CHN POINTERS AND REVIEW NOTES desired change in the family
● Efficiency is the relationship of the resources
-Vaccines, antitoxins, and toxoids provide active
immunity by stimulating the humoral
immune system. Immunoglobulins provide
passive immunity by giving the patient
substances to figh
specific antigens.
-Currently, DTaP is the preferred preparation for
primary and booster immunization against
these diseases in children from 6 weeks to 6
years of age unless use of the pertussis
component is
contraindicated. Tdap is the recommended
vaccine for adolescents and adults, those over
the age of
11 years.
-Contraindications to the administration of
immunizing drugs include allergy to the
immunization itself or to any of its
components, such as eggs or yeast.
-Human papillomavirus virus (HPV) is a common
cause of genital warts and cervical cancer.
The HPV vaccineGardasil, Cervarix) is the first
and only vaccine known to prevent cancer.
-Vaccines work by stimulating the hormonal
immune system Vaccines work by stimulating
the
humoral immune system, which synthesizes
immunoglobulins. They also stimulate the
formation of
antibodies against their specific antigen,
providing active immunity.
-Ligtas Tigdas Month” and the beginning of a
nationwide campaign against measles called the
Philippine Measles Elimination .
-The planning process involves the following
steps:
1. Determining the order of priority of existing
or potential problems
2. Identifying problems that can be handled by
the community health nurse and the family, and
those that maybe referred to others for
assistance.
3. Setting goals and objectives to resolve the
problems
4. Predicting actions and expected outcomes
-Aspects of evaluation that are useful in family
health care:
● Effectiveness is determination of whether
goals and objectives were attained.
● Appropriateness refers to the suitability of the
goals/objectives and interventions to the
identified family health needs
● Adequacy means the degree of sufficiency of
goals/objectives and interventions in attaining
the
use to attain the desired outcomes
-Anaphylaxis is a potential life-threatening
adverse reaction to vaccines. Pain and
Myalgias can occur but are not life threatening.
-Community diagnosis. Population-focused
nursing care means providing care based on
thegreater need of the majority of the
population. The greater need is identified
through community
diagnosis.
Universal health coverage means that all
people
have access to the health services they need,
when
and where they need them, without financial
hardship. It includes the full range of essential
health services, from health promotion to
prevention, treatment, rehabilitation, and
palliative
care. (WHO)
WHO uses 16 essential health services in 4
categories as indicators of the level and equity
of
coverage in countries:
1. Reproductive, maternal, newborn and child
health:
● family planning
● antenatal and delivery care
● full child immunization
● health-seeking behavior for pneumonia.
2. Infectious diseases:
● tuberculosis treatment
● HIV antiretroviral treatment
● use of insecticide-treated bed nets for malaria
prevention
● adequate sanitation.
3. Noncommunicable diseases:
● prevention and treatment of raised blood
pressure
● prevention and treatment of raised blood
glucose
● cervical cancer screening
● tobacco (non-)smoking.
4. Service capacity and access:
● basic hospital access
● health worker density
● access to essential medicines
● health security: compliance with the
International
Health Regulations.
On 25–26 October 2018, WHO in partnership
with
UNICEF and the Ministry of Health of
Kazakhstan
UNIVERSAL HEALTH CARE LAW
● Was signed on February 20, 2019
● REPUBLIC ACT No. 11223: Universal
Health Care Act
● also referred to as Kalusugan
Pangkalahatan (KP)
● is the “provision to every Filipino of the
highest possible quality of health care that is
accessible, efficient, equitably distributed,
adequately funded, fairly financed, and
appropriately used by an informed and
empowered public”.
The 3 C’s of Universal Health Care Coverage
1. Centeredness
2. Continuity
3. Competence
The Department of Health (DOH)
-is the national agency mandated to lead the
health sector towards assuring quality health
care for all Filipinos.
VISION
Filipinos are among the healthiest people in
Southeast Asia by 2022, and Asia by 2040.
MISSION
To lead the country in the development of a
productive, resilient, equitable and
people-centered health system.
In the pursuit of its vision and execution of its
mission, the DOH has the following major roles:
1. Leader in health
2. Enable and Capacity Builder
3. Administrator of specific services
2021 HEALTH EVENTS January-December
LIST OF HEALTH PROGRAMS
BLOOD DONATION PROGRAM
● Republic Act No. 7719, also known as the
National Blood Services Act of 1994, promotes
voluntary blood donation to provide sufficient
supply of safe blood and to regulate blood
banks. This act aims to inculcate public
awareness that blood donation is a
humanitarian
act.
CANCER CONTROL PROGRAM
● Pursuant to Rule II Section 4 of the IRR of RA
No. 11215 or the National Integrated Cancer
Control Act (NICCA), the National Integrated
Cancer Control Program was established
under the Cancer Control Division of the Disease
Prevention and Control Bureau (DPCB).
HIV, AIDS AND STI PREVENTION AND CONTROL
PROGRAM
● The National HIV, AIDS and STI Prevention and
Control Program (NASPCP) envisions
ZERO new infections, ZERO discrimination, and
ZERO AIDS-related death.
MENTAL HEALTH PROGRAM
● Republic Act 11036, otherwise known as the
Mental Health Act, has been promulgated to
enhance and integrate mental health service
delivery to Universal Health Care through
promotion and protection of the rights of
persons using psychosocial health services and
increasing investments in mental health.
Data Analysis involves several sub-steps:
Sorting of data for broad categories such as
those related with health status or practices of
family
members or data about home and environment
2. Clustering of related cues to determine
relationships between and among data
3. Distinguishing relevant from irrelevant data
to decide what information is pertinent to
understanding the situation at hand and what
information is immaterial.
4. Identifying patterns such as physiologic
function, developmental, nutritional /dietary,
coping/adaptation or communication pattern
and lifestyle
5. Comparing patterns with norms or standards
of health, family functioning and assumption of
health
task
6. Interpreting results of comparisons to
determine signs, symptoms or cues of specific
wellness
state, health deficit, health threats or
foreseeable crisis/s/stress point/ and their
underlying causes or
associated factors
7. Making inferences or drawing conclusions
about the reasons for the existence of the
health
condition or problems or risks for non-
maintenance of wellness state which can be
attributed to
non-performance of family health tasks.
Health Threats – conditions which are
conducive to disease, accident or failure to
realize one’s health
potential.
Examples:
Family history of hereditary disease
Threat of cross infection
Accident hazards
Faulty eating habits
Poor environmental sanitation
Unhealthy lifestyle/ perssonal habits
Health Deficit – instances of failure in health
maintenance.
-A gap between actual and achievable health
status
-Instances of failurein health maintenance
-possinle precursor of health deficit
-history of repeated infections or miscarriages
-No regular health checkup
Examples:
Illness state diagnosed and undiagnosed
Failure to thrive/develop
Disbility
Transient (Aphasiaor temporary paralysis after
CVA
Permanent (leg amputation secondary to
diabetes, blindness from measles, lamenes from
polio )
Foreseeable Crisis – anticipated periods of
unusual demand on the individual / family or
community in
terms of adjustment / family resources.
Examples:
Marriage
Pregnancy
Parenthood
Divorce or separation
Loss of job
Menopause
Death
Modifiability – refers to the probability of
success in minimizing, alleviating, or totally
eradicating the
problem through interventions.
Preventive Potential – refers to the nature and
magnitude of future problems that can be
minimized or totally prevented if intervention is
done on the problem under consideration.
Salience – refers to the person’s perception and
evaluation of the problem in terms of
seriousness and urgency of attention needed
Community problems and recommendations
1)Poor environmental sanitation as health
threat namely:
 Improper garbage disposal
 Air pollution
 Poor drainage system
 Noise pollution
 Poor ventilation
2.)Accident hazards as evidenced by:
▪ Pointed / sharp objects
▪ Narrow roads without fence
And fire hazards as evidenced by:
▪ Faulty electrical wiring
▪ Fire hazard on makeshifts and attached type of
houses
3.)Threat of cross infection from
communicable disease cases namely:
▪ PTB
▪ Fever
▪ Dengue
▪ Chicken Pox
▪ Malaria
Nursing Diagnosis
1. )Inability to make decision with respect to
taking appropriate action due to: 
1.Inaccessibility of appropriate resources of
care, specifically cost constraints or
economical / financial inaccessibility. 
2. Lack of trust / confidence in government
agencies. 
3. Feelings of confusion, helplessness, and or
resignation brought about perceived magnitude
/ gravity of the problem (or failure to
breakdown problems into manageable units of
attack).
2.) Inability to provide a home environment
conducive to health maintenance and
personal development due to:
▪ Limited financial resources.
▪ Lack of or inadequate knowledge of
preventive measures.
4. Failure to utilize community resources for
health care due to unavailability of required
care / service and inaccessibility of required
care due to cost constraints.
Goal of the student To impart knowledge about
safety measures and first aids.
Goal of the community To have higher levels of
care on taking appropriate actions in improving
the environment and minimize the risks /
possibilities of accidents.
Objectives of the community 
75% - 100% of the population will become
aware of the accident hazards in their
environment. 
50% - 75% will take appropriate action to
minimize possible causes of accidents. 
The community will create a group who can
perform first aid.
Intervention
1. Set a group meeting.
2. Discuss all accident hazards and ways to
avoid it.
3. Set a timetable for conducting seminar on
first aid
4. Coordinate with the Barangay and Local
Government Unit for records of plans to
improve and eliminate presence of accident
hazards.
D. Threat of cross infection from communicable
disease cases namely:
1. PTB
2. Malaria
3. Dengue
4. Pneumonia
5. Chicken Pox
Nursing Diagnosis
1. Inability to recognize the presence of the
problem due to inadequate knowledge.
2. Inability to make decision with respect
to taking appropriate health action due to:
 Inaccessibility of appropriate resources
of care, specifically cost constraints or
economical / financial inaccessibility.
 Low salience of the problem.
 Financial inaccessibility of appropriate
resources for care
3. Inability to provide nursing care to the
sick, dependent or vulnerable / at risk member
of the family
due to:
▪ Lack of or inadequate knowledge about the
nature, severity, complications, prognosis,
and management of the disease / health
condition.
▪ Lack of or inadequate knowledge of the nature
and the extent of nursing care needed.
▪ Lack of the necessary facilities, equipment,
and supplies for care.
▪ Lack of knowledge and skill in carrying out the
necessary treatment/ procedure/ care.
▪ Inadequate family resources for care
specifically financial constraints.
▪ Limited or lack of physical resources (isolation
room).
Goal of the student
To impart knowledge about proper
management of communicable diseases and
ways
to minimize possibilities of cross infection.
Objectives of the community
After nursing intervention:
 The people will become aware of the
threat of cross infection on communicable
disease
that one member has acquired.
 The people will have alternative course
of action to avoid the risk of cross infections.
Intervention
i. Set a group meeting.
ii. Discuss with the community the health
problem that they are having and the
means to minimize the risk of cross infection.
iii. Discuss the cycle of cross contamination.
iv. Coordinate with the Barangay Health
Officials and Local
v. Government Unit for possible financial
support.
Establishing Goals and Objectives (SMART)
● Specific – the objective clearly articulate who
is expected to do what, i.e.,the family or a
target family
member will manifest a particular behavior.
● Measurable – observable, measurable and
whenever possible, quantifiable indications of
the family’s
achievement as a result of their efforts toward a
goal provide a concrete basis for monitoring and
evaluation.
● Attainable – The objective has to be realistic
and in conformity with available resources,
existing
constraints, and family traits, such as style and
functioning.
● Time bound – Having a specified target time
or date helps the family and the nurse in
focusing their
attention and efforts toward the attainment of
the objective(Doran,1981)
TYPES OF EVALUATION
ONGOING EVALUATION – done while or
immediately after implementing an order;
enables nurse to make on the spot
modifications in an intervention.
INTERMITTENT EVALUATION - performed at
specified time intervals (once a week) to show
the extent of
progress toward the goal and enables nurse to
correct any deficiencies and modify care plan;
also called
PROCESS EVALUATION.
TERMINAL EVALUATION - indicates client
condition at the time of discharge; includes
status of goal
achievement and an evaluation of the client’s
self-care abilities with regard to follow - up care.
WAYS of CONDUCTING AN EVALUATION
FORMATIVE Evaluation – judgment made about
effectiveness of nursing interventions as they
are
implemented.
SUMMATIVE Evaluation – determining the end
results of family nursing care and usually
involves measuring outcomes or the degree to
which goals have been achieved.
ASPECTS OF EVALUATION
1. Effectiveness
2. Appropriateness
3. Adequacy
4. Effeciency
Home Visit - A professional, purposeful
interaction that takes place in the family’s
residence aimed at
promoting, maintaining or restoring the health
of the family or its members.
• The nurse makes a home visit upon the
family’s request, as a result of case-finding, in
response to
a referral, or to follow up clients who have
utilized services of a health facility such as a
health
center, lying-in clinic or hospital.
Phases of Home Visit
1.Pre-Visit Phase
• Determine the family’s willingness
• Set an appointment with them
• Formulate plan for the home visit
2.In-Home Phase
• Initiation
• Implementation
• Termination
3.Post-Visit Phase
• Documentation
THE NURSING BAG
● The bag technique is a tool by which the
nurse, during her visit will enable her to
perform a nursing
procedure with ease and deftness, to save time
and effort, with the end view of rendering
effective
nursing care to clients.
PRINCIPLES OF BAG TECHNIQUE
● Performing the bag technique will minimize, if
not prevent the spread of any infection.
● It saves time and effort in the performance of
nursing procedures.
● The bag technique should show the
effectiveness of total care given to an individual
or family.
● The bag technique can be performed in a
variety of ways depending on the agency’s
policy, the home situation, or as long as
principles of avoiding transfer of infection is
always observed.
IMPORTANT POINTS TO CONSIDER IN THE USE
OF THE BAG
● The bag should contain all the necessary
articles, supplies and equipment that will be
used to answer
emergency needs.
● The bag and its contents should be cleaned
very often, the supplies replaced, and ready for
use
anytime.
● The bag and its contents should be well
protected from contact with any article in the
patient’s home.
Consider the bag and its contents clean and
sterile.
● The arrangement of the contents of the bag
should be the one most convenient to the user,
to facilitate
efficiency and avoid confusion.
EXPANDED PROGRAM ON IMMUNIZATION
(LOGISTICS AND MANAGEMENT)
Mandatory infants and children immunization
act of
2001 (Expanded program of Immunization)
● An Act providing for mandatory basic
immunization services for infants and children
OVER ALL GOAL:
REDUCTION THE MORBIDITY AND MORTALITY
AMONG CHILDREN AGAINST THE MOST
COMMON VACCINE PREVENTABLE DISEASE
SPECIFIC GOALS:
● IMMUNIZE ALL INFANT /CHILDREN
AGAINST MOST COMMON VACCINE
PREVENTABLE DISEASE
● SUSTAIN POLIO FREE STATUS OF THE
PHILIPPINES
● ELIMINATE MEASLES INFECTION
● ELIMINATE MATERNAL AND NEONATAL
TETANUS
● CONTROL DIPHTHERIA, PERTUSSIS
HEPATITIS B AND GERMAN MEASLES
● PREVENT EXTRA PULMONARY
TUBERCULOSIS