MACAHILOS, Patricia Mae

BSN – 3
Semifinals Case Study: Community Health Nursing Intervention
In the intervention phase of Community Nursing Process, partnership and collaboration is
one of the tasks of a CHN to lessen the burden and provide a better financial sustainability in the
nursing intervention program. In the given community health problem, create an implementation
plan that contains on how the intervention will be made and identify who are the possible agency
(private or public) that you need to collaborate and partner with.
Note: Elaborate your answer in a step-by-step process and show some pictures of possible
scenarios in the intervention process that you will create.
Community Health Problems
1. High incidence of road accidents
• Road traffic deaths and serious injuries are to a great extent preventable, since the risk
of incurring injury in a crash is largely predictable and many counter measures, proven
to be effective, exist. Along with heart disease, cancer, and stroke, road traffic injuries
are a preventable public health concern that responds effectively to focused
interventions.
• Road deaths and injuries can be avoided. There are numerous good road safety
interventions available, and addressing the problem requires a comprehensive system
approach. To find a solution, this method should look at the entire traffic system,
including interactions between vehicles, road users, and road infrastructure.
▪ Vehicles
a. Vehicles that are well-maintained and have strong brakes, lighting, and
tires, for example, will reduce accidents.
b. Vehicles that are more than 10 years old and emit a lot of pollution
should be phased out.
c. Vehicles should be provided with seat belts and other necessary safety
provisions (like airbags).
▪ Condition of roads
a. Roads should be well-maintained, with road surfaces being resurfaced
and road safety signs being marked on a routine basis.
b. Pedestrians should have suitable walkways and pedestrian crossings at
crossroads.
c. Separate lanes should be provided for slow-moving and fast-moving
cars.
d. Roads and intersections should be wide and well-lit to provide for good
visibility.
▪ Human factor
a. Drivers can make a big difference in reducing accidents.
 b. The issuance of a driver's license should be solely based on the learners'
minimal proficiency obtained from recognized driving schools.
c. Distinct kinds of drivers should have different minimum qualifications.
d. All drivers should have had sufficient training and hold a valid driver's
license.
e. Educate drivers and the community at large about traffic regulations.
f. Drivers should have their eyesight and hearing checked on a regular
basis.
g. To prevent accidents, mandatory first-aid training, as well as health and
traffic education, should be required for the general population.
h. Indiscriminate honking to be avoided, except in emergency situations.
▪ Legislation
a. Two-wheelers must be required to wear helmets, while four-wheelers
must be required to wear seat belts.
b. The competent authorities should strictly enforce traffic rules.
c. The eradication of stray animals such as cattle, as well as encroachments
on footpaths and road margins, will allow for seamless traffic
movement.
d. To guarantee smooth flow of traffic, prevent haphazard parking of
automobiles on major routes and crossroads.
▪ Management of accident victims
a. The importance of the "Golden Hour" in providing proper treatment to
accident victims and preserving the lives of the injured should be
emphasized to both health professionals and the public.
b. On highways and busy roads, medical care and first-aid facilities should
be available.
c. Ambulances and trained health personnel are available to shift and
transport injured people to local hospitals for treatment.
d. Raising awareness among all sections of society about the importance
of treating accident victims with compassion and without fear in order
to reduce morbidity and death.
• Interventions that are mentioned above can only be performed in
collaboration/partnership with:
▪ Land Transportation Office (LTO) – Inspection and registration of motor
vehicles, issue of licenses and permits, enforcement of land transportation rules
and regulations, and adjudication of traffic matters are all part of the LTO's
responsibilities.
▪ Department of Public Works and Highways (DPWH) – In accordance with
national development objectives, the DPWH is currently responsible for the
planning, design, construction, and maintenance of infrastructure, including
national highways, flood control and water resources development systems, and
other public works.
▪ Department of Health (DOH) – It is the Philippines' primary health
organization. It is responsible for ensuring that all Filipinos have access to basic
public health services by providing high-quality health care and regulating
health-care providers.
▪ Metropolitan Manila Development Authority (MMDA) – It is intended to
improve traffic flow and save travel times by optimizing not only vehicular but
also human, goods, and service mobility.
▪ Local Government Unit (LGU) – It is in charge of providing direct and basic
services to the public as well as maintaining community peace and order.
▪ Land Transportation Franchising and Regulatory Board (LTFRB) – it is
responsible for promulgating, administering, enforcing, and monitoring
compliance of policies, laws, and regulations of public land transportation
services.
▪ Department of Transportation and Communications (DOTC) – It is the primary
government agency that is responsible of transportation and communications
system development and regulation.
▪ Municipal Disaster Risk Reduction and Management Office (MDRRMO) –
The primary objective of it is to ensure effective and efficient implementation
of civil protection program through an integrated, multi-sectoral and
community-based approach and strategies for the protection and preservation
of life, property and environment.

Source: The City Fix

 Source: PIARC Road Safety Manual

2. High morbidity rate of pulmonary TB

• The primary duty for preventing and controlling tuberculosis lies with state and
municipal health agencies. TB control, on the other hand, is a difficult task that
necessitates the cooperation of a wide range of people, organizations, and institutions
from both inside and beyond the public health sector.
• The public health sector plays an important role in TB control through planning,
coordinating, and evaluating TB control and prevention programs. This role requires
that state and local health departments focus and provide oversight on the following
critical elements:
▪ Planning and policy development;
▪ Contact investigation;
▪ Clinical and diagnostic services for patients with TB and their contacts;
▪ Training and education;
 ▪ Surveillance data and information management; and
▪ Monitoring and evaluation.
• Community health centers typically provide primary health-care services to
populations that encounter barriers to those services at other sites in the health-care
system, and include persons who are:
▪ Low-income and their families;
▪ Immigrants and refugees;
▪ Uninsured;
▪ Homeless; and
▪ Poor women and children.
• Patients at high risk for TB disease are frequently treated in emergency rooms or
community health centers for primary and emergency treatment. Community health
centers in particular inner-city regions, for example, may serve predominantly
homeless people, whereas centers in neighborhoods with high concentrations of certain
racial and ethnic groups may become the primary health-care providers for immigrants
and refugees. Newly arrived refugee families are routinely referred to community
health clinics for federally funded health screening services, which may include LTBI
testing and treatment. People who are experiencing signs of tuberculosis should seek
assessment and treatment from a coworker. Persons with symptoms of TB disease
might go first for evaluation and care to a community health center. For these reasons,
community health centers are a critical part of efforts to control and prevent TB disease,
and, therefore, need to perform the following tasks:
▪ Provide their medical staff with the skills and knowledge needed to conduct a
TB risk assessment of their clients, diagnose and initiate treatment for TB
disease, and diagnose and treat LTBI;
▪ Develop close working relationships with consultant physicians, hospitals, and
clinical laboratories;
▪ Develop close working relationships with the public health agency that serves
their jurisdiction;
▪ Arrange for reporting patients with suspected TB disease, ensuring availability
of diagnostic services (e.g., sputum smears for acid-fast bacilli, cultures for M.
tuberculosis, and chest radiographs), and providing consultation and referral of
patients for diagnosis, treatment, and hospitalization, as indicated;
▪ Understand federal and state programs that support screening, diagnostic, and
treatment services for patients at high risk and make prevention, diagnosis, and
treatment of TB disease a high priority;
▪ Educate patients about the personal and public health implications of TB
disease and LTBI, and motivate them to accept prevention and curative
services; and
▪ Establish recommended TB infection control practices to protect patients and
staff.
• Community-based organizations (CBOs) can be particularly effective in providing
information and education on TB disease to their constituencies. As part of the
 communities they serve, CBOs are often highly regarded, and their messages might be
accepted more positively than those delivered by the state and/or local health
department. Organizations providing services to populations at risk for TB disease
should perform the following tasks:
▪ Partner with the state and local public health TB program and medical care
providers from the community to facilitate access to diagnostic, treatment, and
prevention services for the target population;
▪ Become involved in support initiatives, such as state and local TB advisory
committees and coalitions; and
▪ Coordinate with public health agencies and educational institutions to develop
education programs that are tailored culturally and linguistically to their
populations.
• Interventions that are mentioned above can only be performed in
collaboration/partnership with:
▪ Department of Health (DOH) – It is the Philippines' primary health
organization. It is responsible for ensuring that all Filipinos have access to basic
public health services by providing high-quality health care and regulating
health-care providers.
▪ Municipal Health Office (MHO)
▪ Rural Health Unit (RHU) – serve as the main source of free basic healthcare for
rural communities.

Source: Britannica
3. Poor environmental and home sanitation
• Some environmental health risks are well-known, such as unsafe drinking water, poor
sanitation, indoor air pollution, infectious and noncommunicable diseases; others, such
as climate change and the built environment, are less well-known. The realization of
how much disease and ill health can be avoided by focusing on environmental risk
factors should bolster global efforts to promote adaptive preventive health measures
using all available policies, strategies, interventions, technology, and information.
• People's health would tremendously benefit from a shift in mindset that views the
environment as a crucial component of health protection. The environment should be
seen as a critical component of health protection and the elimination of health
inequities, and it should be prioritized in primary prevention. These prevention
strategies must be conceived and implemented holistically to be most effective and
sustainable, and action must be taken at all levels of government.
▪ Water safety planning (the management of water from the source to the tap);
domestic water treatment and safe storage) are examples of access to safe
drinking water.
▪ At important times, hand cleaning with soap is required (e.g. after toilet use and
before the preparation of food)
▪ Everyone should have access to hygiene education, as well as safe drinking
water and proper sanitation.
• Interventions that are mentioned above can only be performed in
collaboration/partnership with:
▪ Department of Environment and Natural Resources (DENR) – it is the
executive department of the Philippine government responsible for governing
and supervising the exploration, development, utilization, and conservation of
the country's natural resources.
▪ Department of Health (DOH) – It is the Philippines' primary health
organization. It is responsible for ensuring that all Filipinos have access to basic
public health services by providing high-quality health care and regulating
health-care providers.
▪ Municipal Health Office (MHO)
▪ Rural Health Unit (RHU) – serve as the main source of free basic healthcare for
rural communities.
Source: WASH Education and Training Resources Source: The Guardian

4. High incidence of dengue cases among school children

• Dengue is a disease that affects a wide range of people. This can range from
asymptomatic infection (when people are unaware they are infected) to severe flu-like
symptoms in those who are afflicted. Although rare, some persons get severe dengue,
which can result in a variety of consequences including severe bleeding, organ damage,
and plasma leakage.
• The proximity of mosquito vector breeding grounds to human settlement is a major risk
factor for dengue fever and other diseases transmitted by the Aedes mosquito. At the
moment, the primary technique for controlling or preventing dengue virus transmission
is to attack mosquito vectors. This can be done through:
▪ Prevention of mosquito breeding:
a. Preventing mosquitoes from accessing egg-laying habitats by
environmental management and modification;
b. Disposing of solid waste properly and removing artificial man-made
habitats that can hold water;
c. Covering, emptying and cleaning of domestic water storage containers
on a weekly basis;
d. Applying appropriate insecticides to water storage outdoor containers;
▪ Personal protection from mosquito bites:
a. Using of personal household protection measures, such as window
screens, repellents, insecticide treated materials, coils and vaporizers.
These measures must be observed during the day both inside and outside
 of the home (e.g.: at work/school) because the primary mosquito vectors
bites throughout the day;
b. Wearing clothing that minimizes skin exposure to mosquitoes is
advised;
▪ Community engagement:
a. Educating the community on the risks of mosquito-borne diseases;
b. Engaging with the community to improve participation and
mobilization for sustained vector control;
▪ Reactive vector control:
a. Emergency vector control measures such as applying insecticides as
space spraying during outbreaks may be used by health authorities;
▪ Active mosquito and virus surveillance:
a. Active monitoring and surveillance of vector abundance and species
composition should be carried out to determine effectiveness of control
interventions;
b. Prospectively monitor prevalence of virus in the mosquito population,
with active screening of sentinel mosquito collections;
▪ In addition, there is ongoing research amongst many groups of international
collaborators in search of novel tools and innovative strategies that will
contribute in global efforts to interrupt transmission of dengue, as well as other
mosquito-borne diseases.
• Interventions that are mentioned above can only be performed in
collaboration/partnership with:
▪ Department of Health (DOH) – It is the Philippines' primary health
organization. It is responsible for ensuring that all Filipinos have access to basic
public health services by providing high-quality health care and regulating
health-care providers.
▪ Municipal Health Office (MHO)
▪ Rural Health Unit (RHU) – serve as the main source of free basic healthcare for
rural communities.

Source: Lowy Institute Source: Los Angeles Times

References:

Chapter 4 Interventions - World Health Organization. (n.d.). Retrieved October 31, 2021, from
https://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/ch
apter4.pdf.

Chapter 8 Community Tuberculosis Control. (n.d.). Retrieved October 31, 2021, from
https://www.cdc.gov/tb/education/corecurr/pdf/chapter8.pdf.

Gopalakrishnan, S. (2012). A public health perspective of road traffic accidents. Journal of

Family Medicine and Primary Care, 1(2), 144. https://doi.org/10.4103/2249-4863.104987

Well-being and disease prevention by Improving Environment Management. Health Environment

Management. (n.d.). Retrieved October 31, 2021, from
https://www.greenfacts.org/en/health-environment-management/l-2/index.htm#0.

World Health Organization. (n.d.). Dengue and severe dengue. World Health Organization.
Retrieved October 31, 2021, from https://www.who.int/news-room/fact-
sheets/detail/dengue-and-severe-dengue.