Chn Review March 1 2011 Complete
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Chn review march 1 2011 complete - Presentation Transcript 1. COMMUNITY HEALTH NURSING ROMEO D. PIANSAY, JR., R.N., M.A.N. 2. o CHN ??? o Boring?? o Verbose?? o Confusing?? o Repetitive?? 3. 9 PRIMARY QUALITIES OF CHN 4. Promotion of OLOF thru health teaching and delivery of care 1 Primary GOAL 5. Health Teaching 2 Primary DUTY 6. 3 Health care for the ENTIRE community Primary PRINCIPLE 7. Health Promotion 4 Primary FOCUS 8. Nursing Process 5 Primary METHODOLOGY 9. Population-focused care (MASS – BASED) 6 Primary TYPE of CARE DELIVERY 10. Recognized Needs of Clients 7 Primary BASIS 11. Family 8 Primary UNIT of SERVICE 12. 9 Primary CLIENT & SETTING Community 13. o Linguistic Origin o [L. communitas, fellowship] o [MOSBY] a group of species who reside in a designated geographic area and who share common interests or bonds
Transcript of Chn Review March 1 2011 Complete
Chn review march 1 2011 complete - Presentation Transcript
1. COMMUNITY HEALTH NURSING ROMEO D. PIANSAY, JR., R.N., M.A.N. 2.
o CHN ???
o Boring??
o Verbose??
o Confusing??
o Repetitive??
3. 9 PRIMARY QUALITIES OF CHN
4. Promotion of OLOF thru health teaching and delivery of care 1 Primary GOAL
5. Health Teaching 2 Primary DUTY
6. 3 Health care for the ENTIRE community Primary PRINCIPLE
7. Health Promotion 4 Primary FOCUS
8. Nursing Process 5 Primary METHODOLOGY
9. Population-focused care (MASS – BASED) 6 Primary TYPE of CARE DELIVERY
10. Recognized Needs of Clients 7 Primary BASIS
11. Family 8 Primary UNIT of SERVICE
12. 9 Primary CLIENT & SETTING Community
13.
o Linguistic Origin
o [L. communitas, fellowship]
o [MOSBY] a group of species who reside in a designated geographic area and who share common interests or bonds
o [STEDMAN] a group of persons united by some common feature or shared interest
COMMUNITY
14. Qualities of a Healthy Community 4) Awareness community health status 5) Independence people & leaders 6) Role Models parents & guardians 7) Active Concern health threats 8) Sustainability environment & needs 9) Accessibilty health services 1) Resources open & controlled 2) Empowerment active participation 3) People healthy citizenry 10) Politics mass-based & respected (REPAIR ASAP)
15. Classification of a Community
16.
o Rural or Open lands
o Agricultural / fishing
o less dense
o more spacious
1
17.o Urban or the City
o non-agricultural
o dense & highly populated
o highly industrialized
2
18. Rurban or the Capitals - mixed type of rural & urban 3 19. COMPONENTS OF A COMMUNITY
o THE CORE
o People demographics, values & beliefs
20. B. 8 subsystems of the community 4) Economics livelihood projects 5) Recreation community activities 6) Fire and safety bldg. & house check 7) Politics & gov’t selection of leaders 8) Health health services & programs 1) Communication open all channels 2) Housing adequate shelter & security 3) Education health teachings, seminar (CHEER for public health)
21. APPROACHES TO COMMUNITY DEVELOPMENT
o A. Welfare approach
the immediate & spontaneous response to ameliorate poverty
assumes that poverty is God-given
poverty is destiny must accept fate
just reward in heaven
22.
o B. Modernization approach
aka “project development approach”
introduces lacking resources
o C. Transformatory/participatory approach
involves people empowerment & transformation of the poor
assumes that poverty is not God-given
poverty historical past existence of oppressive structures in society
23.
o State of complete physical, mental and social well-being, not merely the absence of disease or infirmity
o WORLD HEALTH ORGANIZATION
o OLOF of individuals, families & communities being influenced by several factors in the eco-system
o MODERN CONCEPT OF HEALTH
o [NLPGN, CHN committee, 2000]
HEALTH
24. ECO-SYSTEM FACTORS THAT AFFECT COMMUNITY HEALTH (OLOF) 25.
o This factor pertains to the power and authority to regulate the environment
o EXAMPLES:
o Safety
o Oppression
o People empowerment
P O L I T I C A L
26.
o One component of this factor is the primary health care which is a partnership approach
o GOAL: effective provision of health services that are community-based and accessible
o COMPONENTS:
o Promotive, Preventive, Curative & Rehabilitative
HEALTH CARE DELIVERY SYSTEM
27.o COMPONENTS
o Culture
o Habits
o Ethnic customs
o EXAMPLES
o Smoking
o Intake of alcoholic drinks
o Substance abuse
o Lack of exercise
B E H A V I O R A L
28.o COMPONENTS
o Employment
o Education
o Housing
SOCIO ECONOMIC INFLUENCES
29.o COMPONENTS
o Air
o Food
o Water waste
o Urban/rural noise
o Radiation
o Pollution
ENVIRONMENTAL INFLUENCES
30.o COMPONENTS
o Genetic endowment
o Defects
o Strengths
o Risks:
Familial
Ethnic
Racial
H E R E D I T Y
31. 4) Environment air, food, water, noise 5) Behavior culture, habits, customs 6) Health care delivery system promotive, preventive, curative, rehab 1) Political safety, oppression, gov’t. 2 ) Socio-economic employment, educ. 3) Heredity genetics, race, ancestry ECO-SYSTEM FACTORS THAT AFFECT CH Physician Sometimes Heals Everyone But Himself
32.
o Public health as the science and art of preventing disease, prolonging life and efficiency to enable every citizen to realize his birthright of health and longevity.
DEFINITIONS W I N S L O W
33.o Public health is dedicated to the common attainment of the highest level of
physical, mental and social well-being and longevity
o GOAL: contribute to the most effective total development and life of the individual and his society
H A N L O N
34.o Community health nursing is a learned practice discipline
o Ultimate goal : contribute to the promotion of client’s optimum level of functioning
o Through teaching and delivery of care
J A C O B S O N
35.o CHN is a service rendered by a professional nurse with the community, groups,
families and individuals
o GOAL: promotion of health, prevention of illness, care of the sick at home and rehabilitation
F R E E M A N
36.o Philosophy of community health nursing is based on the worth and dignity of man
S H E T L A N D
37. 5 Core Business of Public Health o Disease control
o Injury prevention
o Health protection
o Health public policy
o Promotion of health and equitable health gain
38. MIND GAMES – HOW MANY FACES CAN YOU SEE?
39.
o [MOSBY] the practice in which a nurse assists the individual, sick or well, in the performance of those activities contributing to health or its recovery ( or to a peaceful death)…
o - adaptation from Virginia Henderson
NURSING
40. PUBLIC HEALTH NURSING o Lillian Wald coined the term “public
o health nursing” to denote “ a service
o that was available to all people”
o PHN Public/gov’t agency
o care of poor people
o CHN -> nursing for the health of the
o ENTIRE public/community, NOT ONLY for the
o public who are poor
o PHN & CHN have been used interchangeably in the Philippines by both foreign and local authors
41.
o Public Health Nurses (PHNs) – refer to nurses in the local /national health dept or public schools whether their official position title is Public Health Nurse or Nurse or School Nurse
PHN ACCORDING TO NLPGN, 2005
42. PHN ACCORDING TO NLPGN, 2005 o Public Health Nursing – refers to the practice of nursing in national and local govt
health dept. and public schools. IT IS CHN PRACTICED IN THE PUBLIC SECTOR.
43. FIVE FOLD MISSION OF CHN / PHN: 4) Disease Prevention – avoid consequences Primary prevention immunizations Secondary prevention screenings Tertiary Prevention rehabilitation 5) Social Justice – right to “basics of life” 1) Health Promotion – lifestyles / choices 2) Health Protection – alter community dses 3) Health Balance – biopsychosocial homeo Holding Hands, Hugs, Don’t Smack
44. 8 Millenium Dev’t Goals (2015) 4) Gender equality and women empowerment 5) Environmental sustainability 6) Universal primary education 7) Combat HIV/AIDS, malaria & other dses 8) Global partnership for development 1) Extreme poverty and hunger eradication 2) Maternal health improvement 3) Child mortality reduction Every Married Cool Guy Eyeballs Underage Cool Girls
45.
o APIE over-all community health plan
o Provide quality nursing services
o Coordinate the health team, NGO’s & gov’t. agencies
o Researches relevant to PHN services
o Continuing education & professional growth
OBJECTIVES OF CHN: ALL PUBLIC COMFORT ROOMS CONTAMINATED
46.o SPECIALIZED FIELDS OF CHN:
o COMMUNITY MENTAL HEALTH NURSING
A unique clinical process which includes an integration of concepts from nursing, mental health, social psychology, community networks & the basic sciences
FOCUS: mental health promotion
47.
o OCCUPATIONAL HEALTH NURSING
The application of nursing principles & procedures in conserving the health of workers in all occupations
AIMS:
Health promotion
Prevention of diseases
Risk reduction
Safe workplace
48.
o SCHOOL HEALTH NURSING
Application of nursing theories & principles in the care of the school population
COMPONENTS:
School Health services
Health instruction
Healthful school living
School-community linkage
49. LEADING AILMENTS/DEFECTS AMONG SCHOOL CHILDREN
o Dental Caries
o Intestinal Helminthiasis
o Colds
o Pediculosis
o Upper respiratory tract infection
50.
o 1) Individual - Not the main client in CHN, but receives CHN care through the family
o Family - the basic unit of care
o Population group
o Community
o The ultimate patient is the COMMUNITY .
4 Levels of Clients / patients
51. 4 Major Functions of the Family o Physical Function
o Economic Function
o Reproductive Function
o Socialization Function
52. KINDS OF FAMILY STRUCTURE
o A) Traditional Family
nuclear family
Extended family
o B) Alternate Family Structure
Single-Parent Families
Cohabitating families
53.
The beginning family
The early child-bearing family
The family with pre-school children
The family with school-age children
The family with teen-agers
The Family as Launching Center
The middle-aged family
The aging family
Stages of Family Development
54. Infants & young children
School age
Adolescents
Mothers
Elderly
Males *
VULNERABLE POPULATION GROUPS
55. CHN ROLES OF THE NURSE Facilitate & empower people 3) COLLABORATOR Coordinates community resources 1) CLINICIAN Focus on the health of individuals 2) COMMUNITY ORGANIZER
56. CHN ROLES OF THE NURSE Gives KSA, better informed choices a) INFORMATION – provision of knowledge b) EDUCATION – change thru KSA 4) COUNSELOR Listening, give feedback & support 5) EDUCATOR c) COMMUNICATION – exchange of info 3 ASPECTS OF HEALTH TEACHING
57. CHN ROLES OF THE NURSE Shows examples of good behavior 8) CHANGE AGENT Influences & motivate others good behavior 6) RESEARCHER/STATISTICIAN/RECORDER Analyzes data to predict future phenomenon 7) ROLE MODEL 9) HEALTH ADVOCATE Aids people in asserting their rights; promotes self-care and self-determination
58. CHN ROLES OF THE NURSE providing nursing care skills in a home setting 10) CASE MANAGER oversees all aspects of care to facilitate delivery of cost-efficient care; to individualize and coordinate care 11) HOSPICE CARE
59. 7 FUNCTIONS OF PHN
o Management function
o Supervisory function
o Nursing care function
o Collaborating & coordinating function
o Health promotion & education function
o Training function
o Research function
60. Sample Questions:
o The community health nurse acting in a role of clinician would be more likely to:
A) Work to articulate the special needs of a population such as homeless people
B) Focus on reducing the incidence of disease in a population
C) Address the spiritual needs of a group without performing any screening or treatment
D) Coordinate the various components of care in different areas of the health system
o Answer: B
61.
o The CHN acting in the role of advocate would be
o most likely to promote:
Self-care & self-determination for the population
Telling the people in a community that the medical experts know what is best for them.
Smoking cessation
That health care options should be pursued without the influence of friends or families
o Answer: A
62.
o Which of the following is not a role for the nurse
o providing hospice or end-of-life care?
o Providing resources for caregivers to prevent burnout
o Ensuring that the client is given every reasonable chance to extend life and is encouraged not to give up too easily
o Working as part of a multidisciplinary team to meet client’s needs.
o Promoting & coordinating palliative care
Answer: B
63.
64. Philippine Herbal Medicine
65. T.A.M.A. OF 1997
o REPUBLIC ACT NO. 8423
o (TRADITIONAL & ALTERNATIVE MEDICINE ACT)
o Created PITAHC (Phil. Institute of Traditional & Alternative Health Care)
o - scientific research & development of traditional & alternative health care system that have impact on public health care.
66. Phil. Institute of Traditional & Alternative Health Care (PITAHC)
o BACKGROUND:
o Administrative Order No. 12 (1992)- Traditional Medicine Program, through former Health Secretary / Senator Juan M. Flavier
o This special program was tasked to promote and advocate traditional medicine nationwide.
67.
o Vision
o "Traditional and alternative health care in the hands of the people"
o Mission
o "PITAHC upholds the right of every Filipino for better health through the provision of safe, effective and affordable traditional and alternative health care products, services and technologies."
68. Products of PITAHC
69. Handling Tips on Medicinal Plants / Herbs
o If possible, buy herbs that are grown organically - without pesticides.
o Medicinal parts of plants are best harvested on sunny mornings. Avoid picking leaves, fruits or nuts during and after heavy rainfall.
o Leaves, fruits, flowers or nuts must be mature before harvesting. Less medicinal substances are found on young parts.
70. Tips on Preparation for Intake of Herbal Medicines:
o Use only half the dosage prescribed for fresh parts like leaves when using dried parts.
o Do not use stainless steel utensils when boiling decoctions. Only use earthen, enameled, glass or alike utensils.
o As a rule of thumb, when boiling leaves and other plant parts, do not cover the pot, and boil in low flame.
71.
o Reminders:
o One kind of plant for each type of s/s
o No insecticides
o Use clay pot and plant part advocated
o Stop in case of untoward reactions; seek consultation if signs/symptoms not relieved after 2-3 doses
72. QUESTION
o In preparing herbal medicines, which of the following is incorrect?
o A) When boiling, cover the pot well to preserve the nutrients.
o B) You must boil them in low flame.
o C) One kind of plant for each type of symptom
o D) Use a clay pots.
o ANSWER: A
73. QUESTION
o In the use of herbal medicine, one should remember to
o a. use all parts of the plant in making decoction.
o b. boil leaves sprayed with insecticide.
o c. stop giving herbal medicine if allergy occurs.
o d. continue giving decoction even if signs and symptoms persist.
o ANSWER : C
74. QUESTION
o Which of the following is a correct statement?
o a) local plants and herbs in the Philippine backyard are all effective in treatment of ailments
o b) since they are readily available at no cost, you may use 2 or more for kinds for faster cure
o c) no side effects or untoward reactions
o d) not recommended for everyone to use herbal medicines
o ANSWER : D
75. QUESTION
o The Traditional & Alternative Medicine Act of 1997 is also known as:
o A) PD #8243
o B) RA # 8342
o C) PD # 8432
o D) RA # 8423
o ANSWER: D
76. 10 DOH herbal medicines ( AUNTY LABS B )
o A AMPALAYA
o U ULASIMANG BATO
o N NIYOG-NIYUGAN
o T TSAANG GUBAT
o Y YERBA BUENA
o L LAGUNDI
o A AKAPULKO
o B BAWANG
o S SAMBONG
o B BAYABAS
77. Ten (10) Herbal Medicines in the Philippines Approved by the Department of Health (DOH)
78. 1. Ampalaya (Mamordica charantia) - "bitter gourd" or "bitter melon" in English, - treatment of diabetes (diabetes mellitus), for the non-insulin dependent patients.
79. 2. Ulasimang Bato (Peperomia pellucida) - also known as "pansit-pansitan" - for arthritis and gout
80. 3. Niyog-niyogan (Quisqualis indica L.) - is a vine known as "Chinese honey suckle“ - for intestinal worms, particularly the Ascaris and Trichina
81. 4. Tsaang Gubat (Ehretia microphylla Lam.) - enhance intestinal motility - mouth wash (high fluoride content)
82. 5. Yerba Buena (Clinopodium douglasii) - commonly known as Peppermint - an analgesic to relieve body aches and pain
83. 6. Lagundi (Vitex negundo) - "5-leaved chaste tree“ - for the relief of cough & asthma
84. 7. Akapulko (Cassia alata) - also known as "bayabas-bayabasan" and "ringworm bush" in English - Antifungal: Tinea Flava, ringworms, athlete’s foot and scabies
85. 8. Bawang (Allium sativum) - popularly known as "garlic“ - reduces cholesterol in the blood - helps control blood pressure
86. 9. Sambong (Blumea balsamifera) - English name: Blumea camphora - A diuretic for excretion of urinary stones - anti-edema
87. 10. Bayabas (Psidium guajava) - "guava" in English an antiseptic - to disinfect wounds - mouth wash to treat tooth decay and gum infection
88. QUESTION a. lagundi. b. akapulko. c. niyog-niyogan. d. bawang. ANSWER: D Allium sativum is the scientific name of:
89. QUESTION a. lagundi. b. bayabas. c. niyog-niyogan. d. tsaang gubat. ANSWER: C A vine which acts as an anti-helminthic is
90. QUESTION a. lower cholesterol levels. b. wash wounds. c. treat diabetes mellitus. d. lower uric acid. ANSWER: A The use of bawang is advocated in order to
91. QUESTION a. lagundi. b. bayabas. c. niyog-niyogan. d. tsaang gubat. ANSWER: A WHICH OF THE FF. IS MAINLY USED FOR THE RELIEF OF COUGH AND ASTHMA?
92. QUESTION A) Clinopodium douglasii B) Allium sativum C) Mamordica charantia D) Shigella bordetella ANSWER: C The scientific name of ampalaya is:
93. QUESTION a. lower cholesterol levels. b. wash wounds. c. treat diabetes mellitus. d. lower uric acid. ANSWER: C Which of the ff is an indication for ampalaya?
94. Narra Pterocarpus indicus
o NARRA
o USES:
o DIARRHEA
o HEADACHE
o PRICKLY HEAT
95. Lansones Lansium domesticum Correa
o LANSONES
o USES:
o DIARRHEA
o ABDOMINAL COLIC
o FEVER
96. Mani Arachis hypogaea Linn. PEANUT
o MANI
o USES:
o BLADDER INFECTIONS
o OILS & LINIMENTS
97. Luya Zingiber officinale Rose. GINGER
o LUYA
o USES:
o ANTISEPTIC
o RHEUMATISM
o SORE THROAT/ HOARSENESS
o COUGH
o HANGOVERS
o HEADACHES
98. Makahiya Mimosa pudica Linn. BASHFUL MIMOSA, SENSITIVE PLANT
o MAKAHIYA
o USES:
o ASTHMA
o EXPECTORANT
o SORE THROAT
o WOUNDS
99. Makopa Syzygium malaccense MALAY APPLE, TERSANA ROSE APPLE
o MAKOPA
o USES:
o DYSENTERY
o AMENORRHEA
100. Oregano Coleus aromaticus Benth.
o OREGANO
o USES:
o ASTHMA
o CHRONIC COUGH
o BRONCHITIS
101. Kauayan BAMBOO
o KAWAYAN
o USES:
o INDUCE LOCHIA AFTER C.B.
o ANTIHELMINTHIC
o ANURIA
102. Mangga Mangifera indica
o MANGGA
o USES:
o DIURETIC
o ASTRINGENT
o STOMATITIS
103. Mangostan Garcinia mangostana MANGOSTEEN
o MANGOSTEEN
o USES:
o ABDOMINAL PAIN
o DIARRHEA
o DYSMENORRHEA
104. Malunggay Moringa oleifera BEN OIL TREE
o MALUNGGAY
o USES:
o INTESTINAL PARASITISM
o CONSTIPATION
o WOUNDS & CUTS
105. Niyog Cocos nucifera COCONUT
o NIYOG
o USES:
o DANDRUFF
o DRY SKIN
o SCABIES
106. Okra Abelmoschus escuclentus Linn. Hibiscus esculentis Linn.
o OKRA
o USES:
o URINARY INFECTIONS
o SORE THROAT
o WOUNDS
107. Mais Zea mays CORN
o MAIS
o USES:
o DIURETIC
o DYSURIA
o URINARY TRACT INFECTION
108. QUESTION
o It is also known as “ BEAN OIL TREE”.
o NARRA
o NIYOG
o MAKOPA
o MALUNGGAY
o ANSWER: D
109. QUESTION
o WHICH OF THE FOLLOWING IS EFFECTIVE FOR DYSMENORRHEA?
o OREGANO
o OKRA
o MAIS
o MANGOSTEEN
o ANSWER: D
110. QUESTION
o It is also known as “ MALAY APPLE”.
o LANSONES
o MANGA
o MAKOPA
o OREGANO
o ANSWER: C
111. QUESTION
o WHICH OF THE FOLLOWING IS EFFECTIVE
o FOR INDUCING LOCHIA AFTER CHILD BIRTH?
o MAKAHIYA
o KAUAYAN
o NIYOG
o MALUNGGAY
o ANSWER: B
112. Talong Solanum melogena L.
o TALONG
o USES:
o SORE THROAT
o ABSCESS
o CRACKED NIPPLES
113. Sibuyas Allium cepa L. True onion
o SIBUYAS
o USES:
o STIMULANT
o DIURETIC
o EXPECTORANT
114. Patatas Solanum tuberosum
o PATATAS
o USES:
o GENTLE LAXATIVE
o GOUTY ARTHRITIS
o HYPERTENSION
115. Sabila Aloe vera
o SABILA
o USES:
o DANDRUFF
o SCALDS AND BURNS
o SPRAINS
o BRUISES
116. Siling-labuyo Capsicum frutescens CHILE PEPPER, SPANISH PEPPER CAYENNE
o SILING-LABUYO
o USES:
o ARTHRITIS / RHEUMATISM
o DYSPEPSIA
o FLATULENCE
117. Sampalok Tamarindus indica Linn. TAMARIND
o SAMPALOK
o USES:
o FEVER
o LAXATIVE
o ASTHMA
118. Sampagita Jasminum sambac Linn. JASMINE
o SAMPAGUITA
o USES:
o FEVER
o COUGH
o DIARRHEA
119. Tanglad Andropogon citratus Lemon Grass, Ginger grass
o TANGLAD
o USES:
o DIARRHEA
o FEVER
120. Papaya Carica papaya MELON TREE
o PAPAYA
o USES:
o LAXATIVE
o ACNE
o STOMACH ACHE
121. Saging Musa sapientum Linn. BANANA
o SAGING
o USES:
o COOL DRESSING
o THINNING HAIR
o HEADACHES
122. Pito-Pito
o Pito-Pito is a blend of seven seeds or leaves of seven traditional herbal medicinal plants , usually prepared as a decoction
o It is used in a wide variety of applications: headaches, fever, cough, colds, migraine, asthma, abdominal pains, diarrhea, etc.
123. Pito-Pito
o The ingredients vary according to availability and intended use. Seven (pito) is believed to be numerologically essential to the efficacy of the eventual formulation.
124.
o A traditional combination is seven leaves of:
o alagaw,
o banaba,
o bayabas,
o pandan,
o mangga,
o with half a teaspoon each of anis and cilantro
o boiled for 30 minutes, strained and drained.
125. Pito-Pito
o In the urban and suburban areas, it has become part of alternative new-age menu as a herbal tea blend. Commercial tea preparations substitute one or two ingredients with other herbal medicinal components.
126.
127. QUESTION
o It is also known as “ MELON TREE”.
o PATATAS
o NIYOG
o PAPAYA
o PIPINO
o ANSWER: C
128. QUESTION
o WHICH OF THE FOLLOWING IS EFFECTIVE FOR CRACKED NIPPLES?
o SILING-LABUYO
o SABILA
o PANDAN
o TALONG
o ANSWER: D
129. QUESTION
o It is also known scietifically as “ MUSA SAPIENTUM”.
o SAGING
o PATOLA
o PATATAS
o TANGLAD
o ANSWER: A
130. QUESTION
o WHICH OF THE FOLLOWING IS NOT PART OF PITO-PITO?
o BANABA
o BAYABAS
o AMPALAYA
o MANGGA
o ANSWER: C
131. VITAL STATISTICS
132.
o POPULATION STRUCTURE
o POPULATION SEX RATIO
o = M / F x 100%
o ex: 12,349 M / 12,413 F x 100 = 99%
o ( for every 99 males, there are 100 females)
133.
o AGE STRUCTURE
Percentage of a specified age group in comparison to the total number of population
EXAMPLE:
total population = 50
specified age group=children 1– 4 = 30
o 30 / 50 x 100 = 60%
134.
o DEPENDENCY RATIO
Refers to the very young & old population
FORMULA:
Population (0-14) + (65 & above) / (15 – 64) x 100
135.
EXAMPLE:
Population 0 – 14 + 65 & above = 500
Population 15 – 64 y.o. = 500
500 / 500 x 100 = 100 (ratio 1:1)
136.
o MEASURES OF DISTRIBUTION
o DENSITY (D) – shows the number of persons dwelling upon a unit area of land
o D = Population / area
137.
o EXAMPLE:
o land area = 20,000 square meters
o population = 1000
o 1,000 / 20, 000 sq. m = 0.05 sq. m
o THUS: for every 100 sq. m, there are 5 persons living on it
138.
o MEASURES OF MIGRATION
MIGRATION
CRUDE IN – MIGRATION RATE (CMIR)
no. of in – migrants / population x 100
139.
CRUDE OUT – MIGRATION RATE (CMOR)
no. of out – migrants / population x 100
NET MIGRATION RATE
CMIR – CMOR = net migration rate
140.
o MEASURES OF POPULATION GROWTH
o RATE OF NATURAL INCREASE
o CBR – CDR per 1000 population
141.
o AVERAGE ANNUAL PERCENTAGE INCREASE
o Pt / Po – 1 / t x 100
o Where: Pt – population at a later date
o Po – population at an earlier date
o t – time interval between dates t & o
142.
o EXAMPLE:
o Population in 1977 = 5,000
o Population in 1972 = 1,000
o 5,000 / 1,000 – 1 / 5 x 100 = 80%
143.
o ZERO GROWTH RATE
o BIRTH RATE = DEATH RATE
144.
o RATIO
o A relative number expressing the magnitude of one occurrence or condition in relation to another
145.
o RATE
o Measures the probability of occurrence of some particular events
o A relation indicating the number of times a certain number of exposures to the risks of occurrence is present in a given period of time
146.
o MID-YEAR POPULATION
o Population of the area under study as of JULY 1
o POPULATION AT RISK
o Population capable of acquiring the disease
147.
148.
o FERTILITY / NATALITY RATES
o CRUDE BIRTH RATE
o Total live births in a calendar year / MP x 1,000
149.
o GEN. FERTILITY RATE
o Total live births in a calendar year / mid-year population of women of child-bearing age (15 – 44) x 1,000
150.
o MORTALITY RATES
o A. CRUDE DEATH RATE
o Total deaths in a calendar year from all causes / MP x 1,000
o CAUSE – SPECIFIC DEATH RATE
o Deaths from a particular cause / MP x 100,000
151.
o PROPORTIONAL MORTALITY RATE
o Deaths from a particular cause / deaths from all causes x 100
o SWAROOP’S INDEX
o Deaths in persons 50 yrs & above / total no. of deaths x 100 = % (no. of persons who died at 50 yrs. & above)
152.
o CASE FATALITY RATE
o Deaths from a particular cause / no. of cases from the same cause x 100
o INFANT MORTALITY RATE
o Deaths in 1 year of age / total live births in same year x 1,000
153.
o NEONATAL MORTALITY RATE
o Deaths below 28 days of age / total no. of live births x 1,000
o MATERNAL MORTALITY RATE
o Deaths from women directly due to pregnancy, labor or puerperium (90 days after delivery) / total no. of live births x 1,000
154.
o MORBIDITY RATES
Measures the frequency of illness or disability
For groups of allied illnesses within specific populations
155.
o GENERAL MORBIDITY RATE
o Total no. of sick persons / MP x 100,000
o INCIDENCE RATE
It answers how frequently the disease occur within a given period of time
o No. of new cases of a specified disease during a given time / population at risk in the area during that time x 100,000
156.
o ATTACK RATE
A measure of incidence during outbreaks or epidemics
o No. of new cases of a disease in a time period / population at risk during that time x 100
157.
o PREVALENCE RATE
Measure of the status of a particular disease within a given point or interval in time
It answers what proportion of the population or group of persons are actually ill with the particular disease or are infected with a particular agent at a given point in time
158.
no. of new and old cases of a certain diseases
registered at a given time
PR = ___________________________________ x 100
total number of person examined
at same given time
159. MIND GAMES - WHAT DO YOU SEE?
160. COPAR
161. COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH
o DEFINITIONS:
a social development approach that aims to transform the apathetic , individualistic, and voiceless poor into dynamic, participatory and politically responsive community
162. IMPORTANCE OF COPAR
COPAR helps the community workers
to generate community participation
in development activities.
COPAR prepares people/clients to
eventually take over the management
of a development program in the
future.
163.
COPAR maximizes community participation
and involvement; community resources
are mobilized for community services
164. PRINCIPLES OF COPAR
People, especially the most oppressed, exploited and deprived sectors are open to change, have the capacity to change, and are able to bring about change
COPAR should be based on the interests of the poorest sectors of society
COPAR should lead to a self-reliant community and society
165. PROCESSES / METHODS USED
o PROGRESSIVE CYCLE OF ACTION-REFLECTION- ACTION
o – begins with small, local and concrete issues identified by the people and the evaluation and reflection of and on the action taken by them
166.
o CONSCIOUSNESS-RAISING THROUGH EXPERIENTIAL LEARNING
o - placing an emphasis on learning that emerges from concrete action and which enriches succeeding action
167.
o C. PARTICIPATORY & MASS-BASED – it is primarily directed towards and biased in favor of the poor, the powerless and the oppressed
168.
o D. GROUP-CENTERED and NOT LEADER ORIENTED
o – leaders are identified, emerge and are tested through action rather than appointed or selected by some external force or entity.
169. PHASES OF THE COPAR PROCESS
o 1. Pre-entry phase
o - is the initial phase of the organizing process where the community organizer looks for communities to serve or help
o - it is considered the simplest in terms of actual outputs, activities, and strategies and time spent for it
170.
o Activities include:
o designing a plan for community development, including all its activities and strategies for care/development
o designing criteria for the selection of site
o Methods for site selection:
Coordination with community leaders
Ocular observation
Data collection
Informal interviews
o actually selecting the site for community care
171.
o 2. ENTRY PHASE
o - called the social preparation phase
o - activities are the following:
o a) sensitization of the people on the critical events in their life
o b) motivating them to share their dreams and ideas on how to manage their concerns
o c) mobilizing them to take collective action
172.
o signals the actual entry of the community worker/organizer into the community.
o Guidelines for entry:
o “ courtesy call” - recognize the role of local authorities by paying them visits to inform them of your presence & activities
o “ when in Rome, be a Roman” appearance, speech, behavior and lifestyle should be in keeping with those of the community residents without disregard of being role the model
o adopt a low-key profile
173.
o - look for potential leaders & core-group members
Criteria for potential leaders:
Mass based or from poor sector
Directly engaged in production
Respectable & trustworthy
Charismatic
Pro - active & change agent
Conscientious & resourceful
Effective communication skills
174.
o 3. Organization-building phase
o - entails the formation of more formal structures
o - It is at this phase where the organized leaders or groups are being given trainings ( OJT, formal or informal )
o - wider participation & collective community action
175.
o 4. Sustenance and strengthening phase
o - occurs when the community organization has already been established and the community members are already actively participating in community-wide undertakings.
176.
o - strategies used may include:
o a) education & training
o b) networking and linkaging
o c) conduct of mobilization on health and development concerns
o d) implementation of livelihood projects
o e) developing secondary leaders
177. RECORDS & REPORTS
o Records
o – refer to forms on which information pertaining the client is noted
o Reports
o – refers to periodic summaries of services /activities of an organization/ unit or the analysis of certain phases of its work
178.
o Purposes of records and reports:
o a) measure service / program directed to the clients
o b) provide basis for future planning
o c) interpret the work to the public and other agencies
o d) aid in studying the conditions of the community
o e) contribute to client care
179.
o Sample Questions
o One of the primary tasks of the community health nurses during the pre-entry phase is the selection of the Barangay to become the initial site for their organizing efforts. The following are the steps in the selection of the project site by the team, except:
o Developing criteria for site selection
o Identifying potential barangays and choosing the final project village
o Identification of potential leaders
o Identification of the host family
o Answer: C (under entry phase)
180.
o 2. It is considered the simplest in terms of actual outputs, activities, and strategies and time spent for it.
o Organizing-building phase
o Pre-entry phase
o Sustenance phase
o Strengthening phase
o Answer: B
181.
o 3. For potential leaders to perform their roles effectively, they have to possess certain characteristics. Among these are the following, except:
o They must belong to the poor sector
o They must be respected members of the community
o Preferably informal leaders
o Formal leaders with many community responsibilities
o Answer: D (They do not have time to perform additional duties)
182.
o 4. This phase signals the start of community self-management of any development program.
o Pre-entry phase
o Integration phase
o Entry phase
o Organization-building phase
o Answer: D (a community organization facilitates in the participation in health and other development activities)
183. APPLICATION OF COPAR IN COMMUNITY HEALTH CARE PROCESS
184.
o NURSING PROCESS
o A systematic, scientific, dynamic, on-going interpersonal process
o The nurses & the clients are viewed as a system, with each affecting the other & both being affected by the factors within the behavior
185.
o 4 STEPS IN CHN PROCESS:
o A ssessment
o P lanning
o I mplementation
o E valuation
186. Community competence
o refers to the community’s ability to:
o - identify needs
o - achieve working consensus
o - agree and work together to meet goals
187. COMMUNITY ASSESSMENT
o Process of examining the community
o strategies that improve health and quality of life for the community
o Systematic & continuous
188.
o Identifies specific deficiencies or guidance needed
o Estimates possible effects of the nursing interventions
o getting to know the community client
o - this includes:
o a) decide what data to be gathered
o b) plan the process of data gathering
189.
DATA TO BE COLLECTED
Demographic data
Vital health statistics
Community dynamics
Education, socio-cultural, religious & occupational background
Family dynamics
Environment & patterns of coping
190. THREE DIMENSIONS OF COMMUNITY ASSESMENT
o Status - information about morbidity and mortality, life expectancy, crime rates and education.
Structure – socioeconomic, age, gender, resources
Process – how the community operates and functions as a whole
191.
o Planning for a Program of Action
o a) determining objectives for care / action
o - identify what is to be done and what outcomes might be expected from the program/project/services implemented
192.
o Criteria for setting objectives:
o they should be realistically be achievable
o should be specifically stated
o should be flexible enough to allow for change
o should be closely related to the problems and needs identified and felt by the client
o should be closely coordinated with those of the entire health care team
193.
o b) select activities and methods /
o strategies for achieving the objectives
o a. home visits
o b. conferences / demonstrations
o c. health service delivery
o d. group discussion
o e. information dissemination
194.
o Factors in selecting activities:
o a. need / capabilities of the client
o b. identify target clientele
o c. review traditional activities and select only those not detrimental to health, life and limb
o d. bear in mind that a balanced program is far more effective than in those which are unbalanced or biased
195. Program Implementation
o refers to the actual carrying out of the plan
o refers to the mobilization of resources to meet objectives
o must include active participation of the people
196. Program Monitoring & Evaluation
o Monitoring
o – is an internal project/intervention/ care activity concerned to assess whether resources are being used as intended and whether they are producing the intended outputs
197.
o Evaluation
is a process that is designed to show the relationship between services rendered and the objectives or purposes of the service / unit / care provider
not a record nor count of what was done but of what DIFFERENCE the doing made
198. CATEGORIES OF HEALTH PROBLEMS
199.
o A gap between actual and achievable health status
o Instances of failure in health maintenance
o Possible precursors of health deficit:
History of repeated infections or miscarriages
No regular health check-up
HEALTH DEFICIT
200.o EXAMPLES
o ILLNESS states, diagnosed or undiagnosed
o Failure to thrive/develop
o Disability
Transient (aphasia or temporary paralysis after a CVA)
Permanent (leg amputation secondary to diabetes, blindness from measles, lameness from polio)
201.
o Conditions that are conducive to disease, accident or failure to realize one’s potential
o EXAMPLES:
o Family history of hereditary disease
o Threat of cross infection
o Accident hazards
o Faulty eating habits
o Poor environmental sanitation
o Unhealthy lifestyle/personal habits
HEALTH THREAT
202.o Anticipated periods of unusual demand on the individual or family in terms of
adjustment/family resources
o EXAMPLES:
o Marriage
o Pregnancy
o Parenthood
o Divorce or separation
o Loss of job
o Menopause
o Death
FORESEEABLE CRISIS
203.o NATURE OF THE PROBLEM – categorized into health deficit, health threat and
foreseeable crisis
o Health deficit 3
o Health threat 2
o Foreseeable crisis 1
PRIORITIZING HEALTH PROBLEMS
204.o MODIFIABILITY OF THE PROBLEM – refers to the probability of success in
minimizing, alleviating or totally eradicating the problem through intervention
o Easily modifiable 2
o Partially modifiable 1
o Not modifiable 0
205.
o PREVENTIVE POTENTIAL –refers to the nature and magnitude of future problems that can be minimized or totally prevented if intervention is done on the problem under consideration
o High 3
o Moderate 2
o Low 1
206.
o SALIENCE – refers to the family’s perception and evaluation of the problem in terms of seriousness and urgency of attention needed
o A serious problem, immediate attention needed 2
o A problem, but not needing immediate attention 1
o Not a felt need / problem 0
207. NURSING PROCEDURES
208.
o ____ Take clinical history
o ___ Write findings on client records
o ___ Perform physical assessment
o ___ Greet and make client at ease
o ___ Do laboratory examinations
o ___ Take temperature, blood pressure, height and weight
PRE-CONSULTATION CONFERENCE 1 2 3 4 5 6
209.o ___ Inform physician of relevant findings gathered in pre-conference
o ___ Observe confidentiality of examination results
o ___ Ensure privacy, safety and comfort of patient throughout procedure
o ___ Work with the physician during the examination
o ___ Assist client before, during and after examination by physician
MEDICAL EXAMINATION 1 2 3 4 5
210.o ___ Counseling
o ___ Seek information regarding health status of other family members
o ___ Explain and reinforce physician’s orders and advises
o ___ Teach patient measures to promote and maintain health as proper diet, exercise and personal hygiene
o ___ Carry out physician’s orders as giving medication or injection
NURSING INTERVENTION 1 2 3 4 5
211.o ____ Make appointment for next clinic/home visit
o ____ Refer patient to other health worker/agency
o ____ Explain findings and needed care or intervention
POST-CONSULTATION CONFERENCE 1 2 3
212. ACIVITIES OF THE COMMUNITY HEALTH NURSE 213.
o Made to a client or a responsible member of the family
o GOAL : provide necessary health care activities and further attain an objective of the agency
o A professional face-to-face contact made by a nurse to the patient or the family
H O M E V I S I T
214. PHASES OF A HOME VISIT o PREPARATORY PHASE
Review existing records or referral data
Notifies family of intention
Introduce self and explains purpose
o HOME VISIT PHASE
Actual visit to the patient
Assessment, planning, and health teaching
o POST-VISIT PHASE
Records data in the chart
Plan for next visit
Referral to other health professionals
215. STEPS IN A HOME VISIT
o 1.Greet client and introduce self.
o 2. Explain purpose.
o 3. Inquire about health and welfare.
o 4. Place bag in a convenient place.
o 5. Wash hands and wear apron.
o 6. Perform physical assessment & nursing care.
o 7. Give necessary health teaching.
o 8. Wash hands and close bag.
o 9. Record findings.
o 10. Make appointment for clinic or home visit.
216.
217.
o A tool using a public health bag done during a home visit
o The nurse can perform nursing procedures with ease and deftness
o Saving time and effort in view of rendering effective nursing care
B A G T E C H N I Q U E
218.o Use of bag technique should minimize, if not totally prevent, the spread of
infection
o Should save time and effort in the performance of nursing procedures
o Should not overshadow concern for the patient
o Show the effectiveness of total care given to individual or family
PRINCIPLES OF BAG TECHNIQUE
219.o Should contain all necessary articles and equipments
o Bag and contents should be cleaned as often as possible
o Should be protected from contact with any article in the home of the patient
o Arrangement of the contents should be convenient
o Handwashing should be done frequently
o When used in a communicable case, should be thoroughly cleaned and disinfected before keeping and re-using
SPECIAL CONSIDERATIONS
220.o thermometers in case (1 oral & 1 rectal)
o syringes
o alcohol lamp
o sputum cup
o medicine dropper
o zephiran solution
o benedict solution
o tape measure
o hypodermic needles
CONTENTS OF THE PHN BAG
221. 222.
o Essential health care made universally acceptable to individuals and families in the community
o By means acceptable to them and through their full participation
o At a cost that the community and country can afford at every stage of development
P R I M A R Y H E A L T H C A R E
223.o GOAL : Health for all Filipinos and Health in the Hands of the People by the year
2020
o MISSION : To strengthen the health care system wherein people will manage their own health care
o CONCEPT : partnership and empowerment of the people
o LEGAL BASIS:
Letter of Instruction 949
President Ferdinand Marcos
October 19, 1979
224.
o First International Conference on Primary Health care
Alma Ata, USSR
September 6-12, 1978
Sponsored by the World Health Organization and UNICEF
225. ELEMENTS/COMPONENTS of PHC
o Education for Health
o Locally Endemic Disease Control
o Expanded Program on Immunization
o Maternal and Child Health
o Essential Drugs and Elderly Care
o Nutrition
o Treatment of CD and Non-CD
o Sanitation: Water & Environment
ELEMENTS
226.o Framework for meeting the goal of primary health care
o Calls for active and continuing partnership among the communities, private and government agencies in health development
O R G A N I Z A T I O N A L S T R A T E G Y
227. LEVELS OF HEALTH CARE SERVICES o PRIMARY
Barangay Health Station
Private Practitioners
Community Hospitals
Rural Health Unit
o SECONDARY
Emergency/District Hospitals
Provincial/City Hospitals
228. LEVELS OF HEALTH CARE SERVICES
o TERTIARY
Regional Medical Centers and Training Hospitals
National Medical Centers
Teaching and Training Hospital
229.
o VILLAGE / BARANGAY HEALTH WORKERS (V/BHWs)
o - Trained community health workers
o - Health auxiliary volunteer
o - Traditional birth attendant or healer
o INTERMEDIATE LEVEL HEALTH WORKERS
- General medical practitioner
- Public health nurse
- Rural sanitary inspector
- Midwives
TWO LEVELS OF PHC WORKERS
230.o DOH PROGRAMS
231.
o ental health program
o steoporosis prevention
o ealth education & community organizing
o rimary health care
o eproductive health
o lder persons health service
o uidelines for good nutrition
o espiratory Infection Control
o lternative health care
o aternal and child care
o entrong Sigla Movement
DOH PROGRAMS
232.o DENTAL HEALTH PROGRAM
233.
o VISION: A lifetime of oral health & no tooth decay for the next generation
o STRATEGIES
Social mobilization
Coordination and partnership with sectoral groups
Networking
Capacity building and work value formation
DENTAL HEALTH PROGRAM
234.o Project for Social Mobilization
o AIM:
Emphasize the importance of oral health in relation to total body health
Increase public awareness on the prevention of common dental diseases
Solicit one million new toothbrushes from concerned citizens
"Sang Milyong Sepilyo"
235. EXPANDED PROGRAM ON IMMUNIZATION (EPI) 236.
o EXPANDED PROGRAM ON IMMUNIZATION
o A program implemented under PD no. 996 signed on September 16, 1976 which provides for compulsory basic immunization for infants & children below 8 years old
237. ELEMENTS OF EPI (SACIT)
o Surveillance, studies & research
o Assessment & evaluation of the program’s overall performance
o Cold chain logistic management
o Information, Education & Communication
o Target setting
238. Principles & Legal Basis
o Based on EPIDEMIOLOGICAL SITUATION
o Mass Approach
o basic health service (it is integrated into the health system)
o P.D. 996 – compulsory basic immunization for infants and children below 8 years old
o R.A. 7846 – compulsory Hep B immunization for infants and children below 8 years old
239.
o 2 IMPORTANT GOALS OF THE PROGRAM:
o To reduce the morbidity & mortality rates of the 7 EPI diseases
o To reduce the incidence of neonatal tetanus by providing pregnant women with TT immunization
240.
o APRIL 6, 1986 – PP no. 6 – enjoin all gov’t. as well as NGOs to achieve the goal of immunizing every Filipino against the 6 EPI diseases:
o Poliomyelitis
o Measles
o Diptheria
o Pertussis
o Tetanus
o Tuberculosis
o Hepatitis B – added recently
241. The seven target EPI Diseases
o 1) Tuberculosis
o A specific, chronic, infectious disease caused by Mycobacterium tuberculosis, characterized by the formation of tubercles in the tissues.
242.
o 2) Diphtheria
o An acute, specific, highly infectious, epidemic and endemic disease caused by Corynebacterium diphtheria; transmitted by direct and indirect contact and carrier.
243.
o 3) Pertussis
o Whooping cough. A highly communicable infectious disease of children with paroxysms of coughing that reach a peak of violence ending in a long-drawn inspiration that produces a characteristic “whoop”.
244.
o 4) Tetanus
o An acute infectious disease induced by the toxin of Clostridium tetani, an anaerobic organism growing at the site of injury to body tissue. Is characterized by painful muscular contractions, chiefly of the face and neck, hence the appellation “lockjaw”.
245.
o 5) Poliomyelitis
o Inflammation of the grey matter of the spinal cord; an acute epidemic viral disease
o most commonly affecting children; marked by fever, headache, sore throat, stiff neck, gastrointestinal symptoms.
246.
o 6) Measles
o Rubeola. An acute, highly contagious, febrile, exanthematous viral disease; spread by droplets; characterized by fever, blotchy rash, and catarrhal inflammation of the mucous membranes; associated with high rate of complications.
247.
o 7) Hepatitis B
o May be transmitted by contaminated needles, blood mucous membranes (sexual intercourse), or ingestion of contaminated food; characterized by increase in aspartate transaminase and alanine transaminase level and increased bilirubin in the blood.
248. Fully immunized Child (Revised in 1996)
o A child who has received the following vaccines
o 1 BCG, 3 DPT, 3 OPV, 3 Hep B, 1 MV
o At the right intervals
o Before reaching 12 months of age
249. Dosage, route & site of administration Deltoid region, upper arm Intramuscular 0.5 ml TT Outer part of the upper arm Subcutaneous 0.5 ml Measles Upper outer portion thigh Deep IM 0.5 ml DPT Upper outer portion thigh Intramuscular 0.5 ml Hep B Mouth Oral 2 drops OPV Deltoid region right arm Intradermal Infants 0.05 ml BCG Site of Adm. Route of Adm. Dose Vaccine
250. Routine Immunization Schedule for Infants Vaccine Min Age, 1st Dose No. of Doses Min Interval Bet. Doses Reason BCG Birth, anytime after birth 1 - BCG given early protects infants against TB meningitis infection from family members
251. Routine Immunization Schedule for Infants Vaccine Min Age, 1st Dose No. of Doses Min Interval Bet. Doses Reason OPV 6 weeks 3 4 weeks When given early increases extent of protection against polio
252. Routine Immunization Schedule for Infants Vaccine Min Age, 1st Dose No. of Doses Minimum Interval Bet. Doses Reason Hep B w/in 24 hrs of birth 3 6 weeks from 1 st dose to 2 nd dose, and; 8 weeks interval from 2 nd dose to 3 rd dose - Early start reduces chance of infection & becoming a carrier - Eliminate HB before 2012 ( a western regional goal)
253. Routine Immunization Schedule for Infants Vaccine Min Age, 1st Dose No. of Doses Min Interval Bet. Doses Reason DPT 6 weeks 3 4 weeks Early start reduces chance of severe pertussis
254. Routine Immunization Schedule for Infants Vaccine Min Age, 1st Dose No. of Doses Min Interval Bet. Doses Reason Measles 9 months 1 -
o At least 85% of measles cases can be prevented by immunizing at this age
o - Eliminate measles by 2008
255. Immunization schedule for mothers Vaccine Minimum interval Percent protection Duration of Protection TT 1 As early as possible during pregnancy
256. Immunization schedule for mothers Vaccine Minimum interval Percent protection Duration of Protection TT 2 At least 4 weeks after TT 1 80 % Infants protected from neonatal tetanus, 3 years protection for the mother against tetanus
257. Immunization schedule for mothers Vaccine Minimum interval Percent protection Duration of Protection TT 3 At least 6 months after TT 2 95% Infants protected from neonatal tetanus, 5 years protection for the mother against tetanus
258. Immunization schedule for mothers Vaccine Minimum interval Percent protection Duration of Protection TT 4 At least 1 year after TT 3 99% Infants protected from neonatal tetanus, 10 years protection for the mother against tetanus
259. Immunization schedule for mothers Vaccine Minimum interval Percent protection Duration of Protection TT 5 At least 1 year after TT 4 99% Infants protected from neonatal tetanus, lifetime protection for the mother against tetanus
260.
o QUESTION:
o If a woman received 3 doses of DPT during infancy, what will be her current TT immunization schedule?
o A) TT1, previous 3 DPT doses not significant
o B) TT2, 3 doses of DPT equals TT1
o C) TT3, 3 doses of DPT considered TT1 & TT2
o D) TT4, 3 doses of DPT equals 3 TT shots
o ANSWER: C
261. Discard point of OPV using the VVM Constant Temperature, Day and Night Length of Time VVM Reaches “Discard Point” At room temperature + 25 ˚C 8 days At room temperature + 20 ˚C 20 days At room temperature + 4 ˚C 180 days At room temperature - 20 ˚C Over 2 years
262. Proper stocking of Vaccines (refrigerator)
o Neatly arrange the vaccines (segregated by type)
o Domestic refrigerator
o - freezer compartment -OPV, AMV
o - body - BCG, DPT, Hep B, TT, Diluent
o Modified refrigerator
o - freezer compartment - ice packs
o - Body
Top - OPV, AMV
Middle - BCG, DPT, Hep B, TT, Diluent
Lower - Bottles/ ice packs with water
263. How to Maintain Cold Chain
o Stocking of Vaccines in the Transport Box Vaccine Carrier
o Make sure you have enough ice packs
o transport box – 24 pcs
o Vaccine carrier – 4 pcs
o Place OPV, AMV in contact with frozen ice packs
o Wrap DPT, Hep B, TT with paper
o Place BCG in between AMV, OPV and wrapped vaccines
264. What to do with Opened vials of Vaccines?
o I. Continue to use opened vials in the subsequent sessions if all these conditions are met:
Expiry date has not passed
Vaccines are stored appropriately (+2 to +8 ˚C)
Sterile procedures have been fully observed
Opened vial has not been contaminated
265.
o NOTE:
o Discard opened BCG and MV after 6 hours of reconstitution.
o Opened vials of DPT, Hep B, TT can still be used for 4 weeks provided condition 1-4 in the previous slide are met.
266.
o II. Discard an opened vial immediately if any of the following conditions apply:
o Sterile procedures have not been fully observed
o + Suspicion of contamination of the opened vial
o + Visible evidence of contamination (e.g. change in appearance or presence of floating particles)
267.
o If the label has come off, or
o If the VVM has reached discard point
the inner square matches, or
is darker than the circle
o Reconstituted vaccines (BCG, AMV) after 6 hours of reconstitution
268.
o What is reconstitution?
o To restore to the original state by adding water; To build up again by putting back together the original pieces.
o What is a diluent?
o An inert substance that dilutes the strength of a solution or mixture.
269. What is thermal shock?
o It is the process of damage to the vaccine resulting from the use of diluent that is at too high a temperature (above +8°C).
o It results in the death of some or all of the essential live organisms in the vaccine.
270.
271. How to read a vaccine vial monitor The inner square is lighter than the outer circle. If the expiry date has not passed, USE the vaccine. As time passes the inner square is still lighter than the outer circle. If the expiry date has not passed, USE the vaccine. Discard point: the colour of the inner square matches that of the outer circle. DO NOT USE the vaccine. Beyond the discard point: inner square is darker than the outer circle. DO NOT USE the vaccine.
272. POINTS to REMEMBER:
o Only diluent supplied by the manufacturer, specific for the vaccine, should be used. No other diluent may be used.
o Distilled water for injection should NOT be used as a vaccine diluent.
273.
o Oral vaccine diluents should never be injected.
o To ensure the correct quantities are available, diluents must be shipped and distributed together with the vaccine vials that it will be used to reconstitute.
274. During the Reconstitution process:
o Only the diluent supplied by the manufacturer should be used to reconstitute a freeze-dried vaccine.
o A sterile needle and sterile syringe must be used for each vial for adding the diluent to the powder in a single vial or ampoule of freeze dried vaccine.
o Special care must be taken in opening ampules to avoid loss of the dry vaccine.
275. Vaccinators and store keepers should always:
o Include diluents in stock control and ensure adequate supplies.
o Check that the vaccines have been supplied with the right diluent. If any error is noted, the vaccine should not be used and the supervisor must be notified immeditely.
o Use only the diluent that is indicated for each type of vaccine and manufacturer.
276.
Ensure the volume of diluent used is correct so that the proper number of doses per vial is obtained.
Ensure that no other medication or substance which might be confused with the vaccine or its diluent is stored in the refrigerator of the immunization centre.
Reconstituted vaccine should be kept on ice to preserve its potency (by maintaining the maximum possible number of live organisms in each dose).
277.
A sterile needle and sterile syringe must be used for each separate dose of reconstituted vaccine drawn from the vial.
The reconstituted vaccine must be kept cool and any remaining liquid must be discarded after 6 hours.
278. Sizes of syringe and Needle to use During Vaccination DPT, MV and TT - use 2-3 ml syringe with 25 or 30 mm 23 or 25 gauge needle BCG - use 1 ml tuberculin syringe with 10 mm 26 gauge needle In mixing vaccines - use 5 or 10 ml syringe with 18 gauge needle
279. Proper ways of handling syringes and needles
o Disposal of used syringes and needles
o Immediately after use
Do not recap the needle
Place them in a safety collector box
o Disposal options
Burn in pit, bury
Collect and incinerate
280.
o Absolute Contraindications to Immunization:
o BCG to a baby born from a mother with AIDS
o DPT2 and DPT3 to a child who develops convulsion within 3 days of giving DPT
o Infants and children with active neurologic disease
o Relative contraindication
o Any illness which warrants admission to the hospital.
281. "first expiry and first out" (FEFO)
o A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its expiry date. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to expiring.
o Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health facilities and plotted to monitor break in the cold chain.
282. MIND GAMES – WHAT ARE INSIDE THE BOTTLE?
283.
o Implementing guidelines on Hepatitis B Immunization for Infants
284.
o Rationale
hepatitis B is the major health problem in the Philippines
10-12 % of the total population are chronically infected
No affordable and effective drug treatment are currently available
90% of chronic carriers of infection acquire their infection at birth or in early childhood
285. Objectives
o General:
o To improve effectiveness of management in the provision of 3 doses of routine Hepatitis B vaccine among infants including a birth dose.
o Specific:
o To provide new guidelines & procedures for Hepatitis B vaccination for infants at all types of health facilities.
o To provide instructions for administration of birth dose Hepatitis B vaccine accdg to the settings where the birth takes place.
286. New Schedule of Hep. B, DPT & OPV Note: Hep B1 was 6 weeks (old DOH book ); now AT BIRTH (p. 149 new DOH book) Age Hep B DPT OPV At Birth (within 24 hours) Hep B 1 6 weeks Hep B 2 DPT 1 OPV 1 10 weeks DPT 2 OPV 2 14 weeks Hep B 3 DPT 3 OPV 3
287.
o Type of Vaccine
o - Recombinant or genetically engineered vaccine using HBsAg (10mg dose)
o - Synthesized in yeast or mammalion cells into which HBsAg gene has been inserted.
o Formulation
o - Monovalent Hepatitis B vaccine/ univalent
o Protects only against Hepatitis B
o Single antigen formulation
o Used for birth dose
o - Combination vaccines (multivalent)
o Protects against Hepatitis B & other dse
o (DPT-Hep B, DPT-Hep B +HiB, Hib-Hep B)
o Combination with other vaccine
o Used for subsequent doses
288.
o Dosage
o Standard pediatric dose is 0.5 ml
o Sites of administration
o - Recommended series of 3 doses of hepatitis B vaccine shall be given intramuscularly only in the anterolateral thigh muscle .
o - Hepatitis B vaccine
o Shouldn’t be given in the buttocks
o Risk of injury to the sciatic nerve
o Shouldn’t be given intradermal
o It doesn’t produce adequate antibody response to children
o Shouldn’t be mixed in the same syringe with other vaccine
289.
o Vaccine storage and handling Hep B vaccine
o Stored in refrigerators provided solely for vaccine storage at +2 to +8 ˚C
o Transported properly in once-packed containers with cold chain monitors or thermometer
o Should never be frozen or allowed to come into direct contact with ice because it will be inactivated and will no longer be potent.
o Shake test used to determine if the vaccine has been damaged by freezing.
290.
o Indication and Contraindication
o No contraindication for the administration of Hep B vaccine to a newborn within 24 hours of birth. Used to protect against Hepatitis B virus.
o Vaccine side effects and adverse Reaction
o Hep B vaccine is one of the safest vaccines.
o Mild reaction include:
o Soreness & fever at the injection site
o Serious reaction: Anaphylaxis
o – risk for anaphylaxis is estimated at 1/600,000 doses
291.
o Administration of Hep B vaccine birth dose
o While 2nd dose and 3rd dose of Hep b vaccine shall be administered along with 1st and 3rd dose of DPT and OPV, administration of the 1st dose within 24 hour of birth.
o Hospitals and lying-in Clinics
o A) No mother/child should be discharged from the hospital without providing the birth dose of Hepatitis b vaccine to the newborn.
o B) Provision of birth dose of Hep B vaccine as part of the standing order for the routine care of medically stable infants weighing equal to or more than 2000 grams at birth.
292.
o Health centers & Barangay Health Stations
o All infants attended at birth by midwives from the health center/BHS shall be given the monovalent Hepatitis B vaccine within 24 hours after birth .
293.
o Birth taking place outside health facilities
o attended by traditional birth attendants or
o other non-trained providers
o A) TBA or mother should be advised to inform the nearest health facility either by phone or by personal visit for the provision of the Hep B and BCG
o B) Or bring the newborn to the health facility for vaccination
o C) Or the midwife will give immunization during house visit within 7 days after delivery
294.
o Calculation of Hepatitis B Vaccine Needs
o (Steps for Calculating Hep B requirement)
o 1) Identify the important data for computation:
Eligible Population (EP) of infants
o EP= Total Population (TP) x 3%
Wastage Multiplier : 1.2
o National:
o Reserve stock :25%
o Reserve stock multiplier: 1.25
o Region/ province/city:
o Reserve stock: 12.5%
o Reserve Stock Multiplier : 1.125
o Municipality
o Reserve Stock: 12.5%
o Reserve Stock multiplier: 1.1
295.
o 2) Formula
o Hep B requirements of National/Provincial/city level
o =EPx no. of doses x wastage multiplier x reserve stock multiplier
o Hep B requirements of lower level
o = EP x no. of doses x wastage multiplier x reserve stock multiplier
296.
o SEATWORK:
o Given: Province A with a total population of 2,000,000 for 2006.Compute for the annual requirements for hepatitis B
o Compute for the eligible population infants for Province A
o Calculate for the annual needs (in doses) for Province A
o Calculate for annual needs (in vials) for Province A.
297.
o Sample Computation
o Given: Province A with a total population of 2,000,000 for 2006.Compute for the annual requirements for hepatitis B
o Compute for the eligible population infants for Province A
o 2,000,000 x 0.03 = 60,000 infants
o Calculate for the annual needs (in doses) for Province A
o 60,000 x 3 doses x 1.2 x 1.125= 243,000 doses
o Calculate for annual needs (in vials) for Province A.
o 243,000 doses / 10 doses per vial = 24,300 vials
298.
o QUESTION:
o 1) It refers to a protein which can stimulate the production of antibodies and react specifically with those antibodies.
o A) glycoprotein
o B) vaccines
o C) toxoids
o D) antigen
o ANSWER: D
299.
o QUESTION:
o It is a class of specific protein substances in the blood that destroy or render inactive certain foreign substances, particularly bacteria.
o A) antigen
o B) anti-toxin
o C) toxoids
o D) antibody
o ANSWER: D
300.
o QUESTION:
o Which of the following is NOT an element of EPI?
o A) Information, Education & Communication
o B) Surveillance, studies & research
o C) Target setting
o D) Vaccine safety
o ANSWER: D
301.
o QUESTION:
o The law which requires compulsory basic immunization for infants and children below 8 years old.
o A) R.A.7846
o B) P.D. 996
o C) R.A. 8746
o D) P.D. 966
o ANSWER: B
302.
o QUESTION:
o Which of the following does not belong to the 7 target EPI diseases?
o A) diphtheria
o B) tuberculosis
o C) diabetes
o D) tetanus
o ANSWER: C
303.
o QUESTION:
o It is a highly communicable infectious disease of children with paroxysms of coughing that reach a peak of violence ending in a long-drawn inspiration that produces a characteristic “whoop”.
o A) emphysema
o B) pertussis
o C) tuberculosis
o D) bronchial asthma
o ANSWER: B
304.
o QUESTION:
o Which of the following is a fully immunized child?
o A) a 7 month old child who has received 1 MV, 1 BCG, 1 Hep B, 3 DPT and 3 OPV
o B) an 18 month old child who had just completed his 1 BCG, 1 Hep B, 1MV, 3 DPT and 3 OPV
o C) a 1 yr old child who had just completed his 1 BCG, 1MV, 3 Hep B, 3 DPT and 3 OPV
o D) none of the above
o ANSWER: C
305.
o QUESTION:
o When is the recommended schedule for Hep B2?
o A) within 24 hours
o B) together with DPT1
o C) together with DPT2
o D) 14 weeks
o ANSWER: B
306.
o QUESTION:
o Hepatitis B vaccine should not be given in the buttocks because of:
o A) gluteal muscle irritation and pain
o B) inadequate antibody production response to children in that area
o C) risk of hematoma formation
o D) potential injury to the sciatic nerve
o ANSWER: D
307.
o QUESTION:
o Which of the following is an inappropriate nursing intervention about Hepatitis B vaccine?
o A) Shouldn’t be given intradermal
o B) Should be given in the anterolateral thigh muscle
o C) Should do shake test to determine if the vaccine has been damaged by heat
o D) Shouldn’t be frozen to preserve its potency
o ANSWER: C
308.
o QUESTION:
o Which of the following is appropriate?
o A) No mother/child should be discharged from the hospital without providing the mother the required Hepatitis b vaccine.
o B) Provision of birth dose of Hepatitis B vaccine to infants weighing equal to or more than 1000 grams at birth.
o C) Infants attended at birth by midwives shall be given the combination Hepatitis B vaccine within 24 hours after birth.
o D) If birth is attended by TBA outside regular health facilities, the midwife will give immunization during house visit within 7 days after delivery
o ANSWER: D
309.
o QUESTION:
o It assure that all vaccines are utilized before its expiry date ?
o A) vaccine vial monitoring
o B) FEFO system
o C) cold chain management
o D) ECCD monitoring
o ANSWER: B
310.
o QUESTION:
o Which of the following is an example of relative contraindication to immunization?
o A) Melena, a newborn baby of a mother with AIDS, about to be given BCG
o B) Shigella, a eurasian child who develops convulsion within 3 days of giving DPT, & is due to receive DPT2
o C) Bordatella , a 6 wk infant-relative of the nurse, who has active neurologic disease
o D) Rubella, a 14 wk infant, admitted to the hospital due to fever and chills.
o ANSWER: D
311.
o QUESTION:
o Which of the following follows the standard protocol on immunization?
o A) Open a vial of vaccine even if only one eligible child or pregnant woman is present for immunization.
o B) Distribute health information materials on family planning
o C) Conduct health education among mothers with high risk infants only
o D) Use one sterile needle & one syringe for each type of vaccine for all patients.
o ANSWER: A
312.
o QUESTION:
o It means t o restore to the original state by adding water or to build up again by putting back together the original pieces.
o A) dilution
o B) reconstitution
o C) discard point
o D) cold chain
o ANSWER: B
313.
o QUESTION:
o During administration of DPT, MV and TT, what syringe size is appropriate ?
o A) 1 ml syringe
o B) 5 ml syringe
o C) 2-3 ml syringe
o D) none of the above
o ANSWER: C
314.
o QUESTION:
o When injecting BCG to your inafnts, which of the following needle sizes is most appropriate?
o A) 26 gauge needle
o B) 23 gauge needle
o C) 19 gauge needle
o D) 18 gauge needle
o ANSWER: A
315.
o QUESTION:
o Upon inspection of the vaccine vial monitor, you noticed that the inner square is darker than the outer circle. Which of the following is correct?
o A) it has reached the discard point, do not use
o B) it is already expired, do not use
o C) it is already beyond discard point, do not use
o D) it is already expired, do not use if already opened
o ANSWER: C
316.
o QUESTION:
o In storing OPV, which of the following is appropriate?
o A) middle portion of the body of a modified refrigerator
o B) lower body of a domestic refrigerator
o C) freezer compartment of both the domestic or modified refrigerator
o D) top body of a modified refrigerator
o ANSWER: D
317.
o QUESTION:
o In storing diluents, which of the following is appropriate?
o A) middle portion of the body of a modified refrigerator
o B) lower body of a domestic refrigerator
o C) freezer compartment of both the domestic or modified refrigerator
o D) top body of a modified refrigerator
o ANSWER: A
318.
o QUESTION:
o In storing AMV, which of the following is appropriate?
o A) middle portion of the body of a modified refrigerator
o B) lower body of a domestic refrigerator
o C) freezer compartment of both the domestic or modified refrigerator
o D) top body of a modified refrigerator
o ANSWER: D
319.
o Sample Computation Problem
o Given: Tagbilaran city, with a total population of 1,000,000 for 2007.Compute for the annual requirements for hepatitis B
o Compute for the eligible population (infants)
o Calculate for the annual needs (in doses)
o Calculate for annual needs (in vials)
320.
o Problem Solution
o Given: Tagbilaran city with a total population of 1,000,000 for 2007.Compute for the annual requirements for hepatitis B
o Compute for the eligible population (infants)
o 1,000,000 x 0.03
o = 30,000 infants
o Calculate for the annual needs (in doses)
o 30,000 x 3 doses x 1.2 (WM) x 1.125 (RSM)
o = 121,500 doses
o Calculate for annual needs (in vials)
o 121,500 doses / 10 doses per vial
o = 12,150 vials
321. Supply the missing diagram: The inner square is lighter than the outer circle. If the expiry date has not passed, USE the vaccine. As time passes the inner square is still lighter than the outer circle. If the expiry date has not passed, USE the vaccine. Discard point: the colour of the inner square matches that of the outer circle. DO NOT USE the vaccine. Beyond the discard point: inner square is darker than the outer circle. DO NOT USE the vaccine.
322. Supply the missing blanks: New Schedule of Hep. B, DPT & OPV AGE HEP B DPT none Birth (within 24 hours) Hep B1 Hep B3 Hep B2 6 weeks 10 weeks 14 weeks DPT 1 DPT2 DPT3 OPV1 OPV2 OPV3 OPV none none
323.
324. MATERNAL CARE PROGRAM & FAMILY PLANNING
325. WHAT IS MATERNAL & CHILD HEALTH NURSING? Mother & child relation-ship to one another & of the entire family
326.
o GOALS:
o To ensure that every expectant & nursing mother maintains good health
o Learns the art of child care
o Has a normal delivery & bears healthy children
327. ESSENTIAL HEALTH SERVICE PACKAGES
o Antenatal registration
o Tetanus toxoid immunization
o Micronutrient supplementation
o Treatment of diseases & other conditions
o Clean and safe delivery
o Support to Breastfeeding
o Family planning counselling
328.
o Attendants must be aware of the early signs, symptoms and complications. They should follow the 3 CLEANS:
o CLEAN Hands
o CLEAN Surface
o CLEAN Cord
329.
o Situations wherein “trained hilots” are allowed to attend to home deliveries:
o A) Time of delivery
o no licensed health personnel trained on maternal care, is available
o B) Area of domicile of pregnant mother
o there is no licensed health personnel trained on maternal care
330. BREASTFEEDING
o MILK PRODUCTION HORMONES:
o PROLACTIN
Milk – secreting hormone
MILK SECRETION REFLEX
Secreted at the base of the anterior pituitary gland
Delays ovulation & protect against subsequent pregnancy
Sensory stimulation through sucking
331.
o OXYTOCIN
For milk “letdown”
MILK EJECTION REFLEX
HELP REFLEX
Site of baby
Sound of baby’s voice
Sensory impulses from nipples
Anxiety, pain or doubts STOP reflex
332.
o LEGAL MILESTONES:
o EO 51 MILK CODE OF THE PHILIPPINES
o - protection and promotion of breastfeeding
o - to ensure the safe and adequate nutrition of infants through regulation of marketing of infant foods and related products. (e.g. breast milk substitutes, infant formulas, feeding bottles, teats etc. )
333.
o POSITIONS IN BF THE BABY:
o 1. Cradle Hold - head & neck are supported
o 2. Football Hold
o 3. Side Lying Position
334. A ANTIBODIES PRESENT S STOOL INOFFENSIVE(GOLDEN YELLOW) T TEMPERATURE ALWAYS IDEAL F FRESH MILK NEVER GOES OFF E EMOTIONALLY BONDING E EASY ONCE ESTABLISHED B BEST FOR BABIES R REDUCE INCIDENCE OF ALLERGENS E ECONOMICAL D DIGESTED EASILY I N G IMMEDIATELY AVAILABLE NUTRITIONALLY OPTIMAL GASTROENTERITIS GREATLY REDUCED
335.
o RA 7600
o THE ROOMING–IN & BREASTFEEDING ACT of 1992
o - An act providing incentives to government and private health institutions promoting and practicing rooming-in & breastfeeding.
o - Provision for human milk bank.
o - Information, education and re-education drive
o - Sanction and Regulation
336. FOOD FORTIFICATION PROGRAM
337.
o Fortification
o is the addition of a micronutrient deficient in the diet to a commonly and widely consumed food or seasoning.
338.
o Example:
o The use of FIDEL salt
o F ortification for
o I odine
o D eficiency
o EL imination
339.
o REPUBLIC ACT NO. 8976
o Philippine Food Fortification Act of 2000
o a) Voluntary Food Fortification
o - Sangkap Pinoy Seal Program (SPSP)
o a strategy to encourage food manufacturers to fortify processed foods or food products with essential nutrients at levels approved by the DOH. The fundamental concept of the program is to authorize food manufacturers to use the DOH seal of acceptance for processed foods or food products, after these products passed a set of defined criteria. The seal is a guide used by consumers in selecting nutritious foods.
o b) Mandatory Food Fortification
o The fortification of staple foods:
o • Rice – with iron;
o • Wheat flour – with vitamin A and Iron;
o • Refined sugar – with vitamin A;
o • Cooking oil – with vitamin A; and
o • Other staple foods with nutrients as may later be required by the NNC.
o RA 832 – Rice Enrichment Law
o “ All milled rice has to be enriched with premix Rice”
o Government’s nutrition program
o RA 8172 – FIDEL Salt
340. SANGKAP PINOY
o or micronutrients
o are vitamins and minerals required by the body in very small quantities. These are essential in maintaining a strong, healthy and active body; sharp mind; and for women to bear healthy children.
o vitamin A, iron and iodine, which cannot be synthesized by the human body, and therefore must be provided through the diet.
341.
o MARASMUS
o Protein & energy malnutrition
o Usually less than 1 year old when malnutrition started
o Very thin
o Very poor weight gain
342.
o Old man’s face
o Enlarged abdomen
o Prominent ribs
o Loose & wrinkled skin
o Anxious
o Always hungry
343.
o KWASHIORKOR
o Disease of the older child (1-3 y.o.)
o Very thin
o Fails to grow
o Light-colored weak hair
o Moon-shaped, unhappy face
344.
o Enlarged abdomen
o Muscle wasting
o Swollen lower & upper extremities
o Apathetic
345.
o Skin sores & skin peeling
o dark spots on the skin
o Does not want to eat
346.
o TREATMENT:
o Food is the only cure
o Increase:
CHON & energy concentration of food prepared
Frequency of feeding
Variety of food offered
347.
o IRON-DEFICIENCY ANEMIA
o Causes:
Low intake of iron-rich food
Blood loss
Poor absorption of iron
Increased demands
348.
o VITAMIN A DEFICIENCY
o Causes:
Low intake of vitamin A rich food
Low intake of oil & protein
Illness like measles, diarrhea & pneumonia
o Consequences:
Blindness
Low resistance to infection
349.
o IODINE DEFICIENCY
o Causes
Low intake of iodine
o Consequences
o FETUS
Abortion
Congenital abnormalities
Stillbirth
350. Review is Over ... Have a nice day ! Good Bye ! Good Luck and God Bless you !
351.
352.
353.
354. COMMUNITY HEALTH NURSING ROMEO D. PIANSAY, JR., R.N., M.A.N.
355. National Voluntary Blood Service Program (NVBSP)
356.
o The project is the development and implementation of the computer-based Drug Test Operations and Management Information System (DTOMIS).
357. The Doctors to the Barrios Program is the deployment of doctors as Rural Health Physicians to doctorless municipalities, usually hard to reach, economically underdeveloped areas
358. Four Rights in Food Safety
o Rule in Food Safety:
o “ When in doubt, throw it out!”
o Right Source:
o • Always buy fresh meat, fish, fruits & vegetables.
o • Always look for the expiry dates of processed foods and avoid buying the expired ones.
o • Avoid buying canned foods with dents, bulges, deformation , broken seals and improperly seams.
o • Use water only from clean and safe sources .
o • When in doubt of the water source, boil water for 2 minutes .
359.
o Right Preparation:
o • Avoid contact between raw foods and cooked foods .
o • Always buy pasteurized milk and fruit juices.
o • Wash vegetables well if to be eaten raw such as lettuce, cucumber, tomatoes & carrots.
o • Always wash hands and kitchen utensils before and after preparing food.
o • Sweep kitchen floors to remove food droppings and prevent the harbor of rats & insects.
360.
o Right Cooking:
o • Cook food thoroughly. Temperature on all parts of the food should reach 70 degrees centigrade.
o • Eat cooked food immediately .
o • Wash hands thoroughly before and after eating .
361.
o Right Storage:
o • All cooked foods should be left at room temperature for NOT more than two hours to prevent multiplication of bacteria.
o • Store cooked foods carefully. Be sure to use tightly sealed containers for storing food.
o • Be sure to store food under hot conditions (at least or above 60 degrees centigrade ) or in cold conditions (below or equal to 10 degrees centigrade ). This is vital if you plan to store food for more than four to five hours.
362.
o Foods for infants should not be stored at all. It should always be freshly prepared .
o • Do not overburden the refrigerator by filling it with too large quantities of warm food.
o • Reheat stored food before eating. Food should be reheated to at least 70 degrees centigrade .
363. FOUR mula ONE for Health Framework for Implementation
364. Goals Better health outcomes More responsive health systems Equitable health care financing
365. Elements Health Financing Health Regulation Health Service Delivery Good Governance
366.
o The goal of this reform area is to foster greater, better and sustained investments in health. The Philippine Health Insurance Corporation through the National Health Insurance Program and the Department of Health through sectorwide policy support will lead this component jointly.
Health Financing
367.o The goal is to ensure the quality and affordability of health goods and services.
Health Regulation
368.o The goal is to improve and ensure the accessibility and availability of basic and
essential health care in both public and private facilities and services.
Health Service Delivery
369.o The goal is to enhance health system performance at the national and local levels.
Good Governance
370. Key Feature National Health Insurance Program (NHIP) The main lever to effect changes and outcomes in each of the four implementation components.
371.
o The NHIP reduces the financial burden placed on Filipinos by health care costs.
Health Financing
372.o The NHIP’s role in accreditation and payments based on quality acts as a driver
for improved performance in the health sector.
Health Regulation
373.o The NHIP demands fair compensation for the costs of care directed at providing
essential goods and services in health.
Health Service Delivery
374.o The NHIP is a prudent purchaser of health care thereby influencing the health
care market and related institutions.
Good Governance
375. 376.
o Sentrong Sigla Movement is a joint effort of the Department of Health and the LGUs It aims at promoting availability of quality health services in health centers and hospitals and at making these services accessible to every Filipino Its main component is the certification and recognition program that develops and promotes standards for health facilities
377. Contract Distribution System
o A new distribution system for DOH procured core essential drugs (CED). Its goal is to ensure that available stocks are distributed in a timely fashion to health facilities in proportion to health facilities actual use of and requirements for the drugs.
378. PHILIPPINE MEDICAL TOURISM
o Medical tourism is a term that has risen from the rapid growth of an industry where people from all around the world are traveling to other countries to obtain medical, dental, and surgical care while at the same time touring, vacationing, and fully experiencing the attractions of the countries that they are visiting.
379.
o Republic Act No. 9211
o TOBACCO REGULATION ACT OF 2003
o .
o .
o REPUBLIC ACT NO. 9211
o .
o AN ACT REGULATING THE PACKAGING, USE, SALE DISTRIBUTION AND
o ADVERTISEMENTS OF TOBACCO PRODUCTS AND FOR OTHER
o PURPOSES.
380.
381.
382.
o What is TB Network?
o It is the official communication handle of the National Tuberculosis Control Program or NTP that will stand for DOH’s re-energized fight against TB.
o It is a product of DOH’s collaboration with the LGUs, PhilCAT, and Philhealth.
o It is a “special group” dedicated to help/ take care of TB symptomatics and TB patients.
o Initially, it comprises regular health workers in the RHUs, MHOs and PHOs.
o Eventually, it will include everyone in the community who wish to help in the administration and financing of D.O.T.S.; family and relatives of TB symptomatics / patients, church, church organizations, civic organizations, NGOs, schools, companies/corporations.
383.
o Contract Distribution System
o A new distribution system for DOH procured core essential drugs (CED). Its goal is to ensure that available stocks are distributed in a timely fashion to health facilities in proportion to health facilities actual use of and requirements for the drugs.
384. Healthy City
o A Healthy City is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all functions of life and in developing their maximum potential (WHO,1994).
385. Health Sector Reform Agenda (HSRA)
o It describes the major strategies, organizational and policy changes and public investments needed to improve the way health care is delivered, regulated and financed.
386. Blood Donation Program
o > legal basis - RA 7719
o ("Blood Services Act of 1994“)
387.
o The main objectives are: > to promote and encourage voluntary blood donation by the citizenry
o > to instill public consciousness of the principle that blood donation is a humanitarian act;
o > to provide, adequate, safe, affordable and equitable distribution of supply of blood and blood products;
o > to mobilize the community …for voluntary and non-profit collection of blood
388. GMA 50
o The primary goal of the project is to ensure that affordable, high quality, safe and effective drugs and medicines are always available, especially to the poor.
389.
390. Breastfeeding TSEK ( Tama, Sapat at Eksklusibo) campaign
391. Goiter Awareness Week
o Proclamation No. 1188 declares every fourth week of January as Goiter Awareness Week
o “ Iwas Goiter ni Mommy, Lusog Isip ni Baby” theme of 5th GAW on Jan. 23-29, 2011
o focus on informing pregnant & lactating women on the benefits of using iodized salt & dangers of iodine deficiency disorders
392.
o ental health program
o steoporosis prevention
o ealth education & community organizing
o rimary health care
o eproductive health
o lder persons health service
o uidelines for good nutrition
o espiratory Infection Control
o lternative health care
o aternal and child care
o entrong Sigla Movement
DOH PROGRAMS
393. Health Programs o - Adolescent and Youth Health and Development Program
o - Botika Ng Barangay
o - Breastfeeding Program / Mother and Baby Friendly Hospital Initiative
o - Blood Donation Program
o - Cancer Control Program
o - Child Health
o - Diabetes Mellitus Prevention Program
o - Dengue Control Program
o - Dental Health Program
o - Doctors to the Barrios (DttB) Program
o - Emerging Disease Control Program
o - Environmental Health
o - Expanded Program on Immunization
o - Family Planning
o - Food and Waterborne Diseases Prevention and Control Program
o - Food Fortification Program
o - FOURmula One
o - Garantisadong Pambata
o - GMA 50 / Parallel Drug Importation (PDI)
o - Human Resource Health Network
o - Healthy Lifestyle Program
o - Health Sector Development Program
o - Knock-Out Tigdas
o - Leprosy Control Program
o - Malaria Control Program
o - Measles Elimination Campaign (Ligtas Tigdas)
o - National Cardiovascular Disease Prevention and Control Program
o - National Filariasis Elimination Program
o - National Mental Health Program
o - Natural Family Planning
o - Newborn Screening
o - Nutrition
o - Occupational Health Program
o - Health Development Program for Older Persons (Elderly Health)
o - Pinoy MD
o - Persons with Disabilities Program
o - Pnuemonia and Other Acute Respiratory Infections (ARI's)
o - Prevention of Blindness Program
o - Rabies Control Program
o - Safe Motherhood and Women's Health
o - Schistosomiasis Control Program
o - Smoking Cessation Program
o - Soil Transmitted Helmenthiasis
o - TB Control Program
o - Unang Yakap
Botika Ng Barangay (BnB)
394. Botika Ng Barangay (BnB) o refers to a drug outlet managed by a legitimate community organization (CO/non-
government organization (NGO) and/or the Local Government Unit (LGU)
o specifically licensed by the Bureau of Food and Drugs (BFAD) to sell, distribute, offer for sale and/or make available low-priced generic home remedies, over-the-counter (OTC) drugs and two (2) selected, publicly-known prescription antibiotic drugs (i.e. Amoxicillin and Cotrimoxazole)
o aims to promote equity in health by ensuring the availability and accessibility of affordable, safe and effective, quality, essential drugs to all, with priority for marginalized, underserved, critical and hard to reach areas
395. Adolescent and Youth Health and Development Program (AYHDP)
o The program is an expanded version of Adolescent Reproductive Health (ARH) element of Reproductive Health which aims to integrate adolescent and youth health services into the health delivery systems.
o Mission: Ensure that all adolescent and youth have access to quality health care services in an adolescent and youth friendly environment.
396. Promotion of Breastfeeding program / Mother and Baby Friendly Hospital Initiative (MBFHI)
o Realizing optimal maternal and child health nutrition is the ultimate concern
o the main strategy is to transform all hospitals with maternity and newborn services into facilities which fully protect, promote and support breastfeeding and rooming-in practices
o exclusive breastfeeding in the first four (4) to six (6) months after birth is encouraged as well as enforcement of legal mandates.
o RA 7600 (The Rooming-In and Breastfeeding Act of 1992)
o Executive Order 51 of 1986 (The Milk Code)
397. Philippine Cancer Control Program
o integrated approach utilizing primary, secondary and tertiary prevention in different regions of the country at both hospital and community levels.
o Six lead cancers (lung, breast, liver, cervix, oral cavity, colon and rectum)
398. CHILD 21
o is a strategic framework (a document) for planning programs and interventions that promote and safeguard the rights of Filipino children
o Children's Health 2025 – a subdocument of CHILD 21
o ultimate goal – “to achieve good health for all Filipino children by the year 2025”
399. Dengue Control Program
o community-based prevention and control in endemic areas
o Major strategy is advocacy and promotion, particularly the Four O’clock Habit which was adopted by most LGUs. This is a nationwide, continuous and concerted effort to eliminate the breeding places of Aedes aegypti.
400. FOOD FORTIFICATION PROGRAM ROMEO D. PIANSAY, JR., R.N., M.A.N. - CHN REVIEW 2008
401.
o Fortification
o is the addition of a micronutrient deficient in the diet to a commonly and widely consumed food or seasoning.
ROMEO D. PIANSAY, JR., R.N., M.A.N. - CHN REVIEW 2008
402.o Example:
o The use of FIDEL salt
o F ortification for
o I odine
o D eficiency
o EL imination
ROMEO D. PIANSAY, JR., R.N., M.A.N. - CHN REVIEW 2008
403.o REPUBLIC ACT NO. 8976
o Philippine Food Fortification Act of 2000
o a) Voluntary Food Fortification
o - Sangkap Pinoy Seal Program (SPSP)
o RA 832 – Rice Enrichment Law
o “ All milled rice has to be enriched with premix Rice”
o Government’s nutrition program
o RA 8172 – FIDEL Salt
ROMEO D. PIANSAY, JR., R.N., M.A.N. - CHN REVIEW 2008
404. SANGKAP PINOY o or micronutrients
o are vitamins and minerals required by the body in very small quantities. These are essential in maintaining a strong, healthy and active body; sharp mind; and for women to bear healthy children.
o vitamin A, iron and iodine, which cannot be synthesized by the human body, and therefore must be provided through the diet.
405. Emerging Disease Control Program
o Emerging infectious diseases are newly identified and previously unknown infections which cause public health problems either locally or internationally. These include diseases whose incidence in humans has increased within the past two decades or threatens to increase in the near future.
406. Environmental Health
o Environmental Health is concerned with preventing illness through managing the environment and by changing people's behavior to reduce exposure to biological and non-biological agents of disease and injury. It is concerned primarily with effects of the environment to the health of the people.
o Program strategies and activities are focused on environmental sanitation, environmental health impact assessment and occupational health through inter-agency collaboration. An Inter-Agency COmmittee on Environmental Health was created by virute of E.O. 489 to facilitate and improve coordination among concerned agencies. It provides the venue for technical collaboration, effective monitoring and communication, resource mobilization, policy review and development. The Committee has five sectoral task forces on water, solid waste, air, toxic and chemical substances and occupational health.
o Vision:
o Health Settings for All Filipinos
o Mission:
o Provide leadership in ensuring health settings
o Goals:
o Reduction of environmental and occupational related diseases, disabilities and deaths through health promotion and mitigation of hazards and risks in the environment and worksplaces.
407. Expanded Program on Immunization
o Children need not die young if they receive complete and timely immunization. Children who are not fully immunized are more susceptible to common childhood diseases. The Expanded Program on Immunization is one of the DOH Programs that has already been institutionalized and adopted by all LGUs in the region. Its objective is to reduce infant mortality and morbidity through decreasing the prevalence of six (6) immunizable diseases (TB, diphtheria, pertussis, tetanus, polio and measles)
o Special campaigns have been undertaken to improve further program implementation, notably the National Immunization Days (NID), Knock Out Polio (KOP) and Garantisadong Pambata (GP) since 1993 to 2000. This is being supported by increasing/sustaining the routine immunization and improved surveillance system.
408. Family Planning
o A national mandated priority public health program to attain the country's national health development: a health intervention program and an important tool for the improvement of the health and welfare of mothers, children and other members of the family. It also provides information and services for the couples of reproductive age to plan their family according to their beliefs and circumstances through legally and medically acceptable family planning methods.
o The program is anchored on the following basic principles.
o * Responsible Parenthood which means that each family has the right and duty to determine the desired number of children they might have and when they might have them. And beyond responsible parenthood is Responsible Parenting which is the proper ubringing and education of chidren so that they grow up to be upright, productive and civic-minded citizens.
o * Respect for Life. The 1987 Constitution states that the government protects the sanctity of life. Abortion is NOT a FP method:
o * Birth Spacing refers to interval between pregnancies (which is ideally 3 years). It enables women to recover their health improves women's potential to be more productive and to realize their personal aspirations and allows more time to care for children and spouse/husband, and;
o * Informed Choice that is upholding and ensuring the rights of couples to determin the number and spacing of their children according to their life's aspirations and reminding couples that planning size of their families have a direct bearing on the quality of their children's and their own lives.
o E. Intended Audience:
o Men and women of reproductive age (15-49) years old) including adolescents
o F. Area of Coverage:
o Nationwide
o G. Mandate:
o EO 119 and EO 102
o H. Vision:
o Empowered men and women living healthy, productive and fulfilling lives and exercising the right to regulate their own fertility through legally and acceptable family planning services.
o I. Mission
o The DOH in partnership with LGUs, NGOs, the private sectors and communities ensures the availability of FP information and services to men and women who need them.
o J. Program Goals:
o To provide universal access to FP information, education and services whenever and wherever these are needed.
o K. Objectives
o General:
o To help couples, individuals achieve their desired family size within the context of responsible parenthood and improve their reproductive health.
o Specifically, by the end of 2004:
o Reduce
o * MMR from 172 deaths 100,000 LB in 1998 to less than 100 deaths/100,000 LB
o * IMR from 35.3 deaths/1000 livebirths in 1998 to less than 30 deaths/1000 live births
o * TFR from 3.7 children per woman in 1998 to 2.7 chidren per woman
o Increase:
o * Contraceptive Prevalence Rate from 45.6% in 1998 to 57%
o * Proportion of modern FP methods use from 28>2% to 50.5%
o L. Key Result Areas
o 1. Policy, guidelines and plans formulation
o 2. Standard setting
o 3. Technical assistance to CHDs/LGUs and other partner agencies
o 4. Advocacy, social mobilization
o 5. Information, education and counselling
o 6. Capability building for trainers of CHDs/LGUs
o 7. Logistics management
o 8. Monitoring and evaluation
o 9. Research and development
o M. Strategies
o I. Frontline participation of DOH-retained hospitals
o II. Family Planning for the urban and rural poor
o III. Demand Generation through Community-Based Management Information System
o IV. Mainstreaming Natural Family Planning in the public and NGO health facilities
o V. Strengthening FP in the regions with high unmet need for FP: CAR, CHD 5, 8, NCR, ARMM
o VI. Contraceptive Interdependence Initiative
o N. Major Activities
o I. Frontline participation of DOH-retained hospitals
o * Establishment of FP Itinerant team by each hospital to respond to the unmet needs for permanent FP methods and to bring the FP services nearer to our urban and rural poor communities
o * FP services as part of medical and surgical missions of the hospital
o * Provide budget to support operations of the itenerant teams inclduing the drugs and medical supplies needed for voluntary surgical sterilization (VS) services
o * Partnership with LGU hospitals which serve as the VS site
o II. Family Planning for the urban and rural poor
o * Expanded role of Volunteer Health Workers (VHWs) in FP provision
o * Partnership of itenerant team and LGU hospitals
o * Provision of FP services
o III. Demand Generation through Community-Based Management Information System
o * Identification and masterlisting of potential FP clients and users in need of PF services (permanent or temporary methods)
o * Segmentation of potential clients and users as to what method is preferred or used by clients
o IV. Mainstreaming Natural Family Planning in the public and NGO health facilities
o * Orientation of CHD staff and creation of Regional NFP Management Committee
o * Diacon with stakeholders
o * Information, Education and counseling activities
o * Advocacy and social mobilization efforts
o * Production of NFP IEC materials
o * Monitoring and evaluation activities
o V. Strengthening FP in the regions with high unmet need for FP: CAR, CHD 5, 8, NCR, ARMM
o * Field of itinerant teams by retained hospitals to provide VS services nearer to the community
o * Installation of COmmunity Based Management Information System
o * Provision of augmentation funds for CBMIS activities
o VI. Contraceptive Interdependence Initiative
o * Expansion of PhilHealth coverage to include health centers providing No Scalpel Vasectomy and FP Itenerant Teams
o * Expansion of Philhealth benefit package to include pills, injectables and IUD
o * SOcial Marketing of contraceptives and FP services by the partner NGOs
o * National Funding/Subsidy
o VIII. Development /Updating of FP CLinical Standards
o IX. Formulation of FP related policies/guidelines. E.g. Creation of VS Outreach team by retained hospitals and its operationalization, GUidelines on the Provision of VS services, etc.
o X. Production and reproduction of FP advocacy and IEC materials
o XI. Provision of logistics support such as FP commodities and VS drugs and medical supplies
o O. Other Partners
o 1. Funding Agencies
o * United States Agency for International Development (USAID)
o * United Nations Funds for Population Activities (UNFPA)
o * Management Sciences for Health (MSH)
o * Engender Health
o * The Futures Group
o 2. NGOs
o * Reachout foundation
o * DKT
o * Philippine Federation for Natual Family Planning (PFNFP)
o * John Snow Inc. - Well Family Clinic
o * Phlippine Legislators Committee on Population Development (PLPCD)
o * Remedios Foundation
o * Family Planning Organization of the Philippines (FPOP)
o * Institute of Maternal and CHild HEalth (IMCH)
o * Integrated Maternal and CHild Care Services and Development, Inc.
o * Friendly Care Foundation, Inc.
o * Institute of Reproductive Health
o 3. Other GOs
o * Commission on Population
o * DILG
o * DOLE
o * LGUs
409. Food and Waterborne Diseases Prevention and Control Program
o Food and Waterborne Diseases ( FWBDs ) are among the most common causes of diarrhea. In the Philippines, diarrheal diseases for the past 20 years is the number one cause of morbidity and mortality incidence rate is as high as 1,997 per 100,000 population while mortality rate is 6.7 per 100,000 population. From 1993 to 2002, FWBDs such as cholera, typhoid fever, hepatitis A and other food poisoning/foodborne diseases were the most common outbreaks investigated by the Department of Health. Also, outbreaks from FWBDs can be very passive and catastrophic. Since most of these diseases have no specific treatment modalities, the best approach to limit economic losses due to FWBDs is prevention through health education and strict food and water sanitation.
o The Food and Waterborne Disease Prevention and Control Program (FWBDPCP) established in 1997 but became fully operational in year 2000 with the provision of a budget amounting to PHP551,000.00. The program focuses on cholera, typhoid fever, hepatitis A and other foodborne emerging diseases (e.g. Paragonimiasis ). Other diseases acquired through contaminated food and water not addressesd by other services fall under the program.
410. National Drug Policy - Pharmaceutical Management Unit 50
o Mission:
o A team of dedicated, committed, competent & dynamic health & health-related professionals, that endeavors to formulate national policies, processes & design strategies through participatory/ multisectoral coordination & knowledge management that shall ensure availability & accessibility of safe, efficacious & quality essential drugs.
411.
o Vision:
o Providing quality health care through improved access and rational use by the Filipino people of safe, effective, quality and affordable drugs to all, especially the poor.
o Goal:
o Attain universal (at least 85%) regular access to essential medicines by 2015.
412. “ Half-Priced Medicines Program”
o related terms - GMA 50 / Pharma 50 /
o a program that would reduce the cost of medicines commonly bought by the poor to half of their regular prices and make them available nationwide through a distribution network as determined by the Department of Health
o The primary goal of the project is to ensure that affordable, high quality, safe and effective drugs and medicines are always available, especially to the poor.
o Pharma 50 unit, an ad-hoc unit which is currently named as the National Drug Policy-Pharmaceutical Management Unit (NDP-PMU 50)
413. Botika ng Barangay (BnB)
o Among the programs initiated were the Botika ng Barangay (BnB), DOH botikas and the Parallel Drug Importation (PDI). These were created to implement stop-gap measures to the emanating issues. Other existing programs that are continuously implemented are the Generics Advocacy, Philippine National Drug Formulary (PNDF) and Essential Drug Price Monitoring System (EDPMS).
o The establishment of the BnBs in the communities, including the insurgent areas, ensures accessibility of low-priced generic over-the-counter (OTC) drugs and five (5) prescription drugs as recommended by the National Formulary Committee (NFC). Other community drug outlets include Botika Binhi (funded by the members of the Peso for Health with counterpart from the local government unit), Health Plus (funded by the GTZ), Botika sa Parokya (funded by the Office of the President) and the Botika ng Bayan (BNB) under PITC/PITC Pharma Inc. At present, about 11,934 BnB outlets have been established in the country.
414. Parallel Drug Importation (PDI)
o The Parallel Drug Importation was created to address the urgent need to make available quality low-priced medicines to the public immediately. This refers to the importation of similarly branded drug products that are cheaper in other countries to be distributed to the local market. Currently, there are forty-five (45) essential drugs being imported in the country and sold through 72 DOH Retained Hospitals and 3 local government units (LGUs). A revolving fund system was established to assure continuity of this program.
415. Generics Advocacy
o aims to educate the public and health professionals with the end in view of changing the public’s perception on generics – that locally produced generic drugs are of good quality and more affordable, as well as affecting the prescribing and dispensing behaviors of health professionals
416. Philippine National Drug Formulary
o an integral component of the Philippine National Drug Policy (PNDP) aiming at making available and accessible essential drugs of proven efficacy, safety and quality at affordable cost. It is a major strategy in the promotion of rational drug
use that provides list of essential drugs deliberated by the National Formulary Committee (NFC)
417. Electronic Drug Price Monitoring System
o a system and procedure for the data collection on prices of selected essential drugs
418. P100 Project
o aims to provide packages of drug regimen worth 100 pesos or lower, with 100% safety, quality, and efficacy that will soon be available in 100 hospitals (DOH and LGU)
419.
420.
