COMMUNITY HEALTH NURSING REVIEWER

Lecturer: Ms, Rhea Mallari, RN, MAN
CO-PAR
422unity Organizing Participat4ry Acti4n Research

Community Organizing
Pr4cess by which health services, agencies, and pe4ple and 41 the pe4ple 41 the c422unity br4ught
t4gether t4:
4 Identi1y/learn their 4wn pr4ble2
4 Plan activities
4 Act 4n this basis
4 Evaluate

COMMUNITY ORGANIZING EMPHASIZE
Strengthening the c422unity 2e2bers capability in:
4 Pr4ble2 s4lving skills
And Necessary 14r sel1reliant devel4p2ent
4 Decisi4n 2aking skills

422unity Organizing pr4cess has s42e4ne plays the r4le 41 a 422unity Organizer

Roles and Responsibilities of a Community Health Nurse
Manager
Guide
Adv4cate
C44rdinat4r, 4unsel4r, hange Agent
Health are Pr4vider
Nurse Trainer
Researcher
Organizer
Leader
Educat4r Pri2ary r4le, Pri2ary resp4nsibilities pr424ti4n 41 health and preventi4n 41 illness
Supervis4r

Community Organizer
Pers4n wh4 24bilize:
Individual
Family Sick or Well
Community
T4 c42e t4gether in unity and c4llectively address given:
Issues
Needs
Problem
` assess by way of research

PARTICIPATORY ACTION RESEARCH
Is an investigati4n 4n problems and issues 41 the c422unity by way of research.
Representatives 41 c422unity participates in the actual research.
L4cal Researcher
Outside Researcher ÷ 422unity Health Nurse
Act as researchers the2selves, d4ing research 41 their 4wn pr4ble2.
The essential ele2ent 41 Participat4ry Acti4n Research is participati4n

Participatory Action Research Objectives:
4 T4 enc4urage c4nsci4usness 41 the su11ering
4 T4 e2p4wer pe4ple t4 deter2ine the cause 41 their 4wn pr4ble2
4 T4 analyze these pr4ble2
4 T4 devel4p c42petence 14r changing their 4wn situati4n
4 T4 act by the2selves in resp4nding t4 their 4wn pr4ble2s

Ideal participatory research process involves the community in all research aspect
1. Identi1icati4n 41 research pr4ble2
2. F4r2ulati4n 41 research design
3. Data gathering
4. Validati4n 41 research
5. Data presentati4n
6. Rec422endati4ns
7. Acti4n 41 activities

OPAR Phase/Pr4cess
Acc4rding t4 (Sister Ji2enez)

PRE ENTRY PHASE
At the NGO level
4 F4r2ulati4n 41 instituti4nal g4als, 4biectives and targets 14r the pr4gra2
4 Revisi4n 41 curriculu2
4 Training 41 1aculty i1 OPAR
4 44rdinate participati4n 41 4ther depart2ents within the instituti4n

At the community level
4 422unity c4nsultati4ns/dial4gues
4 Setting 41 issues related t4 site selecti4n
4 Devel4p2ent 41 criteria 14r site selecti4n
Criteria in selecting communitv
O Site 2ust be
epressed and underserved
Oppressed
P44r
Expl4ited
Struggling
O Area 2ust n4t have a seri4us peace and 4rder pr4ble2
O Willingness t4 be 4rganized
O 422unity needing health assistance
4 heck vital health statistic can deter2ine general health status
4 Malnutriti4n rate
4 Lack 41 health 1acility/health care pr4viders
O 4unterpart 41 the c422unity (supp4rt, c422it2ent, res4urces)
O Accessible t4 transp4rt and c422unicati4n
4 Site selecti4n
4 Preli2inary S4cial Investigati4n (PSI)
Identi1y c4ntact pers4n
Gather '4verview¨ 41 the de24graphic characteristics, health services and 1acilities 41 the
c422unity
4 Netw4rking with LGU`s, NGO`s and 4ther depart2ents

ENTRY PHASE
Integration with the c422unity 2ain 4biective: Gain Trust
First task c4urtesy call t4 the Brgy. aptain
Establish rapp4rt
* h4use calls
* i4ining t4 s4cial activities

I2bibe their li1estyle

I22erse y4ursel1

Live with the2

Reside 4n the area
* live in the center/24dest dwelling
Sensitizati4n 41 the c422unity s4cial preparati4n
In14r2ati4n ca2paign 4n health services
4ntinuing/deep social investigation
Pr4cess 41 c4llecting, c4llating, analyzing data t4 draw the clear picture 41
the c422unity
4re Gr4up 14r2ati4n (G)
4 4nsist 41 identi1ied p4tential leaders
haracteristics 41 a p4tential leaders
1. Respected c422unity 2e2bers
2. Resp4nsible/c422itted
3. Willing t4 w4rk 14r a desired change
4. Has g44d c422unicati4n skills
5. Has wide 'in1luence¨ t4 elite/p44r c422unity 2e2bers
O Sel1awareness and leadership training (SALT)
O 44rdinati4n with 4ther c422unity 4rganizati4n
4 Representing di11erent sect4rs 41 the c422unity
COMMUNITY IAGNOSIS/STUY PHASE
(research phase)
Selecti4n 41 the research tea2
Training 4n data c4llecti4n
Planning 14r the actual gathering 41 data
Data gathering
Training 4n data validati4n
422unity validati4n
Presentati4n 41 the c422unity study/diagn4sis and rec422endati4ns
Pri4ritizati4n 41 c422unity needs/pr4ble2s 14r acti4n

COMMUNITY ORGANIZATION/CAPABILITY BUILING PHASE
422unity 2eetings t4 drawup guidelines 14r the 4rganizati4n
Electi4n 41 411icer
Devel4p2ent 41 2anage2ent syste2s:
(Delineati4n 41 the R4les, Functi4n, and Task 41 O11icers)
Training 41 leaders
Tea2 building exercises t4 enhance c4hesiveness
Acti4nRe1lecti4nActi4nSessi4n

COMMUNITY ACTION PHASE
Organizati4n and training 41 BHW`s Village 4r Grassr44t W4rkers
PIME 41 health services
Pr4iect I2ple2entati4n/M4nit4ring and Evaluati4n (Pr4iect Manage2ent)
Res4urce 24bilizati4n
5 M`S
MANPOWER
MAHINE
MATERIAL
METHOD
MONEY
SPAE
Setting up 41 linkages/netw4rk/re1erral syste2

SUSTENANCE AN STRENGTHENING PHASE
F4r2ulati4n and rati1icati4n 41 c4nstituti4n and bylaws
Identi1icati4n and devel4p2ent 41 'sec4ndary¨ leaders
Setting up a 1inancing sche2e
4ntinuing educati4n and training 41 BHW`s
Devel4p2ent 41 l4ng ter2 c422unity health devel4p2ent plans
F4r2alizing linkages, netw4rks and re1erral syste2

TURNOVER/PHASE OUT
Trans1er 41 c422unity 4rganizer r4les and resp4nsibilities and d4cu2ents
subsequent 14ll4wup
OPAR 2ain g4al is t4 attain OMMUNITY DEVELOPMENT better quality li1e
` Basic needs are 2et
` Equal rights
` Sel1reliance
` Active participati4n
COMMUNITY HEALTH NURSING
De1initi4n:
WHO Health is a state 41 c42plete physical, 2ental and s4cial well being
M4dern 4ncept Health re1ers t4 4pti2u2 level 41 1uncti4ning 41 individual, 1a2ily, c422unity
OLOF is in1luence by the Ec4 Syste2
Eco System Factors
S4ci4ec4n42ic status
Educati4n
E2pl4y2ent
H4using
Hereditary 1act4r genetic
Health care delivery syste2
Activities and Behavi4r 2ag HL tay4
Manage Stress
Regular Exercise
4 n4t S24ke Pri4rity Message
Regular health checkup
Eat healthy 144ds
Weight l4ss
P4litical 1act4rs
Envir4n2ental 1act4rs
WHO special 1ield 41 nursing that c42bines:
4 Skills 41 nursing
4 Public health
4 S4cial assistance and 1uncti4ns

r. C. E. Winslow public health is a science and art 41 3 P`s
4 Pr424ti4n 41 health
4 Preventi4n 41 illness/hazards thr4ugh 4rganize c422unity e114rts
4 Pr4l4nging li1e
State2ent: 'every citizens has his BIRTHRIGHT 41 g44d health and l4ngevity¨

CHN according to r. Ruth Freeman
A service rendered by a pr41essi4nal nurse
4 T4 individuals, 1a2ily, c422unity and p4pulati4n gr4ups
4 At h42e
4 linics
4 Sch44ls
4 And w4rkplace

CHN subspecialty
Sch44l Health Nursing
Occupati4nal Health Nursing

CHN according to r. Maglaya
The utilizati4n 41 the nursing pr4cess in the di11erent levels 41 clientele, individual, 1a2ily, c422unity
and p4pulati4n gr4ups c4ncerned with the
Pr424ti4n 41 health
Preventi4n 41 disease
And isability and Rehabiliati4n

CHN as Field Of Nursing Practice
Hall2ark 41 HN is that it is P4pulati4n 4r AggregateF4cused
E2phasis 4n the i2p4rtance 41 the 'Greatest G44d 14r the Greatest Nu2ber¨
'G4al 41 i2pr4ving 422unity Health is realized thr4ugh interdisciplinary/2ulti e114rt¨

Philosophy of CHN r. Shetland
HN is based 4n the Worth and ignity of Man

Ultimate Goal of CHN
'T4 raise the level 41 health 41 the citizenry¨

Principles of CHN
Based 4n rec4gnized needs 41 the c422unity
Understand the 4biectives and p4licies 41 the agency
Family is the basic unit 41 service
Always available t4 all regardless 41 Race, reed and S4ci4ec4n42ic status
Use available c422unity health res4urce
Indigen4us res4urce
4 Dried pr4teins
P4unded Dilis
P4unded Shri2p
P4unded M4ngg4
Rec4rd and rep4rt data accurately research/legal
Health teaching is pri2ary resp4nsibility
Evaluati4n 41 pr4gra2s
4ntinu4us pr41essi4nal gr4wth

CONCEPTS OF COMMUNITY HEALTH NURSING
Health pr424ti4n pri2ary resp4nsibility
Generalist never Specialist
P4pulati4n is the 2ain 14cus
Individual, Fa2ily, 422unity including Population Group Pregnant, Newb4rn, Elderly, Y4uth

SlLuaLlonal
analvsls
Coal/Cb[ecLlve
seLLlna
SLraLeav
seLLlna
LvaluLalon
Population Group th4se wh4 share a c4224n characteristics, devel4p2ental stages and c4224n
exp4sure t4 health pr4ble2s

422unity health nursing pr4cess is i2plicit in the practice 41 HN
Essence 41 nursing
Dyna2ic and cyclic pr4cess
Syste2ic appr4ach

CHN PROCESS
1. Assessment
4 Establishing rapp4rt
Greetings
Intr4duce sel1
4 4llecti4n 41 data/1acts/in14r2ati4n
METHOS TO COLLECT ATA
Interview
Rec4rds review Fa2ily Health Rec4rd
Physical assess2ent
Observati4n
iagn4stic exa2
4 Diagn4sis identi1icati4n 41 the client, 1a2ilies and c422unity needs based 4n the gathered data
. Planning
4 Pri4ritizing needs
Ranking and Scaling
O Nature 41 pr4ble2
O Preventive p4tential
O M4di1iability 41 the pr4ble2
O Salience percepti4n
4 Stating g4als and 4biective
4 G4al setting
4 Expected 4utc42e
4 Devel4ping para2eters evaluati4n pr4cess

THE PLANNING CYCLE/PROCESS











1. Situati4nal Analysis
Where are we n4w?
4 Gather, tabulate, analyze and interpret data
4 Identi1y the pr4ble2s/issues/needs

2. G4al and Obiective Setting
Where d4 y4u want t4 g4?
4 De1ine pr4gra2 g4als and 4biectives
4 Assign pri4rites a24ng 4biectives

3. Strategy and Activity Settings
H4w d4 we get there?
4 Design HN pr4gra2s
4 Ascertain res4urces
4 Analyze c4nstraints and li2itati4ns

4. Evaluati4n
H4w d4 we kn4w we are there?
4 Speci1y criteria and standards
4 Deter2ine 4utc42es

HOME VISIT (sh4uld always have: PURPOSE and OBJETIVE)
Is a pr41essi4nal 1ace t4 1ace c4ntact d4ne by the nurse t4 the 1a2ily
Fact4rs A11ecting Frequency 41 H42e Visits
4 Physical/psych4l4gical and educati4nal needs
4 Acceptance 41 the 1a2ily (PRIORITY NEES)
4 P4licy 41 a given agency
Steps during H42e Visit
1. Greetings/Intr4duce Sel1
2. Stating purp4se and 4biective
Pri4rities during H42e Visit
1. Newb4rn (FIRST)
2. P4stPartu2
3. Pregnant 24ther
4. M4rbid individual (LAST)

PUBLIC HEALTH BAG
Is an essential and indispensable equip2ent 41 the Public Health Nurse used during h42e visit

BAG TECHNIQUE
A t44l 2aking use 41 a Public Health Bag and which the Public Nurse can per14r2 pr4cedures during
h42e visits

Rationale in the use of PHN BAG
4 Technique during H42e Visit:
'It help render e11ective nursing care¨
Principle of Bag Technique
1. Mini2ize i1 n4t t4tally prevent the spread 41 in1ecti4n
2. Save ti2e and e114rt
3. N4t t4 4vershad4w the c4ncern 41 the client and 1a2ily
BP apparatus, steth4sc4pe and u2brella are carried separately

SPECIAL CONSIERATIONS
Bag and its c4ntents 2ust be 1ree 1r42 any c4nta2inati4n
Always d4 hand washing
Gather necessary equip2ent`s t4 render Nursing are
Place waste bag, paper lining 4utside

SOLUTION
1. Benedict s4luti4n 14r sugar detecti4n
2. Acetic acid s4luti4n 14r albu2in detecti4n
3. ephira2 s4luti4n s4aking s4luti4n
4. Alc4h4l, Betadine
5. A224nia

LEVELs of CLIENTELE
Individual. Family. Community. Population Group Sick 4r Well

LEVELS OF PRIMARY HEALTH FACILITY
PRIMARY - lient in Fair health and with early sy2pt42s 41 illness
4 Barangay Health enter (BHC), ity Health O11ice (CHO), Municipal Health O11ice (MHO),
Lyingin linics, Puericulture enter, 422unity H4spitals
SECONARY Patient in sy2pt42atic stage 41 an illness and requires 24derately specialized
kn4wledge/1acilities
4 Pr4vincial H4spitals, District H4spitals, Municipal H4spitals, E2ergency H4spitals
TERTIARY Patients seri4usly threaten and requires highly technical 1acilities and kn4wledge
4 Nati4nal H4spitals, Teaching/Training H4spitals, Regi4nal H4spitals
(SPEIALTY HOSPITALS)

TYPES OF PRIMARY HEALTH CARE WORKERS
1. Village/Grassr44t w4rkers Trained hil4ts
4 Trained individuals
BHW, TBA, Trained hil4t, Trained Dentist, Trained Nutriti4nist
2. Inter2ediate Health are W4rkers
4 Pr41essi4nal Gr4ups
RH Physicians, RH Nurse, RH Midwi1e, RH Dentist, Medtech, Nutriti4nist, Sanitary
Inspect4r
Rati4 t4 P4pulati4n
4 1 Physician ÷ 20,000
4 1 Nurse ÷ 20,000
4 1 Med Tech ÷ 20,000
4 1 Sanitary Inspect4r ÷ 20,000
4 1 Dentist ÷ 50,000
4 1 Midwi1e ÷ 5,000

QUALIFICATIONS OF A COMMUNITY HEALTH NURSE
BASI REQUIREMENT
4 BSN
4 RN
4 MAN with P4siti4ns
Positions
1. Chief Nurse
4 BSN, RN, MAN
4 5yrs experience as 422unity Health Nurse
4 3yrs experience as Supervis4r
. Assistance Chief Nurse
4 5yrs experience as 422unity Health Nurse
4 2yrs experience as Supervis4r
. Regional Training Nurse
4 BSN, RN, MAN
4 6yrs experience as 422unity Health Nurse
4 3yrs experience as Train4r /Educat4r
. Regional Supervisor
4 BSN, RN, MAN
4 5yrs experience as 422unity Health Nurse
4 2yrs experience as Supervis4r
. Provincial Supervisor
4 BSN, RN, MAN
4 5yrs experience as 422unity Health Nurse
. Nurse Instructor
4 BSN, RN, MAN
4 3yrs experience as 422unity Health Nurse with teaching abilities
. Nursing Program Supervisor
4 BSN, RN, MAN
4 7yrs experience as 422unity Health Nurse with Training t4 DOH pr4gra2s

PRIMARY HEALTH CARE
Is an essential Health are based 4n practical and s4cially acceptable 2eth4ds and techn4l4gy
Made universally accessible t4 Individual, Fa2ily, 422unity
History of Public Health Care
WHAT: Al2a Ata 4n1erence
WHEN: Septe2ber 612, 1978
WHERE: Al2a Ata,USSR/Russia
WHO: WHO/Unice1
WHO: Dr. Diz4n/Dr. Villar
Public Health Nurse 2
Legal Basis: LOI 949
Signed by: Pres. Ferdinand Marc4s 4n Oct4ber 1979

GOAL OF PUBLIC HEALTH CARE
Health 14r all Filipin4s and health in the hands 41 the pe4ple by year 2020

MISSION
Strengthening the health syste2 wherein pe4ple will 2anage their 4wn health care

KEY/CORE STRATEGY
~PARTNERSHIP¨

PILLARS/CORNERSTONE OF PUBLIC HEALTH CARE
Supp4rt Mechanis2 2ad available
C422unity Participati4n Active
Appr4priate techn4l4gy
MultiSect4ral linkages

CHARACTERISTIC OF PUBLIC HEALTH CARE
Accessible/Available
C422unity Bases
A114rdable
Sustainable
Integral/I2p4rtant
Acceptable

VITAL HEALTH STATISTIC
Is the study 4n vital events such as BirthFertility
Deaths M4rtality
M4rbidity
Main Obiective: t4 deter2ine general health status 41 the c422unity

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