1 Community Health Nursing

Community  Primary goal: Self-reliance; independence;

Health in the hands of the people.
 The community is the client/patient
 Primary Focus: Health promotion – Health
Education
 Basic Unit of Care: Family – Home visit
Characteristics of a community:  4 levels:
 Defined by geographic boundaries o Individual
 Made up of institutions organized into a social o Family
system o Population group
 With common or shared interest o Community
 Have an area with fluid boundaries within which
problems can be identified and solved
 Has a population aggregate Family as a client

Health Family
 Complete physical, mental and social well-being  Any two or more individuals who commit to live
and not merely the absence of infirmity (WHO) together or an extended period of time.
 Dynamic – Fluctuating from different patterns
Types of Family
either towards death or Optimum Level of
Functioning. 1. Nuclear – composed of a mother, father and a
child.
2. Dyad – Commonly in newly wed, without
Community Health children.
3. Extended – With relatives
 Intervention that is concerned on the health of
4. Blended – Ex: Step father; step mother
the whole population
5. Compound – Common for Muslim people
o Aims:
6. Co-habiting – Live in
 The promotion of health
7. Single parent – “Sumakabilang buhay,
 The prevention of disease
Sumakabilang bahay”
 The management of factors
8. Gay/Lesbian
affecting health
Different tasks of a Family

 Allocation of resources
Nursing
 Physical maintenance
 Assisting individual, sick or well, in the  Division of labor
performance of those activities contributing to  Socialization of family member
health or its recovery (or to peaceful death)  3Rs
 In such a way as to help him gain independence o Reproduction
as rapidly as possible. o Recruitment
o Release
 Maintenance of peace and order
Community Health Nursing  Placement of a member to a larger society
 Maintenance of motivation and morale
 The utilization of the nursing process in the
different level of clientele:
o Individuals
Home Visit
o Families
o Population Groups  Family-nurse contact, which allows the nurse to
o Communities assess the home and family situations.
 Goal:
Purpose of Home visit
o “To raise the level of citizenry by
helping communities and families to 1. To give nursing care
cope with the discontinuities in and 2. To assess living condition
threats to health in such a way as to 3. To give health teachings
maximize their potential for high level 4. To establish close relationship/between the
wellness” health agencies and the public
5. To make use of the inter-referral system
Basic Principles in CHN
Should:
 Philosophy: Worth and dignity of man
 Ultimate Goal: Raise the level of citizenry 1. Must have a purpose or objective

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2 Community Health Nursing

2. Should make use of all available information

about a patient
Reminders:
3. Should consider and give priority to needs of
clients 1. Avoid the use of insecticides
4. Should involve the clients 2. Use a clay pot, removed the cover, in low fire
5. Should be flexible 3. Use only the part being advocated
4. Follow accurate dosing
Steps in home visit
5. Use only one herbal plant per disease
1. Greet the patient and introduce yourself 6. Stop if no result after 2-3 doses, (+) adverse
2. State the purpose of the visit reaction
3. Observe the patient and determine the health
needs
4. Put the bag in a convenient place then proceed  Lagundi
to perform the bag technique o Use: AsCoF – Asthma Cough Fever
5. Perform nursing care needed and give health o Preparation:
teachings 1. For Asthma and cough
6. Record all important data, observation and care
rendered Age Dried Fresh
7. Make an appointment for a return visit Adult 4tbsp 6tbsp
7-12 2tbsp 3tbsp
2-6 1tbsp 1½
1. Boil the chopped leaves in 2 glasses
Community as a client
of water
Levels of Health Care Referral System 2. Wait for 15 minutes or until 1 glass
if left
 Primary Level:
3. Drink the decoction – “pinagkuluan”
o Caters: Simple cases and basic health
o Preparation:
care
 Headache
o Managed by: LGU spec: Mayor
1. Crush the leaves and apply on the
o Facilities: Barangay Health Station;
forehead.
Barangay Health Center; RHU
 Ulasimang Bato
 Secondary Level:
o AKA: Pansit-pansitan
o Caters: Common Medical and Surgical
o Preparation
procedure; Common laboratories
1. Boil the chopped leaves in 2
o Managed by: LGU spec: Governor
glasses of water
o Facilities: Provincial Hospital; District
2. Wait for 15 minutes or until 1
Hospital; Emergency Hospital glass if left
 Tertiary Level: 3. Divide the decoction into 3
o Caters: Advanced Procedures parts
o Managed by: DOH  Bawang
o Facilities: Regional Hospital; Medical o Use: Toothaches; hypertension
Centers; National Hospital; National o Preparation: For toothache:
Medical Centers; Specialty Hospital 1. Pound and place
o Preparation: For hypertension
Community Diagnosis 1. Fried, roasted, soaked in vinegar
 Bayabas
 It is a process by which a nurse collects data o Use: Antiseptic; washing of wounds;
about the community circumcision
2 Types of Community Diagnosis o Preparation:
1. Boil the chopped leaves in 2
 Comprehensive Community diagnosis glasses of water
o It aims to obtain general information 2. Wait for 15 minutes or until 1
about the community glass is left
 Problem Oriented Community Diagnosis 3. Apply 2 times a day
o Responds to a particular need  Yerba Buena
o Use: for all types of pain (body pain)

Halamang Gamot Age Dried Fresh

Adult 6tbsp 4tbsp
 RA 8423 – TAMA (Traditional and Alternative 7-12 3tbsp 2tbsp
Medicine Act)
 10 DOH approved
o Preparation:

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1. Boil the chopped leaves in 2  LOI 949 – Legel basis of PHC

glasses of water o Signed by Former President Ferdinand
2. Wait for 15 minutes or until 1 Marcos
glass is left
3. Divide the decoction into 2
parts and drink every 3 hours  Vision:
 Sambong o Achieve health in the hands of the
o Use: Anti-edema; diuretic; kidney people
problems  Mission:
o Preparation: o To increase the opportunity where
people can manage their own health.
Age Dried Fresh
Adult 4tbsp 6tbsp
7-12 2tbsp 3tbsp
1. Boil the chopped leaves in 2 glasses 2 Core Principles
of water 1. Partnership with the people
2. Wait for 15 minutes or until 1 glass 2. Empowerment
is left o Transfer of:
3. Divide the decoction into 3 parts  Knowledge
 Akapulko  Skills
o Use: Anti-fungal; ringworms; athlete’s  Attitude
foot; scabies
o Preparation:
1. Pound the leaves 4 Pillars (AIUS)
2. Apply to the affected area
 Niyog-niyogan 1. Active community participation
o Use: Anti-helminthic; intestinal worms 2. Inter and Intra sectoral linkage
o Preparation: a. Inter: outside HCS
b. Intra: within HCS
Age Number of seeds 3. Use of appropriate technology
Adult 8-10 seeds 4. Support mechanism made available
7-12 6-7 seeds
6-7 5-6 seeds
4-5 4-5 seeds
Characteristics of Primary Health Care (CASASA)
o Take it 2 hours after meal
 Tsaang gubat 1. Community-based
o Use: GI problems 2. Accessible (w/in 3-5 kilometers)
o Preparation: 3. Sustainable
4. Affordable – low cost
Age Dried Fresh 5. Self-reliance
Adult 10tbsp 12tbsp 6. Available
7-12 5tbsp 6tbsp
2-6 2 ½ tbsp 3tbsp
1. Boil the chopped leaves in 2 glasses
Tetanus Toxoid Immunization
of water
2. Wait for 15 minutes or until 1 glass  To prevent tetanus
is left  To prevent neonatal tetanus to newborn
3. Divide the decoction in 4 parts and  2 doses to protect neonate
drink every 3 hours 
 Ampalaya
o Use: To lower the blood sugar level
(DM2)
o Preparation:
1. Boil 6tbsp of young leaves into 2
glasses
2. Wait for 15 minutes or until 1 glass
is left
3. Divide the decoction into 3 parts

Primary Health Care Expanded Program Immunization

 WHO (1970)  PD 996 (1976)
o Alma Ata Conference – USSR

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o Oldest EPI law

o All children below 8yrs old shall receive
free vaccines

 RA 10152 (2011)  Organization/Building phase/Activity phase

o Mandatory Immunization Law 1. Forming of Organization
o All children below 5yrs old shall receive a. Plan for the problem
free vaccines 2. Election of officers (Formalized leaders)
3. Training and teambuilding
4. Planning for solution

 Action Phase
o Implementation
 Mobilization
 Ground working

 Sustenance and Strengthening

phase/Maintenance
o Continue education and training
COPAR (sustenance)
o Build short- and long-term goals and
 A community development approach that
objectives (strengthening)
allows the nurse to systematically analyze plan,
and solve the community problem
 Turn Over/Phase-out
Basic Concepts and Principles of Community o Documentation
Organizing o Follow-up – once a year
o Dissemination
1. Based on concrete analysis of actual
situation
2. Basic trust on people
3. By, for, of, with, and among the people
4. Anyone is capable of change
5. Self-willed changes over imposed changes

Phases of COPAR

 Pre-Entry Phase
1. Site selection
2. Courtesy call – Mayor
a. Respect
b. Safety
3. Preliminary social investigation – more on
observation
4. Selection
 Entry Phase
1. Courtesy call – Barangay Captain
a. Respect
b. Safety
2. Deepening social investigation – identifying
present needs
3. Immersion/Integration
4. Look for potential leaders
a. Desire for change
5. SALT – Self-awareness and Leadership
Training
 Community Diagnosis/Study
1. Selection of Research Team
a. PIE Chart – 3-5 categories
b. BAR Chart - >5 categories
2. Data collection, analysis, presentation
3. Problem prioritization

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