Community Health Nursing: BSN 2-YA-15 - de Leon, Sydney - PRELIM REVIEWER - 2022

Community Health Nursing
BSN 2-YA-15 | De Leon, Sydney | PRELIM REVIEWER | 2022
Community Health Nursing Determinants of Health
What is a Community? Health is affected by combination of many

factors:
➢ A group of people with common
characteristics or interests living ➔ Environment and Circumstances
together within a territory or ➔ Income and Social Status
geographical boundary place where ➔ Employment and Working
people under usual conditions are Conditions
found. ➔ Education
➔ Physical Environment
Definition of Health ➔ Health Services
➔ Social Support Networks
WHO (World Health Organization) ➔ Personal Behavior and Coping Skills
➔ Culture
➢ State of COMPLETE WELL - ➔ Genetics
BEING. PHYSICAL, MENTAL & ➔ Gender
SOCIAL not merely an absence of
disease or infirmity. Public Health
MODERN DEFINITION OLOF (Optimum WINSLOW

Level of Functioning)
➢ A science & Art of Prevents Dse,
ECO-SYSTEM Promote health/efficiency, Prolong
life Organized
POLITICAL – Safety, Oppression, People
Empowerment COMMUNITY EFFORT FOR
BEHAVIOR – Culture, Habits, Ethnic
Customs ➔ sanitation env’t
HEREDITY – Genetic Endowment (Defect, ➔ control CD
Strengths, Risk) ➔ Education personal hygiene
HEALTH CARE DELIVERY SYSTEM – ➔ Organization of Medicine & Nrsg
Promotive, Preventive, Curative, Service
Rehabilitative ➔ For Early dx. & prev. tx of dse.
ENVIRONMENT – Air, Food, Water Waste, ➔ Devp of social machinery to ensure
Urban/Rural, Noise, Pollution, Radiation a STANDARD of ADEQ.
SOCIO-ECONOMIC – Employment, ➔ Living for MAINTENANCE of
Education, Housing HEALTH Enable EVERY CITIZEN to
realize BIRTHRIGHT of health &
longevity
➔ Enable EVERY CITIZEN to realize
BIRTHRIGHT of health & longevity
WHO DEFINITION of CHN by Dr. Ruth Freeman

➢ A SERVICE rendered by
➢ Art of applying science in the context PROFESSIONAL NURSE With the I,
of politics F, G & C At HOME, HC, CLINICS,
SCHOOLS, PLACES OF WORK For
Public Health is a CORE ELEMENT of the PROMOTION of HEALTH,
GOVERNMENT attempt to improve PREVENTION of ILLNESS, CARE
citizens welfare of SICK at home &
REHABILITATION
➔ ESSENTIAL public Health FXNS.
➔ Devp of policy in public health FOUR (4) LEVEL OF CLIENTELE
➔ Regulation to protect public 1. INDIVIDUAL
➔ Human Resource Dev. ➔ Unique
➔ Surveillance ➔ Sick or Well
➔ Research, innovative SOLN. ➔ “Entry Point”
➔ Ensure QUALITY health Service 2. FAMILY
➔ Health Promotion ➔ Group of person bound by
➔ Reduce INEQUALITIES blood marriage adoption
➔ Ensure BEST HEALTH for the ➔ “Unit of Service”
GREATEST number 3. COMMUNITY
➔ Group of persons sharing
Definition of Public Health Nursing same culture situated in
same geographical location
LILLIAN WALD (coined) ➔ Main Patient
➔ Director: Henry St. Settlement in ➔ Main Concern
New York 4. GROUP / POPULATION GROUP /
➔ Service that is AVAILABLE to ALL RISK GROUP
people ➔ Same Age Group
➔ “Public” Government Agency care of ➔ Same Characteristic
poor people ➔ Exposed to Same
Environmental Factor
NATIONAL LEAGUE OF PHIL GOV’T
NURSES (NLPGN) DEFINITION OF COMMUNITY HEALTH
➔ Practice of nrsg. In local/ national NURSING BY JACOBSON
gov’t health dept & public school ➔ Broader than PHN
➔ Position/Title/ Designation: (Civil ➔ Nursing Practice in a WIDE
Service Commission) VARIETY of SERVICES & consumer
➔ Public Health Nurse: (Nurses in advocate areas, variety ROLES,
Local/National Health Dept or public including INDEPENDENT
school) PRACTICE
➔ Diff. PHN & CHN is only ONE AREA ➔ Not confined in Public Health
setting of work as dictated by Nursing
FUNDING
Concepts of Community Health Nursing Unit of Service

➔ Family
FOCUS OF CARE
➔ HEALTH PROMOTION KNOWLEDGE USED
➔ No Knowledge will be obsolete
DURATION OF CARE Current, Updated
➔ Over a long period of time
EVALUATION
COVERAGE OF CARE ➔ Periodic
➔ ALL ages
➔ ALL types of health care PART OF HEALTH TEAM
➔ Care is for ALL (REGARDLESS of
race, creed, nationality & Philosophy - Worth and Dignity of Man
socio-economic, nationality) according to Dr. Margaret Shetland
WHO BENEFITS THE PUBLIC HEALTH NURSE

➔ Family, Community
Professional Qualifications:
KNOWLEDGE USED ➔ Licensed
➔ Current, Multi-disciplinary: (Biology,
Ecology, Social Science) Personal Qualifications:
➔ ”People skills”
GENERALIST IN TERMS OF PRACTICE ➔ Strength: Physical, mental &
APPLIES NURSING PROCESS IN TAKING emotional
ACTION ➔ Tested – Leadership,
resourcefulness, creative, honesty &
GOAL OF COMMUNITY HEALTH integrity
NURSING ➔ Difference – Interest, willingness
➔ Raise Level of Health (capacity to work w/ people)
PRINCIPLES OF CHN FUNCTIONS CONSISTENT W/

1. Nursing Law 2002
➔ Must fully understand objectives & 2. Program Policies of DOH
principles 3. Policies of Local Government Health
➔ Primary Responsibility: HEALTH Agency
TEACHING
➔ Care is based on RECOGNIZED COMPETENCIES SKILL & KNOWLEDGE
NEEDS of I, F & C 1. Nursing Process
➔ Resources of community (GO & 2. Nursing Procedure (home visit/clinic
NGO) must be fully utilized visit)
➔ There should be Accurate Record & 3. Community Organizing
Reporting 4. Health Promotion & Education
5. Surveillance, records & reports
Functions of Public Health Nursing (PHN) TRAINING FXN

➔ Initiate Staff Devp & training
NURSING CARE FXN program for Midwives & BHW
➔ Based on Science & Art of caring ➔ Training Needs Assessment (TNA)
Towards health PROMOTION & ➔ Design, conducts training w/
Dse. PREV : I, F & C resource person, Evaluate training
➔ Uses Nursing Process: Recognized ➔ Training of Nrsg & Midwifery
NEEDS of clients Affiliates (RLE)
➔ Home Visits: ➔ Community – “Community
Referral: Organizing”
➔ Other health provider
➔ Environmental health HEALTH PROMOTION & EDUCATION
➔ Social services FXN
Health Education
COLLABORATING & COORDINATING ➔ Basic Health Service
FXN ➔ Major Component of health program.
➔ Bring grp of activity in harmony w/ Done on a daily basis.
each other ➔ Solid knowledge of principles of
➔ PHN Care Coordinator - teaching/learning
➔ Linkages w/ As an educator – Provide info. better
➔ Gov’t agencies choices
➔ NGO ➔ Uses skills in ADVOCACY, influence
➔ Health professionals for health promotion
➔ Private sector
SUPERVISORY FUNCTION PHN
RESEARCH FXN ➔ Supervisor of midwives & auxiliary
➔ Activity – Disease Surveillance health workers
➔ Continuous collection & ➔ Formulate supervisory plan &
analysis of data of cases & conducts supervisory visit
deaths (supervisory checklist)
➔ Purpose of Disease Surveillance ➔ Identifies w/ supervisee issue
1. Measure Magnitude of / problem
problem ➔ Breach of procedure/
2. Measure effect of program – protocol coaching STAT
To improve strategies Training (needs further
“DATA WILL BE USED TO IMPROVE capacity enhancement)
CARE”
MANAGEMENT FUNCTION NURSE VI

➔ ”Nurse Program Supervisor”
5 Management Organizes nursing
Fxns to attain service – ➔ Conducts Program Orientation.
objective implement nursing ➔ Conducts pre-service & in-service
service plan as part orientation
(1) Planning of the overall ➔ Consolidate reports
(2) Organizing municipal health ➔ Study ratings of PHN performance
(3) Staffing plan ➔ Initiate meeting, conferences for joint
(4) Directing
(5) Controlling planning
(evaluation) ➔ Nursing consultant on technical
matters
Public Health Nurse

Laws Affecting Public Health Nursing
PHN II (Public Health Nurse II)

RA 6758
➔ Frontline Health Worker. First
➢ Standardized SALARIES of
Contact of pt. (Works in health
government employees (Nursing
center)
Personnel)
➔ Prime mover for all health programs
& activities
RA 7305
➔ Assist physician during consultation
Magna Carta of Public Health Workers
➔ Provides health education (pre/post
➢ Improved the social & economic
clinic visit)
well-being of health workers (Higher
➔ Reaches out in community
basic salary, hazard allowance,
➔ Organizes community assemblies
laundry allowance, subsistence
for health promotion
allowance)
➔ Performs Home Visits
➔ Prepare, submit reports (W, M, Q, A)
RA 6713
CODE OF CONDUCT & ETHICAL
PHN III (Public Health Nurse III)
STANDARDS FOR PUBLIC OFFICIALS &
➔ Acts as NURSE–IN–CHARGE
EMPLOYEES
➔ Supervises, guides, coordinates
➢ Utmost Responsibility, integrity,
work of nurse
competence, loyalty, lead modest
➔ Interpret policies, participate in
lives & uphold public interest over
planning health programs.
personal interest
NURSE V “Supervising PHN”

➔ Assigned in health center w/ lying-in
➔ Takes charge of staff & unit
➔ Participates in program planning
➔ Attends ,meeting, conference for
improvement of health services
➔ Evaluate performance of staff
Levels of Care TERTIARY LEVEL OF HEALTH CARE
PRIMARY LEVEL OF HEALTH CARE 1. REGIONAL HEALTH SERVICES

2. REGIONAL MEDICAL SERVICES &
1. Rural Health Unit (RHU) TRAINING HOSPITAL
2. Barangay Health Station (BHS) 3. NATIONAL HEALTH SERVICES
3. Puericulture Center 4. MEDICAL CENTERS
4. Clinics of large Industrial firms – 5. TEACHING & TRAINING HOSPITAL
employee
5. Private practitioners / private clinics ➔ ULTIMATE HIGHLY SPECIALIZED
and others HEALTH PERSONNEL HIGHLY
SPECIALIZED TECHNICAL LEVEL
➔ Basic level of health care SPECIALIZED ICU ADVANCED
➔ Promotion of health, early diagnosis DIAGNOSTIC SERVICES FOR
of dse or disability & prevention of DX,TX OF DSE & DISABILITY
dse.
➔ The FIRST CONTACT between
community members & other levels
of health facility
SECONDARY LEVEL OF HEALTH CARE
1. Emergency Hospital
2. District Hospital
3. Provincial Hospital
4. City Hospital
➔ Moderately specialized equipment &

laboratory facilities Capable of Minor
surgeries Referral Center for PHC
EVOLUTION: PUBLIC HEALTH NURSING Fajardo Act of 1912

IN THE PHILIPPINES ➔ Created Sanitary Divisions made up
of one to four municipalities.
➔ Each sanitary division had a
1577
President who had to be a physician.
➔ Franciscan Friar Juan Clemente
opened medical dispensary in
1915
Intramuros for the indigent
➔ Philippine General Hospital began to
extend public health nursing
1690
services in homes by organizing unit
➔ Dominican Father Juan de Pergero
called Social and Home Care
worked toward installing water
Services
system in San Juan Del Monte and
Manila
1905
Asociacion Feminista Filipina
1805
➔ La Gota de Leche was the first
➔ Smallpox vaccination was
center dedicated to the service of
introduced by Francisco de Balmis,
mothers and babies
a personal physician of King Charles
IV of Spain
Commonwealth Act No. 430 created
Department of Public Health and Welfare
1876
➔ First medicos titulares were
EO No. 317 (1941) - full implementation
appointed by the spanish
of Commonwealth Act No. 430
government
Dr. Jose Fabella - 1st Department

1888
Secretary of Health and Public Welfare
➔ 2-year courses consisting of
fundamental medical and dental
1947
subjects - first offered to UST
Post war
➔ Graduates was called “Cirujanos
➢ The Department of Health was
Ministrantes”
reorganized into bureaus.
➔ Serve as male nurses and sanitation
➔ Bureau of Hospitals and a
inspectors
Bureau of Quarantine was
created under DOH
1901
● Took charge of
United States Philippine Commission
municipal and charity
- Act 517, created Board of Health of
clinics
Philippine Islands with
➔ Bureau of Health with the
Commissioner of the Public Health,
sanitary divisions under it
as chief executive officer (now DOH)
➔ Bureau of Public Welfare
(became the Social Welfare
Administration)
➔ Curative (Bureau of Republic Act 7160 (LOCAL

Hospitals) GOVERNMENT CODE)
➔ Preventive care services (October 1994)
(Bureau of Health)
➔ Creation of Nursing Service ➔ DECENTRALIZATION of entire
Division government
➔ All structures, personnel and
1951 budgetary allocations from the
❖ Sanitary District was converted into provincial health level down to the
a Rural Health Unit barangays were DEVOLVED to the
❖ With 7 Basic Health Services: LOCAL GOVERNMENT UNIT (LGU)
Maternal and Child Health, to facilitate health service delivery.
Environmental Health, ➔ Delivery of Health Service - now the
Communicable Disease Control, responsibility of the LGU
Vital Statistics, Medical Care, Health ➔ DOH changed its role from one of
Education, and Public Health implementation to one of
Nursing governance.
❖ 81 selected provinces
Millennium Development Goals
RA 1082 or Rural Health Act (1954) ➔ Adopted during world summit in
➔ Creation of RHU in every September 2000
municipality
➔ Created post for Municipal Health 1. Eradicate Extreme Poverty and
Officer Hunger
2. Achieve Universal Primary
Restructured Health Care Delivery Education
System 3. Promote Gender Equality and
➔ (1970) Empower Women
➔ Classification of health services into: 4. Reduce Child Mortality
Primary, Secondary and Tertiary 5. Improve Maternal Health
Levels of Care 6. Combat HIV/AIDS, Malaria and
➔ PHN population ratio is 1: 20,000 other diseases
7. Ensure Environmental Sustainability
RA 1891 8. Global Partnership for Development
➔ In 1957 amend certain provisions in
Rural Health Act Created 8
categories of rural health units
corresponding to the population size
of the municipalities
FOURmula One (F1) for health, 2005 &

Universal Health Care in 2010 - agenda
launched in 1999
Health Service Delivery

➔ Both the national government and
LGUs manage the delivery of
promotive, preventive, curative
rehabilitative health services.
Health Governance and Regulation

➔ The enactment of LGC in 1991 led
to dual governance in health, with
the DOH governing at the national
level and the LGUs at the
subnational level.
Universal Health Care

➔ Aims to achieve the health system
goals of better health outcomes,
sustained health financing,
responsive health system that will
provide equitable access to health
care.
Universal Health Care Act Kalusugan

Pangkalahatan (Republic Act No. 11223)
➔ Automatically enrolls all Filipino
citizens in the National Health
Insurance Program
➔ Provide all Filipinos with
access to affordable, quality,
and comprehensive health
services.
Philippines Health Care Delivery System DOH - SPECIALTY HOSPITAL

➔ LUNG CENTER OF THE
The Philippines PHILIPPINES
➔ Archipelago with 7,100 islands ➔ NATIONAL KIDNEY AND
➔ Geographically, divided into 3 main TRANSPLANT INSTITUTE
islands: ➔ PHILIPPINE CHILDREN'S
➔ Luzon, Visayas and Mindanao MEDICAL CENTER
➔ PHILIPPINE HEART CENTER
There are:
➔ 17 regions, including the DOH - METRO MANILA HOSPITALS
Autonomous Region of Muslim ➔ AMANG RODRIGUEZ MEMORIAL
Mindanao (ARMM) MEDICAL CENTER
➔ 82 provinces ➔ DR. JOSE FABELLA MEMORIAL
➔ 135 cities HOSPITAL
➔ 1,493 municipalities ➔ EAST AVENUE MEDICAL CENTER
➔ JOSE R. REYES MEMORIAL
2 Sectors MEDICAL CENTER
Public Sector and Private Sector ➔ NATIONAL CENTER FOR MENTAL
HEALTH
Private Sector ➔ NATIONAL CHILDREN'S HOSPITAL
➔ production and provision of health ➔ E. RODRIGUEZ, QUEZON CITY
goods and services ( private clinics, ➔ PHILIPPINE ORTHOPEDIC
hospitals & laboratories, drugstores, CENTER
& other facilities) ➔ QUIRINO MEMORIAL MEDICAL
CENTER
Public Sector ➔ RESEARCH INSTITUTE FOR
➔ Decentralized health care system TROPICAL MEDICINE
➔ Department of Health (DoH) ➔ RIZAL MEDICAL CENTER
➔ Local government units (LGUs) ➔ SAN LAZARO HOSPITAL
➔ Devolving primary and secondary ➔ TONDO MEDICAL CENTER
health services delivery Local
government units (LGUs) DOH - REGIONAL HOSPITALS
➔ Managed, coordinated and regulated
by the DOH REGIONAL HOSPITALS IN CAGAYAN
➔ DOH - composed of Central Office VALLEY
➔ 17 Regional Offices (ROs) ➔ BATANES GENERAL HOSPITAL
➔ retained hospitals ➔ CAGAYAN VALLEY MEDICAL
RA 7160: Implementing Rules and CENTER
Regulation (IRR) of the Local ➔ SOUTHERN ISABELA GENERAL
Government Code of 1991 HOSPITAL
➔ Devolution of health services ➔ REGION II TRAUMAAND MEDICAL
➔ Decentralization of basic health CENTER
services
REGIONAL HOSPITALS IN NCR NEW CLASSIFICATIONS OF HOSPITALS

➔ DR. JOSE N. RODRIGUEZ & OTHER FACILITIES
MEMORIAL HOSPITAL -TALA,CAL. (According to Scope of Service)
CITY (According to Functional Capacity)
➔ LAS PIÑAS GENERAL HOSPITAL &
SATELLITE TRAUMA CENTER A. General Hospital
➔ SAN LORENZO RUIZ GENERAL ➔ Provides medical and
HOSPITAL surgical care to the sick and
➔ VALENZUELA MEDICAL CENTER injured and maternity care
and shall have as minimum.
LEVELS OF HEALTH CARE DELIVERY The following clinical
➔ Section 8 “Minimum Standards and services; Medicine,
Construction of a Hospital.”, Pediatrics, Obstetrics and
Republic Act No. 4226 (Hospital Gynecology, Surgery and
Licensure Law) categorized based Anesthesia, Emergency
on “service capacities and Services, Out-patient, and
compliance with standards for Ancillary Services.
manpower, equipment, construction B. Specialty Hospital
and physical activities. ➔ Specializes in a particular
disease or condition or in one
LEVELS OF HEALTH CARE type of patient.
● Primary Prevention HOSP. CLASSIFICATION SCHEME -

● Secondary Prevention GENERAL HOSP
● Tertiary Prevention Svcs for all types of illness, injuries or
deformities
NEW CLASSIFICATIONS OF HOSPITALS
& OTHER FACILITIES Categories of General Hospitals
(According to Ownership )
According to Functional Capacity
A. Government
➔ Created by law. May be General : Level 1
under DO, DND, DOJ, PNP, ➔ Consult: Medicine, Pedia, OB
LGU, SUCs, GOCC, and Gyn,Surgery
others. ➔ ER & OPD
B. Private ➔ Isolation Facility
➔ May be a single ➔ Surgical/ Maternity facilities
proprietorship, partnership, ➔ Dental Clinic
corporation, cooperative, - A staff of qualified medical, allied medical
foundation, religious, and administrative personnel
non-government organization - Headed by a physician duly licensed by
and others. the Professional Regulation Commission
(PRC);
General : Level 2 HOSP. CLASSIFICATION SCHEME -

➔ Level 1 plus SPECIALTY HOSP
➔ Departmentalized clinical svcs.
➔ Respiratory unit For specific dse, cond or type of patient
➔ General ICU ➔ particular disease
➔ High Risk Pregnancy Unit ➔ particular organ or groups of organs
➔ NICU ➔ particular group such as children,
- An organized staff of qualified and women, elderly and others
competent personnel with Chief of
Hospital/Medical Director and appropriate
board-certified Clinical Department Head
General : Level 3
➔ Level 2 plus
➔ Teaching/training w/ accredited
residency training program in 4
clinical srcv
➔ Physical Medicine & rehabilitation
unit
➔ Ambulatory surgical clinic
➔ Dialysis clinic
HEALTH FACILITIES CLASSIFICATION
- Teaching and/or training hospital with
accredited residency training program for
CAT. A / PRIMARY CARE FACILITY
physicians in the four (4) major specialties,
First contact health facility
namely:
➔ Without in-pt. h. ctrs, out pt clinic,
➔ Medicine
dental clinics
➔ Pediatrics
➔ With in-pt.- birthing (lying-in),
➔ Obstetrics and Gynecology
infirmary
➔ Surgery
CAT. B / CUSTODIAL CARE FACILITY

➔ Long-term care with food and shelter
to chronic condition needing needing
ongoing health & nursing care due to
impairment, reduce independence in
activities of daily living & rehab
➔ Ex. Custodial psychiatric
facilities, substance drug
abuse tx & rehab ctr, nursing
homes, leprosaria/ sanitaria
CAT. C / DIAGNOSTIC / THERAPEUTIC

FACILITY
Ex.
➔ Lab facility
➔ Radiologic facility
➔ For cancer dx- facility
CAT. D / SPECIALIZE OUTPATIENT

FACILITY
Ex.
➔ Dialysis clinic, ambulatory surgical, 1. DOH
cancer chemotherapeutic center/ ➔ Main governing body
clinic, radiation facility, physical ➔ Guidance/technical assistance to
medicine & rehab center/clinic LGU
➔ Center for Health Development
2. PROVINCIAL GOVERNMENT
➔ Administration of provincial or district
hospital
3. MUNICIPAL OR CITY GOVT
➔ In-charge of PHC (RHU/Health Ctr.)
(BHS)
➔ Plan, implement basic health
services (h. srvc.)
DOH ROLES AND FUNCTIONS:
Classification of Hospitals 1. Leadership in health

(According to Trauma Capability: Guidelines ➔ National policy & regulatory
Formulated by PCS) institution
➔ Leader in formulation,
A. Trauma-Capable Facility monitoring & evaluation of
➔ DOH licensed hospital national health policies
designated as a trauma ➔ Advocate adoption of health
center policies
2. Enabler and capacity builder
B. Trauma-Receiving Facility ➔ Innovate new strategies in
➔ DOH licensed hospital within health
the trauma service area ➔ Oversight function &
which receives trauma monitoring, evaluation of
patients for transport to the national health plan -
point of care or a trauma ➔ Ensure highest stand
center.
3. Administrator of specific services sympathy & benevolence for people in

➔ Manage selected national need.
health facilities
➔ Administer direct service for Commitment – With all our hearts & minds,
emergent concern the Dept. commits to achieve its vision for
➔ Administer health emergency health & development of future generations.
response services
Teamwork – DOH employees work together
Attached Agencies: The DOH – with a result- oriented mindset.
constituted of various central bureaus and
services in the Central Office, Centers for Stewardship of the health of the people –
Health Development (CHD) in every region, Being stewards of health for the people, the
and DOH retained hospitals Dept shall pursue sustainable development
& care for environment since it impinges on
Vision - Filipinos are among the healthiest the health of Filipinos
people in Southeast Asia by 2022 and Asia
by 2040 GOAL
Mission - To lead the country in the Health Sector Reform Agenda (HSRA)
development of a Productive, Resilient, - Health financing, health regulation,
Equitable, and People-centered health local health system, public health
system for Universal Health Care programs & hospital system
Core Values FRAMEWORK OF HSRA - FOURmula One

Professionalism - DOH performs its for Health Plus (F1 Plus)
functions in accordance with highest ethical
standards, principles of accountability, and 4 Pillars of F1 for Health
full responsibility.
1. Health Financing
Integrity – The Department believes in 2. Health Regulation
upholding truth & pursuing honesty, 3. Health Service Delivery
accountability & consistency in performing 4. Good Governance
its functions
Financing - Secure sustainable
Excellence – DOH continuously strives for investments to improve health outcomes
the best by fostering innovation, and ensure efficient and equitable use of
effectiveness & efficiency, pro-action, health resources
dynamism, and openness to change.
Service Delivery - Ensure accessibility of
Compassion & respect for human dignity – essential quality health services at
DOH upholds quality of life, respect for appropriate levels of care
human dignity is encouraged by working w/
Regulation - Ensure high quality and Goal 7 “Clean energy”

affordable health products, devices, Goal 11 “Sustainable cities and
facilities, and services communities”
Goal 13 “Climate action”
Governance - Strengthen leadership and Goal 16 “Peace, justice”
management capacities, coordination, and
support mechanisms necessary to ensure World Health Organization (WHO)
functional, people-centered and
participatory health systems ➔ A specialized agency of the United
Nations (UN) provides global
(Performance Accountability) - Use leadership on health matters
management systems to drive better ➔ The WHO constitution came into
execution of policies and programs in the force on April 7, 1948.
DOH while ensuring responsibility to all
stakeholders 5 CORE FUNCTIONS OF DOH:
The national policy on UHC espouses 1. Provide leadership on matters

three strategic thrusts: critical to health & engage
partnerships when joint action is
1. Better Health Outcomes needed
2. More responsive health systems 2. Shape research agenda. Stimulate
3. More Equitable Health Financing generation, translation, &
dissemination of valuable
Cross-cutting pillar of F1 Plus for Health, knowledge.
which is on . It introduces evidence-based 3. Setting norms, standards. Promote
metrics in the health system to objectively & monitor implementation.
monitor and ensure its responsiveness to 4. Articulating ethical and
addressing the healthcare needs of evidence-based policy options.
Filipinos. 5. Provide technical support, catalyze
change & build sustainable
It supports the achievement of Ambisyon institutional capacity.
Natin 2040: Matatag, Maginhawa at
Panatag na Buhay
Health targets of Sustainable

Development Goals (SDG) 2030,
particularly:
Goal 3 “Good health & well-being” and other

health-related targets in:
Goal 1 “No poverty”
Goal 2 “Zero hunger”
Goal 6 “Clean water and sanitation”
Primary Health Care ELEMENTS
Brief History ➔ Education for health

➔ Locally endemic disease treatment
➔ Sept 6 – 12, 1978 ➔ Expanded Programme on
➔ International Conference for Primary Immunization
Health Care ➔ Maternal and Child Health with
➔ At Alma Ata, USSR Responsible parenthood
➔ WHO & UNICEF (United Nations ➔ Essential drugs
Children’s Fund) ➔ Nutrition
➔ Health & development of workers for ➔ Treatment of Com Disease &
the protection & promotion of health Non-Communicable Disease
of all the people ➔ Safe water and Sanitation
➔ Health – basic fundamental right
➔ Global burden of health inequalities Universal Goal
exist
➔ Economic & Social devp – basic Health for all by year 2000
importance for full attainment of ➔ Acceptable level of health for all in
health for all the world
➔ Govt has resp for health of people ➔ Through I and C self-reliance
➔ Letter of Instruction (LOI) 949 of
1979 Letter of Instruction Theme
➔ First Asian country ➔ Health in the Hands of the People by
➔ Health is a product of Social & 2020
Economic development.
Key Principles of Primary Health Care
DEFINITION
4A’s
➔ Essential health care
➔ practical, significantly sound & Accessibility/Accessible - Consider the
socially acceptable methods & time travel within 30 mins
technology
➔ Universally accessible to I & F in Affordable - It considers the out of the
community pocket expenses. It is with the bracket of
➔ Through full participation - active PhilHealth
involvement
➔ At cost can afford to maintain Availability - Services are regularly
➔ At every stage of their development available, organized given affordability
➔ In Spirit of self-reliance &
self-determination Acceptability -
➔ Support Mechanism -
➔ Multisectoral Approach 3 LEVELS OF PREVENTION

➔ Intersectoral Linkages
➔ Intrasectoral Linkages Primary Prevention – an intervention that
➔ Communication, prevents the disease process from ever
collaboration, beginning
cooperation within - Ex. Diabetes:
health sector - adopt a healthy diet
- Exercise or other plans to prevent
➔ Community participation diabetes onset in the future
➔ Clients are not recipients of
care but ACTIVE partners Secondary Prevention – an intervention
that identifies and stops a disease early on
➔ Equitable distribution of health in the disease process before the patient
resources even realizes anything is wrong (before any
➔ DTTB (doctors to the barrio clinical signs arise)
program) fifth-sixth class - ex. Diabetes
municipalities for 2yrs - Doing blood glucose screenings of
➔ RN Heals - registered nurse asymptomatic patients
health enhancement and
local services - 1 year Tertiary Prevention – an intervention that
is used for those who already have clinical
➔ Appropriate technology signs of disease. These interventions
➔ Health technology - tools, attempt to cure pt, decrease morbidity,
drugs, methods, procedures decrease mortality or increase functionality
and techniques - ex. Diabetes
➔ CRITERIA: safe, effective, - Use of medications to treat
affordable, feasible/reliable. previously diagnosed diabetics in
Ecological effects, potential hopes of decreasing the onset
to contribute to I and C devp and/or severity of symptoms
2 LEVELS OF PHC WORKERS

1. VILLAGE OR BARANGAY HEALTH
WORKER - auxiliary health workers,
trained health workers
2. INTERMEDIATE LEVEL HEALTH
WORKERS - Gen Med practitioners,
PHN, PHM, Dentist, RSI
Varies Depending on:

1. Availability of health manpower
2. Local health needs and problems
3. Political and financial feasibility
Rural Health Unit 3. PHM / PUBLIC HEALTH MIDWIFE

➔ Manages BHS, trains BHW
RHU ➔ Provides midwife srvs & prog
➔ Health Centers ➔ Pt. assessment for referral
➔ Primary level health facility in ➔ Health info, educ & comm
municipality ➔ Organizes community
➔ Focus: preventive, promotive health ➔ Facilitate brgy health
services planning
➔ Supervision of BHS
➔ 1 : 20,000 4. RSI / RURAL SANITARY
INSPECTOR
BHS ➔ Ensures healthy environment
➔ 1st contact health care facility ➔ Through advocacy,
➔ Basic services at brgy level monitoring, regulatory
➔ Satellite station of RHU ➔ Ex. Inspect water supply
➔ Manned by volunteer BHW under
the supervision of midwife 5. BHW / BRGY HEALTH WORKER
➔ Interface between community
RHU PERSONNEL & RHU
➔ Training: preventive h. care.
1. MHO / MUNICIPAL HEALTH FP, MCH, Nut, Sanction,
OFFICER Repetitive H.
➔ Or Rural Health Physician ➔ RA 7883.. Entitled to hazard
➔ Head the health services & subsistence allowance
➔ Roles / functions
➔ Administrator of RHU LOCAL HEALTH BOARD
– plan & budget ➔ Chairman – mayor / prov. Governor
➔ Community physician ➔ Fnx:
➔ Medico-legal officer of 1. prepare budget
municipality 2. advisory committee
3. advisor
2. PHN / PUBLIC HEALTH NURSE
➔ RHM - Supervises/guides HEALTH REFERRAL SYSTEM
➔ FHSIS – Prepares, report - Set of activities undertaken by health
➔ Nursing Process – utilize care provider in response to its
when responding inability to provide necessary health
➔ GO,NGO, private business, intervention
people
INTERLOCAL HEALTH ZONE

ILHZ
Composition
➔ People – Ideal health district
population size (100,000 & 500,000)
- for optimum efficiency,
effectiveness (WHO, 1986).
➔ population vary - depending on
number of LGUs decide to
cooperate & cluster
➔ Boundaries – Clear boundaries
between Inter Local Health Zones -
determine accountability & resp.
health service providers.
➔ Geographical locations & access to
facilities such as are usual basis in
forming the boundaries
➔ Health Facilities – A district or
provincial hospital (referral hospital
for 2ndary level of health care),
Rural Health Units (RHU), Barangay
health stations (BHS) & other health
services deciding to work together
as an integrated health system.
➔ Health Workers – Right mix of health
providers needed to deliver
comprehensive health services.
Grps of health providers are: DOH ,
district hospital, RHU, BHS, private
clinics, volunteer health workers,
NGO & community-based
organizations.
➔ They form a LHZ team to plan joint
strategies for district health care.
Herbal Medicine MEDICINAL PLANTS PREPARATIONS
Republic Act 8423, known as the DECOCTION

Traditional and Alternative Medicine Act ➔ Boil recommended parts in water
(TAMA) of 1997 - traditional medicine ➔ Boiling time: 20 mins
program
INFUSION
Traditional and Alternative Medicine Act ➔ Plant part soaked in hot water like
(TAMA) Authored by Senator Juan tea
Flavier and approved on December 1997 ➔ 10 – 15 mins
➔ This gave rise to the creation of POULTICE

Philippine Institute of Traditional and ➔ Directly apply recommended part on
Alternative Health Care (PITAHC) affected area
➔ tasked to promote and advocates ➔ For bruises, wounds, rashes
use of traditional & alternative health
care modalities through scientific TINCTURE
research & product development ➔ Mix plant part in alcohol
➔ The Philippine Department of Health
(DOH) through its "Traditional Health Halamang Gamot (na aprobado ng DOH)
Program" has endorsed 10
medicinal plants to be used as ➔ Akapulko
medicine in the Philippines due to its ➔ Ampalaya
health benefits. ➔ Bawang
➔ Bayabas
TRADITIONAL HEALTH PROGRAM ➔ Lagundi
➔ 10 medicinal plants as herbal ➔ Niyog-niyogan
medicines in Philippines ➔ Sambong
➔ attested by National Science & ➔ Tsaang Gubat
Development Board ➔ Pansit-pansitan
➔ Yerba Buena
TRADITIONAL MEDICINE: DEFINITION
➔ Sum total of knowledge, skills & Lagundi
practice on health care, not ➔ Lagundi (Vitex Negundo
necessary explicable in the context ◆ "5-leaved chaste tree“
of modern, scientific philosophical ◆ used in Philippine herbal
framework medicine to treat cough,
➔ Recognized by people to help colds and fever.
maintain & improve their health ◆ relief for asthma &
towards the wholeness of their pharyngitis, .
being, community & society & their ➔ Lagundi Uses & Preparation:
interaction based on culture, history, ➔ Asthma, Cough & Fever –
heritage & consciousness Decoction ( Boil raw fruits or
leaves in 2 glasses of water ◆ Insect bites – Crush leaves

for 15 minutes) and apply juice on affected
➔ Dysentery, Colds & Pain – area or pound leaves until
Decoction ( Boil a handful of like a paste, rub on affected
leaves & flowers in water to area
produce a glass, three times ◆ Pruritus – Boil plants alone or
a day) with eucalyptus in water. Use
➔ Skin diseases (dermatitis, decoction as a wash on the
scabies, ulcer, eczema) - affected area.
Wash & clean the skin/wound ◆ Pain (headache,
with the decoction stomachache) – Boil
➔ Headache – Crush leaves chopped leaves in 2 glasses
may be applied on the of water for 15 minutes.
forehead Divide decoction into 2 parts,
➔ Rheumatism, sprain, drink one part every 3 hours.
contusions, insect bites – ◆ Rheumatism, arthritis and
Pound the leaves and apply headache – Crush the fresh
on affected area leaves and squeeze sap.
Massage sap on painful parts
Yerba Buena with eucalyptus
➔ Yerba Buena (Mentha cordifolia) ◆ Cough & Cold – Soak 10
◆ analgesic to relieve body fresh leaves in a glass of hot
aches and pain due to water, drink as tea.
rheumatism and gout. It is (expectorant)
also used to treat coughs,
colds and insect bites Sambong
➔ Yerba Buena Uses & Preparation: ➔ Sambong (Blumea Balsamifera
◆ Swollen gums – Steep 6 g. of ◆ treat kidney stones, gout
fresh plant in a glass of ➔ Sambong Uses & Preparation:
boiling water for 30 minutes. ◆ Anti-edema, diuretic,
Use as a gargle solution anti-urolithiasis – Boil
◆ Toothache – Cut fresh plant chopped leaves in a glass of
and squeeze sap. Soak a water for 15 minutes until
piece of cotton in the sap and one glassful remains.
insert this in aching tooth ◆ Divide decoction into 3 parts,
cavity drink one part 3 times a day.
◆ Menstrual & gas pain – Soak ◆ Diarrhea – Chopped leaves
a handful of leaves in a glass and boil in a glass of water
of boiling water. Drink for 15 minutes. Drink one
infusion. part every 3 hours.
◆ Nausea & Fainting – Crush
leaves & apply at nostrils of
patients
Tsaang Gubat ➔ Bayabas Uses & Preparation:

➔ Tsaang Gubat (Carmona Retusa) ◆ For washing wounds –
◆ "Wild tea" Maybe use twice a day
◆ taken as tea to treat diarrhea ◆ Diarrhea – May be taken 3-4
with abdominal pain times a day As gargle and for
➔ Tsaang Gubat Uses & toothache – Warm decoction
Preparation: is used for gargle. Freshly
◆ Diarrhea – Boil chopped pounded leaves are used for
leaves into 2 glasses of toothache. chopped leaves
water for 15 minutes. Divide for 15 minutes at low fire. Do
decoction into 4 parts. Drink not cover and then let it cool
1 part every 3 hours and strain
◆ Stomach Ache – Boil
chopped leaves in 1 glass of Akapulko
water for 15 minutes. Cool ➔ Akapulko (Cassia alata)
and strain ◆ Called as "ringworm bush or
“shrub" and "acapulco"
Niyog-niyogan ◆ to treat tinea infections,
➔ Niyog-niyogan (Quisqualis Indica) insect bites, ringworms,
◆ known as "Chinese eczema, scabies and
honeysuckle". • to eliminate itchiness
intestinal parasites. ➔ Akapulko Uses & Preparation:
➔ Niyog-niyogan Uses & ◆ Anti-fungal (tinea flava,
Preparation: ringworm, athlete’s foot and
◆ Anthelmintic – The seeds are scabies)
taken 2 hours after supper. ◆ Fresh, matured pounded
◆ If no worms are expelled, the leaves are pounded
dose may be repeated after ◆ Apply soap to the affected
one week. area 1-2 times a day
◆ (Caution: Not to be given to
children below 4 years old) Ulasimang Bato / Pansit-Pansitan
➔ Ulasimang Bato / Pansit-pansitan
Bayabas (Peperonica pellucida)
➔ Bayabas (Psidium Guajava) ◆ effective in treating arthritis
➔ "Guava" in English. and gout.
◆ as antiseptic, ➔ Ulasimang Bato | Pansit-Pansitan
anti-inflammatory, anti- Uses & Preparation:
spasmodic, antioxidant ◆ Lowers uric acid (rheumatism
hepatoprotective, anti-allergy, and gout)
antimicrobial, antiplasmodial, ◆ One and a half cup leaves
anti- cough, antidiabetic, and are boiled in two glasses of
antigenotoxic in folkloric water over low fire. Do not
medicine cover the pot.
◆ Divide into 3 parts and drink ◆ Take 1/3 cup 3 times a day
one part 3 times a day after meals
Bawang REMINDERS ON THE USE OF HERBAL

➔ Bawang (Allium sativum) MEDICINE
◆ Common name in English is
"Garlic". 1. Avoid the use of insecticide as these
◆ treat infection with may leave poison on plants.
antibacterial, anti 2. In the preparation of herbal
inflammatory, anti-cancer and medicine, use a clay pot and remove
anti- hypertensive properties. cover while boiling at low heat.
◆ to reduce cholesterol level in 3. Use only part of the plant being
blood. advocated.
➔ Bawang Uses & Preparation: 4. Follow an accurate dose of
◆ Hypertension - May be fried, suggested preparation.
roasted, soaked in vinegar 5. Use only one kind of herbal plant for
for 30 minutes, or blanched each type of symptoms or sickness.
in boiled water for 15 6. Stop giving the herbal medication in
minutes.Take 2 pieces 3 case untoward reaction such as
times a day after meals allergy occurs.
◆ Toothache - Pound a small 7. If signs and symptoms are not
piece and apply to affected relieved after 2 to 3 doses of herbal
area medication, consult a doctor.
Ampalaya ALTERNATIVE HEALTH CARE

➔ Ampalaya (Momordica charantia) MODALITIES - AS DEFINED BY LAW
◆ Common names: "bitter
melon " or "bitter gourd " in ➢ Other forms of nonallopathic,
English. occasionally nonindigenous or
◆ treatment of diabetes imported healing methods.
(diabetes mellitus), ➢ includes: reflexology, acupressure,
hemorrhoids, coughs, burns chiropractic, nutritional therapy
and scalds, and being
studied for anti-cancer ACUPRESSURE
properties.
➔ Ampalaya Uses & Preparation: ➢ Application of pressure on
◆ Diabetes Mellitus (Mild acupuncture points w/o puncturing
non-insulin dependent) the skin
◆ Chopped leaves then boil in ➢ acupressure stimulates the body at
a glass of water for 15 certain meridians, or pressure points
minutes. Do not cover.
◆ Cool and strain.
REFLEXOLOGY HERBAL MEDICINE / PHYTOMEDICINE
➢ Application of therapeutic pressure ➢ Finished, labeled, medicinal

on the body’s reflex points to products that contain as active
enhance the body's natural healing ingredients, aerial or underground
mechanisms & balance body parts of the plant or other materials
functions. Based on the principle or combination thereof, either in the
that internal glands & organs can be crude state or as plant preparations.
influenced by properly applying
pressure to the corresponding reflex NUTRITIONAL THERAPY
area on the body.
➢ Use of food as medicine & to
ACUPUNCTURE improve health by enhancing the
nutritional value of food components
➢ Using needles to puncture & that reduces risk of disease.
stimulate specific anatomical points Synonymous w/ nutritional healing
of body
➢ Acupuncture points are anatomically PRANIC HEALING
defined areas on the skin relative to
certain landmarks on the body. ➢ Holistic approach of healing that
Indicated that there were holes in follows the principle of balancing
the skin through which qi energy energy.
could flow.
MASSAGE
➢ Superficial soft parts of the body are

rubbed, stroked, kneaded or tapped
for remedial, aesthetic, hygienic or
limited therapeutic purposes
CHIROPRACTIC
➢ Concerned w/ pathogenesis,
diagnosis, therapy & prophylaxis of
functional disturbances,
pathomechanical states, pain
syndromes & neurophysiological
effects relate to static & dynamics of
locomotor system, esp. spine &
pelvis
➢ Traditionally uses manipulation of
the spine and limbs
Family Health Nursing INITIAL DATA BASED
National Statistical Coordination Board Components:
➢ A grp of person usually living ➔ Family structure, characteristics and

together & composed of the head by dynamics
blood, marriage & adoption ➔ Socio-economic and cultural
characteristics
Johnson ➔ Home and environment
➢ Social unit interacting with the larger ➔ Health status of each member
society ➔ Values and practice on health
promotion, maintenance and
Allen disease prevention
➢ Characterized by people together
because of birth, marriage, adoption FAMILY FORMS/ FAMILY STRUCTURE
or choice (Based on Internal Organization and
Membership / Components)
EO 209 Family Code
➢ Marriage - spl contract of permanent Dyad
union bet man & woman ➔ Empty nester
Cohabitating
Friedman ➔ Live-in
➢ 2 or more persons who are joined ➔ Common law spouses & children
together by bonds of sharing & Compound family
emotional closeness & identify ➔ Man has more that 1 wife
themselves as part of FAMILY ➔ PD 1083
Blended
Family Assessment ➔ 1 or both spouses bring in
child/children from previous
The Family Interview marriage in their new living
arrangement.
➔ Effective communication is essential Nuclear
in the 1st step to establish trusting ➔ Husband,wife, children
relationship ➔ Marriage
➔ Same principles used in an effective ➔ procreation
interview with a client apply. Extended
➔ Family assessment tools are ➔ 3 generations
available. ➔ Married sibling & their F w/
➔ Many agencies have a standard grandparents
form Single Parent
➔ ex. IDB / Initial Data Base ➔ Pregnancy outside of wedlock
➔ Separation
➔ Death of spouse
Gay/Lesbian Family Based on Amount of Mates

➔ Cohabitating couple of same sex
➔ Not legal Monogamous Family - In this instance, a
husband only has one wife. This is the
Classification of Family western idea of a typical marriage.
(Based on Pattern of Residence Polygamous Family -In this case, the
Based on Pattern of Lineage husband has more than one wife at the
Based on Amount of Mates same time. This type of family can be found
Based on Authority) mostly in Saudi Arabia.
Polyandrous Family - This family consists
Based on Authority of a wife with more than one husband. This
can be found in the Todas of Southern India.
Patriarchal - authority is vested on the
oldest male in the family, often the father. Genogram
Matriarchal - authority is vested in the ➢ known as McGoldrick–Gerson study,
mother or mother’s kin. a Lapidus schematic or a family
Matricentric - prolonged absence of the diagram
father gives the mother a dominant position ➢ a pictorial display of a person's
in the family, although the father may also family relationships and medical
share with the mother in decision making. history
Patricentric -
Culturagram
Based on Pattern of Residence ➢ (Congress & Kung, 2005)
➢ develop a better understanding of
Patrilocal - When a married couple lives the sociocultural context of the
with or near the husband’s family. family as well as identify appropriate
Matrilocal - When a couple lives with or interventions for the family.
near the mother’s family. ** Areas (Congress & Kung, 2005) **
Neo-Local - When a married couple sets up ➔ Reasons for relocation
a home separate from either side of their ➔ Legal status
families. ➔ Time in the community
➔ Language spoken at home and in
Based on Pattern of Lineage the community
➔ Health beliefs
Patrilineal Family - This type of family ➔ Crisis events
occurs when property and title inheritance ➔ Holidays and special events
passes down through the father’s side. ➔ Contact with cultural and religious
Matrilineal Family - This is where the institutions
property and title inheritance passes ➔ Values about education and work
through the mother’s side. ➔ Values about family structure
(power, hierarchy, rules,
subsystems, and boundaries)
DEVELOPMENTAL ASSESSMENT F. W/ ADOLESCENTS
➢ Duvall (1977) theory of development ➔ Devp. Of increasing autonomy for

stages of family life children
➢ stages within the life cycle of every ➔ Midlife reexam. Of marital & career
family; each stage includes distinct issues
family developmental tasks ➔ Initial shift towards concern for older
generation
DEVELOPMENTAL STAGES OF FAMILY ➔ Scope of the Stage - with 13y/o to
20 y/o children
MARRIAGE ➔ Family Developmental Tasks =
Balancing freedom with
➔ Formation of identity as a couple responsibility as teens, mature and
➔ Inclusion of spouse in realignment of emancipate
relationship with extended families ➔ Family Developmental Tasks =
➔ Parenthood decision making Establishing outside interests and
➔ ++ BY duvall & miller 1985 career
➔ Scope of the Stage: Married couple
Couple makes commitment to one F. As LAUNCHING CENTERS
another
➔ Family Developmental Tasks - ➔ Est. for diff identities for parents &
Establishing a mutually satisfying children
marriage ➔ Renegotiation of marital relationship
➔ Family Developmental Tasks - ➔ Readjustment of relationship to
Fitting into the kin network include in-laws & grandchildren
➔ Dealing w/ disabilities & older
F. W/ YOUNG CHILDREN generation
➔ Scope of the Stage = First child
➔ Integration of children into F. unit leaves home to last child leaving
➔ Adjustment of tasks: Child rearing, home
financial & household ➔ Family Developmental Tasks =
➔ Accommodation of new parenting & Assisting young adults to work,
grandparenting role attend school, military or marriage
➔ Scope of the Stage - Oldest child is
infant through 12y.o and parent AGING F.
➔ Family Developmental Tasks
Adjusting to infants and encouraging ➔ Maintaining as couple/indv.. while
their development adapting to aging process
➔ Establishing a satisfying family life ➔ Support role of middle generation
for both child ➔ Support & autonomy of older
generation
➔ Prep. For own death, deal w/ loss of
spouse, sibling, peers
➔ Scope of the Stage - Retirement to PHYSICAL MAINTENANCE

moving out of Family home
➔ Family Developmental Tasks = ➢ Survival needs of dependents
Coping with loss and living alone
➔ Family Developmental Tasks = WELFARE & PROTECTION
Adapting to retirement and aging
PARTNERS
By Defrain & Montalvo
➢ companionship,affective,sex,
➔ Interact w/ one another socioeconomic
➔ Can establish priorities
➔ Support, respect, affirm one another CHILDREN
➔ Members has flexible role
➔ Foster responsibility & value service ➢ Emotional gratification,
to others psychological security, motivation,
➔ Have sense of play morale
➔ Ability to cope w/ stress
FUNCTIONS OF FAMILY
PROCREATION
➢ Universal accepted institution for

reproductive fxning / child-rearing
SOCIALIZATION OF F. MEMBERS
➢ F. First teacher of societal rules;
STATUS PLACEMENT
➢ F. Confers its social rank into the

society.
ECONOMIC FXN
➢ RURAL FAMILY - UNIT OF

PRODUCTION
➢ URBAN FAMILY - UNIT OF
CONSUMPTION, ENTERPRISE
Family Nursing and Nursing Process ➔ The nurse gathers information about
the family’s state of being and
Family Nursing Process behavioral responses.
➔ Presence of S/S
“The blueprint of the care that the nurse ◆ Physical makeup of each
designs to systematically minimize or member
eliminate the identified health and family ◆ Communication or language
nursing problems through explicitly patterns expected and
formulated outcomes of care and tolerated.
deliberately chosen set“ ◆ Role perception/task
assumption by each member,
Nursing Process including decision-making
patterns.
“A problem-solving approach that enables ◆ Conditions in home and
the nurse to provide care in an organized environment
and scientific manner. It is applicable to
individuals, families and community groups 2. Interviewing
at any level of health. It is adaptable to any ➔ Productivity of the interview process
practice setting or specialization and the depends upon the use of effective
components may be used sequentially or communication techniques to elicit
concurrently.” needed responses.
➔ Encourage verbalization of thought
Nursing Assessment Phase and feelings and offer needed
1. Data Collection support or reassurance.
2. Data Analysis
3. Physical Examination
Data Collection ➔ Done through inspection, palpation,
percussion, auscultation
Three Sources Of Data measurement of specific body parts
and reviewing the body systems
First source - Health status of the family
Second Source - Family’s status as a 4. Review of Records
functioning unit ➔ Reviewing existing records and
Third Source - Family's environment reports pertinent to the client
Methods of Gathering Data

5. Laboratory/ Diagnostic Tests
1. Direct observation ➔ Performing laboratory tests,
➔ A method of data collection which is diagnostic procedures or other tests
done through the use of all sensory of integrity and function carried out
capacities by the nurse herself and /or health
workers.
5 Types of Data use as Initial Data Base ➔ Adequacy of the furniture

for Family Nursing Practice ➔ Food storage and cooking facilities
➔ Presence of accidents hazards
1. Family structure and Characteristics ➔ Water supply-source, ownership,
A. Members of the household; potability
relationship to the head of the family. ➔ Toilet facility-type, ownership,
B. Demographic data- age, sex, civil sanitary condition o Garbage/refuse
status, position in the family disposal- type, sanitary condition of
C. Place of residence of each member - Drainage system- type and sanitary
whether living w/ or elsewhere. condition
D. Type of family structure-matriarchal, B. Kind of neighborhood- congested,
patriarchal,nuclear / extended. slum, etc.
E. Dominant family members in terms C. Social and health facilities available
of decision making in matters of D. Communication and transportation
health care.
F. General family relationship - 4. Health Assessment of Each Member
presence of obvious/ready A. Medical and Nursing History
observable conflict between indicating past significant illness,
members; communication beliefs and practices conducive to
illness.
2. Socio-economic and Cultural Factors B. Nutritional assessment (specifically
A. Income and expense for vulnerable or at risk members)
➔ Occupation, place of work, income ➔ Anthropometric data- weight, height.
of each working member ➔ Dietary history indicating quality and
➔ Adequacy to meet basic necessities quantity of food intake per day
(food,clothing,shelter) ➔ Eating/feeding habits and practices
➔ Who makes decision about money C. Current health status indicating
and how it is spent presence of illness states
B. Educational attainment of its (diagnosed/undiagnosed by medical
members practitioner)
C. Ethnic background and religious
affiliation 5. Value Placed on Preventive Disease
D. Significant others - roles they play in A. Immunization status of children
the family B. Use of other preventive services
E. Relationship of family to community. Nursing Assessment Phase
What is the participation of the family
in community activities? Data Analysis
3. Environmental Factors “Comparison of the gathered DATA

A. Housing to the STANDARDS OR NORMS”
➔ Adequacy of living space
➔ Sleeping arrangement.
➔ Presence of insects and rodents.
Three Types of Standards or Norms ➔ Diagnosed/suspected illness states

of family members
1. Normal health of individual members ➔ Sudden or premature or untimely
2. Home and environment conditions death illness or disability and failures
conducive to family development to adapt reality of life emotional
3. Family characteristics, dynamic and control and stability
level of ➔ Deviations in growth and
development
Health Problem ➔ Personality disorders
Ex.
“Is defined as a situation or condition which ➔ Illness regardless whether it is
interferes with the promotion and/ or diagnosed
maintenance of health and recovery from ➔ Failure to thrive or inability to
illness and injury.” develop according to normal rate.
➔ Disability arising from illness,
“A health problem becomes a nursing whether transient/temporary
problem when it can be modified through TEMPORARY
nursing interventions.” ➔ Aphasia or temporary paralysis after
CVA
Health Need PERMANENT
➔ Leg amputation secondary to DM,
“Exist when there is a health problem that blindness from measles, paralysis
can be alleviated with medical or social from polio.
technology.”
B. Stress Points/ Foreseeable Crisis
Nursing Diagnosis Phase Situation
➔ Anticipated periods of unusual
Typology of Nursing Problem demand on the individual or family in
terms of adjustments/family
“The study or systematic classification of resources.
types.” Ex.
➔ Marriage
“A tool or classification of a family nursing ➔ Pregnancy, labor, puerperium
problem that reflects the family status and ➔ Parenthood
capabilities as a functioning unit.” ➔ Additional member-newborn, lodger.
➔ Abortion
Nursing Diagnosis Phase ➔ Entrance at school
➔ Adolescence
A. Health Deficits ➔ Loss of job
➔ Instances of failure in health ➔ Death of a spouse /member
maintenance and development ➔ Resettlement in new community
➔ Occurs when there is a gap between ➔ Illegitimacy
actual and achievable health status.
C. Health Threats B. Excessive smoking

➔ Conditions that are conducive to C. Walking barefooted
diseases, accidents or failure to D. Eating raw meat/fish
realize one’s health potential. E. Poor personal hygiene
Ex. F. self-medication
1. Health history of specific G. Use of dangerous drugs or narcotics
condition/disease- a. family history H. Sexual promiscuity
of DM I. Engaging in dangerous sports
2. Threat of gross infection of CD case 10. Inherent personal characteristics- short
3. Family size beyond what resources temper
can adequately provide 11. Health history which may precipitate the
4. Accident Hazards occurrence of health deficit-previous history
A. Broken stairs of difficult labor.
B. Pointed sharp objects, poison and 12. Improper role assumption-child
medicine improperly kept assuming mother’s role, father not
C. Fire hazards assuming his role.
D. Fall hazards 13. Lack of/ inadequate immunization status
5. Inadequate food intake both in quantity of children
and quality 14. Family disunity
A. Excessive intake of certain nutrients A. Self-oriented behavior of members
B. Faulty eating habits B. Unresolved conflicts among
6. Stress Provoking Factors members
C. Strained marital relationship C. Intolerable disagreements
D. Strain parent-sibling relationship
E. Interpersonal conflicts between Drill:
family members. Deficit
7. Poor Environmental Sanitation Threat
A. Inadequate living space Foreseeable Crisis / Stress Point
B. Inadequate personal Dengue - HD
belongings/utensils TB - HD
C. Lack of food storage facilities Congested - HT Separated - SP / FC
D. Polluted water supply Teenage Preg - SP
E. Presence of breeding places of
insects and rodents First Level of Assessment
F. Improper garbage/refuse disposal
G. Unsanitary waste disposal I. Presence of health deficit, health threats,
H. Improper drainage system and foreseeable crisis/ stress points in the
I. Noise pollution family.
J. Air pollution II. Inability to recognize presence of problem
8. Unsanitary Food Handling and III. Inability to make decisions with respect
Preparation to taking appropriate health action
9. Personal Habits/ Practices
A. Frequent drinking of alcohol
IV. Inability to provide adequate nursing 3. Nursing care plan, as with all other
care to the sick, disabled, dependent or plans, relates to the future.
vulnerable/at risk member of the family. 4. Nursing care plan is based upon
V. Inability to provide home conducive to identified health & nursing problems.
health maintenance, personal development 5. Nursing care is a means to an end,
VI. Failure to utilize community resources not an end in itself.
for health care 6. Nursing care plan is a continuous
process not a one-shot deal.
Two Parts:
1. General Desirable Qualities a Nursing Care Plan
➢ the statement of the unhealthful
response 1. Based on a clear definition of the
Ex. problems.
➔ Inability to utilized the community 2. Good plan is realistic.
resources for health care due to 3. Should be consistent with goals &
2. Specific philosophy of the health agency.
➢ the statement of factors which are 4. Nursing care plan is drawn with the
maintaining the undesirable family.
response and preventing the desired 5. Nursing care plan is best kept in
change written
Ex.
➔ Lack of adequate family resources, Importance of Planning Care
specifically;
➔ Financial 1. Individualized care to clients
➔ Manpower 2. Nursing care plan helps in setting
➔ Time priorities by providing information
about the client as well as the nature
NURSING PLANNING PHASE of his problem.
3. Nursing care plans promote
Family Nursing Care Plan (FNCP) systematic communication among
those involved in health care efforts.
“A Family Nursing Care Plan is the set of 4. Continuity of care is facilitated
actions the nurse decides to implement to through use of nursing care
be able to resolve identified family health 5. Nursing care plans facilitate
and nursing problems.” coordination of care by making
known to other members of the
Characteristics Family Nursing Care Plan health team what the nurse is doing
1. Nursing care plans focus on actions

which are designed to solve or
minimize existing problems.
2. Nursing care plan is a product of
deliberate systematic process.
Four Criteria for Determining Priorities Goals and Objectives
1. Nature of condition or problem Establishment of Goals

➢ Categorized into wellness state/ Goals
potential, health threat, health deficit ➔ Is a general statement of condition
of foreseeable crisis. or state to be brought about by
2. Modifiability of the Problem specific courses of action.
➢ Refers to the probability of success ➔ It is the end towards which all efforts
in minimizing, alleviation or totally are directed.
eradicating the problem through Example:
nursing ➔ After nursing intervention, the family
3. Preventive Potential will be able to take care of the
➢ Refers to the nature and magnitude premature infant competently.
of future problems that can be Goals relate to health matter
minimized or totally prevented if ➔ specifically the alleviation of disease
intervention is done on the problem conditions.
under consideration. ➔ And health problems that intertwined
4. Salience with other problems like
➢ Refers to the family’s perception and socio-economic ones.
evaluation of the problem in terms of Example 1:
seriousness and urgency attention ➔ At the end of nursing intervention,
needed. the family will be able to start a
piggery business.
Scoring Example 2:
A. Decide on a score for each of the ➔ At the end of nursing intervention,
criteria. the family will be able to start
B. Divide the score by the highest litigation proceedings against the
possible score and multiply by the landlord.
weight. A cardinal principle in goal setting states
SCORE/HIGHEST SCORE X WEIGHT that goals must be set mutually with the
C. Sum up the scores for all the criteria. family.
The highest score is 5, which is ➔ Basic to the establishment of
equivalent to the total weight. mutually acceptable goals is the
family’s recognition and acceptance
Scale for Ranking Family Health of existing health needs and
Problems according to Priorities problems.
Example Summary ➔ Goals set by the nurse and the
The list of health problems ranked family should be realistic or
according to priorities is presented: attainable.
➔ MALNUTRITION 5 ➔ Goals are best stated in terms of
➔ SCABIES 4 client’s outcomes, whether at the
➔ IMPROPER REFUSE DISPOSAL individual, family, or community
3.67 levels.
Barriers to Joint Goal Setting Between Example of Nursing Goal / Objective

Nurse and Family
The family will cope effectively with the
1. Failure on part of the family to threat of pulmonary tuberculosis.
perceive the existence of the ➢ Short Term - The infant and
problem. preschool members of the family will
2. Family may realize the existence of be immunized with BCG.
a health condition/problem but is too ➢ Medium Term - All members of the
busy at the moment. family will have a complete physical
3. Sometimes, family perceives the check-up to rule out pulmonary
existence of a problem but does not tuberculosis.
see it as serious enough to warrant ➢ Long Term - All members of the
attention. family will participate in the care of
4. Families may perceive the presence the sick members and apply
of a problem & need to take action. preventive measures against the
However, I refuse to face & do spread of infection.
something about the situation.
A. Reasons to this kind of behavior: NURSING IMPLEMENTATION PHASE
➔ Fear of consequences of taking
actions. Selecting Appropriate Nursing Actions The
➔ Respect for tradition. choice of nursing intervention is highly
➔ Failure to perceive the benefits of dependent on two major variables:
action.
➔ Failure to relate the proposed action 1. The nature of the problem
to the family’s goals. ➢ resolve around the family's
5. A big barrier to collaborative goal setting assumption of the health tasks.
between nurses & the family is the working 2. Resource available to solve the
relationship. problem
➢ aimed at minimizing or eliminating
Formulation Objectives of Nursing Care reasons for or causes of family’s
inability to do these tasks.
“Objectives -refer to more specific
statements of the desired results or Goals and Objectives
outcomes of care." S – Specific
M – Measurable
“Either a) nurse-oriented based on activities A – Attainable
of nurse or b) client-oriented stated in terms R – Realistic
of outcomes.” T- Time Bound
Principles of Nursing Actions support system provided by relatives

and significant others.
➔ stimulate recognition & acceptance
of health needs/problems 2. NURSE RESOURCES- knowledge
➔ work on the family’s failure to decide about family health, her skills in
on taking appropriate health actions helping family manage them. These
➔ increase family’s confidence in skills may range from simple nursing
providing nursing care to its sick, procedures to complicated
disabled and dependent members behavioral problems such as marital
through demonstrations on nursing disharmony. Availability of time &
procedures utilizing supplies and logistical support are also part of
equipment available in the home. resources of the nurse.
➔ involve patients & family in order to
motivate them to assume 3. COMMUNITY RESOURCES-
responsibility for their own care. include existing agencies, programs
➔ Explain and clarify doubts thus the or activities for health and related
role of the nurse shifts direct care needs/problems and community
giver to that of a teacher. organization for health actions.
➔ Explore ways to minimize or prevent
threats to the maintenance of health Methods of Intervention Family-Nurse
& personal development among Contact
family members
➔ Utilize intervention measures Home-Visit
involving environmental ➢ Home visit is a professional,
manipulations through purposeful interaction that takes
improvements on physical facilities place in the family’s residence aimed
in home either by construction of at promoting, maintaining and
needed ones or modifying existing restoring the health of the family or
ones. its members.
➔ Minimize or eliminate psychological Clinic- Visit
threats in the home environment. ➢ takes place in a private clinic health
Nurses can work closely with family center, barangay health station.
to improve its communication ➢ Major advantage is the fact that a
patterns, role assumptions & family member takes the initiative of
relationships & interaction patterns. visiting the professional health
worker, usually indicating the family
Types of Resources readiness to participate in the health
care process.
1. FAMILY RESOURCES- physical & ➢ Because the nurse has greater
psycho-social strengths assets of control over the environment,
individual members, financial distractions are lessened and the
capabilities, physical facilities & family may feel less confident to
discuss family health concerns.
Group Approach ➢ It saves time and effort by ensuring

➢ appropriate for developing that the articles needed for nursing
cooperation, leadership, self-reliance care are available.
and or community awareness ➢ Bag technique should not take away
among group members. the nurse’s focus on the patient and
➢ The opportunity to share the family.
experiences and practical solutions ➢ Bag technique may be performed in
to common health concerns is a different ways, principles of asepsis
strength of this type of family-nurse are of the essence and should be
contact. practiced at all times.
Telephone Conference
Written Communication NURSING EVALUATION PHASE
➢ used to give specific information to
families, such as instructions given “The determination of whether the
to parents through school children. objectives set were obtained or to what
School Visit or Conference degree they were attained.”
Industrial or Job Site Visit
“Evaluation is always related to objectives.”
The Nursing Bag
“Evaluation when address to the result or
➢ Frequently called the PHN bag is a outcome of care answers the question
tool used by the nurse during home
or community visits to be able to “did the intended results occur?”
provide care safely and efficiently.
➢ Serves as a reminder of the need for “There is always an element of subjectivity
hand hygiene and other measures to in evaluation; the process involves value
prevent the spread of infection. judgment which is subjective”
➢ Nursing bag usually has the ff.
contents: “Evaluation also involves decision-making”
- Articles for infection control
○ Articles for assessment of Dimensions of Evaluation
family members EFFECTIVENESS - focus is attainment of
○ Note that the stethoscope the objectives
and sphygmomanometer are EFFICIENCY - relates to cost whether in
carried separately. terms of money, time, effort, or materials
○ Articles for nursing care of APPROPRIATENESS - ability to solve or
Sterile items correct existing problem situations, a
○ Clean articles question that involves professional
○ Pieces of paper judgment.
➢ Bag technique helps the nurse in ADEQUACY - pertains to its
infection control. comprehensiveness whether all necessary
➢ Bag technique allows the nurse to activities were performed in order to realize
give care efficiently. the intended results.
Criteria and Standard PHYSICAL CONDITION - decreased

temperature or weight and change in clinical
STANDARD - once a value judgment is manifestations
applied to a criterion; it acquires the status
of a standard. PSYCHOLOGICAL OR ATTITUDINAL
➔ It refers to the desired level of STATUS - decreased anxiety and favorable
performance corresponding with a attitude towards health care personnel.
criterion against which actual
performance is compared. KNOWLEDGE ON LEARNING BEHAVIOR
➔ It tells us what the acceptable level - compliance of the patient with instructions
of performance or state of affairs given by the nurse
should be for us to say that the
intervention was successful. NOTE:
Once Done, review the “National/Global
CRITERIA - refer to signs or indicators that Health Situation” Topic
tell us if the objective has been achieved.
➔ They are names & descriptions of
variables that are relevant indicators
of having attained the objectives.
➔ They are free from any value
judgment and are independent of the
time frame.
Activity and Outcome
ACTIVITIES - are actions performed to

accomplish an objective. They are the
things the nurse does in order to achieve a
desired result or outcome. Activities
consume time and resources. Examples are
health teachings, demonstration and
referrals.
OUTCOME - is the results produced by

activities. Where activity is the cause,
outcome is the effect. They can also be
immediate, immediate or ultimate outcomes.
Patient care outcomes can be measured
along three broad lines

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Community Health Nursing

BSN 2-YA-15 | De Leon, Sydney | PRELIM REVIEWER | 2022

Community Health Nursing Determinants of Health

What is a Community? Health is affected by combination of many

MODERN DEFINITION OLOF (Optimum WINSLOW

WHO DEFINITION of CHN by Dr. Ruth Freeman

Concepts of Community Health Nursing Unit of Service

WHO BENEFITS THE PUBLIC HEALTH NURSE

PRINCIPLES OF CHN FUNCTIONS CONSISTENT W/

Functions of Public Health Nursing (PHN) TRAINING FXN

MANAGEMENT FUNCTION NURSE VI

Public Health Nurse

PHN II (Public Health Nurse II)

NURSE V “Supervising PHN”

Levels of Care TERTIARY LEVEL OF HEALTH CARE

PRIMARY LEVEL OF HEALTH CARE 1. REGIONAL HEALTH SERVICES

SECONDARY LEVEL OF HEALTH CARE

➔ Moderately specialized equipment &

EVOLUTION: PUBLIC HEALTH NURSING Fajardo Act of 1912

Dr. Jose Fabella - 1st Department

➔ Curative (Bureau of Republic Act 7160 (LOCAL

FOURmula One (F1) for health, 2005 &

Health Service Delivery

Health Governance and Regulation

Universal Health Care

Universal Health Care Act Kalusugan

Philippines Health Care Delivery System DOH - SPECIALTY HOSPITAL

REGIONAL HOSPITALS IN NCR NEW CLASSIFICATIONS OF HOSPITALS

● Primary Prevention HOSP. CLASSIFICATION SCHEME -

General : Level 2 HOSP. CLASSIFICATION SCHEME -

CAT. B / CUSTODIAL CARE FACILITY

CAT. C / DIAGNOSTIC / THERAPEUTIC

CAT. D / SPECIALIZE OUTPATIENT

DOH ROLES AND FUNCTIONS:

Classification of Hospitals 1. Leadership in health

3. Administrator of specific services sympathy & benevolence for people in

Core Values FRAMEWORK OF HSRA - FOURmula One

Regulation - Ensure high quality and Goal 7 “Clean energy”

The national policy on UHC espouses 1. Provide leadership on matters

Health targets of Sustainable

Goal 3 “Good health & well-being” and other

Primary Health Care ELEMENTS

Brief History ➔ Education for health

➔ Multisectoral Approach 3 LEVELS OF PREVENTION

2 LEVELS OF PHC WORKERS

Varies Depending on:

Rural Health Unit 3. PHM / PUBLIC HEALTH MIDWIFE

INTERLOCAL HEALTH ZONE

Herbal Medicine MEDICINAL PLANTS PREPARATIONS

Republic Act 8423, known as the DECOCTION

➔ This gave rise to the creation of POULTICE

leaves in 2 glasses of water ◆ Insect bites – Crush leaves

Tsaang Gubat ➔ Bayabas Uses & Preparation:

Bawang REMINDERS ON THE USE OF HERBAL

Ampalaya ALTERNATIVE HEALTH CARE

REFLEXOLOGY HERBAL MEDICINE / PHYTOMEDICINE

➢ Application of therapeutic pressure ➢ Finished, labeled, medicinal

➢ Superficial soft parts of the body are

Family Health Nursing INITIAL DATA BASED

National Statistical Coordination Board Components:

➢ A grp of person usually living ➔ Family structure, characteristics and

Gay/Lesbian Family Based on Amount of Mates