COMMUNITY HEALTH NURSING REVIEWER

Lecturer: Ms, Rhea Mallari, RN, MAN

CO-PAR
Community Organizing Participatory Action Research
Community Organizing
Process by which health services, agencies, and people and of the people of the community brought
together to:
o Identify/learn their own problem
o Plan activities
o Act on this basis
o Evaluate
COMMUNITY ORGANIZING EMPHASIZE
Strengthening the community members capability in:
o Problem solving skills
And
Necessary for self-reliant development
o Decision making skills
Community Organizing process has someone plays the role of a Community Organizer
Roles and Responsibilities of a Community Health Nurse
Manager
Guide
Advocate
Coordinator, Counselor, Change Agent
Health Care Provider
Nurse Trainer
Researcher
Organizer
Leader
Educator Primary role, Primary responsibilities promotion of health and prevention of illness
Supervisor
Community Organizer
Person who mobilize:
Individual
Family
Sick or Well
Community
To come together in unity and collectively address given:
Issues
Needs
Problem
* assess by way of research

PARTICIPATORY ACTION RESEARCH

Is an investigation on problems and issues of the community by way of research.
Representatives of community participates in the actual research.
Local Researcher
Outside Researcher = Community Health Nurse
Act as researchers themselves, doing research of their own problem.
The essential element of Participatory Action Research is participation
Participatory Action Research Objectives:
o To encourage consciousness of the suffering
o To empower people to determine the cause of their own problem
o To analyze these problem
o To develop competence for changing their own situation
o To act by themselves in responding to their own problems
Ideal participatory research process involves the community in all research aspect
1. Identification of research problem
2. Formulation of research design
3. Data gathering
4. Validation of research
5. Data presentation
6. Recommendations
7. Action of activities
COPAR Phase/Process
According to (Sister Jimenez)
PRE ENTRY PHASE
At the NGO level
o Formulation of institutional goals, objectives and targets for the program
o Revision of curriculum
o Training of faculty if CO-PAR
o Coordinate participation of other departments within the institution
At the community level
o Community consultations/dialogues
o Setting of issues related to site selection
o Development of criteria for site selection
Criteria in selecting community
Site must be
Depressed and underserved
Oppressed
Poor
Exploited
Struggling
Area must not have a serious peace and order problem
Willingness to be organized

Community needing health assistance

o Check vital health statistic can determine general health status
o Malnutrition rate
o Lack of health facility/health care providers
Counter-part of the community (support, commitment, resources)
Accessible to transport and communication

o Site selection
o Preliminary Social Investigation (PSI)
Identify contact person
Gather overview of the demographic characteristics, health services and facilities of the
community
o Networking with LGUs, NGOs and other departments
ENTRY PHASE
Integration with the community main objective: Gain Trust
First task courtesy call to the Brgy. Captain
Establish rapport
* house calls
* joining to social activities
Imbibe their lifestyle
Immerse yourself
Live with them
Reside on the area
* live in the center/modest dwelling
Sensitization of the community social preparation
Information campaign on health services
Continuing/deep social investigation
Process of collecting, collating, analyzing data to draw the clear picture of
the community
Core Group formation (CG)
o Consist of identified potential leaders
Characteristics of a potential leaders
1. Respected community members
2. Responsible/committed
3. Willing to work for a desired change
4. Has good communication skills
5. Has wide influence to elite/poor community members
Self-awareness and leadership training (SALT)
Coordination with other community organization
o Representing different sectors of the community
COMMUNITY DIAGNOSIS/STUDY PHASE
(research phase)
Selection of the research team
Training on data collection

Planning for the actual gathering of data

Data gathering
Training on data validation
Community validation
Presentation of the community study/diagnosis and recommendations
Prioritization of community needs/problems for action

COMMUNITY ORGANIZATION/CAPABILITY BUILDING PHASE

Community meetings to draw-up guidelines for the organization
Election of officer
Development of management systems:
(Delineation of the Roles, Function, and Task of Officers)
Training of leaders
Team building exercises to enhance cohesiveness
Action-Reflection-Action-Session
COMMUNITY ACTION PHASE
Organization and training of BHWs Village or Grassroot Workers
PIME of health services
Project Implementation/Monitoring and Evaluation (Project Management)
Resource mobilization
5 MS
MANPOWER
MACHINE
MATERIAL
METHOD
MONEY
SPACE
Setting up of linkages/network/referral system
SUSTENANCE AND STRENGTHENING PHASE
Formulation and ratification of constitution and by-laws
Identification and development of secondary leaders
Setting up a financing scheme
Continuing education and training of BHWs
Development of long term community health development plans
Formalizing linkages, networks and referral system
TURNOVER/PHASE OUT
Transfer of community organizer roles and responsibilities and documents
subsequent follow-up
CO-PAR main goal is to attain COMMUNITY DEVELOPMENT better quality life
* Basic needs are met
* Equal rights
* Self-reliance
* Active participation

COMMUNITY HEALTH NURSING

Definition:
WHO Health is a state of complete physical, mental and social well being
Modern Concept Health refers to optimum level of functioning of individual, family, community
OLOF is influence by the Eco System
Eco System Factors
Socio-economic status
Education
Employment
Housing
Hereditary factor genetic
Health care delivery system
Activities and Behavior mag HL tayo
Manage Stress
Regular Exercise
Do not Smoke Priority Message
Regular health check-up
Eat healthy foods
Weight loss
Political factors
Environmental factors
WHO special field of nursing that combines:
o Skills of nursing
o Public health
o Social assistance and functions
Dr. C. E. Winslow public health is a science and art of 3 Ps
o Promotion of health
o Prevention of illness/hazards
through organize community efforts
o Prolonging life
Statement: every citizens has his BIRTHRIGHT of good health and longevity
CHN according to Dr. Ruth Freeman
A service rendered by a professional nurse
o To individuals, family, community and population groups
o At home
o Clinics
o Schools
o And workplace
CHN subspecialty
School Health Nursing
Occupational Health Nursing
CHN according to Dr. Maglaya

 The utilization of the nursing process in the different levels of clientele, individual, family, community
and population groups concerned with the
Promotion of health
Prevention of disease
And Disability and Rehabiliation
CHN as Field Of Nursing Practice
Hallmark of CHN is that it is Population or Aggregate-Focused
Emphasis on the importance of the Greatest Good for the Greatest Number
Goal of improving Community Health is realized through interdisciplinary/multi effort
Philosophy of CHN Dr. Shetland
CHN is based on the Worth and Dignity of Man
Ultimate Goal of CHN
To raise the level of health of the citizenry
Principles of CHN
Based on recognized needs of the community
Understand the objectives and policies of the agency
Family is the basic unit of service
Always available to all regardless of Race, Creed and Socio-economic status
Use available community health resource
- Indigenous resource
o Dried proteins
Pounded Dilis
Pounded Shrimp
Pounded Monggo
Record and report data accurately research/legal
Health teaching is primary responsibility
Evaluation of programs
Continuous professional growth
CONCEPTS OF COMMUNITY HEALTH NURSING
Health promotion primary responsibility
Generalist never Specialist
Population is the main focus
Individual, Family, Community including Population Group Pregnant, Newborn, Elderly, Youth
Population Group those who share a common characteristics, developmental stages and common
exposure to health problems
Community health nursing process is implicit in the practice of CHN
Essence of nursing
Dynamic and cyclic process
Systemic approach

CHN PROCESS
1. Assessment
o Establishing rapport
Greetings
Introduce self
o Collection of data/facts/information
METHODS TO COLLECT DATA
Interview
Records review Family Health Record
Physical assessment
Observation
Diagnostic exam
o Diagnosis identification of the client, families and community needs based on the gathered data
2. Planning
o Prioritizing needs
Ranking and Scaling
Nature of problem
Preventive potential
Modifiability of the problem
Salience perception
o Stating goals and objective
o Goal setting
o Expected outcome
o Developing parameters evaluation process
THE PLANNING CYCLE/PROCESS

Evalutai
on

Situatio
nal
analysis

Strategy
setting

Goal/Objecti
ve setting

1. Situational Analysis
Where are we now?
o Gather, tabulate, analyze and interpret data
o Identify the problems/issues/needs
2. Goal and Objective Setting
Where do you want to go?
o Define program goals and objectives

o Assign priorites among objectives

3. Strategy and Activity Settings
How do we get there?
o Design CHN programs
o Ascertain resources
o Analyze constraints and limitations
4. Evaluation
How do we know we are there?
o Specify criteria and standards
o Determine outcomes
HOME VISIT (should always have: PURPOSE and OBJECTIVE)
Is a professional face to face contact done by the nurse to the family
Factors Affecting Frequency of Home Visits
o Physical/psychological and educational needs
o Acceptance of the family (PRIORITY NEEDS)
o Policy of a given agency
Steps during Home Visit
1. Greetings/Introduce Self
2. Stating purpose and objective
Priorities during Home Visit
1. Newborn (FIRST)
2. Post-Partum
3. Pregnant mother
4. Morbid individual (LAST)
PUBLIC HEALTH BAG
Is an essential and indispensable equipment of the Public Health Nurse used during home visit
BAG TECHNIQUE
A tool making use of a Public Health Bag and which the Public Nurse can perform procedures during
home visits
Rationale in the use of PHN BAG
o Technique during Home Visit:
It help render effective nursing care
Principle of Bag Technique
1. Minimize if not totally prevent the spread of infection
2. Save time and effort
3. Not to overshadow the concern of the client and family
BP apparatus, stethoscope and umbrella are carried separately
SPECIAL CONSIDERATIONS
Bag and its contents must be free from any contamination
Always do hand washing

Gather necessary equipments to render Nursing Care

Place waste bag, paper lining outside
SOLUTION
1. Benedict solution for sugar detection
2. Acetic acid solution for albumin detection
3. Zephiram solution soaking solution
4. Alcohol, Betadine
5. Ammonia
LEVELs of CLIENTELE
Individual, Family, Community, Population Group Sick or Well
LEVELS OF PRIMARY HEALTH FACILITY
PRIMARY Client in Fair health and with early symptoms of illness
o Barangay Health Center (BHC), City Health Office (CHO), Municipal Health Office (MHO),
Lying-in Clinics, Puericulture Center, Community Hospitals
SECONDARY Patient in symptomatic stage of an illness and requires moderately specialized
knowledge/facilities
o Provincial Hospitals, District Hospitals, Municipal Hospitals, Emergency Hospitals
TERTIARY Patients seriously threaten and requires highly technical facilities and knowledge
o National Hospitals, Teaching/Training Hospitals, Regional Hospitals
(SPECIALTY HOSPITALS)
2 TYPES OF PRIMARY HEALTH CARE WORKERS
1. Village/Grassroot workers Trained hilots
o Trained individuals
BHW, TBA, Trained hilot, Trained Dentist, Trained Nutritionist
2. Intermediate Health Care Workers
o Professional Groups
RH Physicians, RH Nurse, RH Midwife, RH Dentist, Medtech, Nutritionist, Sanitary
Inspector
Ratio to Population
o 1 Physician = 20,000
o 1 Nurse = 20,000
o 1 Med Tech = 20,000
o 1 Sanitary Inspector = 20,000
o 1 Dentist = 50,000
o 1 Midwife = 5,000
QUALIFICATIONS OF A COMMUNITY HEALTH NURSE
BASIC REQUIREMENT
o BSN
Public Health Nurse 2
o RN
o MAN with Positions
Positions
1. Chief Nurse

2.

3.

4.

5.

6.

7.

o BSN, RN, MAN

o 5yrs experience as Community Health Nurse
o 3yrs experience as Supervisor
Assistance Chief Nurse
o 5yrs experience as Community Health Nurse
o 2yrs experience as Supervisor
Regional Training Nurse
o BSN, RN, MAN
o 6yrs experience as Community Health Nurse
o 3yrs experience as Trainor /Educator
Regional Supervisor
o BSN, RN, MAN
o 5yrs experience as Community Health Nurse
o 2yrs experience as Supervisor
Provincial Supervisor
o BSN, RN, MAN
o 5yrs experience as Community Health Nurse
Nurse Instructor
o BSN, RN, MAN
o 3yrs experience as Community Health Nurse with teaching abilities
Nursing Program Supervisor
o BSN, RN, MAN
o 7yrs experience as Community Health Nurse with Training to DOH programs

PRIMARY HEALTH CARE

Is an essential Health Care based on practical and socially acceptable methods and technology
Made universally accessible to Individual, Family, Community
History of Public Health Care
WHAT: Alma Ata Conference
WHEN: September 6-12, 1978
WHERE: Alma Ata,USSR/Russia
WHO: WHO/Unicef
WHO: Dr. Dizon/Dr. Villar
Legal Basis: LOI 949
Signed by: Pres. Ferdinand Marcos on October 1979
GOAL OF PUBLIC HEALTH CARE
Health for all Filipinos and health in the hands of the people by year 2020
MISSION
Strengthening the health system wherein people will manage their own health care
KEY/CORE STRATEGY
PARTNERSHIP
PILLARS/CORNERSTONE OF PUBLIC HEALTH CARE
Support Mechanism mad available

Community Participation Active

Appropriate technology
Multi-Sectoral linkages
CHARACTERISTIC OF PUBLIC HEALTH CARE
Accessible/Available
Community Bases
Affordable
Sustainable
Integral/Important
Acceptable
VITAL HEALTH STATISTIC
Is the study on vital events such as Birth-Fertility
Deaths Mortality
Morbidity
Main Objective: to determine general health status of the community