NCM 103

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NCM 103

FUNDAMENTALS OF NURSING

CHEENA P. BERBER MAN, RN, LPT


UNIT 2

CHAPTER 6
HEALTH CARE DELIVERY SYSTEM
CHAPTER 7
COMMUNITY NURSING AND
CARE CONTINUITY
The Philippine Health Care Delivery System

• “the totality of all policies, facilities,


equipment, products, human resources and
services which address the health needs,
problems and concerns of the people. It is
large, complex, multi-level and multi-
disciplinary.”
The Philippine Health Care Delivery System

Lead Agency:
•DEPARTMENT OF HEALTH
DR. FRANCISCO DUQUE III
DEPARTMENT OF HEALTH
5 MAJOR FUNCTIONS:
1. Ensure equal access to basic health services
2. Ensure formulation of national policies for proper
division of labor and proper coordination of
operations among the government agency
jurisdictions
DEPARTMENT OF HEALTH
3. Ensure a maximum level of implementation
nationwide of services regarded as public health
goods
4. Plan and establish arrangements for the public
health systems to achieve economies of scale
5. Maintain a medium of regulations and standards
to protect consumers and guide providers
VISION BY 2030 (DREAM OF DOH)
A Global Leader for attaining better health
outcomes, competitive and responsive health
care systems, and equitable health financing
Principles to attain the vision of DOH

•Equity: equal health services for all-no


discrimination
•Quality: DOH is after the quality of service not
the quantity
•Philosophy of DOH: “Quality is above quantity”
•Accessibility: DOH utilize strategies for delivery
of health services
MISSION
•To guarantee EQUITABLE, SUSTAINABLE and
QUALITY health for all Filipinos, especially the
poor and to lead the quest for excellence in
health
Events in our Health Care Delivery System
• Fidel Ramos- Devolution/Decentralization (RA 7160)
• Joseph Estrada- Health Sector Reform Agenda
• *Gloria Arroyo- FOURmula ONE for Health
• Noynoy Aquino- Kalusugang Pangkalahatan (Universal
Health Care)
•Rodrigo Duterte
•All for Health Towards Health for All (Healthy
Philippines)
3 LEVELS OF HEALTH CARE

1. Primary-Prevention of illness or promotion of


health
2. Secondary-curative
3. Tertiary-rehabilitative
3 LEVELS OF HEALTH CARE
PRIMARY PREVENTION (Pre-pathogenesis)
1. Promotion and general or holistic health
• Nutrition and Exercise
• Stress management
2. prevention of specific diseases
• Vaccination and personal surveillance
• isolation/quarantine
3 LEVELS OF HEALTH CARE
SECONDARY PREVENTION (Pathogenesis)
1. Early detection
2. Immediate treatment of acute condition
• Medical intervention
3 LEVELS OF HEALTH CARE
TERTIARY PREVENTION (Post-pathogenesis)
1. Rehabilitation
• Optimize the client’s remaining function
• Delay the complication
2. Palliation
• Promote comfort
Three levels of health care services

•Primary Level of Care


•Secondary Level of Care
•Tertiary Level of Care
Secondary
Primary
Emergency/District
Barangay Health
Hospitals
Station
Provincial City Tertiary
Rural Health Units
Health Services National Health
Community
Provincial/City Services Medical
Hospitals and
Hospitals Centers Tertiary
Health Centers
Regional Health Teaching and
Private Training Hospital
Services
Practitioners/
Regional Medical
Puericulture
Centers and
Centers
Training Hospitals
REFERRAL SYSTEM:

BHS→ RHU→ MHO→ PHO→


RHO→ National Agencies→
Specialized Agencies
COMMUNITY HEALTH NURSING: AN OVERVIEW

What is a community?
•a group of people with common characteristics
or interests living together within a territory or
geographical boundary
•place where people under usual conditions are
found
CLASSIC CONCEPT OF HEALTH

WHO (1995)

"Health is a state of complete physical,


mental and social well-being and not merely
the absence of disease or infirmity."
Modern concept of health
OLOF
•OPTIMUM LEVEL OF FUNCTIONING OF
INDIVIDUALS, FAMILIES, AND COMMUNITIES
What is community health?
•part of paramedical and medical
intervention/approach which is concerned on
the health of the whole population
aims:
1. health promotion
2. disease prevention
3. management of factors affecting health
What is nursing?
assisting sick individuals to become healthy and
healthy individuals achieve optimum wellness
What is Community Health Nursing?
“The utilization of the nursing process in the
different levels of clientele- individuals, families,
population groups and communities, concerned
with the promotion of health, prevention of
disease and disability and rehabilitation.”
- Maglaya, et al
Community Health Nursing: goal

•To raise the level of health of the citizenry by


helping communities and families to cope with
the discontinuities in and threats to health in
such a way as to maximize their potential for
high-level wellness.
BASIC PRINCIPLES OF CHN
• The community is the patient in CHN, the family is
the unit of care and there are four levels of
clientele:
• IFPC
•*individual, family, *population group,
and the community.
• In CHN, the client is considered as an ACTIVE
partner NOT PASSIVE recipient of care
BASIC PRINCIPLES OF CHN
•CHN practice is affected by developments in
health technology, in particular, changes in
society, in general
•Health education is the primary responsibility of
the community health nurse.
•CHN is a part of health care system and the
larger human services system.
What is PUBLIC Health?
• SCIENCE AND ART OF PREVENTING DISEASE,
PROLONGING LIFE, PROMOTING HEALTH and efficiency
through organized community effort for the sanitation of the
environment, control of communicable diseases, the education of
individuals in personal hygiene, the organization of medical and
nursing services for the early diagnosis and preventive treatment
of disease, and the development of social machinery to ensure
everyone a standard of living adequate for the maintenance of
health, so organizing these benefits as to ENABLE EVERY
CITIZEN TO REALIZE HIS BIRTHRIGHT TO HEALTH
AND LONGEVITY
-Dr. C. E. Winslow
CHN VS PHN
Public health nursing refers to the practice of nursing
in national and local government health departments
(which include health center and rural health units),
and public schools.
It is COMMUNITY HEALTH NURSING PRACTICES IN
THE PUBLIC SECTOR.

- Standards of Public Health Nursing in the Philippines


ROLES OF THE community HEALTH NURSE
•Clinician or health care provider
•Health Educator
•Coordinator and Collaborator
•Supervisor
•Leader and Agent Change
•Manager
•Researcher
PUBLIC HEALTH WORKERS (PHW)
PHW’s: are members of the health team who are professionals namely
• Medical Officer (MO)-Physician
• Public Health Nurse (PHN)-Registered Nurse
• Rural Health Midwife (RHM)-Registered Midwife-
• Dentist
• Nutritionist
• Medical Technologist
• Pharmacist
• Rural Sanitary Inspector (RSI)-must be a sanitary engineer
PRIMARY HEALTH CARE
• Essential health care based on practical, scientifically
sound and socially acceptable methods and technology
made universally accessible to individuals and families
in the community through their full participation and at
a cost that the community and country can afford to
maintain at every stage of their development in the
spirit of self-reliance and self-determination.
WHO, 1978
UNIT 2

CHAPTER 8
HOME CARE
HOME HEALTH NURSING/VISITING NURSE
•Includes the nursing services and products
provided to clients in their homes that are
needed to maintain, restore or promote their
physical, psychological, and social well-being.
HOSPICE NURSING
•Support and care for the dying person and
family.
•Delivered to clients who are terminally ill on
their own residence or a shelter.
ROLES OF THE HOME HEALTH NURSE
•HEALER
•CAREGIVER
•EDUCATOR
•ADVOCATE
ROLES OF THE HOME HEALTH NURSE
HEALER
• recognizes that most human beings value health, are
responsible and active participants in their health
maintenance and illness management, and desires
harmony and wholeness with their environment
• Holistic approach is essentially viewed in context of
their biological, emotional, social, cultural and
spiritual elements.
ROLES OF THE HOME HEALTH NURSE
CAREGIVER
•Conscientious application of nursing process to
care of the elders.
•Providing care, efficiency and best interest that
rob them of their existing independence
ROLES OF THE HOME HEALTH NURSE
EDUCATOR
•Formal and informal opportunities to share
knowledge, skills related to care of older adults.
•Educating others including normal aging,
pathophysiology, geriatric pharmacology and
resources.
ROLES OF THE HOME HEALTH NURSE
ADVOCACY
•includes aiding older adults in asserting their
rights and obtaining required services,
facilitating a community or other group’s effort
to affect change and achieve benefits for older
adults.
UNIT 2

CHAPTER 9
ELECTRONIC HEALTH RECORDS
AND INFORMATION
TECHNOLOGY
INFORMATICS
•Science of computer information systems.
•Use of information and technology to
communicate, manage knowledge, mitigate
error and support decision making

HEALTH INFORMATICS/Health information


technology
•Management of health care information using
computers
NURSING INFORMATICS
• Science of using computer information systems in the
practice of nursing.
• A speciality that integrates nursing science,
computer science and information science to
manage and communicate data, information, and
knowledge in nursing practice… to support patients,
nurses and other providers in their decision making
in all roles and setting”
NURSING INFORMATICS: Importance
•Created significant opportunities for nurses to be
aware of current information when making
decisions
•Created new roles for nurses and emphasized
the need for all nurses to become more
knowledgeable about health information
concepts
NURSING INFORMATICS: Importance
•Accelerated efforts to implement information
systems such as electronic health record
Electronic health record:
collection of all individual’s interactions with
the health care system that will be available
electronically to health care professionals
anywhere.
APPLICATION OF NURSING INFORMATICS
CLINICAL
PRACTICE

EDUCATION NURSING ADMINISTRATION


INFORMATICS

RESEARCH

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