CHNN 312 REVIEWer 2.

Education: change within the individual

Responsibilities of CHN o 3 Key Elements of Education:

— K nowledge
— be a part in developing an overall health plan, its — A ttitude
implementation and evaluation for communities — S kills
— provide quality nursing services to the three levels of
clientele 3. Communication: interaction involving 2 or more persons or
— maintain coordination/linkages with other health team agencies
members, NGO/government agencies in the provision of
public health services o 3 Elements of Communication:
— conduct researches relevant to CHN services to improve — Message
provision of health care — Sender
— provide opportunities for professional growth and — Receiver
continuing education for staff development.

Standards of CHN
1. Theory: Applies theoretical concepts as basis for decisions in
practice
2. Data Collection: Gathers comprehensive, accurate data
systematically.
3. Diagnosis: Analyzes collected data to determine the needs/
health problems of IFC
4. Planning: At each level of prevention, develops plans that
specify nursing actions unique to needs of clients
5. Intervention: Guided by the plan, intervenes to promote,
maintain or restore health, prevent illness and institute
rehabilitation.
6. Evaluation: Evaluates responses of clients to interventions to
note progress toward goal achievement, revise data base,
diagnoses and plan
7. Quality Assurance and Professional Development
— Participates in peer review and other means of
evaluation to assure quality of nursing practice.
— Assumes professional development.
— Contributes to development of others.
8. Interdisciplinary Collaboration: Collaborates with other
members of the health team, professionals and community
representatives in assessing, planning, implementing and
evaluating programs for community health.
9. Research: Indulges in research to contribute to theory and
practice in community health nursing.
PUBLIC HEALTH WORKERS (PHW)
PHW’s: are members of the health team who are professionals
namely
o Medical Officer (MO)-Physician
o Public Health Nurse (PHN)-Registered Nurse
o Rural Health Midwife (RHM)-Registered Midwife-
o Dentist
o Nutritionist
o Medical Technologist
o Pharmacist
o Rural Sanitary Inspector (RSI)-must be a sanitary
engineer
DOH FIVE MAJOR FUNCTIONS:
o Ensure equal access to basic health services
o Ensure formulation of national policies for proper
division of labor and proper coordination of operations
among the government agency jurisdictions
o Ensure a minimum level of implementation nationwide
of services regarded as public health goods
o Plan and establish arrangements for the public health
systems to achieve economies of scale
o Maintain a medium of regulations and standards to
protect consumers and guide providers.
EO 103: 3 MAJOR FUNCTIONS
1. LEADERSHIP IN HEALTH: Policies in Health
2. ENABLER and CAPACITY BUILDER: New strategies
and Training
3. ADMINISTRATIVE FUNCTION: Manages Tertiary
facilities

3 ELEMENTS IN HEALTH EDUCATION: IEC
1. Information: to share ideas to keep population group
knowledgeable and aware
VISION: Filipinos are healthiest in Southeast Asia in 2022, in
Asia in 2040
MISSION: To lead the country in the development of a
productive, resilient, equitable and people-centered health system
for Universal Health Care.
 EPIDEMIOLOGY

2. Distribution - Epidemiology is concerned with the frequency

and pattern of health events in a population:

Analysis by:

 Places
 time and
 classes of people affected

FREQUENCY

— Frequency refers to the number of health events & the

relationship of that number to the size of the population.
— Compare disease occurrence across different Natural Life History of Disease & Application of Levels of
populations. Disease Prevention

PATTERN

— Refers to occurrence of health-related events by time,

place, and person.
— Time patterns may be annual, seasonal, weekly, daily,
hourly, weekday versus weekend, or any other
breakdown of time that may influence disease or injury
occurrence.

LEVEL OF PREVENTION

— Administered to patient is dependent on the stage of the

disease when patient was diagnosed.

Primary Prevention

o Primordial Prevention - focusing on prevention of

emergence of risk factors
o Specific Protection - Removal of the risk factors of
reduction of their levels.

Secondary Prevention

o Aims to identify & treat existing health problems at

earliest possible time.

Tertiary Prevention

o Limits disability progression.

o Reduce magnitude of residual effects of both infections
and non-communicable disease.

Steps of Epidemiological Investigation

1. Operationally define what constitute a “case”

 o Case Definition - It is a set of standard criteria for
classifying whether a person has a particular disease,
syndrome, or other health condition
Case finding / screening activities:
o Screening is the presumptive identifications of
unrecognized diseases or defects
o Case finding is done to look for previously unidentified
cases of diseases
o Sensitivity is the proportion of persons with a disease
who test positive on a screening test.
o Specificity is the proportion of persons without a disease
who have negative results on a screening test.
2. Based on the operational definition, identify the cases
Case classification
o Suspected: A case that meets the clinical case definition.
o Probable: A suspected case as defined above or ongoing
epidemic and epidemiological link to a confirmed case.
o Confirmed: A suspected or probable case with
laboratory confirmation.
NOTE: “ case “ classified as suspected or probable while waiting
for the laboratory results to become available. If laboratory
provides report, case can is reclassified as either confirmed or
“not a case”.
3. Based on the number of cases identified, verity the existence
of an outbreak
o Outbreak carries the same definition of epidemic, but is
often used for a more limited geographic area.
o Cluster - aggregation of cases grouped in place & time
that are suspected to be greater than the number
expected, even though the expected number may not be
known.
4. Establish the descriptive epidemiologic features of the cases
 Correlate : char. Of grp of persons, place, time
TIME - The occurrence of disease changes over time. Some of
these changes occur regularly, while others are unpredictable.
Time Variations:
Cyclical Variation
 FLUCTUATION in incidence
o Short period of time
o Due to seasonal
o Ex. Measles.
Secular Variation
 Changes in the TREND of disease occurrence
o Over a long period of time.
SHORT TIME FLUCTUATIONS
a) Common Source Epidemic – Simultaneous exposure of
a large number of people to a common infectious agent.
b) Propagated Epidemic – Person to person transmission.
Place
a. Describing occurrence of disease by place provides insight into:
 geographic scope of the problem
 geographic variation.
b. Characterization by place
 Refers not only to place of residence but to any
geographic site pertinent to disease occurrence.
c. A map provides a more striking visual display of place data.
5. Record the clinical manifestation of cases.
6. Based on clinical manifestations, incubation period, available
laboratory findings & other information gathered, formulate a
hypothesis regarding probable etiologic agent, sources of
infection, mode of transmission & the best approach for
controlling an outbreak
7. Test hypotheses by collecting relevant specimens from
patients and from environment.
8. Based on the results of investigation, implement prevention and
control measures to prevent recurrence of a similar outbreak.
9. Disseminate findings of investigation through media and other
forms to inform public.
SOURCES OF DEMOGRAPHIC DATA
Census - conducted by a national government and attempts to
enumerate every person in a country.
o De jure – People were assigned to the place where
assigned to the place they usually live regardless of
where they are at the time of census. (counted ka dun
sa permanent address mo, even if andito ka by the time
na nagcensus sila)
o De facto – People where assigned to the place where
they are physically present at are at the time of
census regardless, of their usual place of residence.
(counted ka kung asan ka man today)
Sample Survey - is data gathered from small number of people
proportionate to the general population.
Registration System - deals of recordings of vital events.