Meaning of WHO
WORLD HEALTH ORGANIZATION
Primary role of WHO
to direct and coordinate international health
within the United Nations system.
WHO Headquarters
Celebrated every year as World
Health Day
Geneva, Switzerland
April 07, 1948
Mandated the devolution of health
services to the local government RA 7160
Shared vision among WHO and
member states triple billion
SDG
Virus's widespread distribution,
COVID-19 infections
high income countries
Main functions of WHO
direct, coordinate, and collaboration
World's leading cause of death
from single infectious agent
TB
Year has been designated as the
International Year of Health and
Care Workers
2021
SDG meaning
Sustainable Development Goals
WHO Triple Billion targets
One billion more people benefit from universal
health coverage;
one billion more people are better protected
from health emergencies,
and One billion more people are enjoying
better health and wellbeing.
most affected region of COVID19
Americas and the European Region
HICs
high-income countries
COVID-19 cases to date appear to
be concentrated predominantly in HICs
more common among people who
lived in uncrowded households
Regular daily handwashing practices
LE
life expectancy
HALE
LE and HALE among ___ were
consistently higher than ___
healthy life expectancy
DALYs
Disability Adjusted Life Years
YLD
Years Lived with Disability
___ and ___ have both dropped
out og the top 10 global causes of
death in 2019
remains the world’s leading
cause of death from a single
infectious agent.
have been reduced by 40% since
the peak in 1998
The ___ mortality rate has been
more than halved
females;males
HIV/AIDS and tuberculosis
Tuberculosis (TB)
HIV infections
malaria
UHC
one of the targets the nations of
the world set when adopting the
SDGs in 2015
Universal health Coverage
SCI
service coverage index
responded heroically since the
pandemic began
International Year of Health and
Care Workers
density of health workers is the
lowest in the WHO ___Region,
with just ___ doctors per 10 000
population and ___
nursing/midwifery personnel per
10 000 population.
UHC
global health workforce
2021
African;3;10
83% of global births were assisted
by ___, including medical doctors,
nurses and midwives.
skilled birth attendants
people who respond to both
emergencies and everyday needs. frontline health professionals
holds the over-all technical
authority on health as it is a
national health policy-maker and
regulatory institution
DOH| DEPARTMENT OF HEALTH
DOH Mission
To lead the country in the development of a
productive, resilient, equitable
and people-centered health system
DOH Vission
Filipinos are among the healthiest people in
Southeast Asia by 2022, and Asia by 2040
DOH Roles in the Health SectoR
(1) leadership in health;
(2) enabler and capacity builder; and
(3) administrator of specific services
To develop national plans, technical standards,
and guidelines on healt
DOH Mandate
The Philippines has a ___
healthcare system that operates
within a fragmented environment. mixed public-private
The ___ sector caters to only about
30 percent of the population but is
far larger than the ___system in
terms of financial resources and
staff
PRIVATE;PUBLIC
created the Philippine Health
Insurance Corporation (PhilHealth)
to provide health insurance
coverage for all Filipinos but
enrolmentwas not made
compulsory.
National Health Insurance Act of 1995
PhilHealth
Philippine Health Insurance Corporation
(NHIP)
national health insurance program
The National Health Insurance Act
of 1995 created the Philippine
Health Insurance Corporation
(PhilHealth) to provide health
insurance coverage for all Filipinos
but enrolment was not made
compulsory. In 2013, it was
amended, expanding the
contribution based national health
insurance program (NHIP) beyond
formal employment to include
the(6)
.
The ___ serves as the over-all
steward and technical authority on
health being the national health
policy-maker and
regulatory institution.
It is mandated to develop national
plans, technical standards, and
guidelines on health.
underprivileged, sick, elderly, persons with
disabilities (PWDs) and women and children
DOH
DOH
It is also in charge of licensing
hospitals, laboratories and other
health facilities through the
(HFSRB), and health products
through the (FDA)
regulates and supervises the
operations of private insurance
companies
Health Facilities and Service Regulatory Bureau
Food and Drug Administration
MMR
Measles, Mumps, and Rubella
(NTPS)
National TB Prevalence Survey
Insurance Commission (IC)
leading causes of mortality in the
Philippines in 2016 consisted of
non-communicable diseases
(NCDs) like(7)
Several NCDs share common
lifestyle-related risk factors (7)
remained to be the top leading
cause of death in the country,
followed by cancer and
pneumonia.
included in the top 10 leading
causes of death for males in 2016
are also susceptible to risks
brought by the increasing impact
of globalization and climate
change,
Philippines ranking ___ in the
world in terms of exposure to
disaster risks
ischemic heart disease, neoplasms or cancer,
cerebrovascular diseases or stroke,
hypertensive diseases, diabetes and other
heart diseases,
cigarette smoking, hypertension,
hyperglycemia, dyslipidemia, obesity, physical
inactivity and poor nutrition
Ischemic heart disease
assault
Filipinos
third
flooding can increase transmission
of certain diseases such as ___and
___, while power cuts may disrupt
water treatment and supply,
exposing the population to the risk
of ___
leptospirosis; dengue; water-borne diseases
is the science and art of (1)
preventing disease, (2) prolonging
life, and (3) promoting health and
efficiency through organized
community effort for:
1. sanitation of the environment,
2. control communicable
infections,
3. education of the individual in
personal hygiene,
4. organization of medical and
nursing services for the early
diagnosis and preventive
treatment of disease, and
5. development of the 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 of health and
longevity.―(Hanlon)
Public health
term used to describe the state of
health and how easy or difficult it
is to be healthy where people live,
learn, work and play.
Community Health
A component or subset of CHN
PUBLIC HEALTH NURSING
The synthesis of public health and
nursing practice
PUBLIC HEALTH NURSING
Defined as the field of professional
practice in nursing and in public
health in which technical nursing,
interpersonal, analytical, and
organizational skills are applied to
problems of health as they affect
the community. These skills are
applied in concert with those of
other persons engaged in health
care, through comprehensive
nursing care of families and other
groups and through measures for
evaluation or control of threats to
health, for health education of the
public and for the mobilization of
the
public for health action. (Freeman,
1963)
The practice of promoting and
protecting the health of
populations using knowledge from
nursing, social and public health
sciences (ANA; American Public
Health
Association, 1996)
Population-focused, with the goals
of the promoting health and
preventing disease and disability
for all people through the creation
of conditions in which people can
be
healthy.(ANA, 2007)
ynthesis of nursing practice and
public health practice applied to
promoting and preserving health
of the populations
broader and more general
specialty area that encompasses
subspecialties that include public
health nursing, school nursing,
occupational health nursing, and
other developing fields of practice,
such as home health, hospice care,
and independent
nurse practice―
PUBLIC HEALTH NURSING
PUBLIC HEALTH NURSING
PUBLIC HEALTH NURSING
COMMUNITY HEALTH NURSING
COMMUNITY HEALTH NURSING
Safe and Quality Nursing Care
Management of resources and environment
Health Education
Legal Responsibility
Ethicomoral Responsibility
Personal and Professional Development
Quality Improvement
Research
Records Management
STANDARDS OF PUBLIC HEALTH
Communication
NURSING IN THE PHILIPPINES (11) Collaboration and Teamwork
knowledge of health/illness status
of the client, sound decision
making; safety, comfort, privacy,
administration of meds and health
therapeutics and nursing process Safe and Quality Nursing Care
- organization of workload; use of
financial resources for client care;
mechanism to ensure proper
functioning of equipment and
maintenance of a safe
environment
Management of resources and environment
- assessment of client’s
learning needs; development of
health education plan and learning
materials and implementation and
evaluation of health education
plan
Health Education
#NAME?
- respect for the rights of the
client; responsibility and
accountability for own decisions
and actions; and adherence to the
international and
national codes of ethics for nurses
- identification of own learning
needs, pursuit of continuing
education; involvement in
professional image; positive
attitude towards change and
criticism
- data gathering for quality
improvement; participation in
nursing rounds; identification and
reporting of solutions to identifies
problems related to client
care.
#NAME?
- accurate and updated
documentation of client care while
observing legal imperatives and
record keeping
Legal Responsibility
Ethicomoral Responsibility
Personal and Professional Development
Quality Improvement
Research
Records Management
- uses therapeutic communication
techniques, identifies verbal and
nonverbal cues, responds to client
needs, while using formal and
informal channels of
communication and appropriate
information technology
Communication
#NAME?
Franciscan Friar Juan Clemente
opened medical dispensary in
Intramuros for the indigent
Collaboration and Teamwork
___ opened medical dispensary in
Intramuros for the indigent
Franciscan Friar Juan Clemente
1577
___ worked toward installing a
water system in San Juan del
Monte and Manila
Dominican Father Juan de Pergero
Dominican Father Juan de Pergero
worked toward installing a water
system in San Juan del Monte and
Manila
smallpox vaccination was
introduced by Francisco de Balmis ,
the personal physician of King
Charles IV of Spain
smallpox vaccination was
introduced by
Francisco de Balmis
the personal physician of King
Charles IV of Spain
Francisco de Balmis
Francisco de Balmis , the personal
physician of
King Charles IV of Spain
first medicos titulares were
appointed by the Spanish
government
medicos titulares
2-year courses consisting of
fundamental medical and dental
subjects was first offered in the
University of Santo Tomas.
Graduated were known as
“cirujanos inistrantes―and
serve
as male nurses and sanitation
inspectors
2-year courses consisting of
fundamental medical and dental
subjects was first offered in the
___.
2-year courses consisting of
fundamental medical and dental
subjects was first offered in the
University of Santo Tomas.
Graduated were known as
“___―and serve
as male nurses and sanitation
inspectors
1690
1805
1876
medical doctors
1888
University of Santo Tomas
cirujanos ministrantes
United States Philippines
Commission, through Act 157,
created the Board of Health of the
Philippine Islands with a
Commissioner of the Public Health
,as its chief executive officer
(now the Department of Health)
1901
created sanitary divisions made up
of one to four municipalities. Each
sanitary division had a president
who had to be a physician
Fajardo Act of 1912
he Philippine General hospital
began to extend public health
nursing services in the homes of
patients by organizing a unit called
Social and Home Care services
1915
Lagota de Leche was the first
center dedicated to the service of
the mothers and babies
Asociacion Feminista Filipina (1905)
the first women’s club in the
Philippines, dedicated to the
promotion of social welfare and
the encouragement of the
participation of women in public
affairs. It was founded by
Concepcion Felix de Calderon, in
collaboration with Trinidad Rizal,
Clemencia Lopez, Bonifacio
Delgado De Barretto, Maria
Arevalo, Sofia Reyes, Helen
Wilson, Paz Natividad, Maria de
Villamor, Teresa Solis, Agueda and
Jacoba Paterno.
Asociacion Feminista Filipina
the Department of Health was
reorganized into bureaus:
quarantine, hospitals that took
charge of the municipal and charity
clinics and health with the sanitary
divisions under it.
1947
Congress passed RA 1082 or the
Rural Health Act that provided the
creation of RHU in every
municipality
AN ACT STRENGTHENING HEALTH
AND DENTAL SERVICES IN THE
RURAL AREAS, AND PROVIDING
FUNDS THEREFOR.
Rural Health Act
enacted in 1957 amend certain
provisions in the Rural Health Act
Created 8 categories of rural
health units corresponding to the
population size of the
municipalities
1954
RA 1082
RA 1082
RA 1891
enacted in 1991, amended that devolution of
basic health services including health services,
to local government units and the
establishment of a
local health board in every province and city of
RA 7160 (Local Government Code) municipality
– adopted during the world summit in
Millennium Development Goals
September 2000
aims to achieve the health system
goals of better health outcomes,
sustained health financing, and
responsive health system that will
provide equitable access to
health care
Universal Health Care
Programmer/Planner
Health Educator/Trainer/ Counsellor
Community Organizer
Coordinator of services
Provider of Nursing Care
Health Monitor
Researcher
ROLES AND RESPONSIBILITIES OF A Statistician
COMMUNITY HEALTH NURSE (9) Change Agent
• Identifies the needs and
concerns of individuals, groups,
families, and the community
• Formulates health plans,
especially in the absence of a
community physician
• Interprets and implements
nursing plans and programs
• Assists other health team
members in implementing health
programs in the
Programmer/Planner
• Acts as resource speaker on
health and health-related services
• Advocates health programs in
the community through
dissemination of IEC or
Information Education and
Communication materials
• Conducts advocacy educations
concerning premarital,
breastfeeding, and immunization
counsellings
• Organizes orientation/ training
of concerned groups like pregnant
mothers
• Identifies and interprets
training needs of health team
members and formulate
appropriate training program for
them
• Conducts and facilitates
necessary training or educational
orientation to other health team
members in the community
Health Educator/Trainer/ Counsellor
• Promotes self- reliance of
community and emphasizes their
involvement and participation in
planning, organizing,
implementing and evaluating of
health services
• Initiates and implements
community development activities Community Organizer
• Coordinates health services
with concerned individuals and
families through the community
health team members,
government organizations and
nongovernment organizations
• Coordinates nursing plans and
programs with other health
programs
Coordinator of services
• Renders direct care to various
clients with different needs, may it
be at home, in school, clinics or
work settings
• Involves the family in the care
of the sick or dependent individual,
i.e., sick
child
Provider of Nursing Care
• Monitors and detects the
presence of health concerns in the
community through contacts or
home visits.
• Utilizes various effective data
gathering techniques in keeping an
eye on the health status of all
recipients of care.
• Records and reports health
status and presence of health
problems in thecommunity
Health Monitor
• Follows a systematic process
of monitoring the health status of
the community through the
conduct of surveys and home visits
• Conducts researches
concerning the health of the
community
• Coordinates with government
and non- government
organizations in theconduct and
implementation of studies
Researcher
• Records data systematically
and ensures its validity through
accurate and complete data
gathering
• Reports prepared reports to
concerned organizations i.e.
government organization for
immediate necessary plans or
programs
• Consolidates and reviews
reports efficiently.
• Analyzes and interprets
consolidated data for monitoring
the development in
the health matters of the whole
community
• Promotes and motivates
change in the community in their
health practices and lifestyle
behaviors for them to promote
and maintain good health, be
knowledgeable and has the
initiative in accessing health
services
• Inculcates self- reliance to
brought about development and
improvement in the
community
Statistician
Change Agent
The main focus of community
health nurse is health promotion.
The recipient of care of community
public health nursing practice is
extended not only to the individual
but also to benefit the whole
family and community.
Community health nurses are
generalists in terms of their
practice through life’s
continuum.
Continuity of care with the client,
family or and the community
extends for a longer time involving
individuals of all ages and health
needs.
The nature of nursing practice in
the community needs the
knowledge of biological and social
sciences, ecology, clinical nursing,
and community organizing, for it to
be effective.
This field of nursing practice
utilizes a dynamic process
(assessment, planning,
implementation, and evaluation)
in the provision of continuous care
until termination is implicit.
Programmer/Planner
Health Educator/Trainer/ Counsellor
Community Organizer
Coordinator of services
Provider of Nursing Care
Health Monitor
Researcher
Statistician
Change Agent
MDG’s
Millennium Development Goals
On September 6 to 8, 2000, world
leaders on UN General Assembly
participate in ___.
Millennium Summit
1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower
women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other
diseases
7. Ensure environmental sustainability
Millennium Development Goals (8) 8. Global partnership for development
The following are the eight
MDG’s and the targets
corresponding to healthrelated
MDG’s __,__, and __
4,5, and 6
Reduce child mortality. Target:
reduce by 2/3, between 1990 and
2015, the under-five mortality
rate.
Improve maternal health. Target:
a. Reduce by three quarters the
maternal mortality ratio
b. Achieve universal access to
reproductive health
4
5
Combat HIV/AIDS, malaria and
other diseases. Targets:
a. Have halted by 2015 and begun
to reverse the spread of HIV/AIDS
b. Achieve by 2010, universal
access to treatment for all those
who need it
c. Have halted by 2015, and begun
to reverse the incidence of
malaria and other major diseases.
End poverty and all its forms
everywhere
End hunger, achieve food security
and improved nutrition and
promote sustainable agriculture
Ensure healthy lives and promote
well-being for all at all ages
Ensure inclusive and equitable
quality education and promote
lifelong learning opportunities for
all
Achieve gender equality and
empower all women and girls
Ensure availability and sustainable
management of water and
sanitation for all
Ensure access to affordable,
reliable, sustainable and modern
energy for all
Promote sustained, inclusive and
sustainable economic growth, full
and productive employment and
decent work for all
Build resilient infrastructure,
promote inclusive and sustainable
industrialization and foster
innovation
Reduce inequality within and
among countries
Make cities and human
settlements inclusive, safe,
resilient and sustainable
Ensure sustainable consumption
and production patterns
Take urgent action to combat
climate change and its impacts
6
GOAL 1
GOAL 2
GOAL 3
GOAL 4
GOAL 5
GOAL 6
GOAL 7
GOAL 8
GOAL 9
GOAL 10
GOAL 11
GOAL 12
GOAL 13
Conserve and sustainably use the
oceans, seas and marine resources
for sustainable development
Protect, restore and promote
sustainable use of terrestrial
ecosystems, sustainably manage
forests, combat desertification,
and halt and reverse land
degradation and halt
biodiversity loss
Promote peaceful and inclusive
societies for sustainable
development, provide access to
justice for all and build effective,
accountable and inclusive
institutions at all levels
Strengthen the means of
implementation and revitalize the
global partnership for sustainable
development
Medicos Titulares
GOAL 14
GOAL 15
GOAL 16
GOAL 17
BEFORE 1898
Hospital system with 13 hospitals BEFORE 1898
Central Board of Vaccination &
Board of Health and Charity
BEFORE 1898
Department of Public Works,
Education and Hygiene
Board of Health for the City of
Manila
Abolishment of Board of Health
Registration of births, deaths, and
marriages
Insular Board of Health
Provincial and municipal health
boards
Abolishment of the Insular Board
of Health
Insular Board of Health
District health officers, instead of
provincial health boards
Fajardo Act
Consolidated municipalities into
sanitary divisions
Bureau of Health renamed and
became Philippine Health Service
1898
1898
1899
1899
1901
1905
1906
1912
1915
Office of the Commissioner of
Health and Public Welfare
Formalized the Department of
Health and Public Welfare
Reorganization and renaming of
the Department of Health and
Public Welfare into Department of
Health
Second Reorganziation of the
Department
Decentralization of health services
Creation of 8 regional health
offices
Philippine Medical Care Act of
1969
Restructured Health Care Service
Delivery: Primary, secondary,
tertiary levels
Renamed into Ministry of Health
Additional four regional health
offices
Creation of the Integrated
Provincial Health Office and Health
Education and Manpower
Development Service
Renamed back to Department of
Health
Additional three regional offices
(NCRCAR& ARMM)
National Health Facilities
1986-19867
Office of Health Facilities
Standards, and Regulation
Intensified programs: Doctors to
the Barrios National Micronutrient
Campaign& "Let's DOH it
1991-1993
Health Sector Reform Agenda
(HSRA) of the Philippines 19992004
Inational Objectives for Health
1999-2004
HSRA as the major framework for
health policies and investments
1932
1941
1947
1950
1958
1969
1970
1972
1982
1999
2000
HSRA
Health Sector Reform Agenda
Guidelines on the HSRA
implementation plan with 13
convergence sites
One-Script Systems
Improvement Program
68 DOH-retained hospitals
provided with fiscal autonomy
FOURmula ONE for Health (F1) as
blueprint of reform
National and international
recognitions from the Presidential
Anti-Graft Commission and
Guinness World Records Limited
One-stop shop licensure system for
hospitals
Sector-wide Development
Approach for Health
Maternal, Neonatal, and Child
Health and Nutrition Strategy
(MNCHN)
Universally Accessible Cheaper
and Quality Medicines Act of 2008
Universal Health Coverage as the
new platform on health
Framework on Health Sector
Response to Terrorism
National Policy on Climate Chage
Adaptation for the Health Sector
Sin Tax Reform Law
Responsible Parenthood and
Reproductive Health Act
Food Safely Act
Malaria Elimination Hubs
Graphic Health Warnings Law
Service Delivery Networks for
Kalusugan Pangkalahatan
Universal Health Care-High Impact
Five (HI-5) Strategy for Hospitals
DOH Academy
2001
2003
2005
2006
2007
2008
2010
2011
2012
2013
2014
2015
Philippine Health Agenda 20162022
*All for Health towards Health for
All" Framework
Philippine National Standards for
Drinking Water of 2017
DOH quitline
Republic Act No. 7160
Maintenance of barangay health
center
Implementation of programs and
projects on primary health care,
maternal and child care, and
communicable and noncommunicable disease control
services;
Access to secondary and tertiary
health services
Purchase of medicines, medical
supplies, and equipment needed
to carry out the said services
Hospitals and other tertiary health
services
All the services and facilities of the
municipality and province
primary health services are
otherwise known as
2016
2017
Local Government Code of 1991
Barangay
Municipality
Province
city
basic health services
delivered at health centers or rural
health units (RHUs) and barangay6
health stations
primary health services/basic health services
medical services that are
accessible in some rural health
units, infirmaries, district hospitals,
and out-patient departments of
provincial
hospitals.
secondary health services
include medical and surgical
diagnostics, treatment, and
rehabilitative care that are usually
provided by medical specialists in a
hospital
setting
tertiary health services
a first contact health care facility
that offers basic service including
emergency services and provision
for normal deliveries
Primary Health Care Facility
health centers, out-patient clinics, and dental
clinics.
Without in-patient beds
a short-stay facility where the
patient spends on the average of
one to two days before discharge. With in-patient beds
With in-patient beds
Infirmaries and birthing (Lying-in) facilities.
a health facility that provides longterm care, including basic services
like food and shelter, to patients
with chronic conditions requiring
ongoing health and nursing care
due to impairment and a reduced
degree of independence in
activities of daily living, and
patients in need of rehabilitation. Custodial Care Facility
substance/drug abuse treatment
and rehabilitation centers,
sanitaria, leprosaria, and nursing
homes
Custodial Care Facility
a facility for the examination of the
human body, specimens from the
human body for the diagnosis,
sometimes treatment of disease or
water for drinking analysis. The
test covers the preanalytical,
analytical and post analytical
phases of examination.
Diagnostic/Therapeutic Facility
a facility that performs highly
specialized procedures on an
outpatient basis.
Specialized outpatient facility
Dialysis clinic, ambulatory surgical
clinic, cancer chemotherapeutic
center/clinic, cancer radiation
facility, and physical medicine and
rehabilitation
center/clinic.
Specialized outpatient facility
health centers
Primary Health Care Facility
out-patient clinics
Primary Health Care Facility
dental clinics
Primary Health Care Facility
Infirmaries
Primary Health Care Facility
birthing (Lying-in) facilities
Primary Health Care Facility
substance/drug abuse treatment
and rehabilitation centers
Custodial Care Facility
sanitaria,
Custodial Care Facility
leprosaria,
Custodial Care Facility
nursing homes
Custodial Care Facility
Dialysis clinic
Specialized outpatient facility
ambulatory surgical clinic
Specialized outpatient facility
cancer chemotherapeutic
center/clinic
Specialized outpatient facility
cancer radiation facility
Specialized outpatient facility
physical medicine and
rehabilitation center/clinic.
Specialized outpatient facility
RHU
Rural Health Unit
commonly known as health center Rural Health Unit
is a primary level health facility in
the municipality
Rural Health Unit
The focus of ___ is preventive and
promotive health services and the
supervision of BHSs under its
jurisdiction.
Rural Health Unit
BHS
first contact health care facility
that offers basic services at the
barangay level.
satellite station of the RHU
Barangay Health Station
BHW’s
Barangay Health Workers
BHS
BHS
BHS is manned by ___, under the
supervision of
Volunteer Barangay Health Workers
Rural Health Midwife
RHM
Rural Health Midwife
Who released the Philippine
Health Agenda 20162022 ?
President Rodrigo Duterte
In order to attain health-related
sustainable development goals,
the A.C.H.I.E.V.E. strategy is
followed
A- Advance quality, health promotion and
primary care,
C- Cover all Filipinos against health-related
financial risk,
H- Harness the power of strategic HRH
development,
I- Invest in eHealth and data for decisionmaking,
E- Enforce standards, accountability and
transparency,
V- Value all clients and patients, especially the
poor, marginalized, and vulnerable,
E- Elicit multi-sectoral and multi-stakeholder
support for
health
30th World Health Assembly
decided that the main health
target of the government and
WHO is the attainment of a level of
health that would permit them to
lead a socially and economically
productive life by the year 2000.
May 1977 First International Conference on
PHC in Alma Ata, Russia (USSR) The
Alma Ata Declaration stated that
PHC was the key to attain the
“health for all―goal
September 6-12, 1978
Letter of Instruction (LOI) 949, the
legal basis of PHC was signed by
Pres. Ferdinand E. Marcos, which
adopted PHC as an approach
towards the design, development
and implementation of programs
focusing on health development at
community level.
essential health care made
universally accessible to
individuals and families in the
community by means acceptable
to them, through their full
participation and at cost
that the community can afford at
every stage of development
a practical approach to making
health benefits within the reach of
all people.
an approach to health
development, which is carried out
through a set of activities and
whose ultimate aim is the
continuous improvement and
maintenance of health
status
October 19, 1979
Primary Health Care
Primary Health Care
Primary Health Care
HEALTH FOR ALL FILIPINOS by the year 2000
AND HEALTH IN THE HANDS OF THE PEOPLE by
the year 2020.
An improved state of health and quality of life
for all people attained through SELF
RELIANCE.
Goal of Primary Health Care
permeate as the core strategy in
the effective provision of essential
health services that are community
based, accessible,
acceptable, and sustainable, at a
cost, which the community and the Partnership with and Empowerment of the
government can afford.
people
• Improvement in the level of health care of
the community
• Favorable population growth structure
• Reduction in the prevalence of
preventable, communicable and other disease.
• Reduction in morbidity and mortality rates
especially among infants and children.
• Extension of essential health services with
priority given to the underserved sectors.
• Improvement in Basic Sanitation
• Development of the capability of the
community aimed at self- reliance.
• Maximizing the contribution of the other
sectors for the social and economic
Objectives of Primary Health Care development of the community.
Two Levels of Primary Health Care Barangay Health Workers
Workers
Intermediate level health workers
To strengthen the health care system by
increasing opportunities and supporting the
conditions wherein people will manage their
own health care.
Mission of Primary Health Care
trained community health workers
or health auxiliary volunteers or
traditional birth attendants or
healers.
Barangay Health Workers –
include the Public Health Nurse,
Rural Sanitary Inspector and
midwives.
Intermediate level health workers-
4 A’s
Accessibility,
Availability,
Affordability &
Acceptability,
Appropriateness of health services.
The health services should be
present where the supposed
recipients are. They should make
use of the available resources
within the community, wherein
the
focus would be more on health
promotion and prevention of
illness.
4 A’s
heart and soul of PHC
Community Participation
Barriers of Community
Involvement
Lack of motivation
Attitude
Resistance to change
Dependence on the part of community people
Lack of managerial skills
1. 4 A’s
2. Community Participation
3. Multi sectoral linkages
4. Use of technology
Principles of Primary Health Care
Is not merely the absence of
disease. Neither is it only a state of
physical and mental well-being.
Health-
being a social phenomenon
recognizes the interplay of
political, socio-cultural and
economic factors as its
determinant.
is manifested by the progressive
improvements in the living
conditions and quality of life
enjoyed by the community
residents
is the quest for an improved
quality of life for all.
is multidimensional. It has
political, social, cultural,
institutional and environmental
dimensions
it is measured by the ability of
people to satisfy their basic needs
Health
Good Health
Development-
Development
Development
s one of the potent methodologies
for information dissemination. It
promotes the partnership of both
the family members and health
workers in the promotion of
health as well as prevention of
illness.
Education for Health
he control of endemic disease
focuses on the prevention of its
occurrence to reduce morbidity
rate. Example Malaria Control and
Schistosomiasis Control
Locally Endemic Disease Control
This program exists to control the
occurrence of preventable
illnesses especially of children
below 6 years old. Immunizations
on poliomyelitis, measles, tetanus,
diphtheria and other preventable
disease are given for free by the
government and
ongoing program of the DOH
Expanded Program on Immunization
The mother and child are the most
delicate members of the
community. So the protection of
the mother and child to illness and
other risks would ensure good
health for the community. The goal
of Family Planning includes spacing
of childrenand responsible
parenthood.
Maternal and Child Health and Family Planning
The goal of ___ includes spacing of
children and responsible
parenthood.
Family Planning
Environmental Sanitation is
defined as the study of all factors
in the man’s environment,
which exercise or may exercise
deleterious effect on his well-being
and survival. Water is a basic need
for life and one factor in man’s
environment. Water is necessary
for the maintenance of healthy
lifestyle. Safe Water and
Sanitation is necessary for basic
promotion of health.
defined as the study of all factors
in the man’s environment,
which exercise or may exercise
deleterious effect on his well-being
and survival
a basic need for life and one factor
in man’s environment.
necessary for the maintenance of
healthy lifestyle
necessary for basic promotion of
health.
Environmental Sanitation and Promotion of
Safe Water Supply
Environmental Sanitation
Water
Water
Safe Water and Sanitatio
One basic need of the family is
food. And if food is properly
prepared then, one may be
assured healthy family. There are
many food resources found in the
communities but because of faulty
preparation and lack of knowledge
regarding proper food planning,
Malnutrition is one of the
problems that we have in the
country.
One basic need of the family
s one of the problems that we
have in the country
The diseases spread through direct
contact pose a great risk to those
who can be infected. Tuberculosis
is one of the communicable
diseases continuously occupies the
top ten causes of death. Most
communicable diseases are also
preventable. The Government
focuses on the prevention, control
and treatment of these
illnesses.
one of the communicable diseases
continuously occupies the top ten
causes of death.
This focuses on the information
campaign on the utilization and
acquisition of drugs.
Nutrition and Promotion of Adequate Food
Supply
food
Malnutrition
Treatment of Communicable Diseases and
Common Illness
Tuberculosis
Supply of Essential Drugs
n response to this campaign, the
GENERIC ACT of the Philippines is
enacted. It includes the following
drugs:
Cotrimoxazole,
Paracetamol,
Amoxycillin,
Oresol,
Nifedipine,
Rifampicin,
INH (isoniazid) and Pyrazinamide,
Ethambutol,
Streptomycin,
Albendazole,
Quinine
Elevating Health to a Comprehensive and
Sustained National Effort.
Promoting and Supporting Community
Managed Health Care
Major Strategies of Primary Health Increasing Efficiencies in the Health Sector
Care
Advancing Essential National Health Research
(ENHR)
Essential National Health Research
s an integrated strategy for
organizing and managing research
using intersectoral, multidisciplinary and scientific
approach to health programming
and delivery
Essential National Health Research
Four Cornerstones/Pillars in
Primary Health Care
Medicinal Plants for
Asthma, cough and colds, fever,
dysentery, pain
1. Active Community Participation
2. Intra and Inter-sectoral Linkages
3. Use of Appropriate Technology
4. Support mechanism made available
Lagundi - Decoction
Medicinal Plants for
Skin disease (scabies, ulcer,
eczema), wounds
Lagundi - Wash affected site with decoction
Medicinal Plants for
Headache, stomachache
Yerba Buena - Decoction
Medicinal Plants for
Cough and colds
Yerba Buena - Infusion
Medicinal Plants for
Rheumatism, Asthritis
Yerba Buena - Massage sap
Medicinal Plants for
Antiedema/antiurolithiasis
Sambong - Decoction
Medicinal Plants for
Diarrhea
Stomachache
Tsaang Gubat - Decoction
Medicinal Plants for
Antielminthic
Niyog-niyogan - Seeds are used
Medicinal Plants for
Washing wounds Diarrhea, gargle,
toothache
Bayabas - Decoction
Medicinal Plants for
Antifugal
Akapulko - Poultrice
Medicinal Plants for
Lowers blood uric acid
(rheumatism and gout)
Medicinal Plants for
Hypertension, lowers blood
cholesterol
Medicinal Plants for
Toothache
Medicinal Plants for
Diabetes mellitus (mild noninsulindependent)
boiling the plant material in water
for 20 min.
plant material is soaked in hot
water for 10 - 15 minutes.
directly apply plant material on the
affected part, usually in bruises,
wounds and rashes.
mix the plant material in alcohol.
Ulasimang Bato/ Pansit-pansitan Decoction/Eaten raw
Bawang - Eaten raw/fried
Bawang - Apply on part
Ampalaya - Decoction Steamed
DECOCTION
INFUSION
POULTRICE
TINCTURE
#NAME?
Acupressure
#NAME?
Acupuncture
this improves health by enhancing
the nutritional value to reduce the
risk of the disease
Nutritional therapy/nutritional healing
follows the principle of balancing
energy
Pranic Healing
application of pressure on the
body’s reflex joints to enhance
body’s natural healing.
Reflexology
activities enhance resources
directed at improving well-being.
ctivities protect people from
disease and effects of disease.
relates to activities directed at
preventing a problem before it
occurs by altering susceptibility or
reducing exposure for susceptible
individuals.
early detection and prompt
intervention during the period of
early disease pathogenesis.
-implemented after a problem has
begun but before signs and
symptoms appear and
targets populations who have risk
factors (Keller).
targets populations that have
experienced disease or injury and
focuses on limitations of disability
and rehabilitation.
-aims to reduce the effects of
disease and injury and to restore
individuals to their
optimum level of functioning.
Immunization
Health promotion
Disease prevention
Primary Prevention
Secondary Prevention
Tertiary prevention
Primary Prevention-
Screening for sexually transmitted
disease
secondary Prevention
Teaching insulin administration in
the home
Tertiary Prevention
also referred to as Kalusugan
Pangkalahatan (KP)
Universal Health Care
is the “provision to every
Filipino of the highest possible
quality of health care that is
accessible, efficient, equitably
distributed, adequately funded,
fairly financed, and
appropriately used by an informed
and empowered public―
Universal Health Care
UHC GOALS AND OBJECTIVES
1. Better health outcomes
2. Sustained health financing, and
3. A responsive health system by ensuring that
all Filipinos, especially the disadvantaged
group, have equitable access to affordable
health care.
1. Financial risk protection through expansion
in NHIP enrollment and benefit delivery
The attainment of the goal of UHC 2. Improved access to quality hospitals and
is through the pursuit of three
health care facilities
strategic thrusts:
3. attainment of the health-related MDGs
instrument to increase resources
for health that will be effectively
allocated and utilized to improve
the financial protection of the poor
and the vulnerable
sectors.
Health financing
instrument to transform the health
service delivery structure to
address variations in health service
utilization and health outcomes
across socioeconomic
variables
Service delivery
instrument to ensure equitable
access to health services, essential
medicines, and technologies of
assured quality, availability and
safety.
Policy, standards, and regulation
instrument to establish the
mechanisms for efficiency,
transparency, and accountability,
and prevent opportunities for
fraud.
Governance for health
nstrument to ensure that all
Filipinos have access to
professional health care providers
the appropriate level of care.
Human resources for health
instrument to establish a modern
information system that shall:
a. Provide evidence for policy and
program development;
b. Support for immediate and
efficient provision of health care
and management of
province-wide health systems.
Health information
PUBLIC HEALTH PROGRAMS
Reproductive and maternal health:
Expanded Garantisadong Pambata (child
health)
Control of communicable disease
control of noncommunicable or lifestyle
diseases
Environmental health
pre-pregnancy services and care
during pregnancy, delivery, and
postpartum period
Reproductive and maternal health
advocacy for exclusive
breastfeeding in the first 6 months
of life, newborn screening
program, immunization, nutrition
services, and
integrated management of
childhood illness
a group of persons usually living
together and composed of the
head and other persons related to
the head by
blood, marriage, or adoption.
a social unit interacting with the
larger society
characterized by people together
because of birth, marriage,
adoption or choice
a two or more persons who are
joined together by bonds of
sharing and emotional closeness
and who identify themselves as
being part of the family
husband, wife, and their
immediate children-natural,
adopted or both
Expanded Garantisadong Pambata (child health
family
family
family
family
Nuclear Family
husband and wife
Dyad Family
consist of three
generations—married sibling, or
grandparents
Extended Family
one or both spouses brings a child
or children from previous marriage
into one living arrangement
where a man has more than one
spouse
live-in arrangement between an
unmarried couple
results from a death of spouse,
separation or pregnancy outside of
wedlock
Blended Family
Compound Family
Cohabiting Family
Single Parent
cohabiting couple of the same sex The Gay or Lesbian Family
PROCREATIONSOCIALIZATION OF FAMILY MEMBERS
STATUS PLACEMENT
ECONOMIC FUNCTION
PHYSICAL MAINTENANCE
WELFARE AND PROTECTION
FUNCTIONS OF THE FAMILY
Despite the changing forms of the
family, it has remained the
universally accepted institution for
reproductive functions and child
rearing.
PROCREATIONSocialization is the process of
learning how to become
productive members of society. It
involves transmission of the
culture of a
social group
SOCIALIZATION OF FAMILY MEMBERS
Society is characterized by a
hierarchy of its members into
social classes. The family confers
it’s societal rank on the
children. Depending on the degree
of social mobility in a society, the
family and the children’s future
families may
move from one social class to
another
STATUS PLACEMENT
Observes that the Rural Family is a
unit of production where the
whole family works as a team
participating in farming, fishing, or
cottage industries.
ECONOMIC FUNCTION
more of a unit of consumption
where economically productive
members work separately to earn
salaries
or wages.
Urban Family
The family provides for the survival
need (food, shelter, and clothing)
of its dependent members, like
young children and the aged.
PHYSICAL MAINTENANCE
The family supports spouses or
partners by providing for
companionship and meeting
affective, sexual, and
socioeconomic needs. By
developing a sense of love and
belonging, the family gives the
children emotional
gratification and psychological
security
WELFARE AND PROTECTION
1. The family is a critical resource.
2. In a family unit, and dysfunctions (like illness,
injury, separation) that affects one or more
family members will affect the members and
unit as a whole.
3. “Case finding―is another reason to work
with families.
4. Improving nursing care.
Reasons it is important for the
nurses to work with families:
In a family unit, and dysfunctions
(like illness, injury, separation) that
affects one or more family
members will affect the members
and unit as a whole.
ripple effect
It is way to explain how the family
as a unit interacts with larger units
outside the family and with
smaller units inside the family.
General System Theory
Three Subsystem of the Family
Parent-Child Subsystem
Marital Subsystem
Sibling-sibling Subsystem
Stages and tasks of the family life
cycle
Marriage
Families with young children
Families with adolescents
Families as launching centers
Aging Families
1. Formation of identity as a
couple
2. Inclusion of spouse in
realignment of relationships with
extended families
3. Parenthood: making decisions Marriage
1. Integration of children into
family unit
2. Adjustment of tasks: child
rearing, financial and household
3. Accommodation of new
parenting and grandparenting
roles
Families with young children
1. Development of increasing
autonomy for adolescents
2. Midlife reexamination of marital
and career issues
3. Initial shift towards concern for
the older generation
Families with adolescents
1. Establishment of independent
identities for parents and grown
children
2. Renegotiations of marital
relationship
3. Readjustment of relationships to
include in-laws and grandchildren
4. Dealing with disabilities and
death of older generation
Families as launching centers
1. Maintaining couple and
individual functioning while
adapting to the aging process
2. Support role of middle
generation
3. Support and autonomy of older
generation
4. Preparation for own death and
dealing with loss of spouse and/or
siblings and other peers
Aging Families
The first ___ is providing its
members with means for health
promotion and disease prevention.
Breastfeeding an infant, a healthy
diet for older family members,
bringing a young child to the
health center for immunizations,
and teaching a child about
proper handwashing are a few
examples of family health task
family health task
• Recognizing interruptions of health or
development.
• Seeking health care.
• Managing health and nonhealthy crisis. The
family’s ability to cope with crisis and
develop from its experience is an indicator of a
healthy family.
• Providing nursing care to sick, disabled or
dependent family members of the family
• Maintaining a home environment
conducive to good health and personal
development. The home should also have an
atmosphere of security and comfort to allow
for psychosocial development.
• Maintaining a reciprocal relationship with
Health Tasks according to Freeman the community and it’s health
and Heinrich
institutions.
• Members interact with each other; they
communicate and listen repeatedly in many
contexts
• Healthy families can establish priorities.
Members understand that family needs are
priority
• Healthy Families affirm, support, and
respect each other.
• The members engage in a flexible role
relationships, share power, respond to change,
support the growth and autonomy of others
and engage in decision making that affects
them.
• The family teaches family and societal
values and beliefs and shares a spiritual core
• Health Families foster responsibility and
value service to others
• Healthy families have a sense of play and
humor and share leisure time.
• Healthy families have the ability to cope
Characteristics of a Healthy Family with stress and crisis and grow from problems.
Filipinos are accustomed to using
the words “po,”“opo,”
and “ho―when they are
conversing with older people or,
sometimes, with those who are in
a high role or a prestigious
member of society. Using these
words is customary in the
Philippines, and it shows a sign
ofrespect if you do so
Paggalang (Respect)
to be respectful or to give respect
to a person.
Paggalang
can also be shown toward your
elders by kissing their hands
before leaving/to say goodbye and
upon arrival/to greet them.
Paggalang
has the connotation of getting
along with people in general.
Pakikisama
means to pay your debt with
gratitude.
Utang na Loob
putting importance on your family. Pagpapahalaga sa Pamilya
This controls the social behaviors
and interactions of a Filipino. It is
the value that drives a Filipino be
obedient and respectful to their
parents, older siblings, and other
authorities.
Hiya
Paggalang (Respect)
Pakikisama (Helping Others)
Utang na Loob (Debt of Gratitude)
Pagpapahalaga sa Pamilya (Prioritizing Family)
Hiya (Shame)
TRADITIONAL FILIPINO FAMILY
VALUES AND TRAITS
one of the practices of Filipino
traditional medicine, thought of as
‘healing’
Hilot
makes use of the most popular and
useful herbs: tanglad, lagundi,
sambong and more native plants
that have healing and therapeutic
properties.
Hilot
expert in post-natal massage.
aligns nerves and balances
electrical energy.
Comadrona
drains excess energy.
uses herbal in healing.
Reflexologist
Herbalist
Acupressurist
a form of alternative medication
that uses “cups―on the skin to
create suction. This suction is
trusted to help in mobilizing blood
flow and promote the healing of a
broad range of medical ailments. Cupping therapy
is used in treating various
diseases/conditions such as acne
and facial paralysis, however,
cupping can cause mild side
effects, such as mild
discomfort, burns, bruises, and
skin infection
Cupping
Is the blueprint of the care that the
nurse designs to systematically
minimize or eliminate the
identified health and family
nursing problems through
explicitly formulated outcomes of
care (goals and objectives) and
deliberately chosen set of
interventions, resources and
evaluation criteria, standards,
methods and tools
FAMILY NURSING PROCESS
Nursing Process
s a problem-solving approach that enables the
nurse to provide care in an organize and
scientific manner. It is applicable to individuals,
families and community groups at any level of
health. It is adaptable to any practice setting or
specialization and the
components may be used sequentially or
concurrently
Three Sources Of Data
First source - Health status of the family
Second Source - Family’s status as a
functioning unit
Third Source - Family's environment
Health status of the family
First source
Second Source
Family’s status as a functioning unit
Third Source
Family's environment
A method of data collection which
is done through the use of all
sensory capacities
The nurse gathers information
about the family’s state of
being and behavioural responses.
Direct observation
Direct observation
Interviewing
Physical Examination
Methods of Gathering Data
Family structure and Characteristics
Socio-economic and Cultural Factors
Environmental Factors
Health Assessment of Each Member
Value Placed on Preventive Disease
5 Types of Data use as Initial Data
Base for Family Nursing Practice
age,sex, civil status, position in the
family
Demographic data
matriarchal, patriarchal, nuclear or
extended
Type of family structure
General family relationship
presence of any obvious/ready observable
conflict between members; communication
patterns among members
Socio-economic and Cultural
Factors
Income and expense
Educational attainment of its members
Ethnic background and religious affiliation
significant others - roles they play in the family
Relationship of the family to the larger
community-what is the participation of the
family in community activities?
Housing
Kind of neighborhood- congested, slum, etc.
Social and health facilities available
communication and transportation
Environmental Factors
Housing Factors
a. Adequacy of living space
b. Sleeping arrangement.
c. Presence of insects and rodents.
d. Adequacy of the furniture
e. Food storage and cooking facilities
f. Presence of accidents hazards
g. Water supply-source, ownership, potability
h. Toilet facility-type, ownership, sanitary
condition
i. Garbage/refuse disposal- type, sanitary
condition
j. Drainage system- type and sanitary condition
1. Medical and Nursing History indicating past
significant illness, beliefs and practices
conducive to illness.
2. Nutritional assessment (specifically for
vulnerable or at risk members)
a. Anthropometric data- weight, height.
b. Dietary history indicating quality and
quantity of food intake per day
c. Eating/feeding habits and practices
3. Current health status indicating presence of
illness states (diagnosed/undiagnosed by
medical practitioner)
Health Assessment of Each
Member
Is defined as situation or condition
which interferes with the
promotion and/ or
maintenance of health and
recovery from illness and injury.
Health Problem
Exist when there is a health
problem that can be alleviated
with medical or social technology. Health Need
Aphasia or temporary paralysis
after CVA
TEMPORARY Health Deficits
Leg amputation secondary to DM,
blindness from measles, paralysis
from
polio.
PERMANENT Health Deficits
the statement of the unhealthful
response
General Nursing Diagnosis
the statement of factors which are
maintaining the undesirable
response and preventing the
desired change
Specific Nursing Diagnosis
A___ is the set of actions the nurse
decides to implement to be able to
resolve identified family health
and nursing problems.
Family Nursing Care Plan
Characteristics Family Nursing
Care Plan
focuses on actions
product of deliberate systematic process.
relates to the future
based upon identified health and nursing
problems
means to an end, not an end in itself
continuous process not a one-shot deal
based on a clear definition of the problems
consistent with the goals and philosophy of the
health agency
Desirable Qualities a Nursing Care drawn with the family
Plan
best kept in a written form
Importance of Planning Care
individualized care to clients
helps in setting priorities
promotes systematic communication
Continuity of care is facilitated through the use
of nursing care
plans facilitate the coordination of care by
making known to other members of the health
team what the nurse is doing
nature of condition or problem
Modifiability of the Problem
Preventive Potential
Salience
Four Criteria for Determining
Priorities
refers to the family’s
perception and evaluation of the
problem in terms of seriousness an
urgency attention needed.
Salience
refers to the nature and magnitude
of future problems that can be
minimized or totally prevented if
intervention is done on the
problem
under consideration.
Preventive Potential
refers to the probability of success
in minimizing, alleviation or totally
eradicating the problem through
nursing intervention
Modifiability of the Problem
Categorized into wellness state/
potential, health threat, health
deficit of foreseeable crisis.
Nature of condition or problem
physical and psycho-social
strengths and assets of individual
members, financial capabilities,
physical facilities and the presence
of support system
provided by relatives and
significant others.
FAMILY RESOURCES
knowledge about family health
and her skills in helping family
manage them. These skills may
range from simple nursing
procedure to complicated
behavioural problems such as
marital disharmony. Availability of
time and logistical
support are also part of resources
of the nurse.
NURSE RESOURCES
nclude existing agencies, programs
or activities for health and related
needs/problems and community
organization for health actions.
COMMUNITY RESOURCES
a professional, purposeful
interaction that takes place in the
family’s residence aimed at
promoting, maintaining and
restoring the health of the
family or its members.
Home-Visit
• takes place in a private clinic
health center, barangay health
station.
• Major advantage is the fact
that a family member takes the
initiative of visiting the
professional health worker, usually
indicating the family readiness to
participate in the health care
process.
• Because the nurse has greater
control over the environment,
distraction are lessened and the
family may feel less confident to
discuss family health
concerns.
Clinic- Visit
• appropriate for developing
cooperation, leadership, selfreliance and or community
awareness among group
members.
• The opportunity to share
experiences and practical solutions
to common health
concerns is a strength of this type
of family-nurse contact.
Group Approach
used to give specific information to
families, such as instructions given
to parents through school children. Written Communication
Home-Visit
Clinic- Visit
Group Approach
Telephone Conference
Written Communication
School Visit or Conference
Industrial or Job Site Visit
Methods of Intervention (FamilyNurse Contact)
Frequently called the PHN bag is a
tool used by the nurse during
home or community visits to be
able to provide care safely and
efficiently.
• Serves as a reminder of the
need for hand hygiene and other
measures to prevent the
spread of infection.
The Nursing Bag
helps the nurse in infection
control.
allows the nurse to give care
efficiently.
it saves time and effort by ensuring
that the articles needed for nursing
care are available.
should not take away the
nurse’s focus on the patient
and the family.
may be performed in different
ways, principles of asepsis are of
the essence and should be
practiced at all times.
focus is attainment of the
objectives
Bag technique
Bag technique
Bag technique
Bag technique
Bag technique
EFFECTIVENESS-
relates to cost whether in terms of
money, time, effort, or materials
ability to solve or correct existing
problem situation, a question that
involves professional judgement.
pertains to its comprehensiveness
whether all necessary activities
were performed in order to realize
the intended results.
refer to the signs or indicators that
tell us if the objective has been
achieved. They are names and
description of variables that are
relevant indicators of having
attained the objectives. They are
free from any value
judgement and are independent to
time frame.
once a value judgement is applied
to a criterion; it acquires the status
of a standard. It refers to the
desired level of performance
corresponding with a criterion
against which actual performance
is compared. It tells us what the
acceptable level of performance or
state of affairs should be for us to
say that the
intervention was successful.
are actions performed to
accomplish an objective. They are
the things the nurse does in order
to achieved a desired result or
outcome. Activities consume time
and resources. Examples are
health teachings, demonstration
and
referrals.
is the results produced by
activities. Where activity is the
cause, outcome is the effect. They
can also be immediate, immediate
or ultimate
outcomes. Patient care outcomes
can be measured along three
broad lines:
EFFICIENCY-
APPROPRIATENESS-
ADEQUACY-
CRITERIA-
STANDARD-
ACTIVITIES-
OUTCOME-
decreased temperature or weight
and change in clinical
manifestation
PHYSICAL CONDITION
decreased anxiety and favourable
attitude towards health care
personnel
PSYCHOLOGICAL OR ATTITUDINAL STATUS
KNOWLEDGE ON LEARNING
BEHAVIOR
compliance of the patient with instructions
given by the nurse