A ssimilate essential principles in the care of patients in

the community

These principles may include…

 have a purpose or objective when conducting home visit
 plan ahead
 priority should be given to the recognized needs of the family
 there is no definite rule as to the frequency of a home visit
 frequency of home visit should take into account. The physical,
psychological and educational needs of the individual and
family
 the initial step in conducting a home visit is to GREET the client
and introduce yourself
 soiled articles with discharge should be boiled in water 30
minutes before laundering

B ag Technique
 steps which are carried out by the nurse to facilitate the
performance of nursing procedures with ease and deftness

Remember the:
Bag and its contents must be protected from any possible
contamination
Always wash your hands to prevent the spread of infection
Gather all necessary article, supplies to answer emergency
needs.
Note: Blood pressure apparatus and stethoscope are
carried separately

Consider the following principles:

1) prevention of contamination
NOTE: place waste paper bag outside the work areas
2) protection of the caregiver
NOTE: clean and alcoholize all articles after use
3) make articles readily accessible
NOTE: place the articles in one corner of the work area
4) make follow-up care
NOTE: set the date and time for the next visit
 C ommunity Based Rehabilitation Program

 The goal of this program is the improvement of quality of life

and productivity of disabled persons.
 R.A. 7277, magna carta for disabled persons, serves as the
legal basis of the program
 The components of the program includes: social preparations,
services preparation, training, information, education and
communication and monitoring, supervision and evaluation
 The VISION of the Department of Health is: Health for all
Filipinos
 The MISSION of the Department of Health is: Ensure
accessibility of health care to improve the quality of life of all
Filipinos, especially the poor
 The basic principles to achieve improvement in Health includes

- nsure universal access to basic health

services
- pidemic logical shift from infecting to
degenerative disease must be managed
- nhance the performance of the health sector
- nsure the prioritization of health and nutrition
of vulnerable groups
 The primary strategies to achieve health goals include:
S – upport for frontline health workers and to local
system development
A – ssurance of the health care
I – ncreasing investment for primary health care
D – evelopment of national standard and objectives for
health

 Primary Health Care (PHC), according to the World Health

Organization is essential health care made universally
accessible to individuals and families in the community by
means acceptable to them through their full participation and at
a cost that the community and country can afford at every
stage of development
 The goal of PHC is health for all Filipinos in the hands of the
people by the year 2020.
 Letter of Instruction (L01) 949 (October 19, 1979) is the legal
basis of PHC
 The first international conference on Primary Health Care was
held in Alma, Ata, USSR on September 6-12, 1978 sponsored
by the WHO and UNICEF
 The framework for meeting the goal of primary health care is
organizational strategy. It calls for among communities, private
and government agencies with the end view of health
development
 The four cornerstones/pillars in primary health care includes:
1. Active community participation
2. Intra and inter sectoral linkages
3. Use of appropriate Technology
4. Support mechanism made available

 The expanded program on immunization aims to reduce the

morbidity and mortality among infants and children caused by
the six childhood immunizable diseases. It was launched in
July 1976. P.D. 996 (September 16, 1976) provides for
compulsory basic immunization for infants and children below 8
years of age. “The EPI program is based on epidemiological
situations. Presidential Proclamation no. 147 (March 3, 1993)
declares April 21 and May 19, 1993 and every third Wednesday
of January and February thereafter for two years as National
Immunization Days.” R.A. 7846 (December 30, 1994) requires
compulsory immunization against hepatitis B for infants and
children below 8 years old.
 The ultimate goal of promotion of reproductive health is
“QUALITY of LIFE”. The focus of the Philippine framework of
the program is Reproductive Health status in terms of, its
elements. The ten elements of Reproductive Health includes:
(1) Maternal and childbirth and nutrition (2) Family Planning (3)
Prevention and Management of abortion complications (4)
Prevention and treatment of Reproductive Tract Infection
(RTI’s) including STD’s, HIV and AIDS (5) Education and
counseling on Sexuality (6) Sexual Health Breast and (7)
Reproductive Tract Cancers and other gynecological conditions
(8) Men’s Reproductive Health Violence Against Women (VAW)
(9) Prevention and Treatment of Infertility and Sexual
Disorders.
 The goal of the 2000 Nutritional Guidance for Filipino’s is the
improvement of nutritional status, productivity and quality of life
of the population through adoption of desirable dietary
practices and healthy lifestyle. An example is the exclusive
breastfeeding of infants from birth to 4-6 months and the use of
iodized salt.
 The use of fluoride in the prevention of tooth decay is carried
out by making four application of fluoride about a week apart
among children who are aged 3, 7, 10 and 13 because at these
ages new teeth have erupted.
 The goal for health care and services for older persons is to
provide a longer disability free line. This is carried out through a
holistic care approach.
 To reduce the blindness prevalence rate in the Philippines, the
prevention of blindness program was conceived. It is
subdivided into four programs namely: cataract program,
primary eye care, vitamin A deficiency program and other eye
care program.
 The goals of the mental health program include: promotion of
mental health, decreased health-related effects of stressful
lifestyle and reduction of prevalence of mental ill health and
disorders in the Philippines.
 The sentrong sigla movement aims to promote availability of
quality health services in health centers and hospitals and to
make these services accessible to every Filipino.
 “Sang Milyong Sepilyo” is a strategy for social mobilization of
Dental health program. It aims to emphasize the importance of
oral health in relation to total body health to increase public
awareness on the prevention of common dental diseases.

E pidemiology

 Systematic, scientific study of the distribution patterns and

determinants of health, disease and condition for the purpose
of promoting wellness and preventing disease/conditions.
 Basic concepts that guide epidemiological study include:
Biostatistics, aggregates at risk, the natural life history of a
disease, levels of prevention, host-agent-environment
 relationships, multiple causation, person-place-time
relationships.
 When monitoring incidence of infectious disease, the terms
used to distinguish relative frequency in time and space include
the following:
Sporadic – presence of occasional cases of the disease
Endemic – constant long-term presence of the disease
Epidemic – presence of the disease at a much higher
frequency over a short period of time
Pandemic – presence of a disease in many countries in a
relatively short period of time

 Effective implementation of the epidemiological process

requires a multi disciplinary approach
 A community health nurse must apply the principles of
epidemiology in order to provide preventive services to the
community
 Community health nurses participate in many epidemiological
activities like: case finding, health teaching, counseling and
follow up essential to the prevention of diseases and other
conditions.

F ormulas for Mortality and Morbidity Statistics

Crude Birth Rate (CBR) – A measure of one characteristic of the

natural growth or increase of a population

CBR = Total No. of livebirths registered in a

given calendar year x 1, 000
Estimated population as July 1 of same year

Crude Death Rate (CDR) – A measure of one mortality from all causes
which may result in a decrease of population

CDR = Total No. of deaths registered in a

given calendar year x 1, 000
Estimated population as of July 1 of same year
Infant Mortality Rate (IMR) – Measure the risk of dying during the 1st
year of life.

Total No. of deaths under 1 year of age

IMR = registered in a given calendar year x 1, 000
Total No. of registered livebirths of
same calendar year

Maternal Mortality Rate (MRR) – It measures the risk of dying from

causes related to pregnancy, childbirth and
puerperium.

MMR = Total No. of deaths from maternal

causes registered for a given year x 1, 000
Total No. of livebirths registered of same year

Incidence Rate (IR) – Measures the frequency of occurrence of the

phenomenon during a given period of time.

No. of new cases of a particular disease

IR = registered during a specified period of time x 1, 000
Estimated population as of July of same year

Prevalence Rate (PR) – Measures the proportion of the population

which exhibits a particular disease at a particular
time.

No. of new and old cases of a certain

PR = disease registered at a given time x 1, 000
Total No. of persons examined
at same given time

A fully immunized child should have received one (1) dose of BCG,
three (3) doses of DPT, three (3) doses of OPV, three (3) doses of
Hepatitis B and one (1) dose of measles, before the child’s first
birthday.

EPI
  Moderate fever, malnutrition, mild respiratory infection, cough,
diarrhea and vomiting are not contraindications to vaccination.
 DPT2 or DPT3 is not given to a child who has had convulsion or
shock within 3 days of the previous dose
 BCG vaccine is not given to a child with clinical AIDS
 Measles and Polio vaccines are most sensitive to heat.

Administration of Vaccines

Vaccine Dose Route of Site of

administration administration

Infant 0.5 ml intradermal right deltoid region of

BCG the arm
School
entrants:
intradermal left deltoid region of
10 ml
the arm

DPT, 0.5 ml intramuscular upper outer portion of

Hepatitis B the thigh

Polio 2 drops, or
depending on oral mouth
manufacture’s
instructions

Measles 0.5 ml subcutaneous outer part of the

upper arm

Tetanus toxoid 0.5 ml deep intramuscular deltoid region of the

upper arm

K ey Points in Vaccine Administration

  BCG - lay the syringe and needle almost flat along the childs’
arm
- if the vaccine is injected correctly into the skin, a flat
wheal with the surface pitted like an orange peel
will appear at the injection site
 OPV - if necessary, open the childs’ mouth by squeezing the
cheeks gently between your fingers to make his
lips point upwards
- put drops of vaccine straight from the dropper onto the
childs’ tongue but do not let the dropper touch
the childs’ tongue
- if the child spits out the vaccine, give another dose

Hepa B and DPT – the best injection site is the outer part of the
childs’ mid-thigh
– ask the mother of the child to hold the childs’
legs

Measles – the best injection site is on the outer side of

the upper arm

Tetanus Toxoid – the best injection site for a woman is the outer
side of the left upper arm

Vaccine Dose Timing of Vaccination

TT1 5-6 months of pregnancy

TT2 4 weeks after TT1
TT3 at least 6 months later
TT4 at least 1 year later
TT5 at least 1 year later

N.B. TT2 provides 3 years protection for the mother, TT3

provides 5 years protection, TT4 provides 10 years protection
and TT5 provides lifetime protection of the mother.

Herbal Plant Uses/s

Akapulko Anti fungal

Ampalaya Diabetes Mellitus

Bawang Hypertension
(to lower cholesterol levels in the
blood)
Toothache
Remember: BawHaT
(Bawang for Hypertension
and Toothache)

Bayabas / Guavas Diarrhea

Washing of wounds
Gargle to relieve toothache

Lagundi Skin diseases

Headache
Asthma, cough and fever
Rheumatism, sprain, insect bites
Eczema
Dry sentery

Niyug-niyogan Anti helminthic

Sambong Anti edema

Diuretic
Anti urolithiasis

Tsaang Gubat Stomach ache

Remember:
Stomach ache
Tsaang gubat
Diarrhea

Yerba Buena Swollen gums

Pain
Insect bites
Toothache
Menstrual and gas pain
 Arthritis
Nausea and fainting
Diarrhea

Ulasimang Bato Uric-acid excretion

(Pansit-pansitan) Remember:
Ulasimang bato, uric acid

DOH PROGRAMS

Dental Health Program

Osteoporosis Prevention

Health Education and Community Organization

Primary Health Care

Reproductive Health

Older Persons Health Services

Guidelines for Good Nutrition

Respiratory Infection Control

Acu pressures

Maternal and Child Care

Sentrong Sigla Movement