FAYE GLENN ABDELLAH
in the
➢Born in March 13, 1919 in New York City.
➢Finished her Basic Nursing Education as
Magna Cum
Laude in 1942 from Fitkin Memorial Hospital
School of
Nursing in Neptune, New Jersy.
➢Obtained her BSN degree in 1945, Master of
Arts in 1947, Doctor of Education in 1955 at
Teachers College of Columbia University.
➢The first nurse and first woman to serve as
DEPUTY SURGEON GENERAL of the US.
•Inducted into the US National Women’s Hall of
Fame in 2000 due to her contribution in the
field of Education and Nursing Research.
➢A Fellow and beneficiary of both National and
International Awards.
➢As retiree, she has written and discussed
more than 100 publications related to nursing
care, education for advanced practice in nursing
or nursing research.
• In 1960, she was profoundly influenced by the
desire to promote client-centered all-inclusive
nursing care, thus making the idea of nursing as
a true humanitarian service to individuals,
families and to society.
• Nursing is grounded as an art and science that
molds the attitude, intellectual capabilities,
technical know-how of the individual nurse into
the desire and capacity to assist people, sick or
well, and to deal with their needs.
• Nursing as a complete humanitarian service, it
includes the following:
✓Be acquainted with the nursing problems of
the pt.
✓Choose the definite courses of action to make
scope of relevant nursing principles.
✓Make available continuous care of the
individual’s entire health
needs.
✓Give continuous care to relieve pain and
discomfort and provide
immediate security for the individual.
✓Regulate the total nursing care plan to meet
the patient’s tailored
needs.
✓Serving the individual to become more self-
determining in achieving maintaining a heathy
state of mind and body.
✓Informing nursing personnel, family and
support system to
provide the individual act for oneself within
perceived limitations.
✓Facilitate the individual to adapt to limits and
emotional problems.
✓Team up with different allied health
professions in working with the diagram for
optimum health on local, state, national and
international levels.
✓Engaging in non-stop evaluation and research
to develop nursing techniques and to create
new techniques to serve the
health needs of different people.
❖Provision of continuous care of the
individual’s total health needs were eliminated
in 1973. The words continuous and total are
impossible to provide.
METAPARADIGM IN NURSING:
PERSON:
❖Classifies the beneficiary of care as
individuals.
❖Does not set standard limits on the nature
and essence of human beings.
❖The 21 nursing problems relate with
biological, psychological and social aspects of
individuals.
HEALTH:
The center and purpose of nursing services.
❖Healthy state of mind and body. She speaks
to a “Total health needs.
ENVIRONMENT:
❖ The idea of environment is included in
“planning for optimum health on local, state,
national, and international levels” She
elaborates her idea, the apex of nursing service
is the individual.
NURSING:
❖Is an all-inclusive service that is based on the
disciplines of art and science that serves
individuals, sick or well, cope with their health
needs.
ABDELLAH’S WORK UTILIZES THREE CHIEF
CONCEPTS:
1.Health Needs are seen as problems, which
maybe:
a. Overt – which is obvious or can be seen
condition.
b. Covert – which is an unseen or masked one.
- sometime attributed with emotions and
relationship in nature and often seen
incorrectly.
- in many instances covert problems may solve
the overt problems as well.
2. Nursing Problems is more in tune with
“nursing goals” and “nursing functions”.
Therefore, the focus of the theory is more
nursing-centered than client-centered. She re-
focused the role of the nurse from the disease
orientation to nursing orientation, but
maintaining the client as the main concern.
- all medicines and nursing practices help the
client, but the nurse must know where she can
excel well, and that is, on caring for the over all
needs of the patient.
3. PROBLEM SOLVING:
=medium for nursing problems as the client is
geared in the direction of health, which is the
outcome.
= this process includes:
a. Identifying the problem
b. Selecting relevant data
c. Devising hypotheses
d. Testing hypotheses through the
assortment of data
e. Revising hypotheses when necessary on
the basis of conclusion obtained from the
data.
TYPOLOGY OF TWENTY-ONE NURSING
PROBLEMS
1. To maintain good hygiene and physical
comfort.
2. To promote optimal activity, exercise, rest,
sleep.
3. To promote safely through prevention of
accidents, injury
or others.
4. To maintain good body mechanics, prevent
and correct
deformity.
5. To facilitate the maintenance of a supply of
oxygen to all
body cells.
6. To facilitate the maintenance of nutrition of
all
body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and
electrolytes balance.
9. To recognize the physiologic responses of the
body to
disease conditions – pathological, physiological,
and
compensatory.
10. To facilitate the maintenance of sensory
function.
11. To facilitate the maintenance of regulatory
mechanism and function.
12. To identify and accept positive and negative
expression, feelings and reactions.
13. To identify and accept interrelatedness of
emotions and organic illness.
14. To facilitate the maintenance of effective
verbal
and non- verbal communication.
15. To promote the development of productive
IPRs.
16. To create or maintain a therapeutic
environment.
17. To facilitate progress toward achievement
and
personal spiritual goals.
18. To facilitate awareness of self as an
individual with varying
physical, emotional, and developmental needs.
19. To accept the optimum possible goals in the
light of
limitations, physical and emotional.
20. To used community resources as an aid in
resolving problems arising from illness.
21. To understand the role of social problems as
influencing factors in the cause of illness.
❖The 21 Nursing Problems as an extensive
collection would give confidence to the
simplification of principles and a result, would:
• Guide care.
• Promote the development of the nurse’s
judgmental ability.
• Increase ability to use the theory in clinical
practice.
• Strengthen the usefulness of the nursing
problems
❖This 21 Nursing Problems is one of the
forerunners of the Nursing Diagnosis as
compiled ny the North American Nursing
Diagnosis Association { NANDA }
THE HEALTH REFERRAL SYSTEM
REFERRAL – is a set of activities undertaken by a  End – referral hospital, jointly
health care provider intervention or facility in serving a common population
response to its inability to provide the necessary
within a local geographic area
health intervention to satisfy patient’s need.
under the jurisdiction of more
REFERRAL SYSTEM – is one that ensures the than one local government.
continuity and complementation of health and
medical services.  ILHZ, as a form of inter-LGU
cooperation is established in
- It is comprehensive, encompassing promotive, order to better protect the
preventive, curative and rehabilitative care. public or collective health of
their community, assure the
- it engages all health facilities from the lowest constituents access to a
to the highest level. range of services necessary
to meet health care needs of
TWO- WAY REFERRAL – it involves movement of
individuals, and to manage
a patient from the health center of first contact their limited resources for
and the hospital at first level referral. When health more efficiently and
hospital intervention has been completed, the equitably.
patient is referred back to the health center.
 ILHZ provides a means for
consolidating health care
TYPES OF REFERRAL efforts. It does not only cover
Internal Referral – occur within the health government health services
but includes all other sectors
facility, from one health personnel to another.
involved in the delivery of
External Referral – is a movement of a patient health services like
from a health facility to another. community- based NGOs and
the private sector both local
A. Vertical Referral – where the patient referral and foreign.
may be from a lower to a higher level of health
COMPONENTS OF INTER-LOCAL HEALTH ZONE
facility or the other way around.

B. Horizontal Referral – where the patient is

referred between similar facilities in different
catchment areas.
INTER- LOCAL HEALTH ZONE
An ILHZ is defined to be:
• Any form or organized arrangement for
coordinating the operations of an array
and hierarchy of health providers and
facilities which typically includes
1. PEOPLE – WHO has described the
ideal population size of a health
district is between 100,000-
500,000. However, the number of
people may vary from zone to zone
especially when taking into
consideration the number of LGYs
that will decide to cooperate and
cluster.

 primary health providers 2. BOUNDARIES – clear boundaries

ILHZ establish accountability and
 Core referral hospital and
responsibility of health service
providers.
 3. HEALTH FACILITIES – RHUs, BHS and other
health facilities that decide to work together as
an integrated health system.
-District or Provincial Hospital serving as the
central referral hospital, make-up the health
facilities.
4. HEALTH WORKERS – who delivers
comprehensive services.
 DOH personnel's
 District and Provincial hospitals
 Rural Health Units
 Barangay Health Units
 Private Clinics
 Volunteer Health workers from NGOs
 Community Based Organizations
THE HEALTH CARE DELIVERY SYSTEM
• HEALTH SYSTEM – consist of all organizations,
people, and actions whose primary intent is
to promote, restore, or maintain health.
SIX BUILDING BLOCKS OR COMPONENTS OF A
HEALTH SYSTEM:
a. Health Service
b. Health workforce
c. Information
d. Medical products, vaccines and
technologies
e. Financing
f. Leadership & governance or
stewardship
PHILIPPINES HEALTH CARE DELIVERY SYSTEM
WHO – specialized agency of the United
Nations {UN} provides global leadership on
health matters.
PROVIDE HEALTH SERVICES:
 Government
 Private Sectors – for profit
 NGOs – nonprofit
National Level:
DOH- set direction by virtue of the
mandate of Local Gov’t { R.A. 7160 }
DOH – serves as the main governing body
of health service in the country.
- is the national agency mandated to lead
the health sector towards assuring quality
health care for all Filipinos. Provides
guidance & technical assistance to LGUs
through the Center for Health Dev. In each
17 regions.
Mission: Guarantee equitable, sustainable,
and quality health for all Filipinos.
Vision: A global leader for attaining better
health outcomes, competitive and
responsive health care system, and
equitable heal financing
 Local Government Units {LGUs} should
have an operating mechanism to meet the
priority needs and service requirements of
their communities.
 Nurse – is an essential member of the
health workforce in the country.
  Local Government Units {LGUs} should
have an understanding of the dynamic
relationships among its components in
order to work efficiently within the health
delivery system.
 a health facility that provides long term
 its role provide motivation to work despite
over-whelming odds.
LEVELS OF HEALTH CARE DELIVERY:
 Primary
 Secondary
 Tertiary
CLASSIFICATION OF HOSPITALS:
A. General Hospital – provides services for
all kinds of illness, injuries or deformities.
Services offered.
 Level I
 Level 2
 Level 3
B. Specialty Hospital – offers services for a
specific disease or condition or type of patient
such as children, elderly or women.
CLASSIFICATION OF OTHER HEALTH
FACILITIES:
1) Category A – Primary Care Facility
 first contact health care facility that offers
basic services including emergency services
and provision for normal deliveries.
a. Without in-patient beds like health
centers, out-patient clinics, and dental
clinics.
b. With in-patient beds- a short stay facility
where the patient spends on the average
of one or two days before discharge, like
infirmaries and birthing { lying in }
facilities.
2. Category B: Custodial Care Facility
care, including basic services like food
and shelter, to patients with chronic
conditions requiring ongoing health
and nursing care due to impairment
and a reduced degree of independence
in activities of daily living, and patient
in need of rehabilitation.
Examples: Psychiatric facilities,
Leprosaria, nursing homes.
3. Category C: Diagnostic/Therapeutic
Facility
 a facility for the examination of the
human body, specimens of the
human body for the diagnosis,
sometimes treatment of disease, or
water for drinking water analysis.
 The test covers the following phases
of examination:
 Preanalytical
 Analytical
 Postanalytical
this category is further classified into:
A. LABORATORY FACILITY:
 Clinical laboratory
 Blood service facility
 HIV testing laboratory
 Drug testing laboratory
 Newborn screening lab
 Drinking water analysis lab
 B. RADIOLOGIC FACILITY PROVIDING SERVICES RURAL HEALTH UNIT PERSONNEL:
such as: X- ray, CT Scan, MRI, Mammography &
 Municipal Health Officer or Rural Health
ultrasonography
Physician
C. NUCLEAR MEDICINE FACILITY  Public Health Nurse
 Rural Health Midwife
a facility regulated by the Phil. Nuclear  Rural Sanitation Inspector
Research Institute utilizing applications of
radioactive materials in the diagnosis,
treatment, or medical research, with the
exception of the use of sealed radiation
sources in radiotherapy as in internal
radiation therapy.
4. Category D: Specialized Outpatient
Facility
 a facility that performs highly specialized
procedures on an outpatient basis.
Examples:
 Dialysis Clinic
 Ambulatory Surgical Clinic
 Cancer Chemo-Therapeutic
Center/Clinic
 Cancer Radiation Facility
 Physical Medicine
 Rehabilitation Center/Clinic

RURAL HEALTH UNIT

 commonly known as a health center is
a primary level health facility in the
municipality.
 its focus is preventive and promotive
services and the supervision of BHSs
under DOH. Ratio of RHU: 20,000
population.

BARANGAY HEALTH STATION

 is the first contact health care facility that
offers basic services at the barangay level.
 a satellite station of RHU {DOH}.
 manned by volunteer barangay Health
workers under the supervision of Rural
Health Midwife.