UNIT V

MANAGEMENT OF RESOURCES

A. Records and Reports (FHSIS)

Field Health Service Information System (FHSIS)

It is a network of information, intended to address the short term needs of DOH and LGU
staff with managerial or supervisory functions in facilities and program areas. It monitors
health service delivery nationwide.

Ultimate Goal of a Health Information System

OBJECTIVE

To provide summary data of health service delivery and selected program

accomplishment indicators at the barangay, municipality/city and district, provincial,
regional and national levels

To provide data which when combined with data from other sources, can be used for
program monitoring and evaluation purposes.
 To provide standardized, facility-level data that can be assessed for more in depth
studies.

To minimize the recording and reporting burden at the service delivery level in order
to allow more time for patient care and promote studies.

IMPORTANCE OF FHSIS

• Helps local government determine public health priorities. Basis for monitoring and
evaluating health program implementation. Basis for planning, budgeting, logistics and
decision making at all levels. Source of data to detect unusual occurrence of a disease.
Needed to monitor health status of the community. Helps midwives following up clients.
Documentation of RHM/PHN day to day activities.

COMPONENT OF FHSIS

A. Individual Treatment Record (ITR) - it is the fundamental building block of foundation of

the Field Health Service Information System. This is a document form of piece of paper upon
which is recorded the date, name, address of patient, presenting symptoms or complaint of
the patient on consultation and the diagnosis (if available) treatment and date of patient.

B. Target Client List - it constitute the second building block of the FHSIS and are intended to
serve several purposes.

a. First is to plan and carry out patient care and delivery services. Such list will be
considerable value to midwives/nurses in monitoring service delivery to clients in
general and in particular to groups of patients identified as "target" or "eligible" for
one or another program of the department.

b. Second purpose of Target Client List is to facilitate the monitoring or supervision of

service delivery activities .

c. The third purpose is to report services delivered.

d. Fourth purpose is to provide clinic-level data base which can be assessed for
further studies .

Target Client List

1. Prenatal Care

2. Post Natal Care

3. List of Under 1 year Old Children

4. Family Planning
5. Sick Children

6. NTP TB Register

7. National Leprosy Program Form 2 Central Registration

Purpose of recording

a. Provides staff members administrators and not only members of the health team with the
documentations of the services that have been rendered and supply data that are essential
for planning and evaluation.

b. To provide the practitioner with data required for the application of (proposal)
professional services for the improvement of family's heath

c. Records are tool of communication between the health workers, family and other
development personnel

d. Effective health records show the health problems in the family and other health factors
that affect health, thus it is more than a standardized sheet or forms.

e. Records indicates plan for the future.

e It provides baseline data to estimate the long term changes related to health.

Purpose of reporting

a. Reports can be compiled daily, weekly, monthly, quarterly and annually.

b. It summarize the service of the agency

c. It shows the size and quantity of the service rendered.

e. To show the progress in reaching goal

f. It aids in planning

Identify ways and means on how to handle the vaccines and syringes

Vaccine Storage Temperatures Vaccines are fragile. They must be maintained at the
temperatures recommended by vaccine manufacturers and protected from light at every
link in the cold chain. Most live virus vaccines tolerate freezing temperatures, but
deteriorate rapidly after they are removed from storage. Inactivated vaccines can be
damaged by exposure to temperature fluctuations (e.g., extreme heat or freezing
temperatures). Potency can be adversely affected if vaccines are left out too long or exposed
to multiple temperature excursions (out-of-range temperatures) that can have a cumulative
negative effect. It is a good idea to post a sign on the front of the storage unit(s) indicating
which vaccines should be stored in the freezer and which should be stored in the
refrigerator.
Freezer

All varicella-containing vaccines should be stored in a continuously frozen state at the

manufacturer recommended freezer temperature until administration. All varicella-
containing vaccines (VAR, Varivax; ZOS, Zostavax; and MMRV, ProQuad) should be stored
between between -58°F and +5°F (-50°C and -15°C). The measles, mumps, rubella vaccine
(MMR) can be stored either in the freezer or the refrigerator. Storing MMR in the freezer
with MMRV may help prevent inadvertent storage of MMRV in the refrigerator.

Refrigerator

All inactivated vaccines require refrigerator storage temperatures between 35°F and 46°F
(2°C and 8°C), with a desired average temperature of 40°F (5°C). The following live
attenuated vaccines must also be kept at refrigerator temperature: influenza (LAIV,
FluMist); rotavirus (RV1, Rotarix and RV5, RotaTeq); typhoid (Ty21-A, Vivotif); and yellow
fever (YF-Vax). Review each manufacturer’s instruc - tions in the product information for
vaccine specific storage temperatures. Before reconstitution with diluent, all varicella-
containing vaccines can be stored at refrigerator temperature between 35°F and 46°F (2°C
and 8°C) for up to 72 continous hours. Contact the vaccine manufacturer and/or your local
or state immunization program for guidance before discarding any refrigerated varicella-
containing vaccine that cannot be used within 72 hours.

Storage and Handling Plans

A routine storage and handling plan provides guidelines for daily activities, such as:

■ ordering and accepting vaccine deliveries;

■ storing and handling vaccines;

■ managing inventory; and,

■ managing potentially compromised vaccines

Thermometers

Thermometers are a critical part of good storage and handling practice. The freezer and the
refrigerator unit or compartment should each have its own thermometer.

Temperature Monitoring

Regular temperature monitoring is vital to proper cold chain management. Temperatures in

both the freezer and refrigerator units should be read twice each day, once in the morning
and once before leaving at the end of the workday. A temperature log should be posted on
the door of the storage unit where the twice daily temperature readings are recorded.

Vaccine Placement and Labeling

 A storage unit should be big enough so that vaccines can be placed away from the
walls, coils, and vents in the part of the unit best able to maintain the constant,
required temperature.
 Vaccines should be kept in their original packaging with the lids in place until ready
for administration and stacked in rows with vaccine of the same type.
 Bins, baskets, or some other type of uncovered containers that allow for air
circulation can be used to organize the vaccines within the storage unit.
 There should be space between the vaccine stacks or containers
 Vaccines that must be reconstituted are shipped with diluent specific to that vaccine.
 Never store any diluent in the freezer because the vials are not designed for freezer
storage and could crack
 Each vaccine and diluent stack or container should be clearly labeled.

Vaccine Transport to Off-Site Clinics

If vaccine transportation to another location is required, it is critical that vaccine potency is

protected by maintaining the cold chain at all times.

When a multidose vial is used, Food and Drug Administration (FDA) regulations require that
it be used only by the provider’s office where it was first opened. A partially used vial may be
transported to or from off-site clinics operated by the same provider as long as the cold
chain is properly maintained.

Diluent should travel with its corresponding vaccine to ensure that there are always equal
numbers of vaccine vials and diluent vials for reconstitution.

Diluent should be trans - ported at room temperature or inside the same insulated cooled
container as the corresponding vaccine, according to manufacturer guidelines for each
diluent.

Vaccine Disposal

Unused vaccine and diluent doses may be returnable under certain circumstances.

Contact the vaccine supplier, which may be the immunization program or the vaccine
manufacturer, for specific policies regarding the disposition of unopened vials, expired vials,
unused doses, doses drawn but not administered, and potentially compromised vaccine due
to inappropriate storage conditions.

Proper handling of syringe

HANDLING AND DISPOSAL OPTIONS WHEN SYRINGES AND NEEDLES ARE NOT SEPARATED
A/ Collection of syringes with needles attached: WHO – UNICEF cardboard Safety boxes
These puncture and leak proof boxes are specifically designed to receive syringes with their
needles attached.

Puncture resistant plastic Safety boxes These plastic boxes are puncture resistant and
slightly more expensive than cardboard Safety boxes. Supplies might be more difficult to
find for small and medium-sized health care facilities. Should not be reused

For example, puncture and leak proof boxes or thick plastic containers that can be closed
can serve as adequate replacements. Open boxes, bleach bottles and thin plastic containers
are not appropriate. Any receptacles used for this purpose should be labelled as containing
hazardous sharps waste.

HANDLING AND DISPOSAL OPTIONS WHEN SYRINGES AND NEEDLES ARE SEPARATED

A/ Separation of needle and plastic syringe: „„„

Needles may be separated with a remover: Needle remover Immediately after injection, the
tip of the used syringe is placed in the needle remover and a lever pressed. A blade then cuts
the hub of the syringe so that the needle drop into a protective container.

It is therefore equally suitable for small and large-sized health-care facilities.. There should
always be one unit kept at the site of every injection session.

Disposable needle remover (or hub cutter) The disposable version of the needle remover is
a rigid plastic box specifically designed with a blade to cut the syringe at hub level The box is
then disposed along with the needles inside. Because it is compact and lightweight, it is well-
adapted for outreach use.

Note: WHO is currently not promoting needle removers; nevertheless, it is recognized that
the removal of needles immediately after injection offers advantages for the management of
waste disposal; therefore one should consider the risk-benefit of introducing such devices.

The FDA recommends a two-step process for properly disposing of used needles and other
sharps.
Step 1: Place all needles and other sharps in a sharps disposal container immediately
after they have been used.

Step 2: Dispose of used sharps disposal containers according to your community

guidelines.

DO NOT reuse sharps disposal containers.