CHN (Sir Daclis)

• Community Health Nursing (CHN)

  Nursing practice focused on promoting health and preventing illness in communities outside of hospitals
• Healthy patients


  • Health education (health teachings) is the primary responsibility
• Focus of CHN


  • Health promotion - increase the level of health and make it healthier
  • Health prevention - maintain health
• Goal of CHN


  Optimum level of function (Optimum level of wellness)
• Fields of CHN


  • School nursing
  • Occupational health nursing
  • Mental health nursing
• School nursing


  Health assessment for children - once a year
• Occupational health nursing


  Also known as company nursing<|>Focus - health of employees<|>Ergonomics (study of people in their working environment) - effectivity and efficiency is maximized
• Mental health nursing


  Nurse promotes mental hygiene<|>RA 11036 (Mental Health Act)
• Public Health Nurse (PHN)

  Salary grade: grade 15 - 36,000
• Department of Health (DOH)


  National authority for health
• DOH Vision


  Filipinos will be the healthiest in Southeast Asia in 2022, and in Asia in 2040<|>Basis for healthiest - life expectancy<|>Life expectancy of Philippines - 72 years old
• DOH Mission


  Develop a PREP health system: Productive, Resilient, Equitable, People oriented
• 3 Main Functions of DOH

  • Leadership in health - Policies
  • Enabler and Capacity builder - New strategies and training programs
  • Administrative function - Manages tertiary, LGU - primary and secondary
• RA 7160 - Local Government Code


  Transfer of power - Decentralisation and Devolution
• Two aspects of LGU

  • Provincial government
  • Municipal or city government
• Provincial government


  Chairman (local chief executive) - governor<|>Vice chairman - provincial health officer (doctor)<|>Secondary - district and provincial hospital
• Municipal or city government

  Chairman - mayor<|>Vice chairman - municipal health officer or city health officer (MHO, CHO, PHO)<|>Primary
• Primary health care


  • Accessible - Within 3-5 km; 30 minutes
  • Offers: Basic health care services
  • Available: Public health midwife
  • Where: Barangay health station, health center, rural health unit
• Barangay health station


  Satellite station<|>Smallest unit<|>Manned by Public Health Midwife + BHW
• RHU or health center


  Main primary center<|>Complete health care team - Public health midwife, Public health nurse, HO or Rural Health Physician, MedTech, Sanitary inspector, Dentist
• 2 levels of primary health workers

  • BHW or auxiliary or grassroot — non-professionals
  • Intermediate — Professionals
• Secondary health care


  • Offers: Common medical, dental, and surgical services
  • Where: District, emergency and provincial hospital
• Tertiary health care


  • Offers: Advance health care services
  • Where: Regional hospital, national hospital, national medical centre, specialty hospitals
• DOH National Objective of Health (NOH)

  Roadmap for ALL stakeholders of health
• DOH Health Sector Reform Agenda (HSRA)

  Overriding goal of DOH
• Formula 1 Plus (F1 PLUS)


  Implementation framework for health sector reform<|>Boosting universal health care<|>Ensures maximization of budget of health
• Five pillars of F1 PLUS

  • Health financing
  • Health regulation
  • Health service delivery
  • Good governance
  • Performance accountability
• Health financing


  Better investment for health<|>NHIP (National health insurance program) - Phil Health<|>RA 11223 - Universal health care act<|>Method of reimbursement - Case rate method
• Health regulation


  Affordable and quality<|>RAQ - regulation, affordable and quality
• Health service delivery


  Accessible and available<|>DHb - Doctors to the Barrios program
• Good governance


  Stakeholders - holds the money of the government<|>Transparent - SALN (Statement of assets, liabilities and net worth)<|>Accountable<|>Efficient
• Performance accountability


  Outcome based approach
• 4 patients of CHN

  • Individual
  • Family
  • Population group or aggregate
  • Community
• Family


  Basic unit of service; there is a sense of relationship between each other<|>Types: Single parent, Nuclear, Extended, Blended, Cohabitation
• Family care plan


  1. Assessment - data collection

  2. Planning - Goal setting, Constructing plan of action, Developing an operational plan

  3. Implementation - plan execution

  4. Evaluation - check outcome
• Categories of health problems

  Wellness state - applicable to health patients<|>Health deficit - diseases and disabilities<|>Health threats - high risk for illness and injury<|>Foreseeable crisis (anticipated) or stress point (abrupt)
• 4 criteria in prioritizing family problems

  • Nature of the problem
  • Modifiability of the problem
  • Preventive potential
  • Salience
• Types of nursing problem scoring

  Nature of the problem<|>Modifiability of the problem<|>Preventive potential<|>Salience
• 3 types of nursing interventions

  • Dependent - need doctor's order
  • Independent - you can do it alone
  • Interdependent - collaborative nursing care
• Quality Assurance Elements (QAE)


  Structural elements - Physical settings, Man power, Money, Materials or equipment<|>Outcome elements - Changes resulting from nursing interventions<|>Process elements - Steps of nursing process - APIE