NCM 113
Community Health Nursing
MONITORING & EVALUATION OF
COMMUNITY HEALTH PROGRAMS
IMPLEMENTED
MONITORING
 to watch and check a situation carefully for
a period of time
 In order to discover something about it:
 to observe and check the progress or
quality of (something) over a period of
time; keep under systematic review.
 to maintain regular surveillance
MONITORING – (United Nations-1978)
 “the continuous or periodic review and
surveillance by management at every level
of hierarchy of the implementation or an
activity to ensure that :
 input deliveries
 work schedules
 targeted outputs
 other required outputs are proceeding
according to plan
 Done during the implementation phase
PURPOSE OF MONITORING:
 Identify deviations or problems so that
corrective measures/actions or
interventions can be instituted immediately.
 Implies reporting to appropriate
persons/offices at regular intervals.
NURSING PROCESS IN CHN
1. Family
2. Individual
3. Population Group
4. Community
EVALUATION :
 the making of a judgment about the
amount, number, or value of something;
 In CHN, evaluation is specifying the worth
of the implemented:
 health programs
 performance of health facilities/human
resources
 Nursing care given to clients
 Analysis of the effectiveness, quality,
scope, and timeliness of services given
 “the process for determining systematically
and objectively the relevance, efficiency,
effectiveness, and impact of activities in the
light of their objectives (UN, 1978)
 Done during planning stage
PROGRAM EVALUATION
aims to:
 discover how well the objectives are being
fulfilled
 determine the reasons for specific successes
and failures
 Uncover principles underlying a successful
program
EVALUATION
 Help prevent costly mistakes
 Improve program planning/ implementation
in the future
RESPONSIBLE FOR EVALUATION IN
CHN:
 Head of the Unit (Physician)
 Local health programs
 Community Health Nurse
 Nursing care rendered to clients/Midwives
performance
 Midwife
 Assist in the evaluation of BHW
STEPS IN THE EVALUATION OF
NURSING CARE:
THE STEPS WILL:
 Guide the nurse in deciding whether to:
 continue
 modify
 terminate the nursing care plan
 Compare “what actually is” and “what
should be”
 Specify Objectives and Criteria
NCM 113

OBJECTIVES: something toward which effort

is directed : an aim, goal, or end of action
should be:
 client-centered
 outcome-focused
SAMPLE EVALUATION CHECKLIST
CRITERIA: a standard by which something can
be judged or decided.
 Objective
 Measurable
 Relevant
 Flexible
EXAMPLES:
 Objective: During home visit, Mr. Rodrigo
will be able to collect a good sputum
sample for microscopy
CRITERIA: Mr. Jaime collects sptum specimen
as instructed: SAMPLE EVALUATION INTERVIEW
 breaths air deeply Criterion:
 coughs strongly at the height of inspiration - The mother will be able to identify the
 spits the sputum into a sterile container consequence of Vit. A deficiency
 (35ml/mucopurulent) Question:
 covers the sputum cup - “Misis pwede mo ma sugid sa akon ang nabal
an mo kung ano matabo sa bata mo nga kulang
OUTCOMES: sya sa Bitamina A?
 Evaluation of nursing care given to clients Criterion:
focuses on outcomes - The mother will be able to identify food
 Outcomes can easily pinpoint nursing sources of Vit. A
interventions that are effective and those Question:
that are not - “Misis pwede ka kahatag sa akon lima ka
 Show value of care/services halimbawa sang pagka-on nga masustansya sa
Example: Mr. Jaime was able to collect sputum Bitamina A?
specime for microscopy correctly.
If skills are the focus of evaluation:
DESIGNING AND IMPLEMENTING  let client demonstrate the specific skill
EVALUATION PLAN AND MONITORING  can ask significant others for their
EVALUATION observation
 Tools/Instruments for evaluating outcomes Attitude:
of nursing interventions:  can be assessed through qualitative or
 Thermometer structured interviews
 BP app/stethoscope  “Kwentuhan” –informal talks but will
 Weighing scale make client more relax, open with their
 Tape measure feelings and not threatened by the presence
 Checklist – post CVA patient of the evaluator
 Interview –related to client’s condition
FEEDBACK:
SAMPLE FORM IN DESIGNING AN  serves many purposes:
EVALUATION FORM  motivates and reinforces positive behavior
 enhances client’s self image
 increases client’s awareness of the need to
improve their behaviors
 provide client the opportunity to articulate
their thoughts regarding tasks on hand
 Should be properly documented
 Family health record should be updated
regularly

PROGRAM EVALUATION
PROGRAM:
NCM 113

 An organize set of activities, projects,  cost-effective

processes or services which aims for the
realization of specific objectives.
 Has a broader scope, magnitude, and
diversity than a project
FOCUS OF EVALUATION
 timely
EXAMPLES OF INDICATORS:
1. Input indicators
 number of Vit. A capsules procured
 number and type of education/information
materials developed/reproduced
 number of BHWs trained on the prevention
of Vit. A deficiency

2. Process Indicator
 percentage (%) of Vit. A capsules
distributed to field offices
 percentage (%) of education/information
materials actually
 distributed to field office
 percentage (%) of BHWs actually trained

THREE TYPES OF PROGRAM 3. Output Indicators:

EVALUATION
1. Ongoing:
 analysis during implementation of the
activity of its continuing relevance,
efficiency, effectiveness
 present and like future outputs,
 effects, impact
 number of preschoolers weighed
 number of school children given Vit. A
 number of BHWs completed the training
4. Effect Indicators:
 number of preschoolers who increased
weight
 number of school children having good
eyesight
 number of trained BHWs doing health
teaching

2. Terminal:
 undertaken from 6-12 months after the
project completion
 a substitute for ex-post evaluation of the
project with short duration
 assess the achievement of overall results in
terms of efficiency, outputs, effect and
impact
 learn lessons for future planning
5. Impact Indicator:
 mortality rate : decreased by 10% in the
number of
 children with Vit. A deficiency
 BHWs manned the BHC during
consultation
STEPS IN PROGRAM EVALUATION
1. Deciding what to evaluate:
 what should be evaluated?
 content
 objectives of the program/project

3. Ex post:
 undertaken some years after project 5 Dimensions of program performance for
completion; impact have been realized evaluation:
 relevance
INDICATORS:  progress
 is a performance measure  effectiveness
 Indicator should be:  impact
 valid  efficiency
 reliable
 objective 2. Design the Evaluation : specifying
 sensitive - data collection methods
 specific
NCM 113

Tools:  Summary and Interpretation of Results:

 questionnaire  Conclusion:
 interview  Recommendation(s):
 checklist
Sources of data: DETERMINING FOCUS OF
 records/reports EVALUATION:
 surveys Basic Components of Focus of Evaluation:
 interview
1. For which audience is the evaluation being
3. Collect relevant data (based on facts) Why conducted?
relevant data is important?  Ex.: patient and families, groups, peers
 indisputable
 creates strong strategies 2. For what purpose is the evaluation
 necessary for optimization conducted?
 builds better relationship  > answer the questions > why is the
 strengthen internal team evaluation being conducted?
 quantifies the purpose of work
 helps cover yourself 3. Which question will be asked in the
evaluation?
4. Analyze data:  must be directly related to the purpose of
What to analyze: the evaluation
 is the program relevant?  must be specific
 progressing according to program plan?  must be measurable
 is it effective?
 is it efficient? 4. What is the scope of the evaluation
 did it make an impact on  > extent of what is being examined
beneficiaries/community? (mothers or entire population)
 do benefits outweighs the problem created?  > time frame
 lessons learned from the program/project?
5. Which resources are available to conduct
5. Make decisions if: the evaluation?
 program is effective/efficient = continued  time
or applied to another program or group  expertise
 there is another phase of the program =  personnel
positive  materials
 result serves as a go signal to start the next  equipment
phase (guided, modified, improved)  facilities
 not relevant = recommend modification or
termination 4 LEVELS OF PROGRAM EVALUATION:
1. Process (Formative) Evaluation
make necessary adjustments to an activity as
soon as they are identified such as:
 personnel
 materials
 facilities
 methods
 objectives
 attitude

6. Report/Give Feedback 2. Content Evaluation

 should be submitted to:
 Local authorities (Mayor)
 Sanggunian Bayan Chair (Health)
 Local Health Board
SAMPLE FORMAT FOR EVALUATION
REPORT
 Executive Summary of Program Evaluation
 Brief Description:
 Focus/Coverage/Objectives
 determine whether learners have acquired
knowledge or skills
 during the learning experience
 focus on how the teaching-learning process
affected
 immediate
 short term outcomes
 focus on collecting internal evidence to
determine whether objectives for a
specific group of learners were met
NCM 113

 The accomplishments and degree to

3. Outcome (Summative) Evaluation which objectives are met and the quality of
 determine the effects of teaching effort service rendered
 measures that changes that results from
teaching efforts PURPOSES OF HEALTH RECORDS:
1. Patient care
4. Impact Evaluation 2. Communication
 determine the relative effects of education 3. Legal documentation
on the community 4. Billing and Reimbursement
 obtain information that will help decide 5. Research and Quality Assurance
whether continuing the activity is worth its
cost (cost effective) USES OF HEALTH RECORDS:
 Empower health care professionals to
BARRIERS TO EVALUATION treat patients to the best of their ability.
1. Lack of clarity  Safety can be increased
 if focus of evaluation is unclear, unstated,  Processes can be sped up
or not well defined= unknown result  Claims processes and reimbursement can
2. Lack of ability – often results from lack of: be improved
 knowledge  Effectiveness of treatments and therapies
 interest can be monitored and tracked
 confidence  With growing amount of information,
 resources needed to carry out the outcome predictions can be made
evaluation process  Liability is reduced as a result of oversight
3. Fear of punishment or loss of self esteem  With IT, loss of information, errors, and
 evaluation might be perceived as a omission can be significantly reduced
judgment of someone’s value or personal
worth TIPS FOR RECORD KEEPING:
 both teacher and learner may fear that 1. Always date and sign your name
anything less than perfect will result to: 2. Correction must be shown clearly as:
 criticism  alteration
 punishment  complete with date
 being labeled as incompetent  amendments
 name of nurse
RECORDS IN FAMILY NURSING 3. Making good notes should become a
HEALTH PRACTICE routine
4. Document all:
HEALTH RECORDS – is a written document  decisions made
about a target client, whether:  discussion
 individual person,  information given
 family,  relevant history
 a group or  clinical findings
 a whole community  patient progress
 results
 Relates an event pertinent to health care  investigation
services:  Referrals
 clinic 5. DO NOT WRITE offensive or gratuitous
 hospitalization comments
 Immunization 6. Patient can access to his/her record
 consultation 7. Maintain best practice aiding clear
 home visit communication
 births/marriages/deaths 8. Essential for good medical practice and
continuity of care
HEALTH REPORTS – account or summary 9. Appropriate record keeping is recognized
of the services rendered to the clients and as important to professional standard
rationalizes the continued existence of the
program. FIELD HEALTH SERVICES
 Gives a description and analysis of the INFORMATION SYSTEM
problem(s) encountered FHSIS – is a network of information source
 The measures or actions developed by the Department of
taken/implemented Health.
NCM 113
 intended to address the short-term data
needs of the DOH staff with managerial
and supervisory functions in the DOH
facilities and in each of the program areas
 aims to monitor national health service
delivery system act as:
 source of referral
 evaluation
 legal document in court cases
 validation
 delivery of quality patient care
OBJECTIVES OF FHSIS:
1. Provide summary of data on health services
and selected program indicators in all levels
2. Provide data for program monitoring and
evaluation purposes
3. Ensure that data reported are useful,
accurate, and easy to understand
4. Minimize recording and reporting burden
at the service delivery level
IMPORTANCE OF FHSIS:
 Helps local government to 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 for detecting unusual
occurrence of illness
 Helps in monitoring the health status of
the community
 Helps midwives/ CHN nurses in
monitoring clients
 Helps in documentation of RH
Midwives/CHN Nurse day-to-day
activities
DOH PROGRAMS AS FOCUS OF FHSIS:
 Maternal and Child Health (MCH)
 Maternal Care
 Expanded Program on Immunization (EPI)
 Control of Diarrheal Disease (CDD)
 Leprosy
 Nutrition
 Tuberculosis/Malaria,
 Schistosomiasis
 Dental Health
 Family Planning
 Environmental health
COMPONENTS OF FHSIS:
A. Recording:
1. Individual Treatment/Family Treatment
Record
 most basic record which must be kept in
the facility
 Fundamental building block of FHSIS it
contains:
 client’s data: name, address, date of birth,
religion,
 weight
 chief complaints, vital signs, diagnosis,
treatment(s)
 date of treatment, consultation
FORMAT OF TREATMENT RECORD
Target/Client List:
A. Constitute the second building block of
the FHSIS
4 Purposes:
1. Plan and carry out patient care and service
delivery to prevent duplication or redundancy
2. Facilitate monitoring and supervision
3. Report services delivered, information or
tally sheets for easy reporting
4. Provide clinic-level data base for further
studies
B. Programs to be maintained in the
target/client list:
 EPI
 Eligible Population
 Children 9-59 months (risk, Under 5
Children)
 Nutrition
 Pre-Natal Care
 Post Partum Care
 Family Planning
 TB Symptomatic/TB Patients under
SCC/TB Patients under Standard Regimen
 Leprosy/Malaria/Schistosomiasis Patients
3. SUMMARY TABLE
a) Is a form with 12-month column retained
at the Barangay Health Station (BHS)
- Midwives made relevant monthly report
b) parts of the summary table:
 health program accomplishment
 midwives record all data found in the target
client list (TCL)
 serves as source of data for reports
prepared by midwives
 serves as data source for survey, study, or
research
 serves as a tool for the midwife to assess
her own accomplishment
4. MONTHLY CONSOLIDATION TABLE–
show monthly trend of disease occurrence
B. REPORTING:
NCM 113

1. Tally/Reporting Forms- data are  Feel group belongingness

transmitted from one health facility to
another
* weekly* monthly* quarterly* annually* or
even few minutes
 Intensification of personal involvement
 Group intimacy and closeness
 Freedom to talk about themselves
 Unite against the world
 Consider others outside the group as
“enemies”
= becomes a mature work group

THE WORK GROUP STAGE: (true

teamwork)
2. Output Reports/Tables – produced at the
 The uniqueness of the members/leaders are
PHO back to BHS/BHC to RHO
seen and expected
 Conflict exist on substantive issues rather
THE STAGES OF GROUP
than emotional ones
DEVELOPMENT (Dependency Stage)
 Emerging of mutual support for
 Task confronting group members during
individuality
initial stage:
 May last for the remainder of the group’s
1. They must determine a way of achieving their
life
primary task (the purpose to which they join the
 The tension in the work group is between
group)
“work” or progress, and regression to an
2. They must find a place for themselves in the
early stage which can be minimizes
group ( gratification from the pleasure of group
through:
membership)
 nursing interventions
 tasks
BEHAVIORAL PATTERNS OF INITIAL
 techniques
GROUP MEMBERS:
A. “in” or “out” of the group
STAGES OF WORK GROUP
B. Liked, respected or ignored by the group
DEVELOPMENT:
C. Communication are limited, repetitious,
and restrained
 members are careful with their words
 discuss topics with little substantive interest
 vehicle to explore how they are perceived
by co-members=discovers who eventually:
 responds favorably
 sees things the way she/he does
 whom to fear
 whom to respect
D. Members search for similarities (group
cohesiveness)
E. Giving and seeking advice
 Early group members can be described as a
groping, testing, or reluctant group
 Lines of interaction within the group are
leader-centered THE TERMINATION STAGE:
 Experience a sense of ending
THE STAGE OF CONFLICT: (authority)  Tasks on this stage includes:
 Characteristics :  finishing the agenda
 dominance  establishing key decisions
 control  completing the group product
 power  tying up loose ends
 judgmental  writing off unfinished business
 emergence of hostility towards the leader  Key emotions are joy and sadness
( imperfections, limitations, favoritism)  Celebrates work achievements
 groups may be divided into competing (party/graduation)
groups
THE STAGE OF COHESIVENESS:
 Characteristics:
 Increase of morale and mutual trust
NCM 113
INTERVENTIONS TO FACILITATE
GROUP GROWTH
I. PROVIDE THE NECESSARY
ORIENTATION, STRUCTURE, AND
DIRECTIONS
 preliminary introductions should be made
 opportunities to clarify or elucidate:
 on the goals and purposes of the group,
 expectations and perceptions on roles and
responsibilities
 lines of interaction can be changed from
leader-centered to group-centered
 Help group members meet their
interpersonal needs:
 Acknowledge importance of the presence
and contributions of each group member
(feeling of belonging)
 Leader encourage productive group
participation
 Observe member for signs/effort to be
heard
 Giving opportunity to contribute
 Identify those too eager to talk (take up all
groups time)
 Encourage and support members who
actively participate
 Summarizing and clarifying contributions
 Not monopolizing the discussion or
 Commenting frequently
II. PROCESS, NEGOTIATE, AND
RESOLVE CONFLICTS TO
MEMBERS SATISFACTION:
A. Understanding nature of conflict
a) Conflict is natural of any relationships
and of any group
b) Conflict is desirable and extremely
valuable
 encourages inquiry, promotes objectivity,
and sharpens analysis
 stimulates interest and curiosity, increases
motivation and energy of group members
 reduce natural tension and frustration of
working together
 achieve greater self understanding/self-
awareness
c) Conflict can be handled constructively
through:
 developing specific norms/rules conducive
to healthy management of conflicts
 encourage group cooperation
 use problem-solving techniques
B. Conflict Resolution Through the Problem-
Solving Approach
Basic steps:
 Clarify Issues – opposing view points
must be clarified
 Diagnose the dimension and causes of
conflict
 cognitive or intellectual (differences in
information, beliefs, opinions, ideas,
assumptions)
 psychological or emotional
C. Explore ways to settle the conflict
Steps to better Problem-Solving
1. Identify the problem
2. Generate potential solutions
3. Choose one solution
4. Implement solution
5. Evaluate results
D. Decide upon and implement agreement
satisfactory to the group
E. Evaluate the success of the action taken
C. GENERATING NEW WAYS OF
LOOKING AT THE SITUATION OR
PROBLEM
 Creative problem-solving is traditionally
based on the following key principles:
1. Balance Divergent and Convergent
Thinking
 Divergent thinker- thinks of all possible
ways to reach a solution.
 Involves more creativity and accepts
multiple solution to a problem
 Convergent Thinker- thinks of a final
solution
NCM 113
 Focuses on reaching on well-defined
solution to a problem.
2. Reframe Problems as Questions
3. Defer Judgment of Ideas
4. Focus on "Yes, And" Instead of "No, But"
5. Creating a Problem Story
6. Brainstorming
7. Alternate Worlds
D. HELPING MEMBERS ANALYZE THE
HERE-AND NOW EXPERIENCE
 The feelings and experiences of the
members in the present moment
 Intervention helps members recognize,
examine, and understand the “what” And
“how” Of interactions or behavior soon
after they are experienced by the group
members
III. BE AWARE OF THE EFFECTS OF
OWN BEHAVIOR ON THE GROUP:
 Use self for group growth
 Facilitator- model of the group
 on time for meetings
 keep appointments
 keep promises
 do not railroad group decisions (turn
aside/differ)
IV. ACT AS THE GROUP’S
COMPLETER/RESOURCE PERSON
 Facilitator performs the necessary task
functions or group-building functions not
being performed by the group
 Facilitator acts as a resource person when
expertise or information is not available to
the group for good decision-making
V. DERIVE OPPORTUNITIES TO APPLY
LEARNING ON ANOTHER
 Situation
 Facilitator help group members undergo
successfully the stage of termination
 Facilitator help group members to realize
the advantages of investing resources,
efforts, and feelings for a successful
group work far outweigh the unpleasant
emotions of separation
FILIPINO CULTURE, VALUES,
PRACTICES IN RELATION TO HEALTH
CARE
 Is directed towards a concrete other and is
based on free choice, albeit often
accompanied by a strong sense of personal
duty.
 The most human value because it makes it
possible to resist the adversities that arise
throughout life
 It is synonymous with support, backing,
help and protection.
CHARACTERISTICS OF SOLIDARITY
 An awareness of shared interests,
objectives, standards, and sympathies
creating a psychological sense of unity of
groups or classes, which rejects the class
conflict.
 It refers to the ties in a society that bind
people together as one.
7 WAYS TO SHOW SOLIDARITY
1. Take care of the elders
2. Reconnect with family and friends
3. Stay
4. Pay attention to your behavior
5. Be the bearer of good news
6. Don’t buy like crazy
7. Stay together locally and globally
FILIPINO FAMILY VALUES
FILIPINO VALUES:
 Family orientation. The basic and most
important unit of a Filipino's life is the
family.
 Filipino family consists of a husband, wife
and children, extending to include
grandparents, aunts, uncles and cousins.
 Joy and humor
 Flexibility, adaptability, and creativity
 Religious adherence
 Ability to survive – capacity for endurance
despite difficult times
 Ability to survive – capacity for endurance
despite difficult times
 Hospitality
FILIPINO FAMILY CULTURE AND
TRADITIONS
NCM 113
Family Culture
 Filipinos are known for having:
 Strong and close family ties
 Place high regard and put importance on
their family before anything else.
 Work all day and do all they can to feed
and provide for their family.
1. Filipinos are resilient
 Always manage to rise above challenge
 Manage to pick themselves up and smile
 Overcoming experiences of suffering and
trauma due to disasters.
2. Filipinos take pride in their families –
family first
3. Filipinos are very religious
 Images of crosses and other religious
paraphernalia
 Go to church every Sunday
4. Filipinos are respectful
 Using catchphrases – PO and OPO
(pagmamano)
5. Filipinos help one another (Bayanihan
Spirit)
6. Filipinos value traditions and culture
 Set aside a specific day for a celebration
plus preparing sumptuous foods
7. Filipinos love to party
8. Filipinos have the longest Christmas
celebration
9. Filipinos love to eat
10. Filipino loves art and architectures
 love to design creatively, to think
intuitively, and have a passion for anything
different and unique
11. Filipinos love to sing
 to express their happiness
The ten most depicted Filipino traits:
1. Pakikisama - “getting along with others”
2. Hiya -shy, timid, sensitive rather than
ashamed.
3. Utang na loob- means "debt of prime
obligation."
4. Close family ties- results to extended
family having regular meals together
taking holidays as family
5. Bahala na- unable to decide their next
course of action
6. Amor propio
 Personal pride/reputation
 Self-esteem
 Respect for oneself
7. Bayanihan – being a bayan
spirit of community unity/ cooperation
8. Hospitality- the friendly and generous
reception and entertainment of guests
9. Ningas Cogon- lack of sustained
perseverance.
10. Respect to elders- demonstration of
respect
FILIPINO HEALTH PRACTICES
Health beliefs are:
 What people believe about their health,
 What they think constitutes their health,
 What they consider the cause of their
illness,
 And ways to overcome an illness.
 These beliefs are, of course, culturally
determined, and all come together to form
larger health belief systems
Traditional medicine refers to:
 Health practices, approaches, knowledge
and beliefs incorporating plant, animal and
mineralbased medicines, spiritual therapies,
manual techniques and exercises,
 Applied singularly or in combination to
treat, diagnose and prevent illnesses or
maintain well-being.
FILIPINO TRADITIONAL HEALTH
PRACTICES
1. Midwifery - is the health science and health
profession that deals with
 Pregnancy
 Childbirth
 Postpartum period (including caring of the
newborn)
2. Pulse diagnosis - allows one to retrieve
detailed information about the internal
functioning of the body and its organs through
signals present in the radial pulse.
3. Bone Setting - treats musculoskeletal
disorders with the conjunctive use of TCM
orthopedics, osteopathic and chiropractic
approaches. Bone setting procedures are mostly
non-invasive, thus leaving mild to no damage to
the human body
 Traditional bone setter is a lay practitioner
who practices management of dislocations
and fractures without having had any
formal training.
4. Herbology - the study or collecting of herbs
5. Suction cupping- an ancient healing therapy
that some people use to ease pain. A provider
places cups on your back, stomach, arms, legs or
NCM 113
other parts of your body. Inside the cup, a
vacuum or suction force pulls skin upward.
6. Skin scraping – also called spooning or
coining used to scrape over the skin and improve
circulation in the area
7. Herbal steam and smoke
8. Energy medicine - is a branch of alternative
medicine based on a pseudo-scientific belief
that healers can channel "healing energy" into a
patient and effect positive results.
Path to improved health
 Eat healthy. What you eat is closely linked
to your health
 Get regular exercise
 Lose weight if you're overweight
 Protect your skin
 Practice safe sex
 Don't smoke or use tobacco
 Limit how much alcohol you drink
 Have regular medical check up
NURSING CORE VALUES AS CHN
 Shared within the global community
 Reflection of the human and spiritual
approach to the nursing profession
1. Altruism
 The principle and moral practice of concern
for the happiness of other human beings or
other animals
 The unselfish concern for other people—
 Doing things simply out of a desire to help,
not because you feel obligated to out of
duty, loyalty, or religious reasons.
2. Autonomy – freedom/independence
3. Human dignity-
 The recognition that human beings possess
a special value intrinsic to their humanity
and as such are worthy of respect simply
because they are human beings.
 Every human being, regardless of age,
ability, status, gender, ethnicity, etc., is to
be treated with respect
4. Integrity - the quality of being honest and
having strong moral principles; moral
uprightness.
5. Honesty - the quality or fact of being
 honest;
 upright and fair
 truthful
 sincere
 frank
 free from deceit or fraud.
6. Social justice
 Is justice in terms of the distribution of
wealth, opportunities, and privileges
within a society
 Fairness as it manifests in society.
 Includes fairness in healthcare,
employment, housing, and more
 Applies to all aspects of society, including
race and gender, and it is closely tied to
human rights.
PRINCIPLES OF ETHICS IN NURSING
1. Justice- the quality of being just;
righteousness, equitableness, or moral rightness
2. Beneficence
 to act for the benefit of others,
 helping them to further their important and
legitimate interests
 preventing or removing possible harms
3. Nonmaleficence
 obligation of a physician/nurse not to harm
the patient.
 do not kill
 do not cause pain or suffering
 do not incapacitate
 do not cause offense
 do not deprive others of the goods of life.
4. Accountability
 When an individual or department
experiences consequences for their
performance or actions
 Is equated with answerability,
blameworthiness, liability, and the
expectation of account-giving
5. Fidelity
 Allegiance, fealty, loyalty, devotion, piety
mean faithfulness to something to which
one is bound by pledge or duty.
 Fidelity implies strict and continuing
faithfulness to an obligation, trust, or
 Duty.
6. Autonomy
 Independence or freedom
 Ability of the person to make his/her
decision
7. Veracity
 is the quality of being true or the habit of
telling the truth
NCM 113

 credibility Score: 1 out of 1 Yes

 fairness
 genuineness Question 6
 honesty  Which of the following levels of program
 impartiality evaluation makes necessary adjustments to
 probity an activity as soon as they are identified?
 sincerity
 truthfulness Response: Formative evaluation
Correct answer: Formative evaluation
Score: 1 out of 1 Yes

Question 7
 Which of the following is NOT among the
aims of program evaluation?
Question 1
Response: Maintain regular surveillance
 Which of the following health records is the
Correct answer: Maintain regular surveillance
fundamental building block of FHSIS?
Score: 1 out of 1 Yes
Response: Individual Treatment Card
Correct answer: Individual Treatment Card Question 8
Score: 1 out of 1 Yes  Which of the following types of program
evaluation is the analysis during
Question 2 implementation of the activity?
 Which of the following types of program Response: Ongoing evaluation
evaluation is a substitute for ex-post
Correct answer: Ongoing evaluation
evaluation?
Score: 1 out of 1 Yes
Response: Terminal evaluation
Correct answer: Terminal evaluation Question 9
Score: 1 out of 1 Yes  the making of a judgment about a value or
amount of something is?
Question 3
Response: Evaluation
 Which of the following is a standard by which
Correct answer: Evaluation
something can be judge or decided?
Score: 1 out of 1 Yes
Response: Criteria
Correct answer: Criteria Question 10
Score: 1 out of 1 Yes  Which of the following are purposes of health
records?
Question 4
Response: all of the above
 Which step in the evaluation of nursing care,
Correct answer: all of the above
evaluator consider if a new problem arise?
Score: 1 out of 1 Yes
Response: Diagnosis
Correct answer: Diagnosis Question 11
Score: 1 out of 1 Yes  Which of the following records is the second
building block of FHSIS?
Question 5
Response: Target or Client list
 The following statements describe monitoring.
Correct answer: Target or Client list
Which one is not included?
Score: 1 out of 1 Yes
Response: Monitoring is tomaintain irregular
surveilance
Question 12
Correct answer: Monitoring is tomaintain
irregular surveilance
NCM 113

 The analysis of the effectiveness, quality,  Which of the following in program surveillance
scope, and timeliness of the services given to is done during the implementation phase of
the client is: the project?
Response: Evaluation Response: Monitoring
Correct answer: Evaluation Correct answer: Monitoring
Score: 1 out of 1 Yes Score: 1 out of 1 Yes

Question 13 Question 19
 The following are barriers to evaluation  Which of the following is a written document
EXCEPT: about a target client?
Response: Evaluator has confidence on what Response: Health records
to evaluate
Correct answer: Health records
Correct answer: Evaluator has confidence on
Score: 1 out of 1 Yes
what to evaluate
Score: 1 out of 1 Yes Question 20
Question 14  Evaluation in CHN the worth of the following
EXCEPT:
 Feedback is necessary for program
Response: Performance of the program head
evaluation EXCEPT:
Correct answer: Performance of the program
Response: Feedback creates conflict among
head
group members
Score: 1 out of 1 Yes
Correct answer: Feedback creates conflict
among group members
Question 21
Score: 1 out of 1 Yes
 The following are basic components of focus
Question 15 of evaluation. Which among them is not
included?.
 The objectives or aims of a program should
Response: Indicator
be:
Correct answer: Indicator
Response: Client-centered
Score: 1 out of 1 Yes
Correct answer: Client-centered
Score: 1 out of 1 Yes Question 22
Question 16  Which of the following is a network of
information develop the by Department of
 Which of the following is an informal talk Heath to monitor national health care delivery
during evaluation that made client more relax system?
and open his/her feelings towards task on
Response: FHSIS
hand?
Correct answer: FHSIS
Response: Kwentuhan
Score: 1 out of 1 Yes
Correct answer: Kwentuhan
Score: 1 out of 1 Yes Question 23
Question 17  The nursing process in CHN follows these
steps:
 Which of the following is an output indicator?
Response: Assessment, Diagnosis, Planning,
Response: Number of BHWs completed Implementation, Evaluation
training
Correct answer: Assessment, Diagnosis,
Correct answer: Number of BHWs completed Planning, Implementation, Evaluation
training
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 24
Question 18
NCM 113

 Which of the following show value of care or Question 6

services rendered to clients?
 Which of the following Filipino traits refers to
Response: Output being friendly and accommodating in receiving
Correct answer: Output and entertaining visitors?

Score: 1 out of 1 Yes Response: Hospitality

Correct answer: Hospitality
Question 25
Score: 1 out of 1 Yes
 During home visit, Nurse Lea planned that Mr.
Lim will be able to collect good specimen for Question 7
his sputum follow-up. This is an example of:
 The traditional health practice known also as
Response: Objective spooning or coining is:
Correct answer: Objective Response: Skin scraping
Correct answer: Skin scraping
Score: 1 out of 1 Yes

Question 1 Question 8
 Amor Propio is regarded as, EXCEPT:  Which of the following traits of a nurse act for
the best interest of the patient?
Response: Debt of prime obligation
Response: Beneficence
Correct answer: Debt of prime obligation
Correct answer: Beneficence
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 2
Question 9
 The following statements refer to justice.
Which among the is not included?  Which of the following is the building block of
solidarity in the family?
Response: Being credible
Response: Community
Correct answer: Being credible
Correct answer: Family
Score: 1 out of 1 Yes
Score: 0 out of 1 No
Question 3
Question 10
 Utang na loob means:
 Filipino people are resilient because,
Response: Gratitude EXCEPT:
Correct answer: Gratitude Response: They become hopeless after
sufferings
Score: 1 out of 1 Yes
Correct answer: They become hopeless after
Question 4 sufferings
 This refers to the study of gathering herbal Score: 1 out of 1 Yes
plants:
Response: Herbology
Question 11
 Which of the following implies strict and
Correct answer: Herbalism
continuing faithfulness to an obligation or duty:
Score: 0 out of 1 No
Response: Fidelity
Question 5 Correct answer: Fidelity
 Pakikisama is: Score: 1 out of 1 Yes
Response: Getting along with others
Question 12
Correct answer: Getting along with others
 The quality of being honest and morally
Score: 1 out of 1 Yes upright is:
NCM 113

Response: Integrity Correct answer: Relying on others in decision

making
Correct answer: Integrity
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 19
Question 13
 Social justice are defined as, EXCEPT:
 Which of the following statement is the spirit
of community unity or cooperation? Response: Social justice is only for the upper
echelon of society
Response: Bayanihan
Correct answer: Social justice is only for the
Correct answer: Bayanihan
upper echelon of society
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 14 Question 20
 This refers to the habit of a nurse to tell the
 Which of the following traditional health
truth all the time in doing her responsibility to a
practices allows practitioner to retrieve detail
client:
information about body functioning through
Response: Veracity feeling pulses of client:
Correct answer: Veracity Response: Pulse Diagnosis
Score: 1 out of 1 Yes Correct answer: Pulse Diagnosis
Score: 1 out of 1 Yes
Question 15
 Nurse Mary always performs her nursing Question 21
responsibilities appropriately even without her
 Which of the following Filipino traits refers to
head nurse monitoring her work.. This is:
being shy or timid?
Response: Integrity
Response: Hiya
Correct answer: Integrity
Correct answer: Hiya
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 16 Question 22
 The following are reflections of altruism.
 Which of the following is NOT a characteristic
Which one is NOT among them?
of family solidarity?
Response: Feeling obligated to duty due to
Response: Create misunderstanding among
religious reasons
family members or groups
Correct answer: Feeling obligated to duty due
Correct answer: Create misunderstanding
to religious reasons
among family members or groups
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 17 Question 23
 Which of the following traditional health
 Which of the following Filipino traits is
practices healers can channel his/her energy
equated to Juan Tamad?
to cure clients:
Response: Bahala na
Response: Energy medicine
Correct answer: Bahala na
Correct answer: Energy medicine
Score: 1 out of 1 Yes
Score: 1 out of 1 Yes
Question 24
Question 18
 Midwifery refers to health science and health
 Autonomy means EXCEPT:
profession that deals with, EXCEPT:
Response: Relying on others in decision
Response: Immediate Post partum care
making
Correct answer: Family Planning
NCM 113

Score: 0 out of 1 No

Question 25
 Which of the following statements is equated
to answerability or blameworthiness:
Response: Accountability
Correct answer: Accountability
Score: 1 out of 1 Yes

Question 26
 Nurse Lucy decides to perform her
independent nursing care to a client. This is:
Response: Autonomy
Correct answer: Autonomy
Score: 1 out of 1 Yes

Question 27
 Which of the following is an obligation of a
physician or nurse NOT to harm the patient
during his/her care?
Response: Nonmaleficence
Correct answer: Nonmaleficence
Score: 1 out of 1 Yes

Question 28
 Which of the following core values of a
Community Health Nurse refers to the
unselfish concern for other people?
Response: Altruism
Correct answer: Altruism
Score: 1 out of 1 Yes

Question 29
 Mr. Narciso is managing dislocations, sprains
or fractures without formal training. He is
practicing:
Response: Bone setting
Correct answer: Bone setting
Score: 1 out of 1 Yes

Question 30
 This is an ancient healing therapy where
practitioner places cups along several
pressure points at back or stomach of client:
Response: Suction cupping
Correct answer: Suction cupping
Score: 1 out of 1