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Subspecialties of CHN - To reduce child mortality rate

School of nursing - To combat HIV, AIDS malaria and other
Historical background: diseases
- First school health program – 1947 - To ensure environmental sustainability
RA124: HcN to provide for medical inspection
of children involved in private schools, Occupational Health Nursing
colleges, and universities in the Philippines. Article 23 of the United Nations Universal declaration of
- Physician for enrolment of 300 or more human Rights
(Bureau of health) “Everyone has the right to work, to free choice of
School Nursing employment, to just & favorable conditions of work”
- Specialized practice of professional nursing Promote occupational safety & health (OSH)
that advances the well being, academic, Department of Labor and Employment (DOLE) –
success, and life – long achievement of lead government agency on OSD
students OSH: promotion and maintenance of highest
Component of school health program degree of physical, mental and social well-being a workers
1. School Health Services in all occupation
2. School Health Education
3. Health School Environment Why health and safety?
4. Health promotion for school personnel The working environment
5. School community projects - Plays the crucial role in enhancing the potential
6. Nutrition and safety of the work force
7. Physical education and recreation - Is a leading competitiveness factor
8. Mental health counselling & social support Companies depend for their survival and expansion on a
Duties and responsibilities of school nurse: committee/workforce, thriving in a high-quality working
1. Facilities positive student responses to normal environment, with safe and healthy working conditions
development Occupational health concerns in the work place
2. Promote health and safety 1. Health Hazards – elements that can cause work
3. Intervene with actual and potential health related diseases to the worker
problems 2. Safety Hazards – unsafe conditions or unsafe acts
4. Provide case management services that significantly increase the risk of a worker to be
5. Actively collaborate with others to build student injured
and family capacity for adaptation, self-
management, self-advocacy and learning.
Redesigned Approach in School Health Nursing (RASHN) Category Exposures Health effects
DECS Memo No. 375. 1991
Based on the philosophy: Biological Blood/body Bacterial, fungal,
Academic performance determined by quality of fluids viral, infections
health of the population & community where they come (hepatitis B)
from. Chemical Solvents Headaches, CNI
dysfunction
Dep.Ed order no.43,s. 2011 strengthening the school Lead CNS disturbance
health & nutrition programs
- For the achievement of Education for all (EFA) Asbestos Asbestosis lung
and Millennium Development Goals (MDGS) disease
- Integrated School Health nutrition Program Acids
(ISHnP) Burns

ISHnP & EFA goals: Enviromechanica Static Back injuries

- To expand early childhood care l Postures
- To improve the quality of education
- To provide learning & life skills to young people Repetitive/
and adult forceful
- To eradicate extreme poverty and hunger exertions Musculoskeletal
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disorders - Establishment of appropriate support services
Shift work for occupational health
- Development of occupational health standards
Poorly Sleep disorders based on scientific risk assessment
matched - Development of human resources
furniture Strained muscles - Establishment of registration & data systems
- Strengthening of research
Slippery
floors Emerging Field of CHN in the Philippines
Injury Home health care
Hospice home care
Physical Electricity Electrocution
*Project EntrepreNurse
Noise Hearing less Faith Community Nursing or parish nursing

Radiation Reproductive effects Competing standards in CHN

and cancer 1. Safety and quality nursing care
2. Management of resources & environment
Lighting Headache and eye 3. Health education
strain, slips and falls 4. Legal responsibility
5. Ethicomoral responsibility
Vibration Raynaud’s disease 6. Personal & professional development
7. Quality improvement
Heat Heat exhaustion & 8. Research
heat stroke 9. Records management
Psychosocial Unhealthy Fatigue & burnout 10. Communication
stress 11. Collaboration & teamwork

Level
Work home Anxiety reactions 1
imbalance and a variety f\of Prim Prevention of problems
physical symptoms ary before they occur
prev
entio
Duties and functions of OH nurse: n
activi Early detection &
Rule:1965 OH CF the amended OSHS, DOLE, 1996 Level 2
ty intervention
1. Organizing and administering a health service secondary prevention
program integrating occupational safety in the activities Connection &
absence of physicians prevention of
2. Providing nursing care to injured or ill workers deterioration
Level 3
3. Participating in health maintenance examination of disease
4. Participating in the maintenance of OSH by quality tertiary prevention activities
state
suggestions in the work environment
5. Maintaining a reporting & record system
Theoretical foundations of CHN practice
WHO global strategy for occupational health for all (the
rays to health at work) General systems theory
Endorses the global strategy for occupational health for all Cleat is an open system, a set of interacting elements that
prospering the following major objectives for actions exchange energy, matter, or info. With the external
- Strengthening of international & national environment (kAtz & kahn, 1996)
policies for health at work; - Family has the basic structures that all open
- Proportion of a healthy work environment, systems have
healthy work practices & health at work. - Inputs – food, energy, information
- Strengthening of occupational health services - Thruputs – processing
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- Outputs – products that result from family’s 5. Interpersonal influence
processing. 6. Situational influence / options/ aesthetics
7. Commitment to a plan of actions
Social learning theory
People learn from one another & that learning is Transtheoretical Model
promoted by modeling or observing other people (Procheska, et.at.2008)
 The nurse applies this theory by: 1. Stages of change
1. Serving as a live model - Precontemplation
2. Using print or multimedia for health education - Contemplation
Health belief model (Rosentack) - Preparation
Key concepts: - Action
1. Perceived susceptibility - Maintenance
2. Perceived severity – (people usually go to the 2. Division balance
hospital if grabe na) - Pros – benefits of change
3. Perceived benefits (people only adopt something if - Cons – costs of behavior change
there is derived benefits like medical mission)
4. Perceived barriers (things that make people Precede – Proceed Model
difficult in avoiding resources (practicing what you Dr. Laurence Greene
taught them))(i.e religion, culture socio – economic - Model for community assessment, health
status) education planning & evaluation
5. Cues to action (verbalizing they need help) P - redisposing
6. Self – efficacy (can they do it or not) P - olicy
R - einforcing R - egulatory
Milio’s Framework for Prevention
(Nancy Milio) E - nabling O - rganizational
 Propositions L
1. Population health deficits result from deprivation C
and or excess critical health resources E E
2. Behaviors result from limited choices; these arise
from actual & perceived options available as well D E
as beliefs & expectations resulting from E
socialization, & experience D
3. Organizational decisions and policies dictate many
of the options available to individuals, population Predisposing factors – refer to peoples characteristics that
and influence choices motivate them towards health related behavior
4. Individual choices related to health promotion or Enabling factors – refer to conditions in people and
health damaging behaviors are influenced by environment that facilitate on impede health related
efforts to maximized value resources behavior
5. Alteration in patterns of behavior resulting from Reinforcing factors – refer to feedback given by supports
decision – making of a significant number of people person or groups resulting from the performance of the
in a population can result in social change health related behavior.
6. Without concurrent availability of alternative The nurse – client relationship in CHN practice
health – promoting options for investment of CHN nurse – primary role of care provider
personal resources, health education will be largely Client – recipient of care on consumer of nursing services
ineffective in changing behavior patterns Entry Points
Health promotion models (HPM) Individual level – patient coming to the health water
Explores many biopsychosocial factors that influence Family level – wife/mother/father (makes the decision)
individuals to pursue health promotion activities Group & community – formal & informal leaders
Variable:
1. Perceived benefit of action Characteristics of a desirable working relationships
2. Perceived behavior to action between a nurse & a client
3. Perceived self – efficiency 1. The nurse and client regard & accept each other as
4. Activity related affect partners in undertaking
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- The promotion of health, prevention of
disease, on the positive resolution of a health
or health relative problem that has been
identified
2. The relationship is bases on mutual trust or respect
- The nurses believes & trust in the clients
capacity to grow, develop improve or change
- The client trust the nurse’s motivations and
abilities to help him/her
3. The relationship is characterized by an open two –
way communication.
- From the nurse to the client, from client to the
nurse
- Vital information is shared in a manner
understandable to both parties
4. The relationship is nonjudgmental & rarely
coercion
5. The relationship is productive – it produces the
desired or intended results.
6. Encountered between the nurses & the client are
friendly, pleasant, harmonious, courteous, non-
stressful, and satisfying to both parties
Factors affecting the nurse – patient relationship
Nurse factors:
1. The nurse’s view of her job
2. The nurse’s view of the client/patient
3. The nurse’s lead of competence the depth &
breadth as her background knowledge, particularly
from the behavioral sciences, human relation skills
(attitudes & values)
4. Policies & Reward system of employing agency
5. The nurse’s conduct of her personal and
professional life & her image in the community
6. Certain personal attributes and qualities of the
nurse
Factors affecting the N – P relationship
Client factors
1. Culture, educational and socioeconomics
background
2. Previous experiences with nurses & other health
workers
3. Perception or image of the nurse by the public at
large
4. Role of community leaders
Developing & maintaining positive & effective working
relationships of clients
1. Treat all clients/patients equally with courtesy &
respect
- Do not play favoritism
- First come – first serve policy
- Rules and policies need to be applied to all
2. Use appropriate & proper communication &
consideration of the clients socio – cultural &
educational background, as well as age & gender
- Use languages & phrases the client will
understand
- Be courteous of the non – verbal and verbal
aspects of communication and their effects on
the client
3. Make the client feel safe in the relationship by
adopting & demonstrating a nonjudgmental
attitude, avoiding the inpusion of certain values
4. Try to help with feet expressed head first or what is
considered as a priority by the client
5. Be truthful or honest/ do not make false promises
or assurances
- Keep appointments made
6. Provide the best possible quality of nursing serving
in a given situation or circumstances with no –
shortcuts or grave errors of omission or
commission
- Do not appear hurried or make the client feel
you have no time for him
7. Lather health center which may be viewed as the
health tears “home” make each client feel
welcome and treat them like guest
- Minimize waiting time
- Show and express concern
8. As the family of group level, identify the influential
members as the formal & informal leaders in
specific groups