IMCI CASE STUDY

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A case study in Integrated Management of childhood illness during IMCI rotation

Transcript of IMCI CASE STUDY

INTRODUCTION

Community health nursing is one of the two major fields of nursing in the Philippines; the other is hospital nursing. Community health nursing primarily works on the promotion and preservation of the health of the population. The nature of practice is comprehensive, general, continual and not episodic. Its basic knowledge and skills are anchored on nursing theories and important concepts form the science of public health. There are different levels of clientele in community health nursing: the individual, family, population group and community.

Infant and childhood mortality are sensitive indicators of inequity and poverty. Children who are most commonly and severely ill, malnourished and most likely to die of their illness are those of the most vulnerable and underprivileged populations of low-income countries. Every day, millions of parents seek health care for their sick children, taking them to hospitals, health centers, and the like. These factors along with limited supplies and equipment, combined with an irregular flow of patients make providing quality care to sick children a serious challenge. Experience and evidence show that improvements in child health are not necessarily dependent on the use of sophisticated and expensive technologies but rather on effective strategies that are based on a holistic approach which are available to the majority of those in need, and which take into account the capacity and structure of health systems as well as traditions and beliefs in the community. WHO and UNICEF have addressed this challenge by developing a strategy called the Integrated Management of Childhood Illness (IMCI). IMCI is a strategy developed by the World Health Organization's Division of Child Health and Development and UNICEF. It has been introduced to address morbidity and mortality in children under five years. The strategy focuses on the child as a whole, rather than on a single disease or condition. IMCI is a strategy that integrates all available measures for disease prevention and health problems during childhood, for their early detection and effective treatment, and for promoting healthy habits within the family and community. IMCI offers the knowledge and abilities to sequentially evaluate and integrate the status of child health and, in this way, detect the diseases or problems frequently affecting it according to the epidemiological patterns of the respective location. A comprehensive examination for general danger signs and major symptoms of diseases is done for all sick children. The combination of individual clinical signs leads to a classification rather than a diagnosis. The procedures use a limited no. of

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essential drugs. Encouragement of the active participation of caretakes is done. Counseling of caretakers is also done. Based on this evaluation, IMCI gives clear instructions on disease classification and problems, establishing the treatment that should be administered for each one. The strategy also provides instructions on how to control the progress of treatment, in order to identify the need for applying prevention measures as well as how to inform and educate parents on disease prevention and child health promotion. On this basis, IMCI is currently regarded as the most efficient strategy for reducing the burden of disease and disability among the population in this age group. Its main goal is to contribute to a healthy growth and development during the first five years of life.

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OBJECTIVES

General objective: By the end of our 4-week IMCI rotation, we will be able to come up with an all-inclusive mini family case study which aims to present adequate information regarding the general wellbeing of our selected family. Our target is to have an acquisition of new knowledge and enhancement of skills in the application of the community health nursing concepts and principles reflected on our act of service to our client family.

In specific, we aim to: select a family that has the qualifications to be subject for this case study; establish rapport with the family to initiate cooperation in line with the trusting nurseclient relationship throughout the process; gather data regarding the familys over-all status to compose the initial data base for a more systematized presentation of our chosen family through interviews and observations using the family assessment guide; Conduct an IMCI check-up if one of the children has 1 or more of the major symptoms and if he/she is an infant or 5 years and less. Assess the familys coping mechanisms in response to different situations to provide a basis for estimating the nursing needs of our selected family through the family coping index; identify existing and potential problems of the family in their environment, safety, personal hygiene, finances, resources, social relationships, or spirituality; Prioritize the recognized crises to determine what should be considered first and what problems doesnt need immediate solutions; Devise appropriate nursing interventions in order to meet the needs of the family through nursing care plans; Implement the proposed nursing care plans that will solve the familys existing problems, if not, prevent potential problems to occur or to improve the familys way of living; Evaluate the implemented plans whether there was an improvement or otherwise; FAMILY CASE STUDY | 3

Provide health teachings to the family regarding health, its maintenance and promotion towards wellness. Determine the implication of this case study to nursing education, research and practice.

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INITIAL DATA BASE A. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS DEMOGRAPHIC DATA Demographic Data Demography encompasses the study of the size, structure and distribution of populations, and spatial or temporal changes in them in response to birth, migration, aging and death. On November 12, 2012, we, the BSN-2A Group 1 subgroup 2 conducted an interview on the Encarquez Family, an extended family which is composed of 5 families with a total of 50 members. They are currently residing at Barangay 21C Blk-85 Piapi Boulevard, Davao City. They have been living on the community for forty-six years. The house was originally owned by their grandmother but since the latter was dead, they claim the house as their own. The parents are Roman Catholic and pure Dabawenyos.

FAMILY MEMBERS CHART FAMILY MEMBERS FAMILY MEMBERSNO.

RELATION TO HEAD

AGE

SEX

CIVIL STATUS

EDUCAT -IONAL ATTAINMENT

OCCUPATIONTYPE OF WORK PLACE

NAME

1

Romeo Encarguez

-------

35

M

Married

Grade 3

Garbage Collector Anywhe re

2

Melinda Encarguez

Wife

31

F

Married

Grade 6

N/A

N/A

3

Mary Frances Encarguez

Daughter

14

F

Single

Grade 6

FAMILY CASE STUDY |

5

4

Christian Encarguez

Son

13

M

Single

Grade 5 *

5

Rommel Encarguez

Son

12

M

Single

Grade 3 *

6

Chris Mae Anne Encarguez

Daughter

10

F

Single

Grade 1 *

7

Justine Encarguez

Son

5

M

Single

8

Raymond Encarguez

Son

4

M

Single

9

Raymart Encarguez

Son

4

M

Single

10

Reggie Encarguez

Son

4

M

Single

Mr. Romeo Encarguez is 35 years old. He has no stable job because he was not able to finish his studies. He is working as a garbage collector in CENRO. He drinks alcohol almost every day and no one can ever stop him even his daughter. His wife left them 2 years ago due to some family problems. He doesnt cook or prepare food for the children, only his daughter, Mary Frances. Mary Frances is 14 years old. She only graduated grade 6 and was forced to stop because she is the only one to take care of her siblings because their mother left them in such a young age. She sacrifices herself for her younger siblings because their father doesnt care to his children. She is fully in-charge of whatever necessary things for her siblings such as water and food supply. Christian, Rommel and Chris Mae Anne are fortunate enough to avail the program offered by the government. The government take full responsibility of their basic needs and currently living in the place where the government supports like bahay pasilungan, Don Bosco and etc.

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Unfortunately, Justine together with the triplets, Raymond, Raymart and Reggie doesnt go to school due to financial problems. For the meantime, theyre just enjoying being a kid of their time.

PLACE OF RESIDENCE Encarguezs family is residing at their own house at Brgy.21C Blk-85 Piapi Boulevard Davao City.

TYPE OF FAMILY STRUCTURE The Encarguez family is under the Extended family. 5 families are living there, compose of their 4 aunties family and them. All in all, they are composed of 20 adults and 30 children. In their family, it only consist of 6 members including the father since the 3 children lives in the charity.

ACTIVITIES OF DAILY LIVING Body Mass Index calculation and corresponding calculation

Family Member Romeo

Weight (kg) 53 kg

Heigh t (m) 1.6 m

BMI

Malnourished