob.mx/cms/uploads/attachment/file/35880/NOM-009-SSA3-2013.pdf [Accessed 13 Jul. 2019].

General

 Release a final report that globally describes each of the activities carried out in the
Family Medicine Unit No. 73, in the period August 2018 – July 2019.

Specific

 Indicate the total number of activities carried out during social service.
 Provide a narrative report of social service.
 Report the experiences, knowledge, and skills obtained in the service

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IV Health diagnosis of the town:

Health Diagnosis of the Family Medicine Unit No. 73
The Health Diagnosis is a tool that allows identifying the health needs of the population and
the capacity of the health system to resolve them. This must provide the necessary
information to plan the provision of services based on the identification of social and
environmental conditions, health damage expressed as morbidity and mortality, potential
risks, available resources and their performance.
Historical background
The Family Medicine offices were originally integrated into HGZ-MF No. 24, seeing the
prevailing need to provide timely care to a greater number of beneficiaries, HGZ No. 24
was restructured, leaving it only as a Zone General Hospital, thus creating the Unit of
Family Medicine No. 73, on October 4, 2010, transferring the assigned population along
with the 15 Family Medicine offices and the services of stomatology, preventive
stomatology, social work, preventive medicine, continuous medical care, maternal and
child, health at work and nutrition and dietetics.
As of December 1, 2015, the population assigned to UMF No. 72 is transferred along with
4 family medicine offices, stomatology and preventive medicine services to UMF No. 73
and only until June 16, 2016 is when The migration of files from UMF No. 72 to 73 is
unified. Currently being integrated with 19 Family Medicine Clinics, an epidemiology
department, 3 stomatology offices and one preventive stomatology, 8 PREVENIMSS
modules, 2 social work modules, a Nutrition module, an imaging area, 1 TAOD module, 1
occupational medicine office, continuous medical care area (with 1 office, 3 observation
beds, nursing center, dressing and injection area, nebulization and hydration area).

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Government Area that includes Medical Directorate, Administrative Deputy Headquarters.

Also an area assigned to the head of conservation, 4 heads of family medicine service,
head of nursing, head of social work, a coordination of medical assistants, a research and
teaching department, an ARIMAC department area, benefits control, affiliation and validity,
a booth assigned to surveillance and security personnel.
Geographic aspects
Located on Central Poniente Street No. 601, Col. Laredo in the city of Poza Rica de
Hidalgo, Poza Rica de Hidalgo CP 93260., next to the General Hospital of Zone No. 24.
Between the parallels 20° 29' and 20° 36' north latitude; the meridians 97° 24' and 97° 29'
west longitude; altitude between 40 and 200 m.
Boundaries
It borders to the north with the municipalities of Tihuatlán and Papantla; to the east with the
municipality of Papantla; to the south with the municipalities of Papantla and Coatzintla; to
the west with the municipality of Coatzintla.
Climate and relief
Temperature range: 22 – 24°C, Precipitation range: 1 100 – 1 300 mm, Warm subhumid
with summer rains (100%); Province: Coastal Plain of the Northern Gulf (100%),
Subprovince: Plain and hills (100%), Topoform system: Hills with plains (45%), Low Sierra
(32%) and Typical Valley (23%)
Flora
Secondary deciduous forest, palm grove and savanna vegetation. Dominant soil Regosol
(24%), Phaeozem (6%) and Vertisol (4%); Land use: Urban area (66%), agriculture (20%).
Vegetation: Grassland (8%) and jungle (6%)
Fauna
A fauna develops made up of populations of rabbits, raccoon armadillos, opossums,
badgers and coyotes.
Communication Routes
Land: Urban Service, Taxi, Private Cars.
Population

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The panorama of the municipal population and the beneficiary population allows evaluating
the coverage of services and the composition of the population. The rapid population
growth especially in recent years has been due to the decline in the death rate and not the
growth in the birth rate. The fact that food sources, drinking water and public health are
within reach of the majority of the population has resulted in greater longevity.
Among the main factors that directly affect the health status of a population are
demographic factors, which determine the volume, structure and geographical distribution
of the population. Other factors are vulnerability associated with age and risk factors
related to gender, as well as the environment in which individuals live and develop.
Problem prioritization
In general the activities that must be carried out are:
-Characterize the health profile of the population, including access to care and health
inequities.
-Assess unmet health needs and facilitate the identification of priorities.
-Generate evidence for the formulation of disease promotion, prevention and control
strategies that allow their evaluation and impact.
-Strengthen the predictive and resolution capabilities of management, which allow the
construction of prospective health scenarios.
The main problems that must be evaluated are:
-Mellitus diabetes
-Arterial hypertension
-Acute respiratory infections in < 5 years
-Acute diarrheal infections in < 5 years
-Other liver diseases
-Overweight and obesity
-Cerebrovascular disease
-Pneumonia and bronchopneumonia
-Malignant tumor of the cervix
-Malignant tumor of the breast
Epidemiological analysis, health interventions

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This document leads to the integration of:

 Health diagnosis
 Situational diagnostic
 Strategic Plan of the Family Medical Directorate
 Operational Plan and Process Evaluation Method of the Family Medical Unit
 Development of instruments to control the implementation of strategies and
improvement of processes
 Medical Management Management Model
 Methods for supervising the processes of Nursing services
 Analysis of health information and decision making of the Governing Body of the
Medical Unit
The epidemiological analysis is the “tool” that allows us to identify the point where the
“Health-Disease Process of the Unit” is located and from this analysis, health intervention
actions must be generated to positively modify the health of the user population of the unit.
Medical unit:
1. Effective health promotion
2. Timely detection, identification and attention to risk factors
3. Diagnosis, treatment and control. Identification and timely management of
complications
4. Treatment of early or late complications. Rehabilitation
5. Outcome of the impact on health
The epidemiological analysis must consider:

1. Characterization in time, place and person in national, state, delegation and local
context
2. Achievement of medical indicators to achieve:
 Comprehensive Care of Diabetes Mellitus, in the Beneficiary Population of 20 years and
over.
 Comprehensive Care of Hypertensive Diseases in the eligible population aged 20 years
and over.

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 Comprehensive Care of Breast Cancer in Women.

 Comprehensive Care of Cervical Uterine Cancer
 Comprehensive Maternal Care
 Care of Nosocomial Infections in Hospital Units
 Comprehensive Neonatal Care
 Comprehensive Care for Overweight and Obesity, in the Entitled Population of 20 years
and over.
 Comprehensive Care of Acute Respiratory Infection in children under 5 years of age.
 Comprehensive Care of Acute Diarrheal Disease in children under 5 years of age.

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V Organization

Work universe
The Family Medicine Unit No. 73 of the Mexican Social Security Institute provides first-
level care services, provided to a population of beneficiaries, carrying out prevention and
health promotion activities.

Boundaries
Location: Family Medicine Unit No. 73, belonging to the Mexican Social Security Institute,
which is located at Central Poniente no. 601, Laredo neighborhood, with postal code 93260
in Poza Rica de Hidalgo, Veracruz. The family medical unit has an infrastructure made of
concrete and glass, four floors, classrooms, toilets, parking, RPBI warehouse, basic
sanitation services, maintenance, a power plant in case of emergencies and emergency
exits. The facilities are spacious, with good lighting, ventilation and temperature. The
delimitation of the areas inside the building is adequate and emergency services have
access to the outside. It has sufficient furniture and areas to store clothing, equipment and
materials. The areas are in excellent condition, hygiene and order. It has medical services
such as: emergencies, 19 medical offices, 8 PrevenIMSS offices, epidemiological
surveillance, stomatology, nutrition, social service, laboratory, X-rays, pharmacy and CEYE
(Central Equipment and Sterilization). As well as administrative services such as: medical
management, reporting module, affiliation and validity, benefits, clinical file and surveillance
service.

Time
It covered a period from August 1, 2018 to July 31, 2019. With three rotation periods at the
General Hospital of Zone No. 24, the first spanned from August 1, 2018 to October 31,

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2018, the second from November 1, 2018 to February 28, 2019 and the third from May 26,
2019 to July 31, 2019.

Schedule
An 8-hour workday, with a morning shift from 7:00 am to 3:00 pm. Exceptionally on
Saturdays in the morning shift with an 8-hour schedule for National Health Week, and
vasectomy and bilateral otubal obstruction campaigns.

VI Resources

Human Resources
Intern: Anilu Ramirez del Angel.

Social Service Coordinator: Dr. Carina Hernández Guzmán.

Deputy Head of Nursing Education and Health Area Technicians: LEO Silvia Eliosa
Zenteno

Thesis advisor: Lic. Juan Manuel Álvarez Sánchez.

Health diagnosis advisor: Lic. In Cooling: Lic. Roberta Nava Cruz.

Material resources
Granted in its entirety by UMF No. 73 and by HGZ No. 24, such as furniture,
computer equipment, medical equipment, consumer materials, clothing and stationery.
On the part of the intern, with uniforms and personal items .

Financial resources
The expenses generated will be covered by the intern.

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MEXICAN SOCIAL SECURITY INSTITUTE

VERACRUZ NORTH DELEGATION
ZONE GENERAL HOSPITAL N° 24
DEPUTY HEAD OF NURSING EDUCATION

VII Activities carried out

FINAL EVALUATION CARD FOR INTERNS IN SOCIAL SERVICE

Name of the intern Anilu Ramirez del Angel . Career: Nursing.

Period: August 1, 2018 - July 31, 2019. Assignment: Family Medicine Unit No. 73.

AREA
COGNOSCITIVE ACTIVITIES TO EVALUATE QUALIF.
1. Promotes and encourages the health of the patient, family and community through the 9.5
dissemination of Integrated Preventive Care programs
COMPREHENS 2. Perform Multidetections according to the identification of risk factors. 9.5
IVE HEALTH 3. Handles, applies and registers biological products based on regulations. 9.5
4. Gives talks to the population based on theoretical foundations 9.5
CARE 5. Correctly register the information in the Institutional forms. 9.5
6. Carry out promotion, prevention and protection activities in the Community. 9.5
7. Performs the different procedures in your area with precision. 9.5

EDUCATION 8. Actively and timely participate in academic sessions 9.5

KEEP GOING 9. Presents scientific article and reading guide 9.5

INVESTIGATION 10.Presents advances of the research protocol in a timely manner 9.5

USE THE SCALE FROM 0 TO 10 RATING 9.5

SOMETIME ALMOST
NEVER ALWAYS
INDICATORS TO EVALUATE S ALWAYS
AFFECTIVE AREA
0 6 8 10

1. It appears without delay every day 9.5

2. No absences 9.5
3. He is not absent from duty during the work day | 9.5
ATTITUDES 4. He is respectful of patients, superiors and subordinates | 9.5
5. Accept constructive criticism 9.5
6. Accept and comply with instructions 9.5
7. Submit academic work in a timely manner 9.5

8. Appears properly uniformed 9.5

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9. Carry an ID badge every day 9.5

PRESENTATION 10. Your personal appearance is clean and neat 9.5
USE THE SCALE FROM 0 TO 10 RATING 9.5

MEXICAN SOCIAL SECURITY INSTITUTE

VERACRUZ NORTH DELEGATION
ZONE GENERAL HOSPITAL N° 24
DEPUTY HEAD OF NURSING EDUCATION

FINAL REPORT SECOND LEVEL OF CARE

Format 4
Name of the intern Anilu Ramirez del Angel . Career: Nursing.
Period: August 1, 2018 - July 31, 2019. Assignment: Family Medicine Unit No. 73.

Performed activities. Goal Made.

Taking vital signs. 900 915

Medication application. 500 534

Solution change 100 109

Nursing clinical records 300 315

Education for health 200 216

Peripheral venous catheter placement 50 57

Placement/removal of Foley catheters 10/7 15/10

Laboratory sample collection 40 45

Change of bed linen 100 115

Patient admissions 50 52

Placement of evacuative enemas 40 47

Inhalation therapy 250 289

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Shift delivery 40 42

sponge baths 45 54

Position changes 100 150

Diaper change 50 52

Temperature control with physical means 10 13

Surgical wound healing 50 52

Capillary blood glucose measurement 200 220

Placement of heparinized catheter 1 4

Force feeding by nasogastric/orogastric tube. 5/13 9/15

Medical visit pass 20 25

Taking blood gases 2 5

Taking electrocardiograms 2 5

Central venous pressure measurement 1 2

Review of red car components 40 42

Neurological status monitoring 25 26

Initial disinfection 25 43

Assistance in the anesthesiology process 25 57

Counting gauze and compresses 10 25

Reception and delivery of surgical patients 62 65

Assortment of material 35 37

Productivity delivery 30 32

Washing surgical equipment 7 10

Review of equipment operation 35 38

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Administration of blood products 1 5

Surgical room preparation 75 77

Management of surgical times 35 38

Bleeding monitoring 10 35

Bandages 45 47

Assortment of material to services 74 78

Transfer of material to CEYE for sterilization 34 78

Peritoneal dialysis process 60 63

Balances for dialysis patients 80 83

Medical/surgical hand washing 1000/ 4 1390/5

Cephalocaudal assessment 15 18

Uterine involution surveillance 10 16

Labeling of surgical pieces 20 24

Placement of cardiac monitor 1 2

CONTINUING EDUCATION:

1. Attendance at academic sessions 25 36

2. Scientific Articles Presented 1 2

3. Presented Reading Guides 0 0

INVESTIGATION:

1. Research Papers Presented 1 1

____________________________ __________________________________________
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Signature of the intern Name and signature of the person validating

MEXICAN SOCIAL SECURITY INSTITUTE

VERACRUZ NORTH DELEGATION
ZONE GENERAL HOSPITAL N° 24
DEPUTY HEAD OF NURSING EDUCATION

FINAL REPORT FIRST LEVEL OF CARE

Format 2
Name of the intern Anilu Ramirez del Angel . Career: Nursing.
Period: August 1, 2018 - July 31, 2019. Assignment: Family Medicine Unit No. 73.

PERFORMED ACTIVITIES GOA DONE

L

Talks to promote integrated preventive care programs 200 215

Education talks on integrated preventive care programs 100 155

Immunizations ( Influenza:450, SABIN:150,Td:150, HPV:115, 500 954

Pentavalent:18, Pneumococci:18, Tdpa:1, Rotavirus:15,
BCG:30, PPD:4, DPT:3)

Health promotion talks given based on integrated 200 200

preventive care

Visual acuity test 20 28

Weight and size 200 270

Informed provision of condoms 50 80

Promotion of oral health (brushing technique, fluoride 50 81

application, plaque-revealing pin)

Timely DETECTION of cervical cancer (DOC) 20 35

Timely detection of breast cancer (DOCMA) 20 45

Blood pressure measurement 200 235

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SIEVE 5 3

Timely detection of Diabetes Mellitus (DOD) 200 968

Card delivery 100 165

Cholesterol intake 200 291

Performing rapid HIV tests 10 10

Administration of vitamin “ A ” 20 42

Multi-detections carried out 200 733

Daily census of DOC and rapid HIV tests 20 112

sieve CENSUS 15 28

Delivery of consumer materials to AMC 30 52

Delivery of consumer material to CENDIS 30 56

Request material using CC3 format 15 22

Bus delivery to pharmacy 20 55

Preparation of weekly, biweekly and monthly reports 10 29

Attendance at academic sessions 20 25

Mammography requests 20 73

Somatometry 30 30

RAIS sheet filling 200 500

____________________________ __________________________________________
Signature of the intern Name and signature of the person validating

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MEXICAN SOCIAL SECURITY INSTITUTE

VERACRUZ NORTH DELEGATION
ZONE GENERAL HOSPITAL N° 24
DEPUTY HEAD OF NURSING EDUCATION

FINAL REPORT
(NARRATIVE REPORT)
Name of the intern Anilu Ramirez del Angel . Career: Nursing.
Period: August 1, 2018 - July 31, 2019. Assignment: Family Medicine Unit No. 73.

Date Performed activities.

We showed up at the general hospital of zone # 24 of the IMSS, for the induction
course for social service interns, the first presentation was the head of teaching to
introduce herself and give us the safety decalogue, the safety actions as well as
give us the IMSS anthem, after this different nurses presented us with their
respective presentations, such as filling out the RAIS sheet, the updated
immunization schedule, ESAVIS, cold network, priority health programs managed
by the IMSS, we also had a session with the hospital psychologist, so that we
could integrate better as well as to evaluate our psychological state. Upon arriving
August at the general hospital in zone #24, I arrived at the nursing session and there we
were introduced to all the nurses who came to the session, and after that all the
social service interns stayed and we introduced ourselves to the interns from the
previous semester, after that they gave us a tour of the hospital where they
showed us our services and we joined them, I was in the emergency room when I
arrived at the service, I introduced myself to the head of the emergency room and
she proceeded to assign us nurses who were rotating in that service and we did
activities specific to the nursing social service interns specific to the service. This
month we gave health education for World Breastfeeding Week.

September When I arrived at the hospital, I reported to the head of teaching, and I proceeded
to go to my service, which would be Surgery and Trauma, but when I reported to
the head of the floor, she ordered me to join Internal Medicine and assigned me to
different nurses to be found. rotating in the service, then I proceed with the clinical
nursing records, I continue with the application of medications intradermally,
intramuscularly, subcutaneously, oral, cutaneous and ophthalmic according to the
indications, I prepare and apply the nebulizations, I close the clinical nursing
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records , as well as the patients who require it are also aspirated, if any of them
expire, we recanalize them, bandages are made, positions are changed, sponge
baths are given and those who can are instructed to take a shower bath,
Bedclothes and diapers are changed, bandages are made, temperature is
controlled with physical means, uresis is quantified, capillary glucose is measured
in turn, sometimes samples are taken, and transfers are made to clinical studies.
On Wednesday, September 26, 2018, I proceeded to leave at 12:30 pm to go to
the faculty for my laudatory grade.

When I arrived at the hospital, I reported to the head of teaching, and proceeded
to go to the service that corresponded to me, which was the Operating Room, but
when I reported to the head of the operating room, she sent me to the recovery
room, where I presented myself to the nurse and proceeded to take vital signs. ,
and to know the service a little, then I reviewed the material in the red cart and
filled in what was missing, then I proceeded to make clinical nursing records, and
this day there were not so many surgeries so I did not have as much work, now
with the passing of On days the work was easier, I took signs when I arrived, I
opened nursing sheets and checked the patients I had, I changed dressings and
gauze, I checked the material in the red cart, I checked to see if the peripheral
October intravenous line was patent and if they needed medication. I applied them, when
those from outpatient surgeries began to arrive, I checked their vital signs, I
participated in the visit with anesthesia, if I didn't have so much work, I channeled
them and wrote them down in the admission and discharge notebooks. The
following Monday I rotated through room 1, I arrived and introduced myself to the
nurse, I did the initial and helped stock the room, checking that the equipment was
working, such as the electrocautery, the aspirator, the lamps and the iron. On
October 13, 2018, the third vaccination campaign began, so we had to rotate to
the 73rd, the first day was not the best because I was alone and I did not know
anything about filling out the sheets or how to work, the good thing is that it was
only SABIN and I applied 24 doses and 27 mega doses of vitamin A.
On November 1st, return to HGZ No. 24 and upon returning I joined the dialysis
hospitalization service. When I arrived at the service I introduced myself to the
nurse, and I began to do the initial in which my partner counted material, then we
brought dialysis bags to the service, I cleaned them, took vital signs of the
patients who were inside the dialysis module and I proceeded to fill out nursing
November sheets, I went down to the closet for clean pads and to CEYE for bags to put pads
in, I returned to my service I folded the pads, put them in the bag, dried the
brushes and I went down to CEYE to deliver the material for sterilization upon
returning to the day. I performed dialysis processes with twin bags and visited the
nephrologist.

December
I was on vacation, from December 3 to December 17, 2018. When I returned from
vacation I had a meeting with the social service interns, to present progress of the

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thesis and present them, after finishing the meeting I joined the Family Medicine
Unit # 73, where I was for 2 days since I had to continue with the campaign of
vaccination, from the second batch of vaccine, but on Monday I entered there was
no longer any vaccine for the field only for companies, on Monday I only ordered
the results of the DOC, by date of completion and I made Rais sheets. On
Tuesday I went out to work, I went to vaccinate the Hotel Fiesta Inn, I left UMF
#73, at 8 am upon arrival, I started vaccinating the staff, who worked at the hotel,
we finished around 2 and returned to UMF # 73, and when I returned I found out
that on Wednesday we would perform at HGZ # 24. On Wednesday, when I went
up to the boss, she informed me that she needed an intern in the operating room
recovery so that Dunia could go to the ward and enter recovery, I showed up with
the nurse, and I started taking signs and opened some nursing sheets, I asked for
material At CEYE, I received patients from wards, to whom I took their signs,
wrote their postoperative note and gave them the medications that were in their
medical indications and changed the solution if necessary. I changed gauze and
covered surgical wounds, I cleaned the genitals, and monitored the bleeding of
patients after cesarean sections, maintained the body temperature of post-
operative patients, and monitored their neurological status.

January
When I arrived at the hospital I went to the operating room recovery since there
was still no one to enter the operating room to relieve me in the operating room
recovery, so I arrived at the service towards the initial one, I checked that the
material and the red cart were there, if there were patients I monitored the signs
vitals, and started the operating room nursing notes, then requested the material
that was needed from CEYE and returned to the service at 7:30 a.m. the
outpatients were admitted, I reviewed their file, that they had admission, the
surgical nursing sheet, the informed consent, surgical projection sheet 430, pre-
anesthetic evaluation, laboratory tests that do not exceed 3 months from the
intake that had a good hemoglobin level, and available packages of frozen plasma
and blood cells. And after 3 days I rotated to the ward, I showed up with the
nurse, I proceeded to do the initial and stock the room and since the initial had
already started he told me to check the medical equipment, I wore the surgical
plate and the mayo chaloras, I arranged the material so that everything was ready
when the patient was admitted, between 8 and 9 am the patients were received,
they checked that the patients had, admission, the surgical nursing sheet, the
informed consent, the surgical projection sheet 430, pre-assessment anesthetic,
laboratory tests that do not exceed 3 months from their intake and that they had a
good level of hemoglobin, and that there was availability of frozen plasma
packages and/or blood cell packages if required, he placed the patient on the
table and proceeded to assist. In whatever was required, the integrated health

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team (anesthesiologists and surgeons) One day when my ward did not have
surgery, I learned to do parenteral nutrition and then do it myself.

Upon arriving at UMF 73, I proceeded to sign in, and I reported to the boss who
assigned me to the nurse who was in office number 3 on the 2nd floor in office 3, I
introduced myself to the nurse, and proceeded to start with my activities, take
somatometry, take T/A, RR, HR, Temperature, I proceeded to review the cards
and write down API'S, and fill out the different items on the card, to do the
preventive actions indicated on the card, glucose, application of fluoride, T/A,
DOC, DOCMA, Visual acuity, application of vaccines, etc. At 1:30 I began to
supply all the material that was or had been required, then we had to give the
afternoon sessions and at 3 I left the service. On February 14, the nurse I was
with was due to administer the BCG vaccine, so I proceeded to supply more dry
swabs, an injectable water, I went out to collect cards, as soon as 5 RN arrived I
February proceeded to transfer them to the module, they he took somatometry and
abdominal, thoracic, abdominal perimeter and temperature, heart rate, educated
the parents about early stimulation for their age, once finished he uncovered their
right arm and accommodated them, loaded the 0.01 ml vaccine, changed the
needle and cleaned with injectable water , then with a dry swab and applied the
intradermal vaccine. From February 18 onwards, they took me out of the office
because I had to prepare the teaching material that would be used at the
beginning of the first week of vaccination that began on February 23. On
Wednesday, February 20, they returned me to the office because a nurse was
absent due to disability, I was basically the regular nurse and I gave them API,
they were given a RAIS sheet, that day I saw 9 patients, 5 DOC, and one suspect.

March Upon arriving at UMF No. 73, I had to sign up and go to the prevenIMSS modules
where I took somatometry, did multidetections, and administered vaccines. In the
week I was with her I made two sieves. Later, when it was almost 2 o'clock, he
was going to supply me with material, and if he had any suspects, he would take
them to headquarters to add them as a suspect and follow up. The following
weeks they sent me to office 0 because the UMF did not reach the productivity
rates and they put us in charge of an office where on average we saw 19 patients

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and we had to do 5 DOCs, and since we couldn't do them on the computer,

because we are interns, we had to do them on a sheet of paper. After that week
they took me to the prevenimss office 04 because the nurse went on course, and
we took somatometry, we did multidetections and we applied vaccines. On
Thursday of the second week, I had to go up to apply BCG, while I was there I did
2 screenings and administered vaccines, somatometry was taken on the RN and
the postpartum woman was given instructions that she had to have and with the
RN, she was educated on breastfeeding and early stimulation. Finishing I started
to supply material and do productivity.

Upon arriving at UMF 73, I proceeded to sign up, and I reported to the boss
Roberta so that she could tell me which service I would join. She told me that we
would continue in module 0 together with my PSSE colleague Guadalupe Leyva
López, as until that moment I had I went up, proceeded to pack my thermos and
go to my office to do the initial, I went to CEYE for swabs then I went up to the
second floor for the biological and the material that would be given to us, at 8 am
April we proceeded to go to membership and validity, to send us newly affiliated
patients, then we began to transfer them as they arrived to the PREVENIMSS
module, we did the pertinent preventive actions (application of fluoride,
educational talks, DOC, DOCMA, visual acuity, measurement of DOD, T/A, and
cholesterol, etc. such as somatometry, application of vaccines, early stimulation,
use of dental floss) like this for a week.

On April 29, I started my rotation at HGZ No. 24, and proceeded to go to the
pediatric service, but when I went up to the third floor I reported to the floor
manager who was there and she told me that I would be in pediatrics. I introduced
myself to the nurses, I did the initial one, after that I went down to CEYE to bring
the material that was downstairs, then I returned and supplied material to the
May
service, I took vital signs, I gave nebulizations. On May 15 and 16, where I didn't
go because I got sick with gastroenteritis, on May 17 I went to the Adela del Toro
to present our thesis. On May 20, I returned to UMF 73 because the campaign
was starting and I would be there for two weeks.

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On June 3, the mammography campaign begins, and I stay in the mammography

module where we were in charge of preparing the paperwork for the beneficiaries
who would have their mammogram, checking that they were valid, the
mammography request and the request were made. of duly requested surrogate
study, they were sealed and signed by all the directors, we checked that the
patients were without deodorant, talc perfume or seaweed and that they were well
June shaved. To take them down to carry out their study, once they were as required,
we proceeded to take them down. Once down, they wrote down the folio in their
card to collect their results and they were told that in a period of 10 to 20 days,
they had to go to the address. to collect their results and if they were altered they
would be called at the numbers that they had previously provided to us. On June
24, I leave on vacation and return on July 7, 2019

July

____________________________ __________________________________________
Signature of the intern Name and signature of the person validating

24
 MEXICAN SOCIAL SECURITY INSTITUTE August 2018-
VERACRUZ NORTH DELEGATION Promotion July 2019
ZONE GENERAL HOSPITAL N° 24
DEPUTY HEAD OF NURSING EDUCATION

ANNUAL ATTENDANCE CONTROL

Name of the intern Anilu Ramirez del Angel . Career: Nursing.

Period: August 1, 2018 - July 31, 2019. Assignment: Family Medicine Unit No. 73.

Date. Check-in time. Departure time. Service.

Aula magna /
August 07:00 15:00
emergencies.

September 07:00 15:00 Internal Medicine

Operating room recovery

/ Operating room 1 /
October 07:00 15:00
Third national health
campaign.

November 07:00 15:00 Hospital dialysis.

Vacation / Operating
December 07:00 15:00
room recovery.
Operating room 2 /
January 07:00 15:00 Operating room
recovery.
PrevenIMSS Clinic No.
February 07:00 15:00 3/ First national health
campaign.
First national health
campaign / PrevenIMSS
March 07:00 15:00
Clinic N° 0 / PrevenIMSS
Clinic N° 4
PrevenIMSS Office No. 0
April 07:00 15:00
/ Pediatrics.

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Pediatrics / second
May 07:00 15:00
national health campaign
Mammography
June 07:00 15:00
Campaign.

July 07:00 15:00 Hemodialysis.

____________________________ __________________________________________
Signature of the intern Name and signature of the person validating

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VIII Schedule of Activities Carried Out

MONTHS
E
I
Y A
ADMINISTRATIVE ACTIVITIES T T T
e N d N F M M J. J.
O H O
s D
E
R
First level of care

Correctly record the information in the

Comprehensive Health Care Registries
(RAIS).
Management of health records.

Register biological products based on the

cold chain.
Second level of care
Nursing sheet management.
Management of productivity and material
sheets.
Holiday period.

MONTHS
E
I
EDUCATIONAL ACTIVITIES Y A
T T T J J
e N d N F M M
O H O . .
s D
E
R
First level of care

Promote and encourage the health of the

patient, family and community through
Integrated Preventive Care (API)
programs.

Second and first level of care.

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Give health promotion talks.

Making posters, wall newspapers and

flipcharts.

Scientific articles presented in sessions.

MONTHS
E
I
Y A
CARE ACTIVITIES T T T J J
e N d N F M M
O H O . .
s D
E
R
First level of care.

Timely detection of cervical cancer

(DOCACU).

Timely detection of breast cancer

(DOCMA).

Detection of arterial hypertension

Early Diabetes Detection (DOD)

Somatometry (weight, height, waist,

BMI).

Informed provision of VSO,

albendazole, folic acid, condoms.

Application of vitamin “A”.

Preparation of biological thermoses.

Participation in national health week.

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Application of immunizations.

Participation in mammography
campaign.

Assistance activities at second level of

care.

Carrying out PrHIV to pregnant

women.
Second level of care.

Intern activities in nursing social

service in medical emergencies.
Intern activities in nursing social
service in hospitalization.
Intern activities in nursing social
service in the operating room.
Intern activities in nursing social
service in dialysis hospital.
Intern activities in pediatric nursing
social service.
Intern activities in hemodialysis
nursing social service.

MONTHS
E
I
Y A
RESEARCH ACTIVITIES T T T J J
e N d N F M M
O H O . .
s D
E
R
Delivery of monthly report.

Delivery of the social service program.

Meetings at the IMSS.
Meetings of the Veracruzana University.

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General Examination for the Graduation

of Professional Degree in Nursing
(EGEL).
Logbook delivery

Delivery of Nursing Care Processes

(PAE).

Quarterly report delivery.

Delivery of thesis, poster and final report.

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IX Analysis of the report

Based on the goals programmed during the beginning of social service, some of
the activities scheduled since my rotation period at the second level of care were
extended. Which led me to overcome the learning in which they were carried out in
hospital services such as emergencies, internal medicine, dialysis, operating room,
pediatrics, nurseries and hemodialysis. At first level, they were mostly the
application of vaccines and multi-detections such as capillary blood glucose
measurement, blood pressure measurement and cholesterol measurement to the
eligible patients of said aforementioned unit. Carrying out neonatal screening was
a little more complicated in terms of less opportunity for rotation through the
preventive medicine modules, since if any other activity arose to be carried out, we
would be rotated differently than the role established from the beginning of the
service. .

X Conclusion
The social service that I presented in the period from August 1, 2018 to July 2019
was very significant for my academic and professional training, since I applied the
knowledge acquired during the 4 years of my academic training at the nursing
school. Which led me to acquire new knowledge and skill when carrying out each
of the procedures and attention to the beneficiary.
This stage of professional training was rewarding, since being able to adapt along
with the other health personnel, as well as the administrative staff of the unit, led
me to know the importance of each of the preventive activities provided to the
patients. beneficiaries with the purpose of raising awareness in the practice of
health in a way that prevents said chronic-degenerative or communicable
diseases.
Regarding the mastery of skills and abilities within each of the activities carried
out, they were carried out within an ethical and moral framework, respecting the
well-being, privacy, dignity, and beliefs of the beneficiaries served during the
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practice of social service; Likewise, paying special importance to autonomous and

continuous learning, acquiring new knowledge and techniques to be more
competent health personnel.

XI Main problems detected

First level of care.
The problems detected during the social service at the first level of care were the
presence of overweight and obesity in the beneficiaries due to a lack of physical
activity, as well as the alteration of normal blood glucose values, and the presence
of risk factors. to develop Diabetes Mellitus in said beneficiaries.
The Food and Agriculture Organization of the United Nations (FAO) warned about
the need to change eating habits in Mexico , where 73% of the adult population
is overweight or obese.
According to the WHO, overweight and obesity are defined as an abnormal or
excessive accumulation of fat that can be harmful to health. Body mass index
(BMI) is a simple indicator of the relationship between weight and height that is
frequently used to identify overweight and obesity in adults. Overweight and
obesity constitute a public health problem, since it is a condition that causes
various chronic diseases such as heart disease, diabetes, high blood pressure and
5
some types of cancer; as well as highly prevalent disability and premature deaths
.
The presence of overweight and obesity due to excessive eating and the
consumption of fat and sugar leads to triggering the presence of Diabetes Mellitus
in beneficiaries 1 .
In more specific terms, diabetes mellitus is a genetically determined disease, in
which the subject who suffers from it has alterations in the metabolism of
carbohydrates, fats and proteins, together with a relative or absolute deficiency in
insulin secretion and with variable degrees of resistance to it. When the disease

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reaches full development, it is characterized by fasting hyperglycemia and, in the

majority of patients with a long evolution of the disease, by complications. Finally,
non-communicable diseases linked to overweight and obesity can be prevented,
which is why health promotion and education is important 2 .

Second level of care.

The problem detected during the social service at the second level of care was
chronic kidney disease, which mostly occurs as a complication of non-
communicable diseases such as diabetes mellitus and hypertension. According to
the National Health and Nutrition Survey (Ensanut 2012), diabetes mellitus was
present in 9.17% (6.3 million) of the country's total population aged 20 and over
(68.8 million). If we accept the inference provided by the fact that for every known
diabetic (diagnosed by a professional in the field), there is another unknown, there
are 12.6 million people with this condition (18.34%).
By the end of 2015, according to the INEGI population estimate of 77.1 million
people aged 20 and over and applying the same proportions indicated by Ensanut,
there would be a total of 14 million people with type 2 diabetes mellitus (18.34% ).
We know from international statistics and from several studies that reproduce the
screening protocol – among them, National Academy of Medicine of Mexico 4
KEEP: Kidney Early Evaluation Program (Kidney Early Evaluation Program) to
detect the early stages of CKD, developed by the International Kidney Foundation
and adapted to our country by the Mexican Kidney Foundation (FMR) – that it is
possible to carry out these screenings in large groups and find patients with
diabetes who have already developed CKD.
The adult population that currently suffers from CKD secondary to diabetes in
Mexico, stages 1 to 3, is around 6.2 million and should be identified, characterized
and treated by general practitioners, family doctors, internists, nutritionists,
psychologists and experts in physical activation. and exercise, according to a care
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protocol in family medicine clinics, health centers and offices. There should be
basic infrastructure (computer and communications), sufficient supplies
(medications and laboratory reagents for diagnosis and monitoring), and training
and supervision programs through certified nephrologist doctors (who will act as
tutors, reviewers and supervisors) on the execution. of the clinical protocols,
working as a team in order to prevent the disease from progressing and to ensure
that in a large number of cases of primary stages it is reversed and the renal
reserve is recovered.
Currently the Mexican Social Security Institute (IMSS) is a good example for
analysis. Currently, the institution has registered just over 60 thousand patients in
replacement therapy, 25 thousand of whom (41.7%) are in a hemodialysis program
and around 35 thousand receive peritoneal dialysis services (58.3%).

XII Proposals and suggestions

Health Education, as a tool for Health Promotion, will also have to deal with
creating learning opportunities to facilitate changes in behavior or healthy lifestyles,
adherence to treatment, knowledge of the disease and management of signs and
symptoms to that the beneficiaries know and analyze the social, economic and
environmental causes that influence their health.
Some of the activities that could be carried out in Medicine Unit No. 73 are:
- Implement healthy lifestyle talks such as good nutrition and physical activity.
- Inform the population about health, illness, disability and the
ways in which individuals can improve their own health.
- Preparation of brochures, posters and flipcharts, to raise awareness among
beneficiaries.
- The participation of beneficiaries in the PREVENIMSS modules, to guide their
health care.

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While for the General Hospital of Zone No. 24 they are:

- Implement education to avoid complications that raises awareness of the
disease, the importance of adherence to treatment, as well as the management
of signs and symptoms.
- Preparation of brochures, posters and flipcharts, to raise awareness among
beneficiaries.
- Be stipulated in full compliance with the law and the constitutional rights of the
people, as well as the recognition of the needs and demands of the sick.

XIII Final Report Authorization Sheet

_____________________________________
Dr. Claudia Andrea Fernández Acosta
Unit Director

____________________________________
Dr. Gloria Leticia Nuberg Belarde
Health Education and Research Coordinator

_____________________________________
LEO Silvia Eliosa Zenteno
Deputy Head of Education in Nursing and Health Area Technicians

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____________________________________
EESP. Roberta Nava Cruz
Unit Tutor

Dr. Carina Hernández Guzmán

Coordinator of Social Service of the Universidad Veracruzana

____________________________________
Anilu Ramirez del Angel.
Nursing Social Service Intern

XIV Photographic evidence.

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Health promotion on “ International day of action for women's health ” with the
beneficiaries of UMF No. 73 of the morning shift.

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Health promotion on “International Tuberculosis Day” with the beneficiaries of UMF No. 73
of the morning shift.

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Preparation of the altar for UMF N°73.

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Placement of badges alluding to the day of: “The international day of action for
women's health” and “Health week for older people.”

Start of National Health Week and mammography campaign.

XV Bibliography.

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Promotion 2019

1. World Health Organization. Obesity and overweight. Report of the Joint

WHO/FAO Committee of Experts on Diet, Nutrition and Prevention of Chronic
Diseases. [Internet] Geneva: WHO; 2003 [updated 2018; cited 14 Jul 2018].
Available at: http://www.who.int/topics/obesity/es/

2. Islas AS, Revilla M M. Diabetes mellitus: updates. [Internet]Mexico, DF

Bishop Publishing; 2013. [cited 14 Jul 2018]. Available at:
http://cvoed.imss.gob.mx/COED/home/normativos/DPM/archivos/coleccionmedicina
deexcelencia/18%20Diabetes%20mellitus-Actualaciones-Interiores.pdf

3. Tamayo y Orozco J, Lastirini Quirós H. Chronic kidney disease in Mexico.

CONACYT - National Council of Science and Technology [Internet]. 2019 [cited 13
July 2019];(1):81. Available from:
https://www.anmm.org.mx/publicaciones/ultimas_publicaciones/ENF-RENAL.pdf

4. Aldrete Velsco J, Chiquete E, Rodriguez Garcia J, Ricon Pebrero R, Correa

Rotter R, Peña Garcia R et al. Pena Garcia. [Internet]. 2019 [cited 13 July 2019];(4).
Available from:
https://www.medigraphic.com/pdfs/medintmex/mim-2018/mim184d.pdf

Autonomous University of Mexico [Internet] Mexico; 2016 [updated Jul 31, 2017;
cited 12 Jul 2018]. Available at: http://www.dgoserver.unam.mx/portaldgose/servicio-
social/htmls/ss-universitario/ssu-definicion.html

Lopez Zavala Professional ethics in university education, R. (2019). Professional

ethics in university education. scielo , [Internet] (142), p.1. Available at:
http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-
26982013000400017Rodrigo [Accessed 13 Jul. 2019].

Mexican Official Standard Project NOM-038-SSA3-2016, Health Education. DOF

Official Gazette of the Federation . [Internet] Available at:
http://www.dof.gob.mx/nota_detalle.php?codigo=5354092&fecha=28/07/2014
[revised 13 Jul. 2019].

Official Mexican Standard NOM-009-SSA3-2013, Health Education. DOF Official

Gazette of the Federation [Internet] available at:
https://www.gob.mx/cms/uploads/attachment/file/35880/NOM-009-SSA3-2013.pdf
[Revised Jul 13. 2019].

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