Chapter 16: School Health WASH (water, sanitation and hygiene)

• Prevention of communicable diseases

Historical Development of School Health • Use of traditional and alternative health
Programs care in the management of common
• School nursing is a specialized practice health conditions
of professional nursing that advances • Oral hygiene
the well-being, academic success, and
lifelong achievement of students (NASN) • Injury prevention and developing safety
conscious behavior
• First school health program required by
law consisted mostly of school health • Tobacco use
services with the passage of R.A. 124 in • Substance Abuse
1947
• HIV/AIDS and other sexually-transmitted
• Redesigned Approach in School Health
Infections
Nursing (RASHN), officially adopted
B. Physical Education
through DECS Memorandum No. 37,
series 1991 • Habits in childhood are likely to continue
into adulthood, making it imperative that
• Integrated School Health and Nutrition
children are taught the importance of
Program (ISHNP): designed to maintain
being physically active at a young age
and improve the health of school
children by preventing diseases and by C. Health Services
promoting health-related knowledge,
a) Health Screening
skills and practices (DepEd Order No. 43,
s. 2011). Annual individual health assessment
Height and weight measurement
School Health Services Rapid classroom inspection
School Health Programs (SHPs) cover:
1. School health services, b) Emergency Care
2. School health education, and c) Management of Acute and
3. A healthy school environment to include Chronic Conditions
both physical and psychosocial aspects d) Appropriate Referrals
of environment
e) Regular Deworming
4. Health promotion for school personnel,
• Student Records
5. School-community projects and
outreach, – Student health records should be
afforded the same level of confidentiality
6. Nutrition and food safety,
as that given to clients and patients in
7. Physical education and recreation, and other settings
8. Mental health, counseling, and social D. Nutrition
support. • School-Based Feeding Program (SBFP)
aims to rehabilitate at least 70% of the
Topics for Health Education more than 560,000 identified severely
A. Health Education wasted school children to normal
nutritional status at the end of 100-120
• Health education activities are
feeding days; and increase attendance
culture-sensitive and based on the
by 85-100%
identified educational needs of the
target population a) Eating Disorders
• Also include life skills education and staff b) Obesity
education through training and c) Nutritional Education
development of school personnel (WHO, Programs
1997)
• Nutrition;
• Personal and oral hygiene, including
 E. Counseling, Psychological and Social Service offers a Teachers' Health Welfare
Services Enhancement Program
• Children and teens often struggle with – school health personnel conduct
depression, substance abuse, conduct health examination and health
disorders, self-esteem, suicide ideation, profiling of all teachers and
eating disorders, and under- or non-teaching personnel
overachievement
• The school nurse may help the child Family and Community Involvement
learn how to solve problems, how to cope, • School nurses are often asked to provide
and how to build self-esteem. health content to family, parents, and the
community on a variety of topics, such as
• Psycho-Social Intervention Project: allows sexuality, STIs, HIV, communicable
training of other school personnel on diseases, and substance abuse
crisis management especially in war-torn
and calamity-stricken areas • Health education in the community
should consist of programs that are
F. Healthy School Environment designed to positively influence parents,
staff, and others in matters related to
• The school environment should consist health.
of (WHO, 1997):
– A physical, psychological, and School Nursing Practice
social environment that is • School nursing is a specialty unto itself.
developmentally oriented and
culturally appropriate, and that – prepared to work with
enables student to achieve their children of different ages and
potential; under highly variable
circumstances.
– A healthy organizational culture
within the school; and • School nurse's practice is relatively
independent and autonomous and is
– Productive interaction between the comprised of many roles
school and the community.
• The school setting is a perfect place to
conduct research and advocate for
Child Protection Policy health promotion
• Aims to ensure that school discipline is
administered in a manner consistent with
the child’s human dignity
Chapter 17: Occupational Health
• Includes:
– Consciousness raising, mobilization AAOHN Definition of
and education of students, parents, Occupational Health Nursing
teachers, LGUs and other • The specialty practice that focuses on
stakeholders in addressing child the promotion, prevention, and
abuse and bullying; restoration of health within the context of
– Development of a system of a safe and healthy environment. It
standard reporting of incidents of includes the prevention of adverse health
child abuse and bullying; effects from occupational and
environmental hazards. It provides for
– Advocacy campaign and and delivers occupational and
capability-building environmental health and safety
programs and services to clients.
Health Promotion for School Staff
• Staff that participate in health Occupational Health
promotion programs increase their Multidisciplinary Framework
health knowledge and positively change • Nursing
their attitudes and behaviors
• Medicine
• The Department of Health and Nutrition
• Toxicology
 • Industrial hygiene
• Epidemiology
• Business
• Social and Behavioral Sciences
• Environmental Health
• Ethico-Legal
Highlights of the History of
Occupational Health Nursing in the
Philippines
• November 11, 1950 : Ms. Magdalena
Valenzuela of the Department of Health
(DOH) instituted the Industrial Nursing
Unit (INU) of the Philippine Nurses
Association (PNA)
• Ms. Perla Gorres of the Philippine
Manufacturing Company (PMC) served as
the first chairperson
• Ms. Anita Santos of Jardine Davies was
elected as first president
• November 12, 1966: Passage of the
constitution and by-laws governing the
association paved way to the
modification in name to Occupational
Health Nurses Association of the
Philippines (OHNAP), Inc.
Occupational Health and Safety
Hazards
Biological-Infectious
• e.g.: hepatitis B infection among
nursing personnel
Chemical
• e.g.: acid burns among laboratory
workers
Enviro-mechanical
• e.g.: musculoskeletal disorders
among factory laborers
Physical
• e.g.: hearing loss among cement
factory workers
Psychosocial
• e.g.: anxiety reactions among
middle-level managers
Job Safety Analysis
• Observation and Walk-through Methods
• Review of Records
• Process and Equipment Reviews
• Chemical Inventories
• Interview
• Focused Group Discussions
• Surveys
Control of Occupational Hazards
• Administrative
• Engineering
• Materials Provision
Duties and Functions of
Occupational Health Nurses in the
Philippines
● In the absence of a physician, to
organize and administer a health service
program integrating occupational safety,
otherwise, these activities of the nurse
shall be in accordance with the
physician;
● Provide nursing care to injured or ill
workers;
● Participate in a health maintenance
examination. If a physician is not
available, to perform work activities
which are within the scope allowed by the
nursing profession, and if more extensive
examinations are needed, to refer the
same to a physician;
● Participate in the maintenance of
occupational health and safety by giving
suggestions in the improvement of
working environment affecting the health
and well-being of the workers; and
● Maintain a reporting and records system,
and, if a physician is not available,
prepare and submit an annual medical
report, using the prescribed form, to the
employer, as required by this standard.
- 1996 Amended Occupational Safety and
Health Standards
Levels of Preventive Care in
Occupational Health
• Primary
• Secondary
• Tertiary
Levels of Competence of
 Occupational Health Nurses
• Competent
• Proficient
• Expert
Nine Areas of Competence of
Occupational Health Nurses
• Clinical and Primary Care
• Case Management
• Workforce, Workplace, and Environmental
Issues
• Legal and Ethical Responsibilities
• Management and Administration
• Health Promotion and Disease Prevention
• Health and Safety Education
• Research
• Professionalism
Overview of the Philippine Labor Code
• Working Conditions and Rest Periods
• Medical, Dental, and Occupational
Safety
• Compensation
• Working Conditions for Special Groups of
Employees
Confidentiality of Employee Health
Information
AAOHN identifies three "levels of
confidentiality" of health information:
• Level I relates to information required by
law
• Level II covers information that will assist
in management of human resources
• Level III focuses on "personal health
information" including non–job-related
health problems or health counseling
• Disclosure of Levels I and II information
to management should be allowed only
on a "need-to-know" basis, generally with
reference to workability status and
regulatory compliance.
• Disclosure of Level III information to
management and regulatory agencies
should only be allowed as required by law.
• Disclosure of Level III information to
health insurance providers should be
made only with appropriate written
authorization of the employee.
AAOHN Code of Ethics
(From American Association of
Occupational Health Nurses: The nurse
in industry, New York, 1976, AAOHN.)
• Occupational and environmental health
nurses provide health, wellness, safety,
and other related services to clients with
regard for human dignity and rights,
unrestricted by consideration of social or
economic status, personal attributes or
the nature of the health status.
• Occupational and environmental health
nurses, as licensed health care
professionals, accept obligations to
society as professional and responsible
members of the community.
• Occupational and environmental health
nurses strive to safeguard clients' rights
to privacy by protecting confidential
information and releasing information
only as required or permitted by law.
• Occupational and environmental health
nurses promote collaboration with other
professionals, community agencies, and
stakeholders in order to meet the health,
wellness, safety, and other related needs
of the client.
• Occupational and environmental health
nurses maintain individual competence
in nursing practice, based on scientific
knowledge, and recognize and accept
responsibility for individual judgments
and actions, while complying with
appropriate laws and regulations.
OHN Research Priorities
(From American Association of
Occupational Health Nurses: Research
priorities in occupational and
environmental health nursing, 2013)
• Effectiveness of primary health care
delivery at the worksite
• Effectiveness of health promotion
nursing intervention strategies
• Strategies that minimize work-related
adverse health outcomes (e.g.,
respiratory disease)
• Health effects resulting from
chemical exposure in the workplace
• Occupational hazards of health
care workers (e.g., latex allergy,
blood borne pathogens)
• Factors that influence worker
rehabilitation and return to work
• Effectiveness of ergonomic
strategies to reduce worker injury
and illness
• The nature and effects of stress and
workplace stressors on worker
health
• Health effects resulting from the
interaction between aging and
workplace hazards
• Evaluation of critical pathways to
effectively improve worker health
and safety and to enhance
maximum recovery and safe return
to work
• Evaluation of intervention
strategies to improve worker health
and safety
• Strategies for increasing
compliance with or motivating
workers to use personal protective
equipment
• Emergency/pandemic
preparedness in the workplace
• Impact of occupational health
nursing interventions on worker’s
compensation claims

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