Community Health Nursing PUBLIC HEALTH NURSE

VINCE GASMIN
“WIN NA WIN SA
PUSO NATIN!”
REFRESHER

COMMUNITY HEALTH NURSING
OCCUPATIONAL HEALTH
PUBLIC HEALTH
SCHOOL HEALTH
DOH AND PHC

COMMUNITY HEALTH NURSING
CHN PROCEDURES
CHN METHODS
CHN ACTIVTIES

VINCE GASMIN
@beansgasmin
@_beansgasmin

QUESTION TIME
What is the basic principle in CHN?
A. To tell the community their problems are
B. To promote a self-reliant community
C. To be able to lead the community towards
improvement
D. To teach and guide the community to solve their
problems
@_beansgasmin IG/ TikTok

QUESTION TIME
Which of the following statements is the Primary Goal of Community
Health Nursing?
a. Self-Reliance of the Community
b.Enable Every Citizen to Realize His Birthright to Health and
Longevity
c.Service rendered by a professional nurse with communities, groups,
families, individuals at home, in health centers, in clinics, in schools,
in places of work for the promotion of health
d.To raise the level of citizenry by helping communities and families

QUESTION TIME
Which of the following levels of Clientele is the
Entry Point in Community Health Nursing
Practice?
a. Individual
b. Family
c. Population Group
d. Community

QUESTION TIME
In Community Health Nursing Practice, which
of the following levels of Clientele is the Unit
of Service?
a. Individual
b. Family
c. Population Group
d. Community

QUESTION TIME
There are four levels of Clientele, which of the
following is considered as an Aggregate Group?
a. Hypertensives
b. Pregnant Women
c. LGBTQIA+
d. All of the Above

PHILOSOPY: Uphold the worth and
dignity of man – Margareth Shetland
ULTIMATE GOAL: Raise the level of
health of the citizenry. (NISCE)
PRIMARY GOAL: SELF RELIANCE IN
HEALTH

CHN DEFINITIONS
WHO: Combination of nursing
skills, sociology and public health
FREEMAN: A service rendered by a
professional nurse with communities, groups,
families, and individuals in different settings

CHN DEFINITIONS
JACOBSON: Achievement of optimum
level of functioning through teaching and
delivery of care
HANLON: Attainment of highest level of physical,
mental, and social well being at a given place and
time

CHN DEFINITIONS
BAILON-REYES: Field of nursing practice where
services are delivered outside of purely curative
institution
MAGLAYA: Utilization of nursing process
to benefit the individual, family and
community.

4 BASIC ASPECTS OF COMMUNITY
.
SOCIAL CULTURAL POLITICAL GEOGRAPHICAL

LEVELS OF CLIENTELE
.
 Individual –
 Family –
 Population Group -
 Community –

LEVELS OF PREVENTION
.
LEVEL 1 – PRIMARY
LEVEL 2 – SECONDARY
LEVEL 3 – TERTIARY


DETERMINANTS OF HEALTH
.
Optimum
level of
functioning
Political
Behavior
Heredity
HCDS
Environment
Socio-
Economic

TYPES OF COMMUNITY
 Rural
 Urban
 Rurban
 Sub-Urban
 Metropolitan

TYPES OF FAMILY
 Nuclear –
 Extended –
 Dyad –
 Blended –
 Compound –
 Cohabitating –
 Single Parenting

MARRIAGE: JOINING OF FAMILIES
FAMILIES WITH YOUNG CHILDREN
FAMILIES WITH ADOLESCENT
STAGES AND TASK OF A FAMILY

FAMILIES AS LAUNCHING CENTERS
AGING FAMILIES
STAGES AND TASK OF A FAMILY

ROLES OF COMMUNITY HEALTH NURSE
1. Educator
2. Advocate
3. Counselor
4. Change Agent
5. Care Provider
6. Clinicians
7. Hospice Care Provider

ROLES OF COMMUNITY HEALTH NURSE
8. Manager
9. Supervisor
10. Trainer
11. Health Monitor
12. Researcher
13. Role Model
14. Coordinator
15. Organizer

DEPARTMENT OF HEALTH

E.O 102  PRES. ESTRADA
LEADER IN HEALTH
INNOVATOR IN HEALTH
CAPACITY BUILDER and ENABLER
ADMINISTRATOR

LEGAL MANDATE:
1.The 1987 Constitution, Article II, Section 15
2. Executive Order 102  L.I.C.A.
3. Republic Act 7160  LGU CODE

FOURmula One
2005 - 2010
JAN. 2010 – JUNE
2010
DR. ESPERANZA I.
CABRAL
DR. FRANCISCO DUQUE III
KALUSUGAN
PANGKALAHATAN
2010 - 2014
DR, ENRIQUE T. ONA

FOURmula 1 1+
2017 - 2022
DR. PAULYN JEAN B.
ROSELL-UBIAL
Duterte Health
Agenda
2016 - 2017
2014 - 2016
DR. JANETTE L. GARIN DR. FRANCISCO DUQUE III

DR. TEODORO J. HERBOSA
DOH Secretary
DR. MARIA ROSARIO VERGEIRE
2022 - 2023

DR. TEODORO J. HERBOSA
DOH Secretary

2017 - 2022

AMBISYON NATIN 2040
Ambisyon Natin 2040 defines the collective long-term vision
and aspirations of the Filipinos to enjoy a matatag (strongly
rooted), maginhawa (comfortable) at panatag na buhay
(secure), which all sectors of society, whether public and
private, should align their efforts with. All key players in health
have one goal— that all Filipinos live a long and healthy life by
2040.

Health Sector Policy Reforms The country’s health system has undergone several policy reforms and
organization changes since the year 2000 with the inception of the Health Sector Reform Agenda. The key
sector reform plans introduced or implemented through the DOH include:
 Health Sector Reform Agenda (1999-2004), which aimed to improve the way health care is delivered,
regulated, and financed through systemic reforms in public health, the hospital system, local health, health
regulation, and health financing
 FOURmula One (F1) for Health (2005-2009), which implemented the reform strategies in service delivery,
health regulation, health financing, and governance as a single package that is supported by an effective
management infrastructure and financing arrangements, with particular focus on critical health interventions
 Health Financing Strategy (2010-2016), which supported the overall sector goals of improving financial
protection, achieving efficiency gains, and ensuring access to quality care through five pillars: creating more
fiscal space for health (pillar 1), sustaining membership in PhilHealth-pooling pillar 2), who pays for what (pillar
3), provider payments (pillar 4), and fiscal autonomy of health facilities (pillar 5)

Health Sector Policy Reforms The country’s health system has undergone several policy reforms and
organization changes since the year 2000 with the inception of the Health Sector Reform Agenda. The key sector
reform plans introduced or implemented through the DOH include:
 Kalusugan Pangkalahatan (2010-2015), which prioritized financial risk protection, access to quality health
facilities and services, and the attainment of health-related millennium development goals.
 All for Health Towards Health for All (2016-2017), which called for improved financial protection, better health
outcomes, and an improved health system.
 FOURmula One Plus (F1 Plus) for Health (2018-present), which aims to provide UHC to Filipinos in the
medium to long term through better health outcomes, responsive health care delivery systems, and equitable
and sustainable health financing.
 The Universal Health Care Act (2019-present), which has expanded access to health services by
automatically enrolling all Filipinos in PhilHealth's National Health Insurance Program (NHIP), with the aim of
providing all Filipino citizens with access to a comprehensive set of health services without financial hardship

VISION
Filipinos are among the
healthiest people in
Asia by 2040.
To promote healthy
settings, and steer the
development ofan effective,
resilient, equitable, and
people-centered health
system for Universal Health
Care.
MISSION

HEALTH SECTOR GOALS  B.A.S.
 Better health outcomes  reduced health inequities,
improved health metrics, life expectancy and quality of life.
 Access to all levels of care comprehensive access to
culturally-sensitive and gender-responsive health services at
primary, secondary, and tertiary levels
 Stronger health systems strengthened infrastructure,
capacity, and resilience, that proactively anticipates and
responds to health needs and crises,

8 Point Agenda

8 POINT ACTION AGENDA
“PI – KO – HEALTH IN”
The following lists the eight (8) action agenda items and their
corresponding strategic objectives, organized under three (3) major
categories:
1) Para sa Bawat Pilipino;
2) Para sa Bawat Komunidad; and
3) Para sa Bawat Health Worker at
Institusyon.

Three major categories:
1) Para sa Bawat Pilipino
Ensuring that every Filipino achieves the highest
level of health by providing safe, high-quality,
and patient-centered services, utilizing modern
technology for efficient service delivery

Three major categories
2) Para sa Bawat Komunidad
Empowering communities and addressing
determinants of health through health promotion,
preparing them for crises, and fostering mental
health and well-being, ensuring that each
community thrives in the face of challenges

Three major categories:
3) Para sa Bawat Health Worker at
Institusyon
Prioritizing health care workers’ welfare and
rights, and strengthening our health institutions
against the threat of pandemics.

POLICY
RA 7160
LGU CODE
DEVOLUTION
DECENTRALIZATION
REFERS TO THE ACT BY WHICH THE
NATIONAL GOVERNMENT CONFERS
POWER AND AUTHORITY UPON THE
VARIOUS LOCAL GOVERNMENT UNITS TO
PERFORM SPECIFIC FUNCTIONS AND
RESPONSIBILITIES, INCLUDING THE
PROVISION AND DELIVERY OF BASIC
HEALTH SERVICES

Local Health Board

Local Health Board
• Chairman – Local Chief Executive (Mayor) The MHO will serve
as the Vice Chair
• Proposing to the Sangguniang annual budgetary allocations for
the operation and maintenance of health facilities and services
within the province/city/ municipality
• Serving as the advisory committee to the Sangguniang on health
matters and
• Creating Committees that shall advise local health agencies on
various matters related to health services operations

Inter Local Health Zone
• Improved health status and coverage of public health
intervention of the zone population
• Access by everyone in the zone to qualify care and
• Efficiency in the operations of the Inter Local Health
Services

1. PEOPLE:
2. BOUNDARIES:
3. HEALTH FACILITIES:
4. HEALTH WORKERS:

PEOPLE
100,000 – 500,000

LEVEL OF HEALTH CARE
DELIVERY IN THE PHILIPPINES
TERTIARY
NATIONAL HOSPITALS, MED CENTER,
SPECIALIZED / REGIONAL HOSPITAL
SECONDARY
PROVINCIAL HEALTH OFFICE, DISTRICT
HOSPITALS, EMERGENCY HOSPITALS,
PROVINCIAL HOSPITALS
PRIMARY
MUNICIPAL HEALTH OFFICE
RURAL HEALTH UNITS
HEALTH CENTERS BARANGAY HEALTH
STATIONS

HEALTH CARE WORKERS
1 Physician: 20,000
1 Nurse: 10,000
1 Midwife : 5, 000
1 Dentist: 50,000
1 Sanitary Inspector: 20,000
1 MedTech: 20,000
1 PT: 20,000
1 RHU: 20,000
1 BHS: 5,000

PRIMARY HEALTH CARE

Primary Care
 Health in the Hands of the People
 Total Approach
Active Community Paricipation
Partnership
Improve Health in the Community
Access to Basic Health
 At Community Level
 1st Level of Care
 Provision of Interventions to
cure specific Disease
Primary Health Care
VINCE GASMIN

Multi-sectoral policies
Integrated Health Services
Determinants of health (physical, mental and social health and
wellbeing)
Whole-of Government Approach (PHC Aim)
Interventions that encompass the entire life-course
Focusing on Equity
Empowering individuals, communities for increased participation in
health.
Primary Health Care

PRIMARY HEALTH CARE
HISTORY
UN thru WHO
Health in the Hands
of the people by year
2000
PHC Movement -
1977
Alma Ata, USSR
Sept. 6 – 12 1978
Oct. 19, 1979
LOI 949
Pres. F. Marcos, Sr
October 2018
Astana,
Kazakhstan
P
H C

Primary Health Care
Traditional Cornerstones / Pillars
INTER – INTRA SECTORAL LINKAGES
USE OF APPROPRIATE TECHNOLOGY
SUPPORT MECHANISM MADE AVAILABLE
ACTIVE COMMUNITY PARTICIPATION

Primary Health Care
CORE VALUES OF PHC
• SOCIAL JUSTICE
• SOLIDARITY
• SELF RELIANCE
• EQUITY
• RESPECT TO HUMAN DIGNITY / HUMAN RIGHTS

PRIMARY HEALTH CARE
GOAL
Ensure all people
provided access to
Health
PHILOSOPY
Health Care Workers
to rally behind the
communities to
assume responsibility
for their health
STRATEGY
Collaborations of
Private and Public
G P S

Primary Health Care
Essential Services in PHC
ESSENTIAL MEDICINES / DRUGS
SANITATION
SAFE WATER SUPPLY
ENDEMIC DISEASE CONTROL AND MNGT
NUTRITION
TREATMENT TO SIMPLE CONDITIONS
IMMUNIZATION
ACCESS FOR MOTHER & CHILD HEALTH SVCS
LEARNING THRU HEALTH EDUCATION

PHC ADVOCATES THE 5 A’s
ACCESSIBLE
A A A A A
AVAILABLE AFFORDABLE ACCEPTABLE APPROPRIATE

1. Knowledge and Capacity Building
 Community must actively participate
 Shared Leadership and Participatory Governance
 Community Organizing is also done to identify Potential Leader
Determinants of Success of PHC

2. Human Resources for Health
 Multidisciplinary Approach hence the need for skill mix to address
health needs of the people is crucial to the efficient
implementation of PHC
1 RHU / HC Physician: 20,000
1 PHN : 10,000
1 PHM: 5, 000
1 PHDentist: 50,000
1 RHU: 20,000
1 BHS: 5,000
DOH Recommendation for HRH and PHC
Facilities Ratio to Population

3. Financing
 Access of people to essential health services
 Philhealth -> No Balance Billing Policy
 RA 10351 -> Sin Tax Law
 RA 10963 -> TRAIN Law
4. Technology
 In the context of PHC it must be viewed as a means to help the
public maintain, restore and promote their Optimum Level of
Functioning
 Ensure that the people from all walks of life enjoy the highest
possible level of wellness, access to available services and
technology provided

“Strengthening Primary Health Care is the most inclusive, effective and
efficient approach to enhance people’s physical and mental health, as well
as social well-being and that the PHC is a cornerstone of a sustainable
health system for universal health coverage (UHC) and health related
Sustainable Development Goals.” WHO, 2018
ASTANA DECLARATION

17 SUSTAINABLE DEVELOPMENT
GOALS
.

17 SUSTAINABLE DEVELOPMENT GOALS
.
1. NO POVERTY 

Community Health Nursing PUBLIC HEALTH NURSE

QUESTION TIME
As a PHN, you will provide occupational health
services in which of the following settings in your
Municipality?
1. Grocery 400m away with 15 employees
2. Garment Factory 2kn away with 22 workers
3. Printing Press 1.5km away with 33 workers
4. Farm 6km away with 5 works
A. 1, 2 and 3 C. 1, 3 and 4
B. 1, 2 and 4 D. All of these

QUESTION TIME
Which of the following activities reflect primary
prevention in a school health nursing?
A. Screening for Malnutrition
B. Monitoring school population for signs of Measles
during outbreak
C. Conducting an information drive on healthy eating
habits and regular exercise
D. Applying first-aid to a student who sustained a cut
during a cooking class

QUESTION TIME
Health issues in prison that can be addressed by the
nurse include:
A. Overcrowding due to limited spaces
B. Provision of hygiene kits
C. Risk of TB Spead
D. Poor Nutritional Status
A. A, B and C
B. A, B and D
C. B, C and D
D. All of these

QUESTION TIME
The Philippine labor code is under the mandate
of what law:
a. RA 1054
b. PD 442
c. RA 9003
d. RA 124

QUESTION TIME
A nurse working in an occupational health
setting will most likely work as a:
a. Administrator
b. Clinicians
c. Consultants
d. Educators

QUESTION TIME
Which is the best method an occupational health nurse
can use when assessing workplace hazards?
a. Review incident reports.
b. Walk through the worksite.
c. Interview key employees.
d. Support and counselling .

SCHOOL HEALTH
FOCUS: SCHOOL POPULACE
PRIMARY ROLE: Support the student in learning
and ensure that educational potential is not
hampered by unmet health needs

LEGAL MANDATE
RA 124 - AN ACT TO PROVIDE FOR THE MEDICAL
INSPECTION OF CHILDREN ENROLLED IN PRIVATE
SCHOOLS, COLLEGES AND UNIVERSITIES IN THE
PHILIPPINES
PD 603 - THE CHILD AND YOUTH WELFARE CODE
SCHOOL HEALTH

QUALIFICATION OF A NURSE II /
DISTRICT NURSE
• BSN
• RN
• 2 years of relevant Experience
• 4 Hours of Relevant Training
SCHOOL HEALTH

SCHOOL HEALTH
FUNCTION OF A SCHOOL HEALTH NURSE
1. School Health and Nutrition Survey (Annual)
2. Student Health and Nutrition Assessment (Annual)
3. Referral of Cases – MHO / Private / Social Services
4. School Plant Inspection  Environmental Sanitation

SCHOOL HEALTH
5. Attendance to Emergency Cases
6. School – Community Health Council
7. Establish Data Bank on School Activities
8. Health and Nutrition Education Activities
9. Rapid Classroom Inspection
10. Home Visitation

SCHOOL HEALTH

PROCEDURES OF HEALTH ASSESSMENT
 Classroom Lecture
 3 -5 Children in Waiting Area
 Handwashing
 Assessed 1 by 1 / Cephalocaudal
SCHOOL HEALTH

2 2
3
4
5
5
7
7
777
7 7
7
7
7
SCHOOL HEALTH

Clinic Teacher
1. At least 1 Clinic Teacher in every School
2. Trained by the School Nurse
3. Duties are:
Remedies administered are simple like 1st Aid
Records keeping
Responsible for the clinic maintenance
Reports to the principal
Recommends improvement of services

Functional
School Clinic –
Mandated thru
RA 124

EXAMPLES OF PREVENTION AND THE ROLE OF THE
NURSE IN THE SCHOOL SETTING
PRIMARY
PREVENTION
SECONDARY
PREVENTION
TERTIARY
PREVENTION
Nutrition Education
Immunization
Safety
Health Education
Screening
Case Finding
Treatment
Referral of Students for
substance abuse or
behavior problems
Prevention of
complications and
adverse effects
Faculty and Staff
monitoring
SCHOOL HEALTH

Article 23 of the United Nations
“Everyone has the right to work, to free choice of
employment, to just and favorable conditions of work.”
DOLE is the lead agency for Occupational Safety and
Health (OSH)
Target: Workers in all occupations
OCCUPATIONAL HEALTH

LEGAL MANDATES
 PD 442 Philippines Labor Code Repealed RA 1054 of 1954
 The Occupational Safety and Health Standards (OSHS)
 PD 626 Employees Compensation Commission
 RA 6969 – Toxic Substances and Hazardous and Nuclear Waste
Control Act
 RA 11058 – Strengthening Compliance with Occupational Safety
and Health Standard act of 2017
OCCUPATIONAL HEALTH

Duties and Functions of OHN as per DOLE
“O H N A P”
1. Organizing Health Programs
2. Health maintenance examination
3. Nursing Care to Injured and Ill
4. Administering PPE and Supplemention
5. Policy making
OCCUPATIONAL HEALTH

 Nov 11, 1950  Industrial Nursing Unit (INU) Magdalena Valenzuela
 August 19, 1964  Anita Santos elected on, Modified of the name to
(OHNAP)
 Nov. 12, 1966  Independence of OHNAP
 Mercedes L. Castillo, RN, MPSPA National President (2023-2024)
 OHNAP conduct BOSH or Basic Occupational Safety & Health
OCCUPATIONAL HEALTH

DONNING
(GowMaGogGlov)
GOWN then MASK then
GOGGLES then GLOVES
DOFFING
(GlovGogGowMa)
GLOVES then GOGGLES then
GOWN then MASK

Health Hazards
- Elements in the work environment that can
cause work related disease to worker
Safety Hazards
- Unsafe conditions or unsafe acts that
significantly increase the risk of worker to be
injured
OCCUPATIONAL HEALTH

EXAMPLES OF OCCUPATIONAL HAZARDS AND ASSOCIATED
HEALTH EFFECTS
CATEGORY EXPOSURE HEALTH
EFFECTS
BIOLOGICAL Blood or Body Fluids Infections
CHEMICAL Solvents
Lead
Asbestos
Acids
Central Nervous
System Disturbance
Asbestos Lung Dse
Burns
ENVIROMECHANICA
L
Slippery Floors
Poorly matched Furnitures
Shift to Work
Repetitive / Forceful Exertions
Static/ Non-Natural Postures
Injury
Strained Muscles
Sleep Disorder
Musculoskeletal
Disorder
Back Injuries
OCCUPATIONAL HEALTH

CATEGORY EXPOSURE HEALTH EFFECTS
PHYSICAL Electricity
Noise
Radiation
Lighting
Vibration
Heat
Electrocution
Hearing Loss
Reproductive Effects and
Cancer
Headache, eye strains, slips
and falls
Raynauds Disease
Heat Stroke/ Exhaustion
PSYCHOSOCIAL Stress
Work-home Imbalance
Fatigue, Burnout
Anxiety and variety of
physical symptoms
OCCUPATIONAL HEALTH

SCOPE
.
General and Comprehensive
Nursing Concepts

QUESTION TIME
In a municipality with 200,000 population,
how many pubic health nurses must be
deployed to ensure effective health care
delivery service
a. 10
b. 15
c. 5
d. 20

QUESTION TIME
Home visit is a family-nurse contact which allows the health
worker to assess the home and family situations in order to
provide the necessary nursing care and health related
activities. In preparing for home visit which of the following is
the most important factor to consider for the frequency of
visits;
a. policies of agencies
b. needs of the family
c. acceptance of the family
d. past services rendered

QUESTION TIME
Which of the following is a principle in preparing for a home
visit?
a. To give nursing care
b. To assess the living condition
c. To make use of all available information about the family
through family records
d. To provide health teachings and health awareness for the
family

QUESTION TIME
An essential and indispensible equipment of a public
health nurse which she has to carry along during her
home visits.
a. Bag Technique
b. BP apparatus
c. umbrella
d. PHN bag

QUESTION TIME
All of the following are important points in considering in doing bag
technique except;
a. The bag should contain all necessary articles, supplies, and
equipments
b. Consider the bag and its contents clean and sterile
c. the arrangement of the contents should be the one most
convenient to the user.
d. none

QUESTION TIME
Upon utilizing the bag during home visit you are aware
that the weighing scale is located in which area;
a. Top
b. Rear
c. Center
d. none of the above

QUESTION TIME
Which of the following is the Best Family – Nurse
Contact?
a. Home Visit
b. Telemedicine
c. Medical Mission
d. Barangay Health Station Visit

QUESTION TIME
In Clinic Visit, Which of the following method of
prioritization the Nurse can do the Intervention?
a. Non – Program Based
b. Program Based
c. Urgent Referral
d. Triaging

QUESTION TIME
It was past 10 in the morning when nurse Nurse Jv ended his home visit. He
took her PHN bag and his black umbrella. The black umbrella is essential for
home visits. The reason is;
A.Black is professional and fashionable as it matches the black PHN bag
B.Black umbrella absorbs the 90% of the sun’s ray
C.Black is visible to the color -blind dog and can be used to ward and scare
him off
D.Black does not dirty easily especially in the community where anything
goes

ACTIVITIES
PROCEDURES
METHODS

ACTIVITIES IN CHN
Family – Nurse Contact
These are methods of how the Nurse or
any Health Care Workers to contact or
communicate with the Family

ACTIVITIES IN CHN
1.Clinic Visit
2.Home Visit
3.Group Conference
4.Telephone Contact
5.Letter

FIELD HEALTH SERVICE
INFORMATION SYSTEM

CLINIC VISIT STEPS
1. Registration
2. Waiting Time
3. Triage
4. Clinical Evaluation
5. Laboratory

CLINIC VISIT STEPS
5. Laboratory – REFER MEDTECH.
6. Referral System – 2way!
Resources (Meds, Manpower)
BHS  RHU
RHU  RHU
RHU  HOSPITAL
7. Prescription / Dispensing of Meds
8 Health Education  NCP, Follow up

CLINIC VISIT REMEMBER
In Waiting Time “1st come, 1st served”
In Triaging
A. Manage program-based cases
B. Refer all Non Program based cases to Physician
C. Provide first-aid treatment to emergency cases
In Referral BHS to RHU/ RHU – RHU/ RHU - Hospital

HOME VISIT PURPOSE
• Make use referral system
• Establish close relationship
• Give Nursing care
• Health Teaching
• Assess living condition
MEGHA

HOME VISIT COMPONENTS
• Plan – Essential tool in achieving precise and
appropriate Interventions
• Implement – Nurse : Family Partners
A. Socialization Phase
B. Working / Professional Phase
C. Summary Phase
• Evaluate – Audit Family Situation
“PIE - SWS”

HOME VISIT PRINCIPLES
• Available information must be used
• Essential NEEDS is the PRIORITY
• Involve Family in Planning
• Objectives / Purpose
• U-galiing maging Flexible (RN/ Family)
“AEIOU”

HOME VISIT GUIDELINES
• Past Services must be Checked
• Utilize resources of the Family/ Agency
• TRUST  Acceptance of the Family
• Agency’s Policy must be followed
• Needs of the Family  PRIORITY
“PUT A Needs”

HOME VISIT PHASES
• Pre Visit  RHU  A/D
• In-home Phase  P / I
• Post Visit  E

HOME VISIT 7 STEPS
1. Greet / Introduce
2. State Purpose
3. Observe Patient / Determine Needs
4. Bag Technique
5. Nursing Care/ Health Teaching
6. Document
7. Follow up

GROUP CONFERENCE
Provides an opportunity for an initial contact between
the nurse and target families of the community
Opportunity to share experiences and practical
solutions
Sectoral / Population Group / Aggregate
Example: Case Finding

Telephone Contact
Landline / Mobile Phone, provides an easy access
between the nurse and the family
Information transmitted to this is limited and
assessment still requires face to face contact.
Assessment is subjective to the client
Tele-consult / Tele-Medicine

Written Communication
Used to give specific information to the family
One way method, this contact requires literacy and
interest.
Ineffective to people who cannot read and cannot write

PROCEDURES IN CHN
1. Bag Technique
2. Blood Pressure Measurement
3. Benedicts Test
4. Heat and Acetic Acid Test

NURSING BAG
• Articles for Infection Control
• Articles for Assessment
• Articles for Nursing Care – Sterile
• Articles for Nursing Care – Clean

NURSING BAG
• Articles for Infection Control
• Soap, Linen, Disposable paper towels for
handwashing, apron, bottles of antiseptics and
hand sanitizers

NURSING BAG
• Articles for Assessment of Family
Members
• Measuring Tape, New Born weighing scale,
portable diagnostic aid such a Glucometer, Items
for Benedict's Solution

NURSING BAG
• Articles for Nursing Care - Sterile
• Dressing, Cotton balls, Cotton Tip Applicators,
Syringes (2 and 5ml) with needles, surgical gloves,
cord clamp, one pair surgical scissors, sterile pack
with kidney basin, two forceps (straight and curve)

NURSING BAG
• Articles for Nursing Care - Clean
• Pieces of paper: for lining the soap dish, folded paper
to be used as waste receptacle if needed

BAG TECHNIQUE
• TOOL USE BY THE NURSE, ENABLE HER TO
PERFROM NURSING PROCEDURES. WITH EASE AND
DEAFNESS, SAVING TIME & EFFORT
• ESSENTIAL AND INDESPENSABLE EQUIPMENT
PHN BAG

BAG TECHNIQUE
FRONT OF THE BAG
• Thermometers
• Tape Measure
• Adhesive Plaster
• Cotton Applicator

BAG TECHNIQUE RIGHT REAR
• 2 Test Tube 1 Holder
• Medicine Dropper
• Alcohol Lamp
LEFT REAR
• Medicine Glass
• Baby Scale
• Bandage Scissor
• Rubber Suction

BAG TECHNIQUE BACK OF THE BAG
• 70% Alcohol
• Betadine Solution
• Hydrogen Peroxide
• Terramycin Ointment
• Zephiran Solution
• Spirit of Ammonia
• Acetic Acid
• Benedicts Solution
• Liquid Soap
• Cotton in Sterile Water

BAG TECHNIQUE CENTER OF THE BAG
• 2 Pairs of Forceps
• 1 Surgical Scissor
• Sterile Dressing
• Roller Bandage
• Syringes (5ml/2ml)
• Hypodermic Needles
• Sterile Cord Clamp
• Kidney Basin

BAG TECHNIQUE TOP PILE
• Hand towel in a
plastic bag
• Soap in Soap Dish
• Apron
• Plastic / Linen lining
POCKET OF THE BAG
• Surgical Gloves
• Waste Paper Receptacle

BLOOD PRESSURE
MEASUREMENT
PROCEDURE
1. PREPARATORY PHASE
2. APPLYING THE BP CUFF AND STETHOSCOPE
3. OBTAINING THE BP READYING BY
AUSCULTATION
4. RECORDING BP AND OTHER GUIDELINE

BENEDICT’S TEST PROCEDURE
The procedure for Benedict’s test is:
5 mL of Benedict's reagent into a clean, dry test tube.
8 – 10c drops of the liquid sample into the test tube.
Heat for approximately 3 minutes in a heated water bath.
Formation precipitate.
B-G-Y-O-B

HEAT & ACETIC
ACID TEST
PROCEDURE

HEAT & ACETIC
ACID TEST
PROCEDURE
+4  EGG WHITE / DENSE HEAVY
+3  THICK / HEAVY CLOUDINESS
+2  SLIGHT CLOUDINESS
+1  DISTICT CLOUDINESS
1  TRACES

METHODOLOGIES IN CHN
1. FHSIS
2. Omaha System
3. COPAR
4. Community Diagnosis
5. Epidemiology

INFORMATION SYSTEM
AIMS to Provide:
• Raw , Standardized, Evidenced based
data and Facility Based
• Official Reporting and Recording
System
• EO 352

INFORMATION SYSTEM
RECORDING TOOLS
• Treatment Record (ITR)
• Primary Building Block of FHSIS
• Target Client List
• Secondary Building Block
• Summary Table (ST)
• Form with 12 months columns
• Accomplishment and Trends Mortality and Morbidity
• Monthly Consolidation Table (MCT)
• Source of the Quarterly Forms

INFORMATION SYSTEM
REPORTING FORMS
• Monthly Form
• Program Report
• Morbidity Report - Midwife
• Quarterly Report
• Program Report
• Morbidity Report - Nurse
• Annual Form
• Annual Form 1 – Data and Indicators needed on a yearly basis
• Annual Form 2 – Enlisting all the diseases occurred
• Annual Form 3 – Deaths over the year

OMAHA Problem Classification Scheme
Provides a structure, terms, and system of cues and
clues for a standardized assessment of individuals,
families, and communities.
It helps workers to collect, sort, document, classify,
analyze, retrieve, and communicate health-related
needs and strength

OMAHA Problem Classification Scheme
Environmental Domain: Material resources and physical surroundings
both inside and outside the living area, neighborhood, and broader
community.
Psychosocial Domain: Patterns of behavior, emotion, communication,
relationships, and development.
Health Related behaviors domain – Nutrition, Sleep and rest, Physical
activity, Personal care, Family planning
Physiological Domain: Functions and processes that maintain life

COMMUNITY ORGANIZING
It is a social development methodology is
utilized to facilitate the process of forming and
sustaining self-reliant and self-determining
communities

Why is there a need to sustain health program?
“We need to sustain the health of the People”
Emphasis is on Problem Solving Skills and Decision
Making Skills needed for Self reliant development
initiative.

It is a continuous and sustained process of
EDUCATION – to develop critical consiousness
MOBILIZATION – respond and take action on needs
ORGANIZATION – collective and efficient work

A. Preparatory Phase
B. Organizational Phase
C. Education and Training Phase
D. Intersectoral Collaboration Phase
E. Phase Out

A. Preparatory Phase
Area Selection - GIDA – Geographically Isolated and
Disadvatage Area // FAR FLUNG AREA // Depressed
Community Profiling / Initial Data Base
Contact Person – Captain / Sitio Leader / Barrio Leader
Core Group (Initial CG) – Initial Assessment
Entry in the community and integration with the People
M – Modest Dwelling must be choose
A – Adapt to Lifestyle
R- Recognize Authorities
E – Expectation raising must be avoided

B. Organizational Phase
1. Social Preparation
- Nurse deepens and Strengthen ties
2. Spotting and Developing of Leaders
“Willingness to work for the desired change”
Identify, understand and articulate effectively the problem
3. Core Group Formation
Foundation of a strong peoples organization
Sectoral Representatives
4. Setting up the Community Organization

C. Education and Training Phase
1. Conducting Community Diagnosis
2. Training of Community Health Workers
3. Health Services and Mobilization
4. Leadership Formation Activities

D. Intersectoral Collaborative Phase
Assistance and Support in any form can be funneled
into the organization through collaboration
E. Phase Out
Turn Over
Follow up

COMMUNITY DIAGNOSIS
• Aims to obtain general information about the community’s
profile to determine the community’s strengths and
weaknesses.
TWO TYPES
1. Comprehensive
2. Problem – Oriented

1.COLLECTION
2. ANALYSIS
3. COLLATION
4. PRESENTATION
A.1 2 3 4
B. 1 3 2 4
C. 1 3 4 2
D. 1 4 3 2

GMA 7 - 10
TV 5 - 15
VIVAMAX - 35
NETFLIX - 57
ABS CBN 2 - 100

The College of Nursing voted ABS CBN as the most
watch channel with 100 votes or 79% of the
population.

COMMUNITY DIAGNOSIS
DETERMINANTS OF COMPREHENSIVE COMMUNITY
DIAGNOSIS
1. DEMOGRAPHIC VARIABLE
2. SOCIO-ECONOMIC AND CULTURAL VARIABLE
(Social / Economic / Environmental / Cultural)
3. HEALTH AND ILLNESS PATTERNS
4. HEALTH RESOURCES
5. POLITICAL AND LEADERSHIP PATTERNS

STEPS IN
COMMUNITY
DIAGNOSIS
ACTUAL GATHERING OF DATA
06
01 DETERMINING OBJECTIVES
02 DEFINING STUDY POPULATION
03 DETERMINING THE DATA TO BE
COLLECTED
04 COLLECTING DATA
05 DEVELOPING OF INSTRUMENTS

STEPS IN
COMMUNITY
DIAGNOSIS
07 DATA COLLATION
08 DATA PRESENTATION
09 DATA ANALYSIS
10 IDENTIFYING THE
COMMUNITY HEALTH
NURSING PROBLEM
11 PRIORITY SETTING

STEPS IN CONDUCTING A COMMUNITY DIAGNOSIS
IDENTIFYING THE COMMUNITY HEALTH NURSING PROBLEMS
 Health status problems - described in terms of increased or decreased Morbidity,
Mortality, Fertility, Reduced capability for wellness
 Health resources problems – described in terms of lack or absence of Manpower,
Materials, Money, Institutions necessary to solve health problems
 Health Related problems – described in terms of existence of social, economic,
environmental and political factors that aggravate the illness-inducing situation in
the community.

11. PRIORITY SETTING
NA – MO – MAG – PRE – SO 1 – 4 – 3 – 1 – 1
Nature of the condition/problem presented
Health status problems
Health resources problems
Health-related problems
Modifiability of the problem – refers to the probability of reducing, controlling or
eradicating the problem.
Magnitude of the problem – refers to the severity of the problem which can be
measured in terms of the proportion of the population affected
Preventive potential – refers to the probability of controlling or reducing the effects
posed y the problem
Social concern - refers to the perception of the population or the community as they are
affected by the problem and their readiness to act on the problem.

CRITERIA WEIGHT
Nature of the problem
health status 3
health resources 2
health-related 1
1
CRITERIA WEIGHT
Modifiability of the problem
high 3
moderate 2
low 1
not modifiable 0
4

CRITERIA WEIGHT
Preventive potential
high 3
moderate 2
low 1
1
CRITERIA WEIGHT
Magnitude of the problem
75%-100% affected 4
50%-74% affected 3
25%-49% affected 2
<25% affected 1
3

Factors to Consider in Scoring Preventive Potential
Gravity of the Problem – the more severe the problem, the lower the preventive potential
Duration of the Problem – this has a direct relationship with the gravity of the problem
Current Management – presence of appropriate interventions increases the conditions’ preventive potential
Exposure of any vulnerable or high-risk group – increases preventive potential
CRITERIA WEIGHT
Social Concern
Urgent community concern; expressed readiness 2
Recognized as a problem but not needing urgent attention 1
Not a community concern 0
1

COPAR By Sr. Jimenez
1. PRE-ENTRY PHASE
2. ENTRY PHASE
3. COMMUNITY STUDY / DIAGNOSIS PHASE
4. COMMUNITY ORGANIZATION AND CAPABILITY
BUILDING PHASE
5. COMMUNITY ACTION PHASE
6. SUSTENANCE AND STRENGTHENING PHASE

1. PRE-ENTRY PHASE
• Community Consultations / Dialogues
• Setting of issues/ considerations related to site selection
• Development of criteria for site selection
• Site Selection
• Preliminary social investigation
• Networking with LGU NGO and other departments

2. ENTRY PHASE
• Integration with the community
• Sensitization of the community / Information campaigns
• Continuing Social Investigation
• Core Group Formation
• Development of criteria for selection of CG members
• Defining the roles / functions / task of the CG
• Coordination / Dialogue / Consultation with other community
organizations
• Self-Awareness and Leadership Training (SALT) / Action planning

3.COMMUNITY STUDY/DIAGNOSIS PHASE (RESEARCH
PHASE)
• Selection of the research team
• Training on data collection methods and techniques / capability-
building
• Planning for the actual gathering data
• Data Gathering
• Training on data validation
• Community Validation
• Presentation of the community study / diagnosis and
recommendations

4.COMMUNITY ORGANIZATION AND CAPABILITY BUILDING
PHASE (Prioritization of Community needs / problems for
action
• Community meetings to draw-up guidelines for the organization of
the CHO
• Election of Officers
• Development of management systems and procedures including
delineation of the roles function and task of officers and members of
the CHO

4.COMMUNITY ORGANIZATION AND CAPABILITY BUILDING
PHASE (Prioritization of Community needs / problems for
action
• Team Building / Action – Reflection – Action (ARA)
• Working out legal requirements for the establishment of the CHO
• Organization of working committees / task groups
• Training of the CHO officers / community leaders

5. COMMUNITY ACTION PHASE
• Organization and training of community health workers
• Development of criteria for the selection of CHW
• Selection of CHW
• Training of CHW
• Setting – up linkages, network referrals systems
• Orientation to Health Services / Interventions schemes and
Community Development Projects
• Initial identification and implementation of resource mobilization
schemes

6. SUSTENANCE AND STRENGTHENING PHASE
• Formulation and ratification of constitution and by laws
• Identification and Development of Secondary leaders
• Setting up and Institutionalization of financing scheme for
community health program / activities
• Formalizing and institutionalization of linkages, networks
and referral systems
• Development and implementation of viable management
systems and procedures, committees, continuing education
/ training of leaders, CHWs, Community residents

1. PROJECT DIRECTOR – Command Responsibility (Head of
School)
2. PROJECT MANAGER – Plans and Implements Staff
Development, Supervises staff community and health
workers in the implementation of plan; prepare plan for
exposure and immersion of students and faculty
3. COMMUNITY ORGANIZER – Coordinates with Barangay,
Coordinates with project staff on planning and
implementation, Trains researchers, community leaders,
Evaluates the program implementation

4. COORDINATOR OF STUDENT COMMUNITY IMMERSION –
Supervises the students in the Community
5. HEALTH SERVICES COORDINATOR – Provides health care
services
6. TRAINING COORDINATOR – Prepare training design;
Trains student on PAR
7. FINANCIAL OFFICER – Set up financial system
8. BOOKKEEPER – Record fund releases and expenditures,
prep cash flow
9. SECRETARY – Maintains project records and reports,
Documents process and proceedings

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