Community Health Nursing

SARAH MAE C. IDO, RN 2025

TOP RANK ACADEMY
Lecturer: ms. Shannelle kate wee sunga, rn

2QWASCOMMUNITY HEALTH NURSING FIELDS OF CHN

Unique blend of public health and nursing for human Field Focus Target Common
service with holistic approach Group Setting
PHILOSOPHY by Margaret Shetland Public Health Overall health Entire RHU, BHS
Nursing of community Population
“Worth and Dignity of Men” and “Empowering School Health Health in Students, School
individuals to take charge of their own health” Nursing School Teachers, and (Public &
Regardless of their background Staff Private)
➢ Value Occupational Workplace All employees Offices,
Health health and in the Factories,
➢ Respect Nursing safety workplace workplace
➢ Care Community Mental Health Individuals Community
➢ Dignity Mental Health Care with mental mental health
Nursing health issues programs
ULTIMATE GOAL OF CHN R.A. 11036-
➢ OLOF; Optimum of level of Functioning Mental Health
➢ Raise the level of citizenship Care Act
PRIMARY GOAL OF CHN PHILIPPINE HEALTH CARE DELIVERY
➢ Self-reliance; independence SYSTEM
PRIMARY FOCUS Department of Health
➢ Health Promotion → Health to Healthier ➢ National Authority for Health
➢ Disease Prevention→ Healthy stays Healthy ➢ Main Governing body of health services in
PRINCIPLES IN CHN the country
➢ CHN is based on a RECOGNIZED NEEDS VISION: Filipinos will be healthiest in SEA by
4 LEVELS OF CLIENTELE 2022, in ASIA by 2040
Individual Entry Point MISSION: Develop Productive, Resilient,
Family Unit/Point of Care or Service Equitable, and People oriented health care system
Group/ Population- groups of person that FUNCTIONS OF DOH (LEA)
Aggregate shares a common location and EO 102
health needs LEADERSHIP IN HEALTH
Community Primary Client and Active Partner ➢ National Policy and Regulatory Institution
PRINCIPLES IN CHN ➢ Formulation of health POLICIES, PLANS,
➢ A Community Health Nurse must be AND PROGRAMS 3Ps
available to ALL ➢ Serve as an advocate of 3Ps
➢ Community Health Nurse works as a member ENABLER AND CAPACITY BUILDER
of the health team ➢ Innovate new strategies in health
➢ Health Teaching- Primary Responsibility ➢ Monitor and evaluate 3Ps
➢ Periodic Evaluation- CHN services ➢ Ensure the highest possible standards for
➢ Continuing staff education health
➢ Utilized available community health ADMINISTRATOR OF HEALTH SERVICES
resources ➢ Manage national and subnational health
➢ Utilized existing active organizations- tap facilities that can serve as referral centers
key persons ➢ Administer direct services for emerging
➢ Accurate reading and reporting health concerns
FEATURES OF CHN ➢ Emergency responses during disasters and
1. Preventive approach to health epidemics
Primary Secondary Tertiary
2. Population/ Aggregate- focused Who? Healthy At risk Sick/Post
3. Development in nature- Health needs are Treatment
changeable Activity H. Promotion Early Rehabilitation
4. Prepayment mechanisms- NO FREE IN D. Prevention Screening, Maintenance
CHN (Bayad na thru tax) Diagnosis, Palliative
Treatment
5. Care for different levels of clientele First Aid

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NURSING TRANS | IDO,SARAH MAE C.
 PRIMARY DOH handles tertiary levels
Services Promotive and Preventive RA 7160 “Local Government Code” (DeDe)
Lack of H. Promotive Decentralization and Devolution of the government
Prevention D. Prevention – transfer of power
Examples Immunization LGU handles secondary and primary level
Location RHU and BHS DOH formulated programs; tertiary hospitals
Provincial Government
SECONDARY ➢ Chairmen: Governor
Services Curative, Screening, and Diagnosis ➢ Manages: Secondary Facilities
Lack of Screening, Diagnosis, and Municipality/City Government
Prevention Treatment ➢ Chairman: Mayor
Examples Mammogram, X-ray ➢ Manages: Primary Facilities
Location District Hospital, Provincial
Hospital, and Emergency Hospital PHILIPPINE HEALTH CARE DELIVERY
SYSTEM
National Objectives for Health
TERTIARY
➢ GOAL of DOH
Services Specialized Care
Health Sector Reform Agenda (HSRA)
Lack of Rehab, Maintenance, and Palliative
➢ Overriding Goal
Prevention
F1 PLUS (FORMULA 1 PLUS)
Examples Therapies ➢ Implementation Framework of HSRA
Location Regional Hospital, Specialized ➢ THEME: Boosting Universal Health Care
Hospital, and Medical Center 5 PILLARS OF F1 PLUS (FRS GG PA)
1. Health Financing
2-way referral system ➢ National Health Insurance Program (NHIP)-
PhilHealth
RURAL HEALTH UNIT (RHU) ➢ RA 11223- Universal Health Care Act
➢ Health Center - Main primary center ➢ Case Rate Method (Depends on the
➢ comprised with complete healthcare team. Diagnosis)
o Public Health Midwife- Frontliner o bills will only depend ln the diagnosis
o Public Health Nurse- Ex. Dengue (30k) – PhilHealth will
Supervisor/Coach of Midwife/BHW pay 16k only
o Rural Health Officer- Manager
o Medtech- Lab 2. Health Regulation
o Sanitary inspector: responsible for ➢ Affordable but Quality
environmental sanitation; get sanitary ➢ 4A’s
permit health center from sanitary o Accessible- within reach
inspector ▪ 3-5 km away from home
o Dentist: dental health program ▪ 30 mins. Travel period from
BARANGAY HEALTH STATION (BHS) home
➢ Satellite station/backup station o Available- present, ready to use
➢ Smallest Unit o Affordable- low cost but quality
➢ Manned by a public health midwife with a o Acceptable- culturally appropriate
barangay health worker
➢ No nurse, doctor, dentist 3. Health Services and Delivery
TYPES OF HEALTH WORKERS ➢ Acceptable and reliable
AUXILIARY INTERMEDIATE ➢ DTTB- Doctor to the Bario
Trained Educated/Profession
- Provide Basic - First source of 4. Good Governance (TAE)
Healthcare Measures professional health ➢ T- Transparent
- First contact in the - Attend health ➢ A-Accountable
community problems beyond ➢ E-Efficient
- BHW, Auxiliary - Nurse, doctor,
Health Workers, midwife 5. Performance Accountability
Traditional Birth ➢ Outcome-based approach
Attendants, Healers PRIMARY HEALTH CARE (PHC)
RATIO Essential health care made universally accessible and
➢ Nurse: 1:10,000 (updated); 1:20,000 affordable to individuals and families in the
➢ Midwife: 1:5,000 community by means acceptable to them, through
➢ Physician: 1:20,000 their full participation at a cost they can afford in the
spirit of self-reliance and determination.

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NURSING TRANS | IDO, SARAH MAE C.
ALMA-ATA CONFERENCE (1978) Recommended Schedule of POSTPARTUM VISIT
➢ WHO ➢ 1st: 1st week (within 3-5 days)
➢ USSR (Kazakhstan) ➢ 2nd: 6 weeks postpartum
Letter of Instruction 949
➢ Legal Basis PHC- 1979 1. BEmONC – Basic Emergency Obstetrics Care
➢ President Marcos Sr. (aims to address COMMON problems of pregnancy)
VISION: Health in the Hands of Filipinos - Training/Capability building - Infection is common
MISSION: Increases opportunities that people will = 1st dose of antibiotic (parenteral)
manage their own healthcare - Bleeding = parenteral oxytocin injection
GOAL: Self-reliance - Convulsion (+) preeclampsia = parenteral Mg
2 Core Principles Sulfate
• Partnership with the people (active) - Preterm labor – steroids (betamethasone – fetal lung
• Empower the people – transfer KSA (Knowledge, surfactant)
Skills, Attitude) - Assisted delivery
4 Pillars of PHC (AIUS) - Manual removal of placenta
• Active Community Participation (MOST - Retained products of conception
IMPORTANT)
• Intra and Inter sectoral linkages – with 2. CEmONC – Comprehensive Emergency
collaboration and coordination Obstetric Care
➢ 2- way referral system (intra) - upgraded version of BEMOC
➢ Asking for help outside the healthcare - Blood transfusion - Cesarean Incision
delivery system (inter)
Government Organization (department) Other Activities:
Non-Government Organiza4on (foundation) • Mother-Child Booklet
• Use of appropriate technology – the use of rich • Micronutrient supplementation (Vit A, Iron,
resources in the community Iodine)
Ex. Use of herbal medicines *Vit A (retinol)– teratogenic
Give iron – richest source is liver instead give green – bawal sa 1st trim,
leafy vegetables (cheaper) give on 4th month, low dose 10,000 IU 2x/week
Kwashiorkor (normal: 200k IU non preggy)
• Support mechanism made available – support *Iron 60 mg– give everyday with Folic Acid 400 mg,
from the local government; the LGU must help the prevent neural tube defect, best absorbed in acidic,
community recover from poverty (livelihood orange juice
projects) *Iodine – prevent goiter, give once for whole
CHARACTERISTICS OF PRIMARY HEALTH pregnancy
CARE “CASASA” *T.T./Td (tetanus toxoid/Diphtheria) – optional only
• Community-Based – need to visit the community
• Accessible – within 3-5km 30 mins FAMILY PLANNING
• Sustainable – for long-term; herbal medicines RA 10354 “Responsible Parenthood and
• Affordable – low-cost approach; promotes Reproductive Health Act of 2012’
affordable (not free items – will make them ➢ PROPER COUNSELING: Both will decide
dependent) ➢ PROPER BIRTH SPACING - 3-5 years /
• Self-reliance after 2nd pregnancy increased risk for
• Available complications
PRIMARY HEALTH CARE (PHC) MISCONCEPTIONS
ELEMENTS OF PHC ➢ Some family planning methods causes
➢ Education abortion
➢ Legally Endemic Diseases ➢ Using contraceptives will render the couple
➢ Essential Drugs sterile
➢ Maternal and Child ➢ Using contraceptive methods will result to
➢ EPI loss of sexual desire
➢ Nutrition 3 TYPES
➢ Treatment of CD,NCD , Emergency Services 1. Natural
➢ Sanitation 2. Artificial
MATERNAL AND CHILD HEALTH 3. Permanent
Goal: Decrease maternal mortality rate TYPES OF NATURAL
Recommended Prenatal Visits 1. Cervical Mucus Method
➢ DOH: 4 visits (1- 1st & 2nd; 2- 3rd) ➢ Thin, stretchable, clear/transparent→ high
➢ WHO: 8 visits chance of pregnancy
➢ Thick, color (whitish/yellowish), no odor

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NURSING TRANS | IDO, SARAH MAE C.
 2. Basal Body Temperature NUTRIENTS
➢ Check temperature everyday in the morning ➢ Macronutrient – nutrients taken everyday;
before doing anything carbohydrates and proteins
➢ NOT FOR: clients with fever or thyroid ➢ Macronutrient – vitamins and minerals
disorders MICRONUTRIENT DEFICIENCY
➢ Slight dorp in temp and increase in the 1. Marasmus – lacks carbs and proteins
following days (0.5-1^F) a. Skin and bones
3. Standard Days Method b. Wrinkled skin
➢ 8th-19th day of cycle c. Old man’s facie
➢ NOT FOR: irregular menstruation d. Prominent ribs
4. Sympto thermal method e. Apathy
➢ Combination of CMM+BBT 2. Kwashiorkor – okay carbs, lack proteins
5. Lactational Amenorrhea Method a. Muscle (thin)
➢ < 6 months old (just given birth) b. Fluid imbalance
➢ Amenorrhea c. Edema
➢ Exclusive Breastfeeding- 6 months - MOON face - pabilog
- Ascites – tummy edema
d. Thin sparse hair
diet: MEAT
Diagnosis: “MUAC”
➢ Mid-Upper Arm Circumference
➢ RED – severe malnutrition
o Arm circumference - <115mm
➢ YELLOW – moderate malnutrition
o Arm circum - 115 – 125m
➢ GREEN – no malnutrition
o Arm circum - >125mm
➢ Management – RUTF
o Ready to use therapeutic food
MICRONUTRIENT DEFICIENCY
• Lacks vitamins and minerals
• Problem on junk foods → empty calories
➢ Sangkap pinoy celebrated 2x/year (April &
October)
NEWBORN SCREENING o Garantisadong Pambata
- Detect a genetic disorder ➢ Food fortification program (Sangkap Pinoy)
- Undetected can cause mental o Fortified= Added
retardation/death o RA 8976 – vitamin A (Retinol)
- RA 9288 – free newborn screening; heel prick at the o Iron (Ferrous Sulfate)
side and blanch on the filter paper; no need to discard o Iodine (Potassium Iodine)
first blood; NO squeezing ➢ Sangkap pinoy labels- Vitamin A
- Done after 24 hours – certain genetic disorders can o Iodized salt – diamond with red
be detected after the baby has fed outline
2 Types: o Staple foods – diamond
➢ Basic NBS – detect 6 genetic disorders o Processed foods – square (chichirya)
o Congenital Hypothyroidism
o Congenital Adrenal
o Hyperplasia
o Galactosemia
o G6PD deficiency
o Phenylketonuria
o Maple Syrup Urine Disease
➢ Expanded NBS – detect additional 22 genetic
disorders = 28 G D/O
o Cystic fibrosis
o Organic acid disorder
o Amino acid disorders
o Fatty acid metabolic disorder

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NURSING TRANS | IDO, SARAH MAE C.
 Vitamin A deficiency 7. HOMOSEXUAL FAMILY
• Eye problems ➢ FF & MM
• Night blindness 8. COMMUNAL FAMILY
• Xerophthalmia ➢ Orphanage, home for the aged
• Bitot’s spots – bubbles in eyes FAMILY CARE PLAN
Iron • Nursing process
• Given everyday • “APIE”
• Best absorbed in acidic environment 1st level: WHAT?
• Give to prevent goiter 2nd level: WHY
Iodine ASSESSMENT
• Once a day ➢ data collection
TREATMENT OF COMMUNICABLE AND ➢ Check records
NONCOM DISEASES ➢ Interview
➢ Emergency services ➢ Observa4on
➢ Non-comm Dx – lifestyle-related diseases ➢ Participant observation (halubilo)
o Highblood, cancer, diabetes, kidney FIRST LEVEL ASSESSMENT
stones, etc ➢ Review of records
o Number 1 cause of death among ➢ Interview
filipinos – disease of the heart ➢ Observation
o Number 2 - disease of blood vessels ➢ Physical Exam
➢ Risk factors: “PUS” ➢ Laboratory tests
o Physical inactivity Categories: (score)
o Unhealthy diet 1. Wellness State (3) – for healthy pa4ents
o Stop/ avoid smoking 2. Health Deficit (3) – (+) Ds (+) Disability (naiwan
EMERGENCY SERVICES after ng sakit)
Disaster Ex. Blindness aqer diabetes
• Disruption in society Aphasia after stroke
2 types: 3. Health threat (2) – high risk for illness/injury
1. Natural disaster – acts of GOD Ex. Smoker à lung cancer
2. Man-made disaster – Human Slippery floor
Onset 4. Foreseeable crisis (expected)/stress points
• Acute – sudden Ex. Bagyo- within days to weeks (sudden) (1) – anticipated problems
• Chronic/creeping Ex. Climate change- within • Developmental ADJUST
months to weeks • Social
RA 10121- NDRRMC
➢ Emergency Fund
o National Govt: 2%
o LGU: 5%
➢ Principles of disaster
o It is the responsibility of ALL
o Disaster (capability drills (bldg)
before impact
o Priority people
o 2nd priority: resources
FAMILY NURSING CARE/ HOME VISITS
FAMILY - collection of people who are integrated, PLANNING
interacting, and interdependent focal point or focus 1. Goal setting – first step in planning; must be
of care; center in delivery of care SMART
TYPES OF FAMILY 2. Choose nursing intervention
1. NUCLEAR FAMILY 3. Develop an opera>on plan – prioritize a
➢ Father + Mother + Children problem
2. EXTENDED FAMILY PRIORITIZATION: 14 CRITERIA
➢ Father + Mother + Children+ Relative 1) Nature of the problem (1)
3. SINGLE PARENT FAMILY 2) Modifiability of the problem (2) – solution of the
➢ Father + Child/ Mother + Child problem; MOST IMPORTANT; evaluates if the
4. BINUCLEAR FAMILY problem is:
➢ Conjugal Rights/ Co-parenting • Easily (2)
5. STEPFAMILY • Partially (1)
➢ Blended Family • Non-modifiable (0)
6. COHABITING FAMILY
➢ No marriage

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NURSING TRANS | IDO, SARAH MAE C.
3) Preventive potential – future recurrence of the 6. Should make use of all available information of
problem (1) the family
• Highly(3) 7. Planning and delivery of care should involve the
• Moderately(2) family
• Low(1) preventable GUIDELINES TO CONSIDER REGARDING
4) Salience – percep4on of the client about the THE FREQUENCY OF HOME VISITS
problem (1) Frequency depends on the family’s health needs
• Immediate (2) ➢ Physical needs, psychological needs and
• Not that immediate (1) educational needs of indiv/ family
• Not a problem (0) ➢ Acceptance, interest and willingness of
SCORE / HIGHEST SCORE X WEIGHT family
EX. Father (+) HPN ➢ Policy of specific agency, health programs
1. Nature of the problem = 3/3 X 1 = 1 ➢ Other health agencies, number of health
2. Modifiability = ½ X 2 = 1 personnel
3. Preven4ve = 1/3 X 1 = 1/3 ➢ Evaluation of past services, and how the
4. Salience = 0/2 X 1 = 0 family avail of
FINAL SCORE = 2 1/3 ➢ The nursing services
HIGHEST SCORE IS HIGHEST PRIORITY, ➢ Ability to recognize own needs, knowledge
LOWEST SCORE IS LOWEST PRIORITY of available resources, ability to make use of
IMPLEMENTATION their resources
• Dependent STEPS IN CONDUCTING HOME VISITS
• Interdependent 1. Greet and introduce
• Interdependent 2. State purpose of visit
EVALUATION 3. Observe and determine health needs
• Check for the outcome of care: “QAE” 4. Put bag in convenient place - proceed to perform
• QAE: Quality Assurance Elements bag technique
• 3 Elements: 5. Perform nursing care needed and health teaching
• Structural Element – physical seung 6. Record all important data, observation, care
o “May health center ba diyan o rendered
wala?” (Structure) ➢ Accurate documentation is the hallmark of
o Lacks 3 M’s (Manpower, Money, nursing accountability.
Material) 8. Make an appointment for the next visit
• Outcome Elements – changes resulting BAG TECHNIQUE
from nursing interventions; reviews, a tool that will enable the nurse to perform a nursing
feedbacks, and outcomes procedure with ease and deftness, to save time and
o “May nabago ba dahil may effort, with the end view of rendering effective
ginawa ka?” nursing care to clients
o Ex. 39 pts febrile, gave essential and indispensable equipment of PHN
paracetamol, 28 pts febrile MOST IMPORTANT PRINCIPLE: Prevent the
• Process Elements – has something to do spread of infection
with the steps of nursing process APIE; NOTE: BP App & Stethoscope- Do not put inside the
nursing interventions bag → we consider the bag sterile
HOME VISITS EXPANDED PROGRAMON IMMUNIZATION
A home visit is a professional service provided by GOAL: To reduce morbidity and mortality among
public health nurses to individuals and families in children against the most common vaccine
their homes. preventable diseases
Aims to: PD 996 - basic compulsory immunization for infant
➢ Promote health and prevent disease and children below 8yo
➢ Provide continuity of care RA 10152 - mandatory infant and children health
➢ Establish rapport and assess the family's ➢ If the law’s number is more than 5, it is a new
health status in their natural environment law.
First Hand Appraisal- you are able to observe the Elements of EPI (S.I.C.A.T.)
home environment or family dynamics. ➢ Surveillance and Research
PRINCIPLE OF HOME VISIT ➢ IEC (Information, Education, and
1. Planned and purposeful Communication)-
2. Carried with consent of the family o Posters commercials, talking about
3. Basedon priority needs of your family the benefits
4. Should be flexible and adapted to situation ➢ Cold Chain
5. Trusting relationship with the family (TRUST + o Transport, handling, and storage of
Rapport = Participation) vaccine
o Vaccine are heat sensitive

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NURSING TRANS | IDO, SARAH MAE C.
 ➢ Assessment and Evaluation of the program’s FALSE CONTRAINDICATION
overall performance ➢ Malnutrition- unless severe
➢ Target Setting- Vaccine computation ➢ Low-grade Fever (<38.5*C)
(Distribution of Vaccine), to prevent vaccine ➢ Mild Respiratory Infection
wastage ➢ Diarrhea- unless severe
o Infant: Total Population x 2.7% o Give OPV but repeat after 4 weeks
o Pregnant: Total Population x 3.5% ➢ Giving are administered at different sites
COLD CHAIN PRINCIPLES o Vaccines are administered at different
1. Storage: sites
➢ 6 months: Regional Level o IM injections in infants= Best site is
➢ 3 months; Provincial/City/District Vastus Lateralis
➢ 1 month; RHU with refrigerator o Do not administer more than one dose
o Door of freezer and body of fridge of a vaccine at one session
should be separate ▪ Painful and can vaccine
➢ 5 days: BHS with cold dogs interactions
o Storage like a cooler ▪ OPV- vomits within 30
2. Transport - use Cold Bags minutes= Repeat; vomits
➢ Parts of Cold Bags: more than 30 minutes= do not
➢ Vaccine Carriers repeat
➢ Cold Dogs (CD) o Follow appropriate vaccine intervals;
3. Handling at least 4 weeks apart
➢ Reconstituted vaccines must be used within 6 ▪ Okay to be late but not early
hours only BCG: Bacillus Calmette-Guérin
VACCINE STORAGE ➢ Live attenuated tuberculosis bacteria
Heat Sensitive= Freezer ➢ Can be given to a child with Hep B
- 15*C to -25*C ➢ Prevent TB meningitis and leprosy
➢ V- Varicella Zoster Vaccine ➢ There should be scarring
➢ O- Oral Polio Vaccine ➢ Clean site: water only
➢ M- Measles Vaccine o Alcohol can kill the live virus
Other Vaccines ➢ SIDE EFFECTS
➢ Body of refrigerator o Koch's phenomenon
➢ + 2 - + 8*C o Abscess
Light Sensitive ▪ Warm compress
➢ BCG and Rotavirus ▪ Isoniazid powder
➢ Should be wrapped if transported o Deep abscess
▪ Incision and drainage + INH
➢ FEFO- First Expiry, First Out powder
➢ Vaccine Vial Monitor HEPA B VACCINE
➢ recombinant RNA
PENTAVALENT (5IN1) VACCINE
➢ DPTHH
o Diphtheria, Pertussis, Tetanus, Hepa
B, and Hib
➢ Side effects
o Fever
▪ Paracetamol q6 for 24hrs
o Local tenderness
▪ Cold compress- lessen
discomfort
➢ Adverse Effect - Report
Absolute contraindications of EPI vaccines: ➢ Convulsion/ seizure within 3 days
➢ Pentavalent vaccine/DPT to children with (encephalopathy)
recurrent convulsions or for those with o Pertussis
another active disease of the CNS ➢ Don't give penta 2 and 3
➢ Rotavirus vaccine for child with history of o Give the vaccines individually
hypersensitivity, intussusceptions or OPV - ORAL POLIO VACCINE
intestinal malformation or acute ➢ Sabin V
gastroenteritis ➢ Live attenuated (weakened)
➢ BCG to a child who has s/sx of AIDS or other ➢ On the tongue
immune deficiency conditions/
immunosuppressed

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NURSING TRANS | IDO, SARAH MAE C.
 ➢ Vomiting VITAL STATISTICS
o W/in 30mins: give another ➢ The application of statistical measures to vital
o After 30mins: don't give event (births, deaths, illnesses) to achieve the
➢ IPV - inactivated polio vaccine - Salk levels of health, illness and health services of
o Killed vaccine a community
o Fever ➢ PD 651- Registration of Births and Deaths
▪ Paracetamol within local civil registry
MMR: MEASLES MUMPS RUBELLA BIRTHS DEATHS
➢ Live attenuated When: Within 30 days When: within 48 hours
o Avoid in immunocompromised Who: Birth Attendant Who: Physician
o Avoid in pregnant Where: Municipal Where:
o Avoid child that is newly vaxx
exposure to pregnancy - can infect the
pregnant woman
➢ Side effects:
o Rashes
▪ Keep it dry
o Rashes with dob
▪ Refer
BH POP RIV
Vaxx Dose Sched Route Dosage
BROM BRO
BCG At Birth ID 0.05 ml Incidence Rate Prevalence Rate
Hepa B
1 IM 0.5 ml Acute Disease Chronic Disease
PentaV 1½ IM 0.5 ml
OPV
3 2½ PO 2-3 drops
NEW cases OLD+NEW cases
Total no of new cases/total Total no old + new cases/
PCV 3½ IM 0.5 ml population x 1000 total person examined x
RotaV 1½2½ PO 1.5 ml
IPV
2 3½4½ IM 0.5 ml
1000

MMR 9 & 12 mos SubQ 0.5 ml

Attack Rate Case Fatality Rate
How many people out Chronic Disease
of a group got sick
during an outbreak
Gaano nakakahawa OLD+NEW cases
# of people who got sick/ # of deaths due to the
total # of people exposed x disease/ total # of people
100 who got sick x 100

Sex Ratio Swaroop’s Index

Mother to baby → 6 months to 1 year Balance of male/female Longevity of life/
EPIDEMIOLOGY lifestyle of people
➢ Occurrence and distribution of diseases (health status)
➢ Backbone of preventing disease
o Backbone of preventing infection: Male/Female x 100 Total death above 50 y/o
total death x 100
Handwashing
CLASSIFICATION DEMOGRAPHY
Sporadic Few cases, isolated, rare, intermittent, ➢ Study of Population size, composition, and
occasionally, no outbreak spatial distribution
Herd Immunity, Increase immunity ➢ as affected by births, deaths and migration
decrease susceptibility ➢ 3 sources
Ex: Rabies o CENSUS – bulk information, most
ideal but not practical- time-
Endemic Always present, continuous
consuming
occurrence
o SURVEY – sample survey- most
Ex: Malaria- Palawan
practical
Epidemic Sudden increase of cases for a short
o REGISTRATION SYSTEM -PSA,
period of time
NSO
Pandemic Worldwide epidemic; several
TRADITIONAL AND ALTERNATIVE
countries are affected
HEALTHCARE
EPIDEMIOLOGIC TRIAD
RA 8423 or TRADITIONAL AND
1. Host
ALTERNATIVE MEDICINE ACT OF 1997
2. Agent
(T.A.M.A)
3. Environment

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NURSING TRANS | IDO, SARAH MAE C.
 PRINCIPLES IN USE OF HERBAL 3. Reporting Forms/Tally Report
MEDICINES ➢ Only mechanism through which data are
➢ Use fresh leaves routinely transmitted from one facility to
➢ Use Only part of plant that is advocated another
➢ avoid use of insecticides ➢ Prepared and submitted either monthly or
➢ Use clay pot quarterly
o Doesn’t easily get hot 4. Output Reports
o 1. Nakatakip ➢ Objective in designing the output formats:
o 2. If boiling remove cover Make the reports useful for monitoring or
➢ follow accurate dosing management purposes
➢ STOP when: ➢ Consolidated Form: Updated
o (+) Adverse reactions - DOB Quarterly/Annually
o (+) s/sx after 2-3 doses OBJECTIVES
PREPARATION 1. Data Summary
➢ Decoction 2. Program Monitoring and Evaluation
o Boiling 3. Standardized Data Facility Based
o 20 minutes; 2 glasses to 1 glasses 4. Accurate and Reporting and Recording
SANTA Use/Indication Preparation Burden
Sambong Anti urolithiasis Decoction 5. Minimized reporting and reading burden
- Prevent Kidney ENVIRONMENTAL SANITATION
Stones PROGRAMS
- Diuretic 1. FOOD SANITATION PROGRAM
- Anit edema ➢ Food Establishments
Akapulko Antifungal Poultice o Class Rating
Causes Abortion ▪ Class A
Niyog- Anti-helminthic Seeds are ▪ Class B
Niyogan used ▪ Class C
Tsaang Stomachache Decoction o Sanitary Permit
Gubat Diarrhea ▪ Needed by the owner
Constipation o Health Certificates
Ampalaya Lowers Blood Sugar Decoction/ ▪ Food Handlers
DM Type 2 only Steam ➢ 4 Rights of Food Safety (SPCS)
1. Right Source
LUBBY Use/Indication Preparation ➢ Always buy fresh meat, fish fruits &
Lagundi Asthma, Cough, Decoction vegetables
Fever, Skin Disease ➢ Look at the expiry dates of processed food
Ulasimang Decrease Blood Uric Decoction ➢ Avoid buying canned goods with dents,
Bato Acid bulges, deformation, broken seals and
Bayabas Washing Wounds Decoction improper seams
Antibacterial & ➢ Boil water for at least 2 minutes (running
Antiseptic boiling)
Diarrhea 2. Right Preparation
Toothache ➢ Avoid contact between raw food and cooked
Bawang Lowers HTN Raw/Fried food
➢ Always buy pasteurized mild and fruit juices
Lowers Cholesterol Puoltice
Toothache ➢ Wash vegetables well if to be eaten raw such
as lettuce, cucumber, tomatoes & carrots
Yerba Analgesic Properties Decoction/
➢ Wash hands kitchen utensils before and after
Beuna Cough and colds Infusion
preparing foods
Has mental
➢ Sweep kitchen floors to remove food
properties
droppings
3. Right Cooking
FIELDS IN HEALTH SERVICE
➢ Cook food thoroughly (temperature on all
INFORMATION SYSTEM
parts of the food should reach 70 degrees
is the recording and reporting system in public health
centigrade
care in the Philippines.
➢ vEat cooked food immediately
4 MAJOR COMPONENTS
➢ Wash hands thoroughly before and after
1. Family Treatment Record
eating
➢ Fundamental building block of FHSIS
2. Target Client List
➢ Second building block of FHSIS

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 4. Right Storage LEVEL 2
➢ All cooked food should be left at room ➢ Water carriage type with Water Flush type
temperature for not more than two hours with septic vault/tank disposal facilities
➢ Use tightly sealed containers for storing food LEVEL 3
➢ Store food under hot conditions (at least or ➢ Water carriage types of toilet facilities
above 60°C) or in cold conditions (below or connected to septic tanks and/or sewerage
equal to 10°C) if you can plan to store it for system to treatment plant
more than 4 to 5 hours PD 856: ENVIRONMENTAL CODE ON
➢ Do not overburden the refrigerator by filing it SANITATION
with too large quantities of warm food Black Non-infectious, dry, non-bio
➢ Food should be reheated to at least 70 degrees Yellow Non-infections, wet, bio
centigrade Yellow with Infectious
➢ Rule in Food Safety: “When in doubt, throw a band
it out!” Red Chemicals, Expired Reagents,
2. WATER SUPPLY SANITATION Pharmaceuticals
PROGRAM Orange Radioactive
Approved Types of Water Supply Facilities Millennium Development Goals 2000-2015
LEVEL 1 (Point Source)
➢ Protect well or developed spring with an
outlet but without a distribution system
➢ Serves around 15 to 25 households
➢ Outreach must not be more than 250 meters
from the farthest user
➢ Yield or discharge is generally from 40 to 140
liters per minute Important no. 4 and 5
➢ Generally adaptable for rural areas where the Sustainable Development Goals 2015-2030
houses are thinly scattered
LEVEL II (Communal Faucet System or Stand –
posts)
➢ System composed of a source of reservoir, a
piped distribution network and communal
faucets
➢ Located not more than 25 meters from the
farthest house
➢ Designed to deliver 40-80 liters of water per
capital per day
➢ Average households: 100
➢ One faucet per 4 to 6 households
➢ Suitable for rural areas where houses are
LAWS
clustered densely to justify a simple-piped
RA 11036- Mental Health Act
system
➢ 1= Juan
LEVEL III (Waterworks System or Individual
➢ 1= Juana
House Connections)
➢ 0= circle
➢ NAWASA, Maynilad
➢ 3= triangle
➢ 6= Hexagon
Unapproved type of water facility
RA 10354- RPRH- Responsible Parenthood and
➢ Open drug wells
Reproductive Health Act
➢ Unimproved springs
➢ 10 couples
➢ Wells that need priming
➢ 3-5 birth spacing
3. PROPER EXCRETA AND SEWAGE
➢ 4 Pillars * Informed Choices
DISPOSAL PROGRAM
PD 965- Under RA 10354
LEVEL 1
requires applicants for marriage licenses to receive
➢ Non-water Carriage Toilet Facility
instructions on family planning and responsible
o Pit Latrines
parenthood.
o Reed Oderless Earth Closet
➢ 9 months baby
➢ Toilet Facilities requiring small amount of
➢ 6 lessons
water
➢ 5 vows
o Poor Flush Toilet
o Aqua Privies

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NURSING TRANS | IDO, SARAH MAE C.
RA 7610- "Special Protection of Children Against PROCESS IN COPAR
Abuse, Exploitation and Discrimination Act," ➢ ARAS
➢ Ang 7 and 6 years old sinapa ang 10 years old o Action
RA 7160- Local Government Code o Reflection- evaluate
➢ DeDe o Action
➢ 160- LGU o Session
RA 7600- "The Rooming-In and Breastfeeding ➢ Consciousness Raising
Act of 1992" o S
➢ 00- boobs ➢ Participatory/ Mass/ Group/
➢ RA 10028- Expanded Breastfeeding Act WHY do we want to involve our community in
o 00- boobs COPAR?
RA 9482- Anti-Rabies Act of 2007 ➢ Develop Problem-Solving
➢ 9- years old ➢ Sense of commitment and ownership
➢ 4- four the run HOW to get participation?
➢ 8th avenue ➢ Indigenous Leadership
➢ 2- aso o Know and recognize the key persons
RA 9211- Tobacco Regulation Act of 2003 ➢ Interagency collaboration
➢ SS
RA 6675- Generics Act of 1988 PHASES OF COPAR (PECOAST)
➢ 66- Generics ➢ Pre Entry
➢ 75- offered only for 75 pesos ➢ Entry/Social Preparation
RA 3573- Law on Reporting of Communicable ➢ Community Study/ Assessment/ Diagnosis/
Diseases Situational Analysis
➢ 3- CDN ➢ Organizational Phase
➢ 5- Rural Health ➢ Action
➢ 7- Station ➢ Sustenance and Strengthening
➢ 3-CDN ➢ Turnover/ Phase Out
COMMUNITY ORGANIZING PRE-ENTRY PHASE
PARTICIPATORY ACTION RESEARCH Site Selection (DOPES)
(COPAR) ➢ Depressed
Community Organization o Lack access to basic needs
- Identify and plan solutions for the community ➢ Oppressed
problem o People in the community are being
Participatory Action Research discriminated against.
➢ Active Approach ➢ Poor
➢ Action Research o High level of poverty
➢ People are investigators themselves ➢ Exploited
➢ People are solving their own problem o Taken advantage of in terms of- work
➢ Nurses are facilitators o Unfair treatment in the working
GOAL OF COPAR industry
➢ Community Health Development (Social ➢ Safe
Transformation) o Consider safety
OBHECTIVES Courtesy Call
➢ Self-reliance ➢ Mayor- basta pre-entry; not inside the
➢ People Empowerment community
ROLE OF NURSE VS. PEOPLE ➢ To pay respect
➢ NURSES ➢ For Safety
o facilitator Preliminary Social Investigation
➢ PEOPLE ➢ Mere Observation
o Leader ➢ Use of secondary data from various
o Assess government offices, particularly the
o Plan Provincial Health Office and / or RHU
o Implement TEST-TAKING STRATEGY
o Evaluate ➢ ODD ONE OUT
o Makes a recommendation ENTRY PHASE (SOCIAL PREPARATION
PHASE)
➢ Courtesy Call
o Barangay Captain
➢ Deepening Social Investigations
o Identify the pressing of the
community

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NURSING TRANS | IDO, SARAH MAE C.
 o Not yet a formal data collection o Census- Most Ideal
➢ Immersion/Integration o Sample Survey- most Practical, not
o Imbibe the life of people in the time-consuming
community- nakikibuhay o Interviews
o Do what the family is doing o Records Review
▪ Do fishing, farming o Ocular Inspection- bahay2
➢ Spot a Potential Leader o Wind Shield Survey- umiikot sa
o Core group (Informal Leaders) community; Spot Map
▪ 5-6 members ➢ Finalize Sampling Design
▪ Key person ➢ Make a Timetable
▪ Not Elected o Gantt Chart
o They will naturally emerge IMPLEMENTATION PHASE
➢ Characteristics of a leader: ➢ Data Collection
o Poor Data Collation/ Organization
o Respected (tinitngala) o Categorize/ Summarize Data
o Communicator ➢ Data Presentation
▪ must be an active listener o Only present data
▪ Stand out for you o Narrative- Essay Type
o Desire for change o Tabular
▪ Should want improvement o Graphical
o Open-minded ▪ Bar Graph
▪ Open to suggestions • Many variables
o Charismatic • Ex: Top 10
▪ known in the community; morbidities of CDO
approachable ▪ Pie Graph/Chart
COMMUNITY STUDY/ ASSESSMENT/ • Limited Variables
DIAGNOSIS/ SITUATIONAL ANALYSIS • Ex: Sex, Religion
Profiling of Community ▪ Line Graph
➢ get the biodata of the community • Trends
Research Team ➢ Data Analysis
➢ AD HOC Committee o Statistics, Evidence-based practices
o Temporary ➢ Identification of health problems
o Responsible for community ➢ Problem Prioritization
Diagnosis o Community Prioritizes
Community Diagnosis
➢ Actual or Potential
Comprehensive vs Problem-Oriented
➢ Comprehensive
o General Information
▪ Whole community is affected
➢ Problem-oriented
o Specific Population Group Only
Types of Community Problems
➢ Health Status
o MMF- Mortality, Morbidity, Fertility
➢ Health Resources
o 3M’s- Manpower, Money, and
Material
➢ Health Related
o Socioeconomics, Education,
Religion, Environmental, Political,
Cultural
PREPARATORY PHASE
➢ Site Selected
➢ Preparation of the community
o Inform and teach how they will
participate
➢ Statement of goals and objectives
➢ Determine the data to be collected
➢ Identify the methods of data collection
➢ Community Survey

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NURSING TRANS | IDO, SARAH MAE C.
 ORGANIZATIONAL/BUILDING PHASE
Election of Officers
➢ Formal Leader
➢ Usually the core group members
Training Officers
➢ SALT
o Self-Awareness Leadership training
Team Building of Officers
➢ Builds relationship
Plan Solutions for Community Problems
➢ Community Organization
ACTION PHASE
Mobilization
➢ Turn written plans into action
Pime
➢ Program/ Implementation, Monitoring and
Evaluation
Ground working
➢ House to house to encourage participation
Training of BHW
➢ Should be continuous
➢ They implement the plan
SUSTENANCE AND STRENGTHENING
PHASE
Sustenance
➢ Pangmatagalan
➢ By providing continuous education and
training provided by the government
Strengthening
➢ Adhere to short-term and long-term goals
Collaboration, Networking, and Cooperation
➢ Connecting with inter-agencies
TURN OVER/PHASE OUT
Self-Reliance
➢ Nurse stays in the community for 5-10 years
only
Documentation
➢ The primary responsibility of the nurse
during the turnover phase
Follow-Up/Expansion
o Go back to the community
➢ Every 1 year
➢ Expansion- add another projects
NOTE: DO NOT take the community if na COPAR
na
INTEGRATED MANAGEMENT OF
CHILDHOOD ILLNESS
Pink Severe Classification
➢ Urgent Referral to Hospital
except Dehydration
➢ IM antibiotic (Ampicillin and
Gentamycin)
Yellow Moderate Classification
➢ Treatment is given at the health
center
➢ Oral Antibiotic (Ampicillin and
Gentamycin)
Green Mild Classification
➢ Treatment at home
➢ NO antibiotic

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NURSING TRANS | IDO, SARAH MAE C.