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Healthcare Process Applied at the Family LEvel

Healthcare Process Applied at the Family LEvel

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Published by Christian Orense
For DLSHSI CRS BATCH 2015
For DLSHSI CRS BATCH 2015

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Categories:Types, School Work
Published by: Christian Orense on Sep 16, 2011
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01/06/2014

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HEALTH CARE PROCESS applied at the FAMILY LEVEL

HEALTH CARE PROCESS
1.  Family Assessment 2.  Planning for Family Health Care 3.  Implementation 4.  Evaluation

FAMILY HEALTH PROBLEMS
Are situations or conditions which interfere with the promotion & maintenance of health, and with recovery from illness and injury

FAMILY HEALTH PROBLEMS
ò 3 Classifications
ò Health Threats ò Health Deficits ò Foreseeable Crisis

HEALTH THREATS
Definition: Conditions that are conducive to disease, accidents, or failure to recognize one’s health potential

HEALTH THREATS
ò Family history of conditions/ diseases ò Threats of Cross infection from a communicable disease ò Family size beyond what family resources can adequately provide

HEALTH THREATS
ò Accident hazards ò Faulty/unhealthy eating habits ò Stress-provoking factors ò Poor environmental sanitation ò Unsanitary food handling and preparation

HEALTH THREATS
ò Unhealthy lifestyles ò Inherent personal characteristics ò Health Hx which may induce occurence of health deficit ò Lack of immunization ò Family disunity

HEALTH DEFICITS
Definition: Instances of failure in health maintenance

HEALTH DEFICITS
ò Illness states: diagnosed or undiagnosed ò Failure to thrive and develop according to normal rate ò Disability: congenital or from illness; transient or permanent

FORESEEABLE CRISIS
ò Definition: Anticipated periods of unusual demand on the individual/family in terms of adjustment and resources

FORESEEABLE CRISIS
ò Marriage ò Pregnancy, labor and delivery ò Parenthood ò Additional member: newborn or boarder ò Abortion

FORESEEABLE CRISIS
ò School entrance ò Adolescence ò Divorce or separation ò Menopause ò Death of family member ò Loss of job

FORESEEABLE CRISIS
ò Hospitalization ò Resettlement ò Illegitimacy

THE  INITIAL  DATABASE  

THE  INITIAL  DATABASE  
FAMILY  STRUCTURE  CHARACTERISTICS  AND  DYNAMICS   SOCIOECONOMIC  AND  CULTURAL  CHARACTERISTICS  

HOME  AND  ENVIRONMENT  ASSESSMENT  

HEALTH  STATUS  OF  EACH  MEMBER  

STATEMENT  OF  FAMILY  HEALTH  CONDITION  

1. Family Assessment

FAMILY  STRUCTURE  
COMPOSITION  AND  DEMOGRAPHIC  DATA   RELATIONSHIP  TO  THE  HEAD  OF  THE  FAMILY  AND   PLACE  OF  RESIDENCE   TYPE  OF  FAMILY   FAMILY  INTERACTION   DECISION  MAKING  PATTERNS  

EXAMPLE  

INITIAL DATA BASE a. Family Structure Composition 4 members; father, mother etc. Demographic data Name: Ali C. Cruz, Lia C. Cruz etc. Age: 55; 51; 20; 10 etc. Relationship The head of the family is their biological father and they own the residence.

b. Type of family Nuclear family c-d. Family interaction/decision making Family exhibits open communication among its members and decision making originates from the father. However, members are allowed to voice their concerns to refine a particular decision.

SOCIOECONOMIC  AND   CULTURAL  CHARACTERISTICS  
INCOME,  OCCUPATION,  PLACE  OF  WORK   EDUCATIONAL  ATTAINMENT   ETHNIC  AND  RELIGIOUS  BACKGROUND   SIGNIFICANT  OTHERS   FAMILY  RELATIONSHIP  TO  THE  COMMUNITY  

EXAMPLE  

E. SOCIOECONOMIC AND CULTURAL CHARACTERISTICS Occupation and income Father works as an architect and mother is employed as a sales clerk both for Ayala land. They earn 40,000-50,000 / month. Educational attainment Ali and Lia are both College graduates while sons are both highschool students.

Religious background All members are roman catholic Significant others Has grandmother living with them. Family’s relationship to community Family members only mingle with other community members during christmas parties. They have very limited knowledge of the community programs.

ò Home and environment ò Housing adequacy ò Sleeping arrangements ò Food storage ò Cooking facilities ò Water supply ò Presence of accident hazards ò Toilet and garbage disposal ò Availability of social, health, communication, and transportation

HOME  AND  ENVIRONMENT   ASSESSMENT  
Housing  adequacy   Sleeping  arrangements   Food  storage   Cooking  facilities   Water  supply   Presence  of  accident  hazards   Toilet  and  garbage  disposal    

HOME  AND  ENVIRONMENT   ASSESSMENT  
Availability  of  Social,   health,   communication,  and   transportation   services  

EXAMPLE  

F. HOME AND ENVIRONMENT ASSESSMENT Housing Lives in a 20 square meter, single detachment, bungalow type of house. Sleeping arrangments All members sleep in 1 room while grandmother sleeps on the other. Food storage/Cooking facilities Stores their food in a garbage basket and cooks using an electric stove.

F. HOME AND ENVIRONMENT ASSESSMENT Water supply Family relies on water delivery. They request every other day to fill their water tank of 1 gallon. Presence of hazards House corners present sharp edges of metal that can predispose a member to accidents or injuries. Electrical switches are clogged with faulty wires. Toilet/garbage disposal Garbage truck picks it once a year.

HEALTH  STATUS  OF   EACH  MEMBER  
PAST/CURRENT  ILLNESS   BELIEFS  AND  PRACTICES   NUTRITIONAL/DEVELOPMENTAL  STATUS   DECISION  MAKING  

NOTE:
 *Health Status
 Should be individualized for each member

EXAMPLE  

G. HEALTH STATUS OF MEMBERS Ali C. Cruz Past/Current illness ò ( +) Diabetes mellitus (1999; takes Biguanides once a day up until present) ò (+) Stage-3 HPN (2002; takes pindolol everytime BP rises up until present) ò (-) Fractures ò (-) Osteoporosis

ò  Beliefs and practices Client relies on his wife, Lia C. Cruz, to carry out the family’s medical beliefs and practices. ò  Nutritional status/decision making Client’s food consists of rice all meals as a source of carbohydrates. Protein source varies from eggs, beef and fish. Client does not eat fruits and vegetables and prefers protein-rich foods.

ò Values and principles on health promotion and maintenance ò Preventive aspects ò Adequate rest, sleep, exercise and relaxation activites ò Stress management, utilization of health care facilities

g. Values on health promotion/maintenance - The family prevents impending illnesses by having a first aid and medicine kit at home. They do not exercise but aims to sleep at least 8 hours/day. They also go to the nearest massage center to relieve stress and does not avail of the barangay health care facilities.

Please  prepare  for  a  mid-­‐ lecture  quiz  

2. PLANNING FAMILY HEALTH CARE

REVIEW: Family Health Tasks
ò Recognizes signs of health and development ò Manages health and on-health crisis ò Provides health care ò Provides a conducive home environment ò Utilizes community resources for health care

STATEMENT OF FAMILY HEALTH CONDITIONS
capabilities to maintain health and prevent illness.
- A statement of family’s

FAMILY  HEALTH   CONDITION  
Ability  to  recognize  signs  of  health  and  development   Ability  to  manage  health  and  non-­‐health  crisis   Ability  to  provide  healthcare   Ability  to  provide  conducive  home  environment   Ability  to  utilize  healthcare  resources  

Statement of family health conditions
- Based from the family assessment, it is clear that they are unable to recognize most health concerns as well as provide a home conducive to cleanliness and safety. However, the family demonstrated its ability to provide healthcare and manage a health crisis (minor cut) by utilizing their resources such as first aid and medical kits.

ò Familyʼ’s perception

Guidelines in Prioritizing Family Health Conditions

ò Significance of the condition ò Urgency of the condition ò Availability of resources

FORMULATING GOALS AND OBJECTIVES FOR HEALTH PROMOTION AND MAINTENANCE

Problems
1. Inability to provide cleanliness and safety in the home

Goals
- For the family members to promote and maintain a clean and safe home after 1 week.

Plan
- Removal of metal edges from walls. - Transfer of food to refrigerator. - Additional delivery of water.

3. IMPLEMENTING FAMILY HEALTH CARE

*NOTE: Practice clinical decision-making and apply only the interventions pertinent to a specific family.

ò Assisting Prenatal Care ò History & demographic data
ò LMP ò Hx of previous pregnancies: Nature of delivery ò Age in months

Assisting Prenatal Care ò SSx of pregnancy
EARLY
ò  Missed menstrual pregnancy ò  Frequent urination ò  Weight gain (1kg in the first 3 months)

ò Assisting Prenatal Care ò SSx of pregnancy
ò LATE
ò  Enlargement of the abdomen ò  Fetal movement ò  Fetal heartbeat ò  Gain 5 kg by the 2nd trimester

ò Assisting Prenatal Care ò Check-ups during Pregnancy
ò 1st 3 mos – every month ò 2nd 3 mos – every 2 weeks ò 3rd 3 mos - weekly

ò Assisting Prenatal Care ò Immunizations
ò  TT1 – anytime during pregnancy preferably during 1st 3 mos ò  TT2 - 1 mo. After TT1 ò  TT3 – 6 mos after TT2 ò  TT4 – 1 yr after TT3/next pregnancy (7 mos) ò  TT5 – 1 yr after TT4/next pregnancy (7 mos)

ò Assisting Prenatal Care ò Immunizations
ò Give TT 0.5 cc at the 6th and 7th month to woman who did not receive this before.

ò Avoid exposure to persons who have german measles, influenza, typhoid, and active polio.

ò Assisting Prenatal Care ò Nutrition
ò Eat foods rich in proteins, vitamins and minerals, especially iron and calcium. ò Drink at least 8 glasses of water/day. ò Avoid too much sweets, as well as salty foods

ò Assisting Prenatal Care ò Personal Habits
ò Take a bath daily but avoid chilling. ò Wear comfortable loose clothing ò Use low-heeled, comfortable footwear. ò Maintain regular bowel movements. ò Eat plenty of fruits and vegetables. ò Give extra care to teeth. ò No smoking/drinking alcoholic beverages

ò Assisting Prenatal Care ò Others
ò  Sexual Intercourse - not contraindicated ò  Travel – Caution against long distance land travel especially on rugged terrain. ò  Medications – Take medicines only when necesssary and only upon doctorʼ’s advise. ò  Activities – Encourage walking and usual household activities that do not overstrain

ò Care of Newborn ò Breastfeeding
ò Advantages
ò  Protects baby against infection ò  Clean ò  Has the right temperature ò  Helps in child spacing ò  Safe-more easily digestes than cowʼ’s milk ò  Lower risk of getting breats CA (Mother) ò  Economical and convenient

ò Care of Newborn
ò Breastfeeding ò Supplementary feeding
ò When? ... Immediately after birth until 4-6 months
ò  When?... As early as 2 mos; should be gradual to detect allergies (fruit juices) ò  3-4 mos: meat broth, mashed sweet potatoes, fruits ò  5-7 mos: shredded meat, fish, soft rice ò  9 mos: regular diet

ò Care of Newborn ò Cord Care: care of the umbilical
cord which had been cut after delivery to prevent infection.
ò Apply 70% alcohol in a circular motion from inside to outside.

ò Bathing
ò When?... Daily with warm or tepid water in a place where there is no wind to prevent chilling

ò Care of Newborn ò Immunizations
ò Why?... For development of antibodies to fight against diseases

Vaccine   BCG   Route   Dose   Age     ID   0.05  mL  

DPT   IM   0.5  mL  

OPV   Oral   3  drops  

Measles   SQ   0.5  mL   9  mos  

Heapatitis   IM   0.5  mL   1.5,  2.5,  3.5   months  

Birth/ 1.5,  2.5,  3.5   1.5,  2.5,   anytime   months    not   3.5   school   after  5  y/o   months     entrance   not   after  5   y/o     Right   Deltoid   Thighs   Mouth  

Site  

Deltoid  

Thighs  

ò Parenting Resposibilities ò To each other ò To children
ò To society
ò Help in making a good community and bringing about good and just relationship ò love and support, helping in many ways ò love and support, shelter, education

ò Environmental Care & Sanitation ò Cleanliness in the home
ò Screen to protect food from insects ò Food containers should be wellsealed. ò Place stove near window so smoke gets out of the house. ò Hang pots, pans & ladles on the wall.

ò Environmental Care & Sanitation ò Cleanliness in the home
ò Wash plates and utensils with soap and water, and if possible, dry under the sun. ò Keep animals outside the house. ò Collect and dispose garbage. ò Kitchen and bathroom drainage should be coursed to a covered pit.

ò Environmental Care & Sanitation
ò Cleanliness in the home
ò Toilet should at least be 30 meters away from the nearest well. ò Water for home use must come from clean sources.

ò Backyard Sanitation
ò Keep animals tied or inside a pen, & clean up their manure regularly. ò Plant fruit trees, vegetables & medicinal plants.

ò Hygiene Measures
ò Eye care ò Oral Care ò Care of hands and feet ò Perineal care ò Daily baths

ò Proper Nutrition
ò Balanced Diet (Awareness of the Food groups) ò Avoid foods high in cholesterol, sugar and salt ò Proper food handling and preparation

ò Exercise, Rest and Sleep ò Exercise: daily or once to 3x/week ò Rest: daily! ò Sleep: 6-8 hours/day

ò Health Education
ò provides information, education & communication for the improvement of the familyʼ’s health condition

4. EVALUATION

Evaluation
- Measures the effectiveness, efficiency, appropriateness, and adequacy of the entire health care process.

ò Evaluation of Plan:
ò The plan may be evaluated based on standards and/or criteria.

ò Evaluation of Plan:
Standards
ò Desired achievable level of performance against which actual practices are compared

ò Evaluation of Plan:
Criteria
ò Statement of performance behavior and circumstances that explicitly describe what is implied by the goal

IN SUMMARY

TODAY  WE  HAVE   LEARNED    

..THAT  THE   HEALTHCARE  PROCESS   HAS  4  STEPS  NAMELY:    

..THAT  THERE  ARE  3   CLASSIFICATIONS  OF   HEALTH  PROBLEMS   DIFFERENTIATED  BY:  

..OF  THE  VARIOUS   SECTIONS  OF  THE   INITIAL  DATA  BASE   (SUCH  AS)  

..THAT  IMPLEMENTING   HEALTHCARE  INVOLVES  
PRE-­‐NATAL  CARE,  NEWBORN,  PARENTING   RESPONSIBILITIES,  AND  ENVIRONMENTAL  SANITATION  

…THAT  EVALUATION   MAY  BE  DONE  IN  TWO   WAYS  VIA?  

PLEASE  PREPARE  FOR  A   POSTLECTURE  QUIZ  

FIELD  WORK  

PLEASE  INTERVIEW  3   FAMILIES  IN  YOUR  AREA   USING  THE  GIVEN   ASSESSMENT  FORMS   (PLEASE  PHOTOCOPY)  

DOCUMENT  ONE   INTERVIEW  (AMONG   THE  THREE)  THROUGH   VIDEOGRAPHY  

ACCOMPLISHED  IN  A  CD   LABELED  WITH  NAME   AND  SECTION,  DEADLINE   ON  NEXT  HEALTHCARE   MEETING    

THE  COMMUNITY   EXPERIENCE  

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