Public health

Definitions
Health:

It is a state of complete physical,psychological and social well being and not

merely the absence of diseases or infirmity.

Illness:

illness is a state in which a person’s physical emotional,intellectual, social,

developmental or spiritual functioning is diminished or impaired compared with
previous experience

Hospital

Definition

Hospital:

An institution providing medical and surgical treatment and nursing care for sick
or injured people.

Definition of hospital according to WHO:

Hospital is an institution for the care, cure and treatment of the sick and
wounded and For the study of the disease and for the training of doctors and
nurses.

Types of hospital:
Hospital can be classified in any of the following way.

1.According to type of services provided

• General hospital

These are the type of hospitals where different specialist services are provided to
both adult and children under the same roof including Medical, Surgery,
Pediatrics Gynae & Obs., Cardiology, Dermatology, Orthopedic and
Ophthalmology etc.
• Special hospitals

These hospitals deal with specific category of diseases e.g.Eye hospital, hospital
of cardiac disease, ENT hospital,orthopedic hospital, kidney centre or specific
group of people e.g. children hospital maternity home or specific diseases e.g.
T.B Centre, Leprosy Centre.

2.According to size or number of beds

• Regional / Teaching hospital.

These hospitals have more than 600 beds. They are attached to medical colleges
and has all type of specialities and subspecialities e.g. radiotherapy, neurosurgery.
Example of this type of hospital is Jinnah Postgraduate Medical
Centre, Karachi & Mayo Hospital Lahore.

• District Hospitals.

Provide about fifteen specialities including Medical, Surgery, Gynae &

Obs.,ENT, Eye, anesthesia and dermatology and have a range of beds from 100-
600, example include Civil Hospital, Thatta, Jacobabad, Attock etc.

• Rural Hospital.

20 - 100 beds Provide medical, surgical 8 obstetrical care only, e.g. Rural Health
Centre Gharoo, Rural Health Centre, Murad Memon Goth, Malir.

3. According to ownership

• Public Hospital.
These hospitals are owned and managed by government and/or autonomous
bodies e.g. Civil Hospital, Sargodha, Pakistan Institute of Medical Sciences,
National Institute of Child Health etc.

• Private Hospital.
Owned by private people or entrepreneur, can be further classified into.
a) Commercial
b) Non-profit

4. According to duration of stay

Stay more than 30 days leprosy centre, orthopedic hospital.

Stay less than 30 days acute diseases hospital. E.g Eye
hospital.

Other health facilities

1. Clinics and medical offices

Clinics and medical offices typically specialize in one or more areas of

medicine and offer outpatient treatment that doesn’t require an overnight stay
for patients. There are many health care facilities of different types and sizes
that fit this description, with most of them being private practices, group
practice settings or larger clinics that may be affiliated with a hospital.
Some of the most common clinics and medical offices include dental clinics,
mental health clinics, community health clinics that offer free services to
underserved populations, and physical therapy clinics where patients receive
rehabilitative care.

2. Nursing homes

Nursing homes are residential facilities that provide 24-hour care for the elderly
or disabled. They can provide generalized or specialized care for patients with
physical and/or mental needs. As a general rule, the types of illnesses and
injuries treated in nursing homes are not serious and urgent enough for
hospitalization but are too severe to be treated at home. But there are also
facilities that specialize in different levels of treatment and care.

3. Mental health and addiction treatment centers

Mental health treatment facilities can either be general institutions that offer
psychiatric and psychological care to their patients or specialize in one specific
area of mental health. These facilities can offer both inpatient and outpatient
care, depending on the severity and stage of their patients' mental health
rehabilitation process.
Addiction treatment centers typically handle issues with uncontrolled use of
alcohol and various drugs. However, other types of addictions, like gambling,
video games, shopping and others can often also be treated at these facilities.

4. Birth centers

Birth centers are health care facilities that specialize in childbirth. They
typically aim to offer the mother and family a comfortable birth environment.
Unlike hospitals, birthing centers do not typically employ specialized staff for
difficult births, such as surgeons that are prepared to perform C-section
surgeries. For this reason, birth centers are typically only an option for
scheduled pregnancies that do not have any known complications or risks.

5. Hospice care facilities

Hospice care facilities aim to improve the quality of life for people with
advanced and end-stage illnesses, as well as their families and caregivers.
Unlike most health care institutions, which only provide medical care services
to patients, hospice care facilities often employ a diverse group of health care
providers that also take care of the patients' emotional, spiritual and social
needs.

6. Dialysis facilities

Dialysis facilities are centers for patients with kidney disease, who need
constant treatment in the form of dialysis, a procedure that artificially cleans
and filters the blood. This is usually a role that healthy kidneys perform, but if
they are no longer able to handle this function, the patient requires regular
dialysis. Although hospitals are also equipped to perform dialysis, these
facilities are essential due to the high number of people who suffer from chronic
kidney disease.

7. Imaging and radiology centers

These types of facilities offer diagnostic imaging services, such as ultrasounds,

CT scans, MRIs and X-rays. Although other types of health care facilities, like
clinics and hospitals, are usually equipped to perform these services, going to a
specialized imaging and radiology center usually saves time and is more cost-
effective for the patient.

8. Orthopedic rehabilitation centers

These centers are specialized in offering rehabilitation to patients with issues

related to muscles and bones. They typically employ physical therapists that
specialize in various parts of the body and are able to adapt their procedure
based on the patient's physical condition and the severity of their issue.
Orthopedic rehabilitation centers deal with a wide range of potential issues,
from athletic injuries to providing therapeutic support to patients with various
physical disabilities. Aside from diagnosing and treating orthopedic issues,
rehabilitation specialists also provide patients with preventative care.

9. Long-term care hospitals

These medical facilities specialize in providing medical care for patients who
suffer from serious conditions and require constant treatment. Most patients
who arrive at such a facility are transferred from hospital intensive care units
after their conditions have been stabilized. The ultimate goal of long-term care
facilities is to improve their patients' condition so they can return home.

Admission in the hospital

Admission to the nursing unit prepare the client for her stay in the hospital.
Whether the admission is scheduled or follows emergency treatment, effective
admission procedures should accomplish the following goals; verify the client's
identity and assess her clinical status, make her comfortable as possible,
introduce her to other client's or staffs, orient her to environment and routine ,
provide supplies and special equipment needed for daily care.
Admission routines that are efficient and show appropriate concern for the
client can relieve her anxiety and promote cooperation and receptivity to
treatment. Conversely, admission routines that the client perceives as careless
can produce anxiety, impair her response to treatment, reduce cooperation and
may aggravate symptoms.

Equipment:

• Gown
• Bed pan
• Emesis basin
• Bath basin
• Admission form
• Urine and stool specimen container

Preparation of equipment

1. Position the bed as the client's condition requires.

2. Fold down the top linen.
3. Prepare any emergency or special equipment such as suction or oxygen as
required.
4. Adjust the physical environment of the room such as light and room
temperature.
Procedure
Action
1. Speak slowly and clearly. Greet the
client by name and introduce yourself and
any staff present.
Rationale
Calling the client by name, extending
courtesies and welcoming the client and
relatives often helps them to ease and less
frightened.

2. Compare the name and number on the To ensure the right client.
admission form.

3. Quickly review the admission form and Obtaining specimen is an important part
the doctor's orders. Note the reason for of the client's physical admission.
admission, any restriction on activity or
diet and any orders for diagnostic test
requiring specimen collection.

4. Accompany the client to her room/bed Assisting the client to change her gown
if she is not in distress introduce her to her conserve strength.
roommate.Then wash your hands and help Losing items is upsetting to the client.
her gown. Encourage client to keep
valuables or money in the safe or
preferably to send them home. Show
ambulatory client where the bathroom and
cupboards are located.

5. Take and record the client's temperature Obtaining these signs is the nurses
pulse, respiration and blood pressure and responsibility.
collect specimen if ordered.

6. Explain the use of bathroom and Explaining routines and how to use
equipment such as call system, bed equipment helps put the client at ease.
controls and lights. Explain routines such Knowing how to use equipment decreases
as mealtimes and visiting hours. the risk of accidents.

7.Take the complete history which include

previous hospitalizations, illnesses and
surgeries, current drug therapy and food
or drug allergies
 8. Before leaving the client's room, make Helps prevent accidents.
sure she's comfortable and safe. Adjust
her bed and place the call button and other
equipment (water, pitcher, tissue paper)
within easy reach.
9.Document vital signs, allergies and Documentation communicates care given.
specimen collected for laboratory test.

Discharge from the hospital

Discharge requires careful planning and assessment of the client's needs during
hospitalization. Discharge planning aims to teach the client and her family about
her illness, to provide instructions for home care, to communicate dietary
instructions and scheduling of drug treatment. It includes follow-up care and
coordination of outpatient care services.

Equipment

• Wheelchair
• Clients instruction sheet
• Discharge summary
• Plastic bag for client's personal belongings
• Medicines

Procedure

Action Rationale
1.Inform client's family before the day To prepare client and family for
of discharge discharge.

2. Obtain a written discharge order from It is the physician's responsibility to

the physician. discharge a client.

3. Make sure the client has had The client should be able to continue
discharge instructions (regarding diet, with necessary care after discharge
medications) and signs that she when properly Instructed.
understand these instructions.

Saves time and the annoyance of having

to wait when the client is ready to leave.
4.Have all the necessary supplies ready
for the client.

5.Check to see that proper financial Help to prevent delay.

arrangement have been made by the
client/family.

6.Assist the client to dress and pack Assisting help the client conserves
belongings. Make sure the client has all client strength.
her belongings.

7.Make necessary recording on the Permanent records are legally

client's records and complete discharge important.
summary.

8.After the client has left the room, strip To prepare for next admission.
the bed linen and notify housekeeping
staff that the room is ready for cleaning.

9. Document time and date of Documentation communicates care

discharge, the client's condition, special given.
diet or activity instructions, medications
and follow-up dates
 Health team

What is health team?

The health team have been defined as a group of people who share a common
health goals and common objectives determine by community need to the
achievement of which each member of the team contribute in according to his
or her competent and skills and in coordination with the function of other.

Doctor:

A person with a medical degree whose job is to treat people who are ill or hurt:

nurses :

A person who cares for the sick or infirm specifically : a licensed health-care professional who practices
independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and
maintaining health — compare licensed practical nurse, registered nurse.

What is a lady health visitor?

Lady health visitors (LHVs), as a specific cadre of health care provider, have
existed in Pakistan since 1951. They provide a variety of services to urban and
rural communities, including basic nursing care, maternal child health services,
and training of community workers.
What is Community midwife CMW?

Community midwife is a character in the community who assists the mother

during childbirth and primary maternity care
1. In public health, midwife is playing a positive role, promotes health care
system for mother and child, and brings the good change in the maternal
health conditions and newborn baby
2. Community midwife have a multipurpose role in maternal health, public
health.
3. The role of a midwife also includes working independently to promote
normal birth, identifying deviations from the normal, carrying out
emergency processes when compulsory, providing counselling and education
for the woman and her family throughout pregnancy and childbirth, and
promoting health in the wider community

Paramedics

a person trained to give emergency medical care to people who are injured or
ill, typically in a setting outside a hospital."all ambulances were manned by a
nurse or paramedic and a driver"
What Is Maslow’s Hierarchy of Needs?

Maslow's hierarchy of needs is a theory of motivation which states that five

categories of human needs dictate an individual’s behavior. Those needs are
physiological needs, safety needs, love and belonging needs, esteem needs,
and self-actualization needs.

What Are the 5 Levels of Maslow’s Hierarchy of Needs?

Maslow's theory presents his hierarchy of needs in a pyramid shape, with basic
needs at the bottom of the pyramid and more high-level, intangible needs at
the top. A person can only move on to addressing the higher-level needs when
their basic needs are adequately fulfilled.

1. Physiological needs:

The first of the id-driven lower needs on Maslow's hierarchy are

physiological needs. These most basic human survival needs include food
and water, sufficient rest, clothing and shelter, overall health, and
reproduction. Maslow states that these basic physiological needs must be
addressed before humans move on to the next level of fulfillment.

2. Safety needs:

Next among the lower-level needs is safety. Safety needs include protection
from violence and theft, emotional stability and well-being, health security,
and financial security.

3. Love and belonging needs:

The social needs on the third level of Maslow’s hierarchy relate to human
interaction and are the last of the so-called lower needs. Among these needs
are friendships and family bonds—both with biological family (parents,
siblings, children) and chosen family (spouses and partners). Physical and
emotional intimacy ranging from sexual relationships to intimate emotional
bonds are important to achieving a feeling of elevated kinship.
Additionally, membership in social groups contributes to meeting this need,
 from belonging to a team of coworkers to forging an identity in a union,
club, or group of hobbyists.

4. Esteem needs:

The higher needs, beginning with esteem, are ego-driven needs. The
primary elements of esteem are self-respect (the belief that you are valuable
and deserving of dignity) and self-esteem (confidence in your potential for
personal growth and accomplishments). Maslow specifically notes that self-
esteem can be broken into two types: esteem which is based on respect and
acknowledgment from others, and esteem which is based on your own self-
assessment. Self-confidence and independence stem from this latter type of
self-esteem.

5. Self-actualization needs:

Self-actualization describes the fulfillment of your full potential as a

person. Sometimes called self-fulfillment needs, self-actualization needs
occupy the highest spot on Maslow's pyramid. Self-actualization needs
include education, skill development—the refining of talents in areas such
as music, athletics, design, cooking, and gardening—caring for others, and
broader goals like learning a new language, traveling to new places, and
winning awards.